1.

( 1 )
2.
15
3.
4.
5.
6.
7.
8.
9.
10.
_________________________________________________
7



3

, 24



24
( 2 )






,

,




3 ,

( 90 % )
2 , 3 6

( 10 % )


( )
( 80 mmHg )
IKP 20 mmHg ( 60 mmHg )
( )
15
5



5 10 %

90 %


6%

45 75 %


6%

85 %


15 %

25 %

50 %
GLASGOW OUTCOME SCALE ( GOS )
(
)


: 50 %
:
:
:

3 : 65 %
6 : 90 %



( ICP > 20 mmHg )
ICP: 0 - 15 mmHg
ICP: 16 - 25 mmHg
ICP: 26 - 40 mmHg
ICP > 40 mmHg

ICP
,
ICP -
( CPP )
CPP .






> 5


ICP

ICP
ICP

BRAIN TRAUMA FONDATION ( TBF ) U SARADNJI SA AMERICAN
ASSOCIATION OF NEUROLOGICAL SURGENS ( AANS )

( GPS 8 )

C -
( , ,
)

CT ,

> 40

< 90 mmHg

(GCS 14 15 ) ( GCS 9
- 13 ) .
CT
ICP
ICP

-
( )


( )

 ( , )
( )

, ,

, ( ), B C B C
ICP -
50 - 100 mmHg,
5 20 .
ICP 20 mmHg.
.
,
.
ICP




ICP
CPP
( >70 mmHg? )
CPP = MAP - ICP
?
ICP CPP?
!

LUND


ICP


ICP


ICP
CPP

CPP


CPP :

( CVP 8 - 10 mmHg
0, 30 - 0, 35 )

ICP -
( PC2 25 mmHg )



( PC2 < 35 mmHg )
24 (
CBF )

 NaCL

-
:

10 mg / kg 30
5 mg / kg ,
1 mg / kg
3 4
% 0, 12 - 0, 16 mmol / L
- , ,