1. Acute/chronic pain: headaches are related to increased intracranial pressure 2. There is a risk of ineffective brain tissue perfusion: related to increased intracranial pressure and cerebral herniation. 3. There is a risk of insufficient body fluids: related to severe vomiting caused by increased intracranial pressure and the use of dehydrating agents 4. Potential complications: cerebral herniation, cardiac arrest

General care: 1. Position: Elevate the head 15-30° to facilitate venous return 2. Give oxygen, continuously or intermittently for <60 minutes, avoid hyperventilation, maintain oxygen partial pressure 90-100㎜Hg, and carbon dioxide partial pressure 30-35㎜Hg 3. Limit the amount of intravenous infusion per adult, 1500-2000ml per person, isotonic saline ≤500ml, and maintain daily urine output of no less than 600ml 4. Maintain normal body temperature, prevent infection, cool down, and resist infection.

Closely observe changes in condition 1. Consciousness state: awake, blurred, light coma, coma and deep coma 2. Glasgow Scale (GCS) eyes opening, speech, movement (3-15 points, <8 means coma) 3. Pupil changes: size, shape, light reflection 4. Vital signs: pay attention to blood pressure, pulse and breathing 5. Intracranial pressure monitoring time is generally 7-14 days

Prevent increased intracranial pressure: 1. Rest in bed, stabilize your mood, keep your respiratory tract open, avoid severe coughing and straining to defecate, deal with agitation and control epileptic seizures

Medication care: 1. Dehydrating agent: hypertonic dehydrating agent (20% mannitol, initial amount 0.25-1g/kg, infused within 10-20 minutes) 2. Steroid corticosteroids, commonly used intravenous injection of dexamethasone 5-10 mg, 1-2 times a day 3. Barbiturates: commonly used phenobarbital

Mild hypothermia treatment care precautions: 1. First implement drug cooling. The cooling rate is preferably 1°C per hour. It is ideal for the body temperature to drop to a rectal temperature of 33-35°C. 2. Mild hypothermia therapy time is generally 3-5 days 3. The rewarming speed is controlled to increase by 1°C every 4 hours, and the rectal temperature returns to 36-37°C after 12 hours. 4. If the pulse exceeds 100 beats/minute, the systolic blood pressure is lower than 100㎜Hg, and the breathing is slow and irregular during treatment, the doctor should be notified in time to stop the medication.

Care of ventricular drainage: 1. Fix it properly, 10-15cm above the level of the lateral ventricle, and clamp it temporarily when moving 2. Keep drainage smooth: avoid draining too fast, and the drainage volume should not exceed 500ml/d. If there is cerebral fluid flowing out, you can squeeze and aspirate with the up and down fluctuations of breathing and pulse. Do not inject physiological saline. 3. Close observation: 1-2 days after surgery, the symptoms may turn slightly bloody and turn to orange-yellow. 4. Perform strict aseptic operation and replace drainage tubes every day 5. Extubate the tube in time, drainage time is 3-7 days, perform CT examination before extubation, and try to clamp the drainage tube for 24 hours

Tentorial notch herniation: 1. Symptoms of increased intracranial pressure: severe headache, progressive aggravation, irritability, and frequent vomiting 2. Progressive disorder of consciousness: drowsiness, light coma, deep coma 3. Pupil changes: The pupil on the affected side is slightly narrowed and the light response is slow → The pupil on the affected side is dilated and the direct and indirect light response disappears, accompanied by upper eyelid ptosis and exotropia of the eyeball → Bilateral pupil is dilated and the light response disappears

Foramen magnum hernia: 1. Respiration slows, blood pressure rises → respiratory arrest → medullary function is affected 2. Severe headache, frequent vomiting, and disordered vital signs 3. Pain in the back of the neck, neck stiffness, forced head position, and cervical nerve root stretching 4. Consciousness disorder appears late

Nursing measures: Reduce intracranial pressure immediately and use 200-500ml of 20% mannitol as directed by the doctor. If respiratory arrest occurs due to foramen magnum hernia, tracheal intubation and assisted respiration should be performed immediately.