Increased Intracranial Pressure Definition and Meaning

According to ABBREVIATIONFINDER, increased intracranial pressure can be life-threatening and, in severe cases, urgently requires medical intervention. The causes of the syndrome can be skull injuries and chronic or acute diseases. Without treatment, there is a risk of permanent brain damage if there is an increase in intracranial pressure.

What is an increase in intracranial pressure?

An increase in intracranial pressure means an increase in the pressure inside the cranium above the normal physiological value. Since body tissue is an aqueous environment, this pressure can be described as hydrostatic pressure as a first approximation.

Hydrostatic pressure is the pressure in a liquid. The increase in the amount of water in the brain can increase the intracranial pressure because the volume of the brain is limited by the bony, rigid cranial capsule. The pressure inside the skull (intracranial pressure) can be practically equated with the pressure inside the brain.

The norm for healthy people is a value of 0 to 10 Torr for intracranial pressure. 1 Torr is the hydrostatic pressure of a 1 mm high column of mercury (“mmHg”, Hg: chemical symbol for mercury). At an intracranial pressure between 10 and 20 Torr there is a slight increase in intracranial pressure, up to 30 Torr the pressure increase is by definition moderately pronounced. In addition, the doctor speaks of strong or over 40 Torr of a very strong increase in intracranial pressure.

Causes

An increase in intracranial pressure occurs with injuries and various diseases. The increased intracranial pressure can be the result of a 3rd degree traumatic brain injury (abbreviated: TBI).

This head injury, also known as Compressio cerebri (brain compression), always leads to cerebral bleeding (hematoma) or cerebral edema (edema: accumulation of water in the body). Due to the increase in both fluid proportions, the intracranial pressure also increases. A cerebral hemorrhage in the course of a stroke can also be attributed to these two factors.

Increased intracranial pressure can also occur when tumors or abscesses form in the brain and compress healthy tissue. Swelling of the meninges also increases the pressure inside the skull, as is the case with meningitis.

But sunstroke is also an irritation of the meninges – here due to UV radiation – and leads to an increase in intracranial pressure. The harmless-sounding syndrome even causes cerebral edema, resulting in increased intracranial pressure.

Symptoms, Ailments & Signs

In the worst case, an increase in intracranial pressure can lead to the death of the person concerned. However, this case usually only occurs if the increase in intracranial pressure remains completely untreated. Patients with this disease primarily suffer from severe headaches. These can also spread to the ears or even the back and cause pain there as well.

The headaches are often associated with vomiting or nausea, and those affected generally feel ill and exhausted. There is also a slowed pulse and disturbances of consciousness. Tingling sensations and circulatory disorders occur, which can make everyday life difficult for the patient.

In many cases, the increase in intracranial pressure leads to paralysis of the eye muscles and thus to severe visual problems or complete blindness. In general, the increase in intracranial pressure leads to high blood pressure, which has a very negative effect on the health of those affected. This can also lead to a heart attack, from which the affected person can die. If the disease is not treated, the affected person usually loses consciousness and then falls into a coma. Life expectancy is significantly restricted and reduced with this disease.

Diagnosis & History

An increase in intracranial pressure causes symptoms such as headache, nausea to the point of vomiting, exhaustion and dilated pupils and bradycardia (slow heart rate). The doctor will ask about the history of these signs (accident, unconsciousness ?) and inquire about other symptoms ( stiff neck, fever in meningitis).

It should be noted that the symptoms are less pronounced the slower the increase in intracranial pressure develops. If the patient’s condition worsens, direct measurement of intracranial pressure may be necessary. Most of the time the people affected are already unconscious or even in a coma.

The doctor inserts a special probe filled with a physiological saline solution into the drilled skull (trepanation). Without normalization of the intracranial pressure, there is a risk of irreversible brain damage due to an increase in intracranial pressure.

Complications

If left untreated, the increase in intracranial pressure will lead to the death of the patient. Because of this, the condition needs to be treated immediately by a doctor. Severe brain damage continues to occur, which is irreversible and can lead to complications even after treatment. In most cases, those affected primarily suffer from severe headaches.

