Head injury is the most common cause of mortality and acquired disability in childhood. It
is common to elevate the head of patients at risk for increased intracranial pressure,
although it is not clear if it is always beneficial. Every severe pediatric traumatic brain
injured patient will have an optimal head position that prevents rising pressure in the
Head injury is the most common cause of mortality and acquired disability on childhood.
Management of children at risk for intracranial hypertension is both complex and
increasingly controversial. Also, effect of head position on intracranial pressure,
cerebral perfusion pressure, adn cerebral venous outflow in the pediatric population has not
been studied. We will examine the effect of head positioning on ICP, CPP, and cerebral
venous outflow in pediatric patients at risk for intracranial hypertension. The hypothesis
is that ICP will be reduced with improvement in cerebral venous outflow by each patient
having their own optimal head position.
- Neonates, children, and adolescents
- Intracranial pressure monitor in place
- Severe multiorgan system failure
- Hemodynamic instability sufficient to preclude changes in head position