ABSTRACT
Many intensive care unit patients have acutely altered neurological function, whether from chemical sedation, disease of other organs/systems, or specific neurological disease/damage. Most of the total adult intracranial volume is brain tissue, the remaining 300 ml being divided between blood and cerebrospinal fluid – cerebrospinal fluid. Normal adult intracranial pressure is 0–10 mmHg. In health, autoregulation maintains relatively constant cerebral blood flow, if necessary depriving other tissues to supply the brain. Intracranial hypertension is usually caused by cerebral oedema, which can be: interstitial or intracellular. The Glasgow Coma Scale is an established means of assessing level of consciousness by evaluating eye, verbal and motor responses. Pupils constrict in light and dilate in darkness. Pupil response is best assessed in a darkened area (if possible) to dilate the pupils. Both eyes should be assessed for: pupil size and whether both pupils are equal. Limb movement requires both peripheral nerve and muscle function.
