Cushing's triad is a clinical triad variably defined as either hypertension, bradycardia, and irregular respiration [1], or less commonly as widened pulse pressure (with elevated systolic and a either elevated or normal diastolic BP), irregular respiration, and bradycardia.[2] It is sign of increased intracranial pressure, and it occurs as a result of the Cushing reflex.
It should not be confused with Cushing's syndrome, a disease state resulting from the elevated levels of blood cortisol.
[edit] Significance
Identification of the triad is important in emergency medicine because it suggests severe pressure within the cranial vault. This can be the result of cerebral hemorrhage, possibly due to a ruptured aneurysm or other cerebrovascular accident (a hemorrhagic stroke) or head trauma resulting in contusion and associated intracranial bleeding either within or outside the meninges (a subdural or epidural hemorrhage). It can also be due to an enlarging space-occupying lesion (a brain tumor). All of these events lead to the possibility of brain herniation, which can be rapidly fatal.
[edit] Eponym
It is named after Harvey Williams Cushing (1869-1939), an American neurosurgeon.
[edit] See also
[edit] References
- ^ Mayer, S.A.; Chong, J.Y. (2002). "Critical care management of increased intracranial pressure". Journal of intensive care medicine (Wiley Online Library) 17 (2): 55–67.
- ^ Ayling, J (2002). "Managing head injuries". Emergency Medical Services 31 (8): 42. PMID 12224233.
[edit] External links
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