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Semin Respir Crit Care Med 2001; 22(1): 003-012
DOI: 10.1055/s-2001-13835
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Management of Cerebral Perfusion Pressure

Roman Hlatky, Yu Furuya, Alex B. Valadka, Claudia S. Robertson
  • Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

The management of cerebral perfusion pressure is among the most controversial treatment issues. Cerebral perfusion pressure (CPP) is normally expressed as the difference between mean arterial blood pressure and intracranial pressure and has two important physiological roles in the patient with severe head injury. First, CPP represents the pressure gradient acting across the cerebrovascular bed and hence is an important factor in the regulation of cerebral blood flow. Second, CPP contributes to the hydrostatic pressure within the intracerebral vessels, and therefore is one of the factors that determines edema formation in the injured brain. The border between adequate and inadequate CPP should be assessed individually and continuously, as it may fluctuate in time. The treatment plan that includes rapid identification of intracranial hemorrhage, rapid evacuation of extraaxial blood, treatment of intracranial hypertension, and promotion of cerebral and systemic perfusion is likely to provide the best outcome for all patients.

KEYWORD

Brain injury - cerebral perfusion pressure - cerebral blood flow

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