In addition to headache, you may experience nausea, vomiting, and vision changes.
This article explains elevated intracranial pressure, its common symptoms, and possible complications.
It also discusses the causes of increased intracranial pressure and how it is treated.
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What Is Elevated Intracranial Pressure?
Intracranial means within the skull.
Intracranial pressure rises when one of these three componentsbrain tissue, CSF, and bloodrequires more space.
Normal intracranial pressure levels vary by age.
Normal ICP is somewhere between 5 millimeters of mercury (mmHg) and 15 mmHg.
If it increases to more than 20 mmHg, structures in the brain may be impacted.
Oftentimes, the body can compensate, usually by reducing blood flow or effectively squeezing out CSF.
When this is no longer possible, elevated ICP will begin to develop rapidly.
Symptoms include fleeting disturbances in vision, headache, and vomiting.
Complications
Even more concerning than optic nerve damage is how ICP can impact the brain itself.
When pressure rises inside the skull, the brain can be pushed to an area of lower pressure.
Brain damage andstrokecan result.
Similarly, the cerebellum is separated from the rest of the brain by the tectorial membrane.
This can lead to paralysis,coma, and even death.
What Causes Elevated ICP?
There are several things that can trigger an increase in intracranial pressure.
At other times, the normal flow of fluids in and out of the brain is impeded.
If the flow is blocked, intracranial pressure can build.
This is referred to as idiopathic elevated intracranial pressure.
Diagnosis
Elevated intracranial pressure may be diagnosed in a number of different ways.
In addition to an evaluation of symptoms, a fundoscopic exam of the eye may reveal papilledema.
An intracranial monitor requires surgical insertion through a drilled hole in the skull.
With some brain surgeries or atraumatic brain injury, an intracranial monitor may be placed immediately.
Treatment
Elevated intracranial pressure can be dangerous.
The first goal is to stabilize a patient, provide sedation if needed, and relieve the pain.
Intravenous steroids may help decrease cerebral inflammation.
Medications like acetazolamide may slow the production of cerebrospinal fluid.
Intracranial pressure over 20 mmHg is treated aggressively.
2022;48(10):147181. doi:10.1007/s00134-022-06786-y
Kasper DL, Fauci AS, Hauser SL.
Harrison’s Principles of Internal Medicine.
New York: Mc Graw-Hill Education.
