Increased intra-cranial tension is related to:
Correct Answer: Hypertension and bradycardia
Description: Ans. (c) Hypertension and BradycardiaRef: Harrison 18th edition, chapter 25* Cushing's reflex = a hypothalamic response to brain ischemia wherein the sympathetic nervous system is activated which causes increased peripheral vascular resistance with a subsequent increase in BP.* The increased BP then activates the parasympathetic nervous system via carotid artery baroreceptors, resulting in vagal-induced bradycardia.* The brain ischemia that leads to cushings reflex is usually due to the poor perfusion that results from increased ICP due to head bleeds or mass lesions.* Cushing's reflex leads to the clinical manifestation of Cushing's triad.* Cushing's triad = hypertension, bradycardia, and irregular respirations (Cheyne-Stokes breathing).* Cushing's triad signals impending danger of brain herniation, and thus, the need for decompression. Consider administering mannitol, hyperventilation, and elevation of the head of bed as temporizing measures
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