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The increase in elastance (i.e.
Tissue content is relevant insofar as mass lesions influence intracerebral elastance and accentuate the effects of fluid changes.
Once an individual threshold of elastance is crossed, changes in volume exert a mass effect on the draining veins, which act as Starling resistors.
The change in ICP with change in intracranial volume is often referred to as the intracranial compliance curve, but it is more appro- priately termed the intracranial elastance curve (Fig. 84.1).
Any deterioration in ventilatory efficacy adversely affects cerebral elastance through carbon dioxide-induced vaso- dilation and leads to hypoxemia, which can cause direct as well as indirect injury to the brain.14 Arterial hypox- emia, less than 60 mm Hg, is a significant contributor to secondary insult from vasodilatory ICP effects, in addition to reduced oxygen delivery to the cell.
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