Figure 53-4 Pathophysiology of intracranial hypertension. The figure depicts the manner in which increases in the volumes of any or all of the four intracranial compartments, blood, cerebrospinal fluid (CSF), fluid (interstitial or intracellular), and cells (four-part rectangle) result in increases in intracranial pressure and eventual neurologic damage. Elements that are potentially under control of the anesthesiologist are indicated by asterisks. (Control of CSF volume requires the presence of a ventriculostomy catheter.) The herniation pathways are depicted in Figure 53-1 .