Intracranial Hypertension - Increased Intracranial Pressure

Increased intracranial pressure means that the pressure inside the skull is abnormally high, which may cause damage to the brain.

What is going on in the body?

There is normally a small amount of pressure inside the skull. This pressure can become elevated from various conditions. An increased pressure in the skull can put too much pressure on the brain and decrease blood flow to the brain. Increased pressure can also force the brain downward onto the brainstem. This area controls vital functions like breathing, so this is a potentially fatal problem.

What are the causes and risks of the condition?

Increased intracranial pressure may be caused by:

There are other causes, and in some cases the cause is not known.

What are the signs and symptoms of the condition?

The symptoms of increased intracranial pressure may include:

How is the condition diagnosed?

The healthcare provider will start with a history and physical exam. A cranial CT scan or cranial MRI scan, two special types of x-ray tests, may be taken of the brain and skull. A spinal tap may also be done. This is a procedure in which a needle is inserted through the skin of the lower back and into the spinal column. Fluid can be withdrawn from the spinal column and a pressure reading of the fluid can be taken.

What can be done to prevent the condition?

Generally, nothing can be done to prevent the condition.

What are the long-term effects of the condition?

If intracranial pressure is very high, death may occur from brain injury. Some people have mildly elevated intracranial pressure over a long time. These people may develop vision or hearing problems.

What are the risks to others?

Usually, there are no risks to others. Rarely, high intracranial pressure is caused by an infection that may be contagious.

What are the treatments for the condition?

There are many different treatments, depending on the cause and degree of increased pressure present. Treating the underlying cause, if possible, can often return the pressure to normal. Treatment may include putting the person on a ventilator, or artificial breathing machine. Medications, surgery, or repeated spinal taps to remove fluid are other treatment options.

What are the side effects of the treatments?

Ventilators may cause infection or lung damage. Medications may have side effects, such as allergic reactions or stomach upset. Surgery and spinal taps carry a risk of bleeding, infection, and even death.

What happens after treatment for the condition?

If the underlying cause is corrected and the person feels better, he or she can generally go home with no further treatment. If extensive brain damage has occurred, the person may need intense rehabilitation before going home.

How is the condition monitored?

Symptoms and physical examination findings are followed. Sometimes, special instruments are placed through the skin and into the skull to measure the intracranial pressure.

Author:Adam Brochert, MD
Date Written:
Editor:Smith, Elizabeth, BA
Edit Date:04/17/00
Reviewer:William M. Boggs, MD
Date Reviewed:07/24/01

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