Hypertensive responsetoraised intracranial pressure

SUMMARY Meanarterial pressure andintracranial pressure were measuredserially in six infantswith intracranial hypertension (intracranial pressure >20 mm Hg), and cerebral perfusion pressure was calculated from their difference. Overall, mean arterial pressure increased withrising intracranial pressure at amean rate of0-20 mm Hg/mmHg. Thiscaused a fall in cerebralperfusion pressure with increasing intracranial pressure at a mean rate of0-80 mm Hg/mmHgoverall, although cerebral perfusion pressurewas wellmaintainedin one infant. Thusthe rise inblood pressure was usuallyinsufficient to compensate fortheincreasein intracranial pressure. Ininfants with acute encephalopathy vigorous blood pressure support is as important as loweringintracranial pressure. Adequate perfusion of the brain is essential to itsstructural and functional integrity. Impairment of perfusion ofthe developing brain mayhave seriousconsequences resulting in death, or cerebral palsy with global or specific developmental retardation,blindness,