Intracranial pressure in adults

What is intracranial pressureе

The brain is surrounded by a liquid – liquor, which nourishes and protects nerve cells. The cerebrospinal fluid continuously forms and flows away from the skull, thereby maintaining its constant pressure. This is intracranial pressure – a certain force that presses on the brain and the walls of the skull.

Change this pressure in mm Hg. Art., and normally it is from 10 to 15 mm. If it is higher, this is a reason to be wary, and if the pressure exceeds 25 mm Hg. Art., it can be dangerous for brain function. With a value of more than 35 mm Hg. Art. severe and irreversible changes in the brain are possible – such situations are considered critical.

Causes of intracranial pressure in adults

Increased intracranial pressure (ICP) is not an independent disease, but a syndrome. Doctors sometimes call it intracranial hypertension. Pressure inside the brain (similar to arterial pressure) fluctuates when the head is tilted back and forth or to the sides, during exercise or sneezing. But it can rise to serious numbers with pathologies, and there are many of them.

– ICP (intracranial pressure) occurs as a result of an increase in the volume of intracranial contents (liquor or cerebrospinal fluid), tissue fluid, or the appearance of foreign tissue (tumors, cysts, brain abscess), – says neurologist Polina Petrosyan.

In addition, the causes of increased ICP may be:

• craniocerebral trauma;
• tumor;
• intracerebral hemorrhage;
• neuroinfections (encephalitis, meningitis).

The pressure rises due to the fact that the fluid is either produced in excess (for example, due to an infection that has spread to the brain or its membranes), or due to the fact that fluid flows worse from the skull through special pathways. If volumetric processes develop in the cranial cavity (for example, a tumor grows or a hemorrhage occurs), there will be less space for the fluid, and its pressure will also increase.

Symptoms of intracranial pressure in adults

In many cases, a slight increase in ICP may not manifest itself for a long time. If the pressure rises sharply or high enough, the following symptoms may occur:

• headache – it can be pressing or arching, usually occurs in the morning, this pain does not have a clear localization, it can be felt in different parts of the skull;
• nausea and vomiting – they usually occur at the peak of a headache;
• сонливость, недомогание, общее плохое самочувствие;
• memory impairment (forgetfulness), attention disorders, thinking problems;
• changes in the autonomic nervous system – jumps in blood pressure, slow pulse, increased sweating;
• visual impairment up to complete blindness.

Symptoms may come on suddenly or develop gradually over weeks or months.

Treatment of intracranial pressure in adults

Also, neurologist Polina Petrosyan notes:

“The main principle of treatment is taking drugs that reduce the formation of cerebrospinal fluid and activate the process of its absorption,” explains neurologist Polina Petrosyan. – In severe cases, surgical treatment is performed – shunting.

But first of all, you need to consult a doctor and conduct a diagnosis in order to accurately determine the increase in ICP and the cause that led to this.

Diagnostics

By external signs, it is extremely difficult to suspect an increase in ICP. The doctor must know all the complaints and those facts from life that preceded the symptoms. It can be a hypertensive crisis, a head injury, a severe infection, kidney or liver problems. In order to confirm the diagnosis, the doctor will prescribe a series of studies to the patient:

• CT or MRI of the brain to assess the structure of all tissues of the skull, to note the state of the ventricles of the brain, where liquor accumulates;
• echoencephaloscopy to determine the work of the brain;
• Ultrasound of the brain (mainly in children through the fontanel);
• examination of the condition of the fundus by an ophthalmologist;
• puncture of the spinal cord with measurement of the pressure of the outflowing cerebrospinal fluid (the cerebrospinal fluid itself is taken for analysis).

Modern treatments

In some cases, the patient does not require treatment, he is being monitored for the treatment of the underlying disease, which caused the increase in ICP.

If it is necessary to treat pathology, two approaches are used – conservative and operative.

Conservative interventions are carried out for those patients in whom the increase in ICP is chronic, there is no pronounced deterioration in the condition over time. The basis of treatment is drugs that have a diuretic effect, which reduce the amount of fluid in the head. The specific remedy is determined by the level of pressure and the situation. In severe and acute processes, osmotic diuretics (mannitol) are used, in chronic cases – furosemide, hydrochlorothiazide, spironolactone. Against the background of their intake, it is necessary to drink a potassium preparation – Asparkam, Potassium orotate, Panangin.

Surgical treatments for increased ICP depend on the stage and severity of the disease. In acute situations, a craniotomy is performed to reduce the pressure of the fluid on the brain and remove its excess. Special shunts (tubes) are routinely placed, which drain fluid from the brain into the abdominal cavity.

Prevention of intracranial pressure in adults at home

Prevention of increased ICP is the prevention of various diseases affecting the cranial cavity. Including, protection against infections that can affect the brain – vaccination against meningococcal and hemophilic infections, influenza vaccination. It is also necessary to treat various pathologies that can affect the functioning of the brain.

General recommendations are simple:

• observe the daily routine and lead the most healthy lifestyle;
• avoid head injury;
• protect yourself from stress and nervous overload;
• sleep enough.

Popular questions and answers

How to suspect that intracranial pressure is increased and whether it can be corrected by ourselves, at home, when to call a doctor or an ambulance, what to do with an increase in ICP, she told us neurologist Polina Petrosyan.