Intracranial pressure: symptoms and treatment

Intracranial pressure: symptoms and treatment

Increased intracranial pressure (ICP) is a dangerous condition that many people face. It can occur both in childhood and in adulthood. Women suffer from the disease more often than men. Unfortunately, sometimes the symptoms of increased intracranial pressure are not paid attention, which leads to sad consequences. Therefore, it is necessary to know well what it is, the symptoms and principles of treatment of the disease in adults and children.

Causes of High ICP

Why is pressure inside the skull increasing? This phenomenon may be due to various factors. But in most cases, high intracranial pressure is associated with impaired outflow of cerebrospinal fluid from the cavity inside the skull.

First, it is useful to understand what is intracranial pressure. You should not think that only a huge number of nerve cells are located inside the skull and nothing more. A significant amount of brain (more than a tenth) is occupied by cerebrospinal fluid, which is also called CSF. It is mainly located in the region of the ventricles located inside the skull, in its center. Also part of the liquor circulates in the space between the soft and spider shells of the brain. There is cerebrospinal fluid in the spinal canal.

The functions that the liquor performs are varied. This includes the protection of brain tissue from impacts on the bones of the skull, ensuring water and electrolyte balance and removal of harmful substances and toxins from the brain. Another thing is important – the amount of liquor determines the indicator of pressure inside the skull. Part of the cerebrospinal fluid (more than two-thirds) is formed directly in the ventricles, and part is converted from blood circulating in the brain. Liquor is fully updated during the week.

Intracranial pressure is usually indicated in millimeters of mercury or millimeters of water column. For adults, the norm varies in the range of 3-15 mm Hg. Art. From the point of view of physics, this parameter shows how many millimeters the pressure of the liquor exceeds the atmospheric pressure. In children, the pressure inside the skull is normally somewhat lower than in adults. If the volume of cerebrospinal fluid circulating in the brain area becomes larger than normal, then this usually leads to an increase in intracranial pressure.

Increased ICP above the 30 mm mark. Hg Art. often leads to irreversible brain tissue damage and death.

That is why it is important for people to know about the level of ICP. But how to define it, because, unlike blood pressure, ICP can not be measured at home? To determine the pressure inside the skull, special instrumental methods are usually used, which are carried out only in the conditions of a hospital. Therefore, often the cause of suspicion of the diagnosis of “increased intracranial pressure” are characteristic symptoms.

Symptoms of increased intracranial pressure

With an increase in intracranial pressure, symptoms usually see a series of frequently observed symptoms:

  • headaches,
  • visual impairment,
  • dizziness,
  • absentmindedness,
  • memory impairment,
  • sleepiness
  • blood pressure instability (hypertension or hypotension),
  • nausea,
  • vomiting,
  • lethargy,
  • fatigue,
  • sweating,
  • chills,
  • irritability,
  • depression,
  • mood swings,
  • skin sensitivity,
  • pain in the spine,
  • respiratory impairment,
  • shortness of breath,
  • muscle paresis.

If you have some of these symptoms from time to time, then naturally this is not evidence of increased intracranial pressure. Symptoms of increased pressure inside the skull may be similar to other symptoms of ailments.

The most common symptom indicating a disease is headache. Unlike a migraine, it covers the whole head at once and does not concentrate on one side of the head. Most often, pain with high ICP is observed in the morning and night hours. Pain with increased intracranial pressure may increase when turning and head, coughing, sneezing. Taking analgesics does not help eliminate pain.

The second most common symptom of increased intracranial pressure are problems with visual perception – double vision, lack of clarity of objects, reduced peripheral vision, episodes of blindness, fog before eyes, reduced response to light. These signs of increased intracranial pressure are associated with constriction of the optic nerves.

Also, under the influence of increased ICP in a patient, the shape of the eyeball may change. It may bulge so that the patient is unable to completely close the eyelids. In addition, blue circles may appear under the eyes, made up of crowded small veins.

Nausea and vomiting are also common symptoms of increased intracranial pressure. As a rule, vomiting does not bring relief to the patient.

