Emergency neurological life support: intracranial hypertension and herniation

Neurocrit Care. 2012 Sep;17 Suppl 1:S60-5. doi: 10.1007/s12028-012-9754-5.


Sustained intracranial hypertension and acute brain herniation are "brain codes," signifying catastrophic neurological events that require immediate recognition and treatment to prevent irreversible injury and death. As in cardiac arrest, evidence supports the organized implementation of a stepwise management algorithm. Because there are multiple etiologies and many treatments that can potentially reverse cerebral herniation, intracranial hypertension and herniation was chosen as an Emergency Neurological Life Support (ENLS) protocol.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Decompressive Craniectomy
  • Diuretics, Osmotic / therapeutic use*
  • Emergency Medical Services / methods
  • Humans
  • Intracranial Hypertension / etiology
  • Intracranial Hypertension / therapy*
  • Mannitol / therapeutic use
  • Neurosurgical Procedures / methods*
  • Practice Guidelines as Topic
  • Saline Solution, Hypertonic / therapeutic use
  • Ventriculostomy / methods


  • Diuretics, Osmotic
  • Saline Solution, Hypertonic
  • Mannitol