Which postoperative nursing action helps prevent an increase in intracranial pressure after a frontal craniotomy?

• A. Elevate the head of bed to 30 degrees
• B. Keep the head turned to one side
• C. Keep the patient flat
• D. Flex the neck

Answer: (A)

Elevating the head of the bed to about 30 degrees helps prevent a rise in intracranial pressure by promoting venous drainage from the brain. When the head is elevated, venous blood can flow more easily out of the cranial cavity via the jugular veins, which reduces cerebral blood volume and helps maintain stable intracranial pressure after brain surgery. It also supports better cerebral perfusion by reducing venous congestion.

Keeping the head flat would hinder venous outflow and increase ICP. Turning the head to one side or flexing the neck can kink the jugular veins and obstruct drainage, further raising ICP. So the semi-upright position best supports this goal after a frontal craniotomy.