It should be borne in mind that intracranial pressure may increase briefly (2-3 times) and in healthy people – for example, when coughing, sneezing, bending, exercise, stress, etc. However, this ICP should quickly return to normal. If this does not happen, then this is evidence of a chronic increase in intracranial pressure.

Signs of increased intracranial pressure in young children

Signs of increased intracranial pressure in young children
Photo: Romrodphoto / Shutterstock.com

How does the disease manifest in young children? Unfortunately, babies cannot tell their parents about their feelings, so those have to focus on the indirect symptoms of intracranial pressure. These include:

  • lethargy;
  • cry;
  • poor sleep;
  • vomiting;
  • seizures;
  • involuntary eye movements;
  • swelling and ripple spout;
  • increase in head size (hydrocephalus);
  • uneven muscle tone – part of the muscles is tense and part is relaxed;
  • bleeding out of the vascular network under the skin of the head.

On the other hand, symptoms such as nasal bleeding, stuttering, occasional flinching during sleep, irritability, as a rule, do not indicate an increase in pressure inside the skull of a child.

Diagnosis of increased intracranial pressure

For direct measurement of pressure inside the skull, complex, requiring highly skilled physician, sterility and appropriate equipment instrumental methods are used, which are often unsafe. The essence of these methods consists in puncture of the ventricles and the introduction of catheters in the area where the cerebrospinal fluid circulates.

A method such as liquor puncture from the lumbar spine is also used. In this case, both pressure measurement and a study of the composition of the liquor can be performed. This method is necessary if there is reason to suspect the infectious nature of the disease.

Safer diagnostic methods are becoming more common:

  • ultrasound,
  • magnetic resonance imaging,
  • computed tomography.

As a result of these studies, you can identify changes in the structure of the brain and its surrounding tissues, indicating increased intracranial pressure.

These changes include:

  • increase or decrease in the volume of the ventricles of the brain,
  • swelling,
  • increase the space between the shells,
  • tumors or hemorrhages,
  • displacement of brain structures,
  • skull suture divergence.

An important diagnostic method is also encephalography. It allows you to identify violations of the activity of various parts of the brain, characteristic of increased ICP. Doppler ultrasound of the blood vessels helps to detect blood flow disorders in the main arteries and veins of the brain, congestion and thrombosis.

An important diagnostic method is the study of the fundus. In most cases, it can also be used to detect an increase in intracranial pressure. With this syndrome, symptoms such as an increase in the vessels of the eyeball, swelling of the place where the optic nerve comes to the retina, minor hemorrhages on the retina appear. After determining the degree of development of the disease, the doctor should tell the patient how best to treat it.

Causes of increased intracranial pressure.

What causes an increased ICP in an adult? Here we must take into account that increased intracranial pressure is usually a secondary symptom, and not an independent disease.

Factors that can lead to increased intracranial pressure

  • skull and brain injuries;
  • inflammatory processes of the brain and meninges (encephalitis, meningitis);
  • obesity;
  • hypertension;
  • hyperthyroidism;
  • adrenal dysfunction;
  • liver pathologies causing encephalopathy;
  • osteochondrosis of the cervical spine;
  • a tumor in the head;
  • abscess;
  • cysts;
  • helminthiasis;
  • stroke.

Diseases that may result in increased ICP

  • otitis,
  • bronchitis,
  • mastoiditis,
  • malaria.

Medications that can cause increased ICP

  • corticosteroids,
  • antibiotics (primarily biseptol and tetracyclines)
  • hormonal contraceptives.

Factors leading to high intracranial pressure can either provoke an enhanced generation of cerebrospinal fluid, or interfere with its circulation, or interfere with its absorption. Three mechanisms of the onset of the syndrome can take place.

Should also take into account the hereditary predisposition to the disease. In infants, the main factors contributing to the onset of the disease are birth trauma, fetal hypoxia, toxicosis during pregnancy and prematurity. The lack of oxygen in an unfavorable course of pregnancy can lead to a compensatory increase in the production of CSF and, as a result, to hydrocephalus.epilepsy

Causes of increased intracranial pressure
Photo: Roman Samborskyi / Shutterstock.com

Complications

Chronic increased intracranial pressure, contrary to popular belief, tends to progress. Without proper treatment, the disease can lead to serious consequences resulting in disability.

