The Cushing Reflex: Oliguria as a Reflection of an Elevated Intracranial Pressure

Figure 1

Oliguria during intracranial hypertension. (a) Head CT scan, during the first episode of oliguria, shows an obstructive hydrocephalus. (b) Head CT scan, during the second episode of oliguria, shows a hydrocephalus due to obstructed VP-shunt due to intraventricular bleeding. (c) ECG with sinus bradycardia (30 bpm) observed during the second episode of oliguria. (d) This graphic displays the patient’s serum sodium levels (mmol/L) in comparison with diuresis and pulse. We notice two times a significant oliguric phase on 11-Oct and 19-Oct. These were the days that intracranial hypertension was present and surgery for decompression was executed. We see a significant decrease in diuresis on 15-16-Oct; this was due to excessive high doses of desmopressin (8 µg iv).

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