Adult Critical Care Specialty (ACCS) Practice Exam

What is a common neurological complication to monitor in patients after severe head trauma?

1. Hypoglycemia

2. Increased ICP

3. Ocular hypertension

4. Cauda equina syndrome

The correct answer is: Increased ICP

In the context of severe head trauma, monitoring for increased intracranial pressure (ICP) is critical. Severe head injury can lead to various physiological changes that increase the volume within the cranial cavity, either due to cerebral edema, hemorrhage, or other fluid accumulation. Increased ICP can result in decreased cerebral perfusion, which can ultimately lead to secondary brain injury if not managed promptly. The brain is encased in a rigid skull, leaving limited room for swelling or hematoma. As ICP rises, it can cause significant complications, including brain herniation, which can be life-threatening. Therefore, monitoring ICP is a key component of post-trauma care, often involving the use of invasive monitoring techniques like intraventricular or parenchymal pressure monitors. In contrast, hypoglycemia, ocular hypertension, and cauda equina syndrome are not primary complications directly associated with severe head injuries and do not require the same level of vigilance. They may be important in other clinical contexts, but they do not typically arise as direct consequences of trauma to the head. Thus, focusing on increased ICP provides critical information for the management of brain-injured patients.