Intracranial Pressure - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Intracranial pressure

Almost everyone has ever felt a slight dizziness, headache, temporary blurred vision. These symptoms quickly disappeared, and few considered them to be manifestations of increased intracranial pressure. An excess of the ICP norm may indicate a violation of the structure or functioning of the brain tissues due to a tumor, hematoma, hemorrhage, hydrocephalus.

The intensity of the pressure of the cerebrospinal fluid on the brain tissue is defined as intracranial pressure. Its norm is 100-151 mm of water column or 10-17 mm Hg.

Content:

• Causes of increased intracranial pressure
• Symptoms Indicating Intracranial Pressure
• How to determine intracranial pressure in a child?
• Diagnosis of intracranial pressure
• Complications and consequences
• Intracranial pressure treatment
• Facts and myths about increased intracranial pressure

Causes of increased intracranial pressure

Diseases and conditions that provoke an increase in ICP:

• Swelling or inflammation of the brain tissue leading to an increase in brain volume;
• Hydrocephalus - the formation of a large amount of cerebrospinal fluid;
• Tumor, hematoma, foreign body in the tissues of the brain;
• Expansion of the vessels of the brain, an increase in the volume of blood circulating in them, as a result of poisoning or intoxication.

Diseases, the clinical picture of which includes an excess of the level of intracranial pressure:

• Traumatic brain injury;
• Inflammation of the lining of the brain accompanying neuroinfection;
• Violation of cerebral circulation as a result of a stroke;
• Intoxication with poisonous gases, methanol, ethyl alcohol, heavy metal salts;
• Hydrocephalus;
• Tumor of the medulla, meninges, hematomas;
• Dandy-walker syndrome, arnold-chiari;
• Intracranial hypertension of a benign nature.

If intracranial pressure is diagnosed in children under one year old, in 9 cases out of 10 it is caused by a birth injury.

Symptoms Indicating Intracranial Pressure

The clinical picture of ICP is characterized by a variety of symptoms that differ in adults and children.

Typical signs of increased intracranial pressure:

• Pressing and bursting headache of high intensity that occurs after a night's sleep, the place of its localization is the forehead, temples, back of the head;
• Nausea and vomiting;
• Drowsiness;
• Horse racing hell;
• Disorders of cognitive functions (attention, memory, thinking);
• Hyperhidrosis;
• Bradycardia;
• Visual impairment leading to blindness.

Unlike children, most adult patients develop symptoms of increased ICP gradually. The main symptom is headache.

Its parameters:

• The time of appearance - after a night's sleep, is associated with an increase in pressure after a long stay in a horizontal position;
• Character - pressing, throbbing, bursting;
• What provokes the appearance of pain - coughing, sneezing, the application of minimal physical effort, prolonged stay in a horizontal position;
• Concomitant manifestations - dizziness, nausea and vomiting;
• A characteristic feature is that pain cannot be relieved with painkillers.

Manifestations of the syndrome of autonomic dysfunction accompanying an increase in pressure:

• Alternating constipation and diarrhea;
• Heart pain;
• Fluctuations of hell, heart rate;
• Hypersalivation (increased salivation);
• Moisture in the palms and soles of the feet;
• Feeling of suffocation;
• Feeling of fear, anxiety;
• increased irritability;
• Apathy and drowsiness.

Less commonly, the patient experiences a combination of increased ICP with symptoms of stroke, which increases the risk of death:

• Loss of consciousness, development of coma;
• Speech disorder;
• Shaky gait, dizziness;
• Decreased strength in the arms and legs;
• Incontinence of urine and feces;
• Severe vomiting;
• Dysfunction of the respiratory and cardiovascular systems.

What to do if you find signs of increased intracranial pressure?

Algorithm of actions of a patient suffering from ICP:

• Bring your internal state back to normal, remembering that at the modern level of development of medicine, it is possible, even with increased intracranial pressure, to maintain the usual quality of life.
• Get a consultation from a neurologist, undergo the necessary diagnostic measures (MRI, ultrasound of the brain, X-ray examination, consultation with an ophthalmologist).
• Compliance with the treatment regimen chosen by the doctor (diet, medication). If surgical treatment is required, you need to decide on it in order to avoid death.

How to determine intracranial pressure in a child?

Exceeding the norm of ICP in newborns provokes serious complications of the child's health. Timely diagnosed symptoms of the disease will help you choose the right treatment tactics.

Symptoms indicating an increase in intracranial pressure in children:

• Pulsation of fontanelles, their bulging above the surface of the skull;
• Divergence of the bones of the child's skull;
• Conduct disorder - moodiness, restless behavior, or lethargy and drowsiness;
• Chin trembling;
• Gushing vomiting, not relieving the condition, frequent regurgitation;
• Visual impairment, strabismus, limited range of motion of the eyeballs;
• Increased skull volume;
• Disturbances of consciousness, up to its complete loss, the development of coma;
• Seizures;
• Limb movement disorder.

