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CSF..ICP..and More


Normally ICP can rise to 80-100mmHg just when coughing/straining,think of neuro patients when they cough on the tube....

CSF is produced at 500 ml/day with a total of 150 ml in the system. This means there’s continuous circulation reabsorption.


The two types of hydrocephalus are:
  • obstructive – expect big lateral ventricles and normal 4th as there’s a blockage somewhere
  • communicating – general big ventricles but all the piping is OK, it’s the filter/drain that’s blocked – think blood pluggin the arachnoid villi.

  • one of the earliest clinical signs of raised ICP is reduced venous pulsation on fundoscopy – good luck with that…
  • the old hyperventilation to reduce pCO2 and reduce ICP is a bit dodgy as it also does exactly what you don’t want it to do – it reduces cerebral blood flow.
  • mannitol has two actions
    1. volume expander
    2. osmotic diuretic
  • if osmolality is already >320 then mannitol won’t work.
  • steroids work for vasogenic oedema from tumours but not anything else
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