Health Encyclopedia

Increased intracranial pressure

Definition

Increased intracranial pressure is a rise in normal brain pressure.

Alternative Names

ICP; Intracranial pressure - increased

Causes, incidence, and risk factors

Increased intracranial pressure can be due to a rise in cerebrospinal fluid pressure. It can also be due to increased pressure within the brain matter caused by lesions (such as a tumor) or swelling within the brain matter itself.

An increase in intracranial pressure is a serious medical problem. The pressure itself can damage the central nervous system by pressing on important brain structures and by restricting blood flow through blood vessels that supply the brain.

Many conditions can increase intracranial pressure. Common causes include:

Aneurysm rupture and subarachnoid hemorrhage
Brain tumor
Encephalitis
Hydrocephalus
Hypertensive brain hemorrhage
Intraventricular hemorrhage
Meningitis
Severe head injury
Subdural hematoma
Status epilepticus
Stroke

Symptoms

Infants:

Drowsiness
Separated sutures
Soft spot on top of the head (bulging fontanelle)
Vomiting

Older children and adults:

Behavior changes
Headache
Progressive decreased consciousness, lethargy
Neurologic problems
Seizures
Vomiting

Signs and tests

A health care provider will usually make this diagnosis at the patient's bedside in an emergency room or hospital. Primary care doctors may sometimes spot early symptoms of raised intracranial pressure, such as headache, seizures, or neurologic problems.

An MRI or CT scan can often determine the cause and confirm the diagnosis.

Intracranial pressure may be measured during a spinal tap (lumbar puncture). It can also be measured directly by using a device that is drilled through the skull or a tube (catheter) that is inserted inside the brain.

Treatment

Increased intracranial pressure is an emergency. The person will be in the intensive care unit of the hospital. The health care team will measure and monitor the patient's neurological and vital signs, including temperature, pulse, breathing rate, and blood pressure.

Treatment may include:

Breathing support
Draining of cerebrospinal fluid to lower pressure in the brain
Medications to decrease swelling

If a tumor, hemorrhage, or other underlying problem has caused the increase in intracranial pressure, the cause should be treated as appropriate.

Expectations (prognosis)

Raised intracranial pressure is a serious and often deadly condition. If the underlying cause of the raised intracranial pressure can be treated, then the outlook is generally better.

If the increased pressure pushes on important brain structures and blood vessels, it can lead to serious, permanent problems or even death.

Complications

Death
Permanent neurologic problems
Reversible neurologic problems
Seizures

Calling your health care provider

A health care provider will usually make this diagnosis in an emergency room or hospital.

Prevention

This condition usually cannot be prevented. If you have a persistent headache, blurred vision, changes in your alert level, neurological problems, or seizures, seek medical attention as soon as possible.

Review Date:11/1/2007
Reviewed By:Luc Jasmin, M.D., Ph.D., Departments of Anatomy and Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network.

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