S06.10-11 + External Cause Code (V,W,X,Y)
GENERAL MEASURES
Refer patient for neurosurgical opinion, if indicated.
Supportive management. See Stroke.
Note: DVT prophylaxis with heparin may be contraindicated owing to risk of increased bleeding.
The following measures should be used in patients with raised intracranial pressure:
- head elevation and position,
- airway and ventilation control,
- sedation and analgesia,
- control of fever,
- control of hypertension, and
- prevention of seizures.
Currently, no evidence supports the use of hyperventilation in this setting.
MEDICINE TREATMENT
For raised intracranial pressure, pending a definitive neurosurgical procedure only:
- Mannitol 15–25%, IV, 0.25–1 g/kg administered over 30–60 minutes.
- Monitor neurological response and urine output.
- Beware of hypovolaemia and electrolyte disturbances, especially hypokalaemia.
Note: Corticosteroids should not be used in this setting as they have a harmful effect.