These complications include:

  • stroke;
  • impaired motor coordination as a result of a lesion of the cerebellum;
  • violation of reflexes, arrhythmias as a result of squeezing of the brain stem;
  • paralysis;
  • speech disorders;
  • mental abnormalities;
  • blindness;
  • epilepsy.

A frequent result of the development of the disease is death.

It is quite rare, however, and the benign form of the disease, in which the symptoms of increased ICP pass by themselves, without any treatment. With the presence of a similar form of the disease is associated with the misconception that the disease passes on its own. But it is not. The fact is that, as a rule, the benign form of the disease is characteristic only for young women, who are often overweight. So do not rely on the fact that you have just a benign form of the disease. It is best to consult a doctor.

Treatment for increasing intracranial pressure

What should I do if this diagnosis is made? If an increase in intracranial pressure is a secondary process, then the first thing to do is to eradicate the primary disease – atherosclerosis, hypertension, osteochondrosis, and hormonal imbalance. However, symptomatic therapy of increased intracranial pressure is also extremely important.

After detecting high intracranial pressure, treatment should be prescribed by a doctor. There are several ways to treat increased intracranial pressure. They are divided into conservative and surgical.

Conservative methods of treating increased intracranial pressure include, first of all, medication. The goal of therapy in this case is to reduce the pressure of the cerebrospinal fluid, increasing blood flow from the brain.

The main group of drugs that are shown with increasing intracranial pressure is diuretics, for example, Furasemide, Diacarb. If tumors are present, or meningitis is detected, swelling-reducing steroid anti-inflammatory drugs are prescribed. Also accepted drugs that improve venous blood flow, potassium drugs (Asparkam). Studies have shown that nootropic drugs are ineffective with increasing intracranial pressure.

If increased intracranial pressure is caused by some other disease, then drugs are used to treat the underlying disease.

Also, in the treatment of high ICP in adults, physiotherapy can be used (in particular, magnetic effects on the neck area, electrophoresis with medicinal substances), massage of the cervical-collar area and spine, physical therapy, acupuncture, circular douche. These methods are used mainly in mild cases of high ICP, when there is no direct threat to life. Also, in order to prevent the patient can conduct a daily massage of the neck, neck, skull base.

In severe cases of the disease, surgery is performed. Currently, the most common type of surgery is bypass surgery. This is the name of the tube insertion, due to which excess cerebrospinal fluid is pumped out of the cerebral ventricles into the abdominal cavity. This method, however, has its drawbacks, which are expressed in the fact that the catheter can become clogged and fail. In addition, with this method, the risk of complications is high. Children will need to lengthen the tube several times as they grow. Liquor can also be discharged into a special sterile container. You can also apply the method of removal of the cerebrospinal fluid from the ventricles in the region of the space between the membranes at the base of the brain. In this case, the risk of complications is minimal.

As an aid at high pressure in the head, methods of folk therapy can be used, in particular, tinctures of herbs – hawthorn, motherwort, eucalyptus, mint, valerian. They provide a soothing effect and relieve vascular spasms.

Treatment for increasing intracranial pressure
Photo: Oxana Denezhkina / Shutterstock.com

Diet is important. First of all, with an increase in ICP it is necessary to reduce the volume of daily consumed fluid to 1.5 liters. You should also take more products containing salts of potassium and magnesium – sea kale, buckwheat, beans, dried apricots, kiwi. It should reduce the consumption of sodium salt, meat products, especially animal fats, confectionery. You should watch your weight, because overweight is also one of the factors that provoke the appearance of the disease.

In the absence of exacerbations, the patient is recommended to engage in physical culture. A good prophylactic is jogging, swimming. With this diagnosis, overheating of the body, baths, smoking and alcohol are contraindicated. Increasing the temperature above +38 ºС is dangerous for those suffering from an increase in ICP, therefore in such cases it is necessary to take antipyretic drugs. It is necessary to observe the mode of the day, to provide sufficient time for sleep and rest, to minimize brain tension when watching television.

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