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Refractory intracranial hypertension after a severe traumatic brain injury

A 15-year-old male with refractory intracranial hypertension after severe traumatic brain injury. Intracranial pressure steadily rises and initially correlates with intracranial pressure pulse amplitude. RAP, which correlates intracranial pressure to amplitude, is over 1, suggesting impaired brain compliance. This is further reflected in the scatter plot (right) correlating intracranial pressure and amplitude. As intracranial pressure exceeds 65 mmHg, amplitude decreases with rising intracranial pressure, suggesting that the critical threshold of brain compliance has been exceeded. (Contributed by Dr. Brian Appavu.)

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