Increased Intracranial Pressure Symptoms and Causes

Intracranial pressure (ICP) is a measurement of the pressure of brain tissue and the cerebrospinal fluid that cushions and surrounds the brain and spinal cord. It is used to monitor the health of the brain after an injury. An increase in intracranial pressure can be caused by a brain tumor, bleeding into the fluid around the brain, or swelling within the brain.

An increase in intracranial pressure is a life-threatening medical condition. If left untreated, it could lead to brain damage or spinal cord damage by compressing brain structures and restricting the flow of blood to the brain.

Symptoms

Symptoms of elevated intracranial pressure vary by age. Infants exhibit symptoms by vomiting or being drowsy. They may show an outward bulging in the fontanelle, the soft spot on the top of the head. ICP in infants may be a sign of child abuse, especially shaken baby syndrome. It can also be the result of a separation of the bony plates that form the skull also known as separated sutures of the skull.

Older children and adults may display symptoms such as:

• Changes in behavior
• Headache
• Lethargy
• Seizures
• Vomiting without nausea
• Decrease in consciousness
• Neurological abnormalities: abnormal eye movement, double vision, and numbness

Causes

Elevated intracranial pressure can occur separately or in combination with other conditions. Some of the most common causes include:

• Brain tumor
• Trauma
• Intracerebral hemorrhage
• Ischemic stroke
• Meningitis
• Hydrocephalus
• Intracranial hypertension
• Blocked airway
• Hypoventilation
• Hypertension
• Seizures
• Drug-related interaction
• Posture
• Edema
• Encephalitis

Diagnosis

The diagnosis of elevated intracranial pressure is usually made while the patient is in the emergency room or hospital. Early symptoms may be diagnosed during a routine medical examination. Another important sign of increased ICP is papilledema, or swelling of the optic disc, which may be picked up on an eye exam.

To confirm the diagnosis of elevated intracranial pressure, a CT scan or MRI of the head may be performed. It may also be measured by conducting a lumbar puncture of the spine, also known as a spinal tap, to measure the pressure of the cerebrospinal fluid.

Treatment

An increase in intracranial pressure is considered to be a serious and life-threatening medical emergency. Treatment is focused on reducing the pressure. Patients will be treated in the intensive care unit (ICU) of the hospital.

Medical management of elevated intracranial pressure includes the following:

• Sedation
• Drainage of cerebrospinal fluid
• Support for breathing
• Medically induced coma
• Hypothermia
• Decompressive craniectomy

Elevated intracranial pressure is a common complication in patients that are critically ill.

Prevention

While ICP cannot be prevented, some of its leading causes like head injury often can. Wearing a protective helmet when playing contact sports or riding a bike, buckling a seat belt, moving the seat in the car far away from the dashboard, and using a child safety seat can preventing head injuries from becoming life-threatening. Removing clutter from floors and keeping them dry will help to prevent falls at home–a common cause of head injury in the elderly.