Increased Intracranial pressure ,

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Presentation transcript:

Increased Intracranial pressure , Cerebral , Edema And Brain herniation Dr.Khudur Shukur

Rigid

1- Intracranial contents and their Respective Volume a- Brain/ 1400 ml /80% b- Blood / 150 ml c- Cerebrospinal fluid / 150ml 2- The Blood Brain Barrier BBB a- tight junctions :vasogenic edema b- lipid soluble substances: passive c- carriers for sugar and amino acids 3- Cerebral Edema : water : volume a- vasogenic: extracellular/opened tight junctions /tumor/trauma/abscess/ b- cytotoxic/ intracellular swelling /early stage of infarction /hypoxia c- interstitial/CSF : Trans ependymal/ Hydrocephalus/.

4- Cerebral Blood Flow (CBF) 50ml / 100 g / minute a- cerebral perfusion pressure(cpp):effective gradient mean arterial pressure / intracranial pressure b- CO2 c- O2 Autoregulation:

Blood supply to the brain The brain gets 15% of the cardiac output and 20% of the oxygen consumption The brain tissue gets in average 50ml of blood per 100gr of tissue per minute. The gray matter receives about 3 to 4 times more than the white matter Total blood supply to the brain is about 500-600ml per minute

Autoregulation Maintains a regular blood supply to the brain in changing blood pressures The range is 50-160 mm mercury Possible mechanisms are the myogenic control, neurogenic and biochemichal control

Factors Affecting the blood supply Autoregulation Biochemical changes – O2 and CO2 Blood brain barrier - BBB