The clinical picture of intracranial pressure develops in two ways:

• The gradual development of the disease;
• Sudden onset of ICP symptoms, impaired consciousness, development of coma.

In the second case, the probability of death is extremely high, it exceeds 90%.

Diagnosis of intracranial pressure

ICP level measurement is carried out in several ways:

• Study of the functioning of the brain using CT or MRI;
• The introduction of a catheter attached to a manometer into the tissue of the spinal cord or brain;
• Ultrasound of the brain, in children under 1 year of age - neurosonography (ultrasound through the parietal fontanelle);
• Echoencephalography;
• Examination of the fundus with the diagnosis of edema of the optic nerve head.

The choice of the method for measuring intracranial pressure depends on the age of the patient and the characteristics of the disease. Diagnosis of ICP in children under one year old is carried out using echoencephalography and neurosonography. Patients with symptoms of acute cerebral circulation are prescribed MRI, examination of the state of the fundus by an ophthalmologist.

Complications and consequences

Lack of medical care with a sudden increase in intracranial pressure can threaten the patient's life and cause death.

Other complications arising from high intracranial pressure:

• The onset of epileptic syndrome;
• Reduced vision to complete blindness;
• Disorders of the psyche, intelligence, cognitive functions;
• Breathing disorder, disturbance of consciousness due to infringement of the cerebellum;
• Ischemic, hemorrhagic stroke.

Intracranial pressure treatment

After conducting a diagnostic examination and clarifying the cause of the disease, the doctor prescribes a treatment regimen.

1. The first stage is to eliminate the cause of the increase in intracranial pressure

   • Removal of a tumor, aneurysm, hematoma on an emergency basis;
   • Creation of an artificial pathway for the outflow of cerebrospinal fluid in hydrocephalus - bypass surgery.

2. The second stage is conservative treatment with drugs.

   The main pharmaceutical groups used to correct ICP:

   • Osmotic diuretics - Mannitol, Glycerol, which normalize the cerebrospinal fluid volume;
   • Loop diuretics - Furosemide;
   • Hormonal drugs;
   • Diakarb;
   • Neuroprotective agents - Glycine.

3. The third stage is manipulations for medical reasons to reduce the volume of cerebrospinal fluid:

   • Decompression craniotomy;
   • Ventricular puncture.
4. The fourth stage is diet therapy to restrict fluid and salt in the body.

5. The fifth stage - additional methods to compensate for increased ICP:

   • Manual therapy;
   • Hyperventilation;
   • Controlled hypotension
   • Hyperbaric oxygenation.

It is possible that incorrect treatment will lead to an excessive decrease in intracranial pressure.

Symptoms:

• Weakness;
• Drowsiness;
• Dizziness;
• Headache, aggravated by head movements;
• Nausea, vomiting

Treatment of increased intracranial pressure is always carried out in a complex.

Facts and myths about increased intracranial pressure

1. The first myth is that increased intracranial pressure is compensated with age without treatment. This is not true, since the constant long-term pressure of the cerebrospinal fluid on the structures of the brain leads to the development of severe complications.
2. The second myth is that intracranial hypertension, the symptom of which is increased ICP, cannot be cured. A large selection of drugs and surgical methods of treatment leads to the final elimination of the cause that caused the increase in intracranial pressure.
3. The third myth - the tendency to increase ICP is inherited. No research supports a genetic link between these factors.
4. The fourth myth is that children suffering from increased intracranial pressure are necessarily mentally disabled, have a low IQ level. This is an absurd delusion.
5. The fifth myth - to normalize the level of intracranial pressure, it is enough to take the necessary medications. False, since in some cases it is impossible to do without surgical intervention.

Facts:

1. Hydrocephalus is the main cause of increased intracranial pressure in young children;
2. The incidence of idiopathic intracranial hypertension is 1-2 cases per 10 thousand people.
3. Several dozen large medical associations are involved in the problems of intracranial hypertension in the world.
4. A pediatric neurologist, during an outpatient appointment, notes an increase in ICP in every tenth patient;
5. About 100 million people in the world suffer from increased intracranial pressure.
6. Neither homeopathic nor herbal preparations have any effect on the normalization of ICP.
7. Patients with compensated intracranial pressure should be examined by the attending physician at least once every 2 years to prevent relapse.

Despite the fact that the problem of increased intracranial pressure is at least 200 years old, this issue is still not fully understood, scientists are conducting research.

Author of the article: Sokov Andrey Vladimirovich | Neurologist

Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".