Treatment
The treatment of cerebral herniation involves:
- 20% mannitol IV - 1g/Kg (5ml/Kg) over 15 mins - effects last 4-6 hours - used only as a temporary treatment when intracranial pressure is very high and time is needed to arrange surgical management
- corticosteroid, e.g. dexamethasone IV 12 mg bolus followed by 4mg every 6 hours - if vasogenic cause of oedema
- intubate and hyperventilate
- CT scan for neurosurgically remediable lesions
Reference
- Stevens RD, Shoykhet M, Cadena R. Emergency Neurological Life Support: Intracranial Hypertension and Herniation. Neurocrit Care. 2015 Dec;23 Suppl 2(Suppl 2):S76-82
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