Cushing's triad
Cushing's triad (not to be confused with the Cushing reflex) is a sign of increased intracranial pressure. It is the triad of:
1. Hypertension (progressively increasing systolic blood pressure)
2. Bradycardia
3. Widening pulse pressure (an increase in the difference between systolic and diastolic pressure over time)
Cushing's triad suggests a cerebral hemorrhage in the setting of trauma or an space occupying lesion (e.g. brain tumor) that is growing and a possible impending fatal herniation of the brain. Cushing's triad is named after an American neurosurgeon Harvey Williams Cushing (1869-1939).
hypertension and widening pulse pressure
CUSHING'S TRIAD
Bradycardia
Hypertension
(that will lead to a widened pulse pressure)this is done by the body to provide adequate cerebral blood flow to the brain, esp. when autoregulation is not functioning.
Altered Respirations
which would probabably be kussmaul resp. due to incresead CO2
Hypertension of 180 systolic
Hypertension of 180 systolic + HR less than 60 + Cheyne stokes respirations + unequal pupils..... is what I was taught for this.
Intracerebral Hemorrhage
The pupils do not need to be unequal. Depending on the location and extent of the bleed, the pupils can be equal but non-reactive to light.
Correction
Cushing's Triad is:
1-Hypertension
2-Bradycardia
3-Irregular Respirations
Cushing's triad is a sign of increase intracranial pressure (ICP). Signs of increased ICP also include papilledema, nausea, vomiting or mental status changes.
Increased ICP also known as "intracranial hypertension" can be caused by trauma (that resulted in intracranial hemorrhage/hematoma/contusion), but it can also be caused by many other things some acute and some chronic. Some of these include: brain tumors, hydrocephalus, cerebral venous sinus thrombosis, pseudotumor cerebri, medications/toxins etc.
Cushing's triad usually results from acute increased ICP as opposed to chronic because there is no time for compensation.
Cushing's triad
This is actually a late sign of increased intracranial pressure in children twelve and older and in adults. This is rarely seen in the pediatric patient. If it is seen, death is essentially unavoidable.
Cushing's triad
hypertension (with increased pulse pressure) bradycardia, irregular respirations.
Cushing's triad
Cushing's triad involves slowing of the respirations, not widening of the pulse pressure.
H. W. Cushing:Some experimental and clinical observations concerning states of increased intracranial tension. American Journal of the Medical Sciences, Thorofare, N.J., 1902, 124: 375-400.
Cushing's Triad
Don't mean to be putting you down, but the widening pulse pressure is kind of a hallmark sign of intracranial pressure. (October 2011.)
Cushing's Triad
hypertension (with increased pulse pressure) bradycardia, irregular respirations.
I had always thought this as well, but I often see the irregular respirations substituted by hypertension and then widened pulse pressure on its own. I believe the comment before mine is more correct in saying hypertension (with increased pulse pressure) because with the increase in SBP you get not only hypertension but also a widened pulse pressure.
The American Academy of
The American Academy of Orthopedics Surgeons 2010 explain that "Early signs and symptoms of increased ICP include vomiting (often without nausea), headache, an altered level of consciousness and seizures. Later, more ominous signs include, hypertension (with a widening pulse pressure), bradycardia and irregular respirations (Cushings Triad)."