Residual pressure inside the skull, standard = 10 to 14 mmHg.
In the brain there are 3 compartments (parenchyma, fluid, Vascular), the total volume remains constant and is equal to the sum of the volume of the 3 compartments. The volume is inextensible, the compartments must compensate to maintain values in sustainable standards.

  • The parenchymal compartment: Change is slow (dehydration or overhydration = edema), or appearance of a mass: tumor, hematoma
  • The fluid compartment: The CSF is produced by the choroid plexus and absorbed in the upper longitudinal sinus. If alteration of this balance, there is a variation of the intra cranial pressure (ICP)



  • The vascular compartment: Crush veins (= gene drainage decreased resorption of CSF), increase of asphyxia (PCO2 + + +)

The HIC can be compensated:
good-tolerance as the clearing of CSF are effective
Decompensated ICH may be:
commitment of the bulb in the foramen magnum -> instant death.
cone pressure, displacement of the parenchyma (viscosity)
hernia-temporal compression stems gives mydriasis, hemiplegia, and altered consciousness,
-tonsillar herniation: compression of the bulb, crisis and extension stiffness, difficulty breathing
Risk-+ + +: not to lumbar puncture as it has not done a CT scan.


Clinic:
- Headache mainly nocturnal (supine)
- Vomiting, easy in jets (meningo-cerebral damage),
-papilledema on fundus.
signs of seriousness:

  • Impaired consciousness (Glasgow <8)
  • yawn
  • torticollis,
  • pupillary asymmetry,
  • crisis of hypertension (steep, arcuate)
  • sign of commitment:
  • Papilloedema: a sign of HIC vision of a black veil when you lean forward, listing optic atrophy (which may progress to total blindness)

Further examination:
Scanner and / or MRI (tumor, hematoma, hydrocephalus),
No lumbar puncture:
Pressure intra-spinal (but not PL)
-Infants: external sensor on the fontanel,
Method-invasive, intra ventricular drain, sensor extra dural
So monitoring of extreme situations (tumor, hemorrhage, head trauma).

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