Effects of elevated ICP on brain function: Can the multiparametric monitoring system detect the 'Cushing Response'?

Efrat Barbiro-Michaely, Avraham Mayevsky

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13 Scopus citations


The 'Cushing Response' is a significant phenomenon associated with elevated ICP. The purpose of our study was to examine the effects of the intracranial hypertension level and duration on the cerebral tissue physiology, using a Multiprobe assembly (MPA). The parameters monitored simultaneously included ICP, CBF, mitochondrial NADH redox state, extracellular K+ and H+-levels, DC potential and ECoG, calculated CPP and blood pressure. Two groups of rats were used. In one group, ICP was elevated to 50-60 mmHg for 13-15 min and, in the second group, ICP was elevated to 20 mmHg for 30 min. The results show that ICP of 50-60 mmHg led to CPP reduction below the lower limits of autoregulation. However, ICP of 20 mmHg, even for a prolonged period of time is completely tolerated. Additionally, we found that the 'Cushing Response', developed in the moderate treatment (ICP = 20 mmHg) is beneficial, assuring high CBF levels under intracranial hypertension. Furthermore, CBF and CPP monitoring, apparently, are not sufficient for autoregulation assessment; more parameters are needed.

Original languageEnglish
Pages (from-to)42-52
Number of pages11
JournalNeurological Research
Issue number1
StatePublished - Jan 2003


  • 'Cushing Response'
  • Cerebral blood flow
  • Extracellular potassium
  • Intracranial hypertension
  • Mitochondrial function
  • Multiparametric monitoring


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