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학습 자료 둘러보기 →Cushing's triad is a preterminal sign of critically elevated ICP and consists of bradycardia, hypertension (with a widening pulse pressure), and irregular breathing. It indicates that the brain's compensatory mechanisms are failing and the medulla oblongata is ischemic.
The pathophysiology involves a sympathetic surge (CNS ischemic response) to perfuse the compressed brain, causing severe hypertension. This triggers a reflexive, vagally-mediated bradycardia via baroreceptors. Simultaneously, pressure on the brainstem disrupts respiratory centers, leading to irregular patterns like Cheyne-Stokes.
Cushing's triad signals imminent brainstem herniation and is a medical emergency. Immediate interventions include notifying the provider, administering an osmotic agent like hypertonic saline or mannitol, and preparing for possible emergent ICP monitoring or surgery. Do not mistake the bradycardia and hypertension for a primary cardiac issue.
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