What Is the Ideal Head Position for Patients with Large Strokes?

Although head elevation can reduce increased intracranial pressure in patients with large strokes, this study suggests that the optimal head position should be determined cautiously for each patient.

Neurointensivists have been greatly interested in the preferred degree of head elevation in patients with raised intracranial pressure (ICP). Elevating the head and torso is one of the few easily instituted methods of reducing ICP; the ICP probably drops due to drainage of cerebral venous blood and CSF. Although this maneuver can reduce elevated ICP, often it also reduces blood pressure and, thereby, reduces cerebral perfusion pressure (CPP). Indeed, on this basis, the current preference in critical care is to protect cerebral perfusion by nursing patients with intracranial hypertension in the supine position. These researchers prospectively investigated the effects of elevating the upper body to varying degrees in 18 patients with large he…

Reviewing Author

Allan H. Ropper, MD