Focal Neurological Deficit: ICP
Patients with primary intracerebral haemorrhage may also have raised intracranial pressure (ICP) as a consequence of mass effect of the haemorrhage.
Evidence of benefit associated with reduction in BP in these patients is lacking and this may be because cerebral perfusion pressure (CPP) is critically dependant on MAP and will be further compromised by rises in ICP.
Click on the scan to enlarge.
Cerebral perfusion pressure (CPP)
Furthermore, cerebral blood flow is related to CPP by autoregulatory mechanisms and this relationship will be compromised in a hypertensive emergency.
Vasodilators, such as nitrates and nitroprusside, may theoretically increase ICP and are therefore not indicated.
CPP = MAP – ICP
CPP Cerebral Perfusion Pressure
MAP Mean Arterial Pressure
ICP Intracranial Pressure