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Cushing's triad
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Jump to: navigation, search Cushing's triad is the triad of hypertension, bradycardia, and widening pulse pressure (an increase in the difference between systolic and diastolic pressure over time) in patients with head injuries !t is often accompanied by respiratory abnormalities, including "heyne#$tokes respiration, hypoventilation, and central neurogenic hyperventilation, although these are not part of the triad proper !t is named after %arvey Williams "ushing (&'()#&)*)), the +merican neurosurgeon who first described this combination of signs !dentification of the combination of these signs is critically important, especially in the setting of emergency medicine because it is a sign of increasing intracranial pressure ,any times it is a sign of herniation of the brain + patient with these signs will usually re-uire urgent life#saving surgery which may include drilling a burr hole into the head to release intracranial pressure

Cheyne-Stokes respiration
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.ame of $ymptom/$ign: Cheyne-Stokes respiration

ICD-10 ICD-9

01( * 2'( 1)

Cheyne-Stokes respiration is an abnormal pattern of breathing characteri3ed by periods of breathing with gradually increasing and decreasing tidal volume interspersed with periods of apnea !n cases of increasing intracranial pressure, it is often the first abnormal breathing pattern to appear 4he condition was named after John "heyne and William $tokes, the physicians who first classified it 4his is caused by the failure of the respiratory center in the brain to compensate -uickly for changing serum partial pressure of o5ygen and carbon dio5ide

9 4his abnormal pattern of breathing can be seen in patients with strokes, head injuries or brain tumors, and in patients with congestive heart failure !n some instances, it can occur in otherwise normal people during sleep at high altitudes, where it is an important sign of altitude sickness %ospice personnel often note the presence of "heyne#$tokes breathing as a patient nears death, and report that patients able to speak after such episodes do not report any distress associated with the breathing, although it is sometimes disturbing to the family "heyne#$tokes respirations are not the same as 6iot7s 0espirations (8cluster breathing8), where groups of breaths tend to be similar in si3e