Question about Cushing's

Are you sure the diastolic pressure goes down? I can't figure a reason for the diastolic pressure to go down. I see why the systolic goes up to reperfuse the brain from incr ICP, but I can't figure for the life of me why the diastolic goes down. Anyone know?

Per AACN's clinical reference for critical care nursing

"Blood pressure is mediated at a reflec level in the medulla. . . . The mechanism for this riad of symptoms appears to be ischemia and pressure upon medullary brain structures."

The book I am ref. is very old, but what I have on hand. It does not go into the physiology merely states the reason.

Hey Lorus,

Now you sparked my interest and I am not sure why the diastolic goes down. Racking my brain as I used to work neuro ICU.

Just a bit of personal info, 3 years out of ICU and just accepted a hospital job to work per diem in ICU and telemetry. I burned out and took a break in geriatrics but !!!!I am coming back to what I really love. I am looking forward to having patients with at least 5 lines coming out of their bodies so I can see whats going on.

:)

This is not an answer out of a book, but the way that I would explain the low diastolic: the increased systolic is a result of increasing inotropic contraction of the heart to increase pressure thus also increasing pvr (like aortic regurg). The decreased diastolic is a result of shifting the diastolic pressure-volume curve right by increasing left ventricular volume and/or elasticity. Another component to this triad is bradycardia as well, which further potentiates the formentioned physio.