Reduction of Increased Intracranial Pressure

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Abstract
IN EXPERIMENTAL and clinical studies hyperventilation has been shown to reduce both cerebral blood flow (CBF)1-4and increased intracranial pressure (ICP).5The reduction in arterial carbon dioxide tension (Pco2) causes cerebral vasoconstriction which, in turn, produces a diminution in total intracranial blood volume.6,7A significant fall in ICP may follow if ICP is already elevated and at a critical point in the intracranial volume-pressure relationship.8 We have demonstrated recently that hyperbaric oxygen (OHP) can reduce increased ICP by the same mechanism, namely by causing direct active cerebral vasoconstriction, with a fall in CBF and a proportional reduction in ICP.9,10 Although hyperventilation is the simpler and less expensive technique to apply, certain theoretical objections to its use have been raised, based mainly on the premise that reduction of CBF may, in the absence of increased oxygen carriage, jeopardize cerebral metabolism, particularly in areas of the