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- Ramesh Kumar R Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India., Sunit C Singhi, and Pratibha Singhi.
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
- Indian J Pediatr. 2012 Apr 1;79(4):518-24.
AbstractRaised intracranial pressure is a life threatening condition; unless recognized and treated early, it may progress into herniation syndrome and death. Symptoms and signs are neither sufficiently sensitive nor specific, hence a high index of suspicion and vigilance are needed for early recognition. Immediate goal of management is to prevent / reverse herniation and to maintain good cerebral perfusion pressure. The therapeutic measures include stabilization of airway, breathing and circulation, along with neutral neck position, head end elevation by 30°, adequate sedation and analgesia, minimal stimulation, and hyperosmolar therapy (mannitol or 3% saline). Short-term hyperventilation (to achieve PCO(2) ≈ 30 mm Hg) using bag ventilation can be resorted to if signs of impending herniation are present.
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