Effect of head elevation on intracranial pressure, cerebral perfusion pressure, and cerebral blood flow in head-injured patients

• DOI: 10.3171/jns.1992.76.2.0207
• Publication Date: 2009-05-26T20:11:28Z
• Authors: Zeev Feldman; Malcolm J. Kanter; Claudia S. Robertson; Charles F. Contant; Christopher Hayes; Michael A. Sheinberg; Cynthia A. Villareal; Raj K. Narayan; Robert G. Grossman
• Keywords: Cerebral circulation

✓ The traditional practice of elevating the head in order to lower intracranial pressure (ICP) head-injured patients has been challenged recent years. Some investigators argue that with hypertension should be placed a horizontal position, rationale being this will increase cerebral perfusion (CPP) and thereby improve blood flow (CBF). However, ICP is generally significantly higher when patient position. This study was undertaken clarify issue optimal position care patients. effect 0° 30° elevation on ICP, CPP, CBF, mean carotid pressure, other systemic physiological parameters studied 22 patient's elevated at than (84.3 ± 14.5 mm Hg vs. 89.5 14.6 Hg), as (14.1 6.7 19.7 8.3 Hg). There no statistically significant change metabolic rate oxygen, arteriovenous difference lactate, or cerebrovascular resistance associated data indicate reduced majority without reducing CPP CBF.