These can also spread to other regions of the body and cause problems there. It is not uncommon for vomiting and nausea to occur. Patients suffer from a slow pulse and possibly loss of consciousness. A fall can cause a variety of symptoms.

As a rule, the patient’s resilience is reduced and everyday life is made much more difficult. Visual disturbances can also occur. In severe cases, the patient falls into a coma. The treatment of increased intracranial pressure usually depends on the cause of the disease.

Radiation therapy is usually used for a tumor. If a stroke has led to an increase in intracranial pressure, treatment takes place with the help of medication. There are no complications. However, treatment that is too late can result in irreversible consequential damage.

When should you go to the doctor?

People who suddenly suffer from non-specific headaches and a feeling of pressure in the head area should see a doctor. If other symptoms such as nausea and vomiting or dizziness occur, medical advice must be sought immediately. Acute symptoms in the area of ​​the head and cardiovascular system indicate a serious illness that needs to be examined and, if necessary, treated. An increase in intracranial pressure is also manifested by high blood pressure and paralysis of the eye muscles. If the above symptoms occur at the same time, the patient must call the emergency services.

In severe cases, first aid measures must be taken before the emergency doctor arrives. A longer hospital stay is then usually indicated. Increased intracranial pressure often occurs in connection with traumatic brain injury. Abscesses in the brain, meningitis or sunstroke are also possible triggers. Anyone who belongs to one of these risk groups must consult a doctor immediately if the symptoms are mentioned. In addition to the family doctor, the cardiologist is the right contact person. If in doubt, the person concerned should be taken to the nearest hospital immediately.

Treatment & Therapy

The doctor will treat an increase in intracranial pressure by eliminating the respective cause. If a brain tumor is present, it is surgically removed if possible. Chemotherapy or radiation follows.

After a stroke or craniocerebral trauma, the physicians first exploit all the possibilities of drug treatment to alleviate an acute increase in intracranial pressure. Cortisone-like pharmaceuticals (glucocorticoids) also act as anti- inflammatory drugs to reduce swelling. In parallel, water-repellent agents ( diuretics ) belong to the medication as well as osmotherapeutic agents. These are some types of sugar that cause a shift in fluid in the tissue and drain the edematous volumes into the blood.

In severe cases, the increase in intracranial pressure must be addressed by minimally invasive or surgical techniques. Then the doctor performs either ventricular drainage or, as a last resort, a decrompession craniectomy. Parts of the cranium are removed, which reduces intracranial pressure. The bone fragments are reinserted by the neurosurgeons once the disease is over.

Intensive medical monitoring is strictly mandatory, especially in serious cases of increased intracranial pressure.

Outlook & Forecast

In the case of an increase in intracranial pressure, the prospect of a cure is linked to the causal disease. If there is swelling inside the head after an accident or fall, the increase in intracranial pressure is a result of the injury. If no vessels or tissue were damaged, in many cases the swelling gradually subsides within a few days and the increase in intracranial pressure is thus minimized. After a short time, a complete recovery and freedom from symptoms of the patient can be expected.

If a tumor is present, the prognosis is unfavorable. Regardless of whether the tumor is benign or malignant, growth of the affected tissue leads to a further increase in intracranial pressure. Due to the closed shape of the skull, there is no alternative for the tissue. This causes constriction inside the head and can lead to the bursting of various vessels and permanent tissue damage. This is a life-threatening situation for the patient, which in severe cases can result in premature death.

Basically, the prognosis deteriorates significantly the longer the pressure lasts and the higher it is. In addition to death, the patient may experience a comatose state or permanent dysfunction. The movement sequences or disorders of the cardiovascular system and respiratory activity are the lifelong consequences.

Prevention

Counteracting an increase in intracranial pressure in prophylaxis means avoiding the triggers. General measures of a healthy lifestyle can reduce the risk of a stroke, accidents are hardly calculable. Only the observance of the corresponding safety guidelines – for example at the workplace – is to be recommended. In this context, the use of a bicycle helmet is recommended.

People in risk areas in particular should consider vaccination against meningitis. Appropriate headgear helps against sunstroke in midsummer and is therefore a very simple measure against an increase in intracranial pressure.

Aftercare

In the case of an increase in intracranial pressure, in most cases the affected person has very few or even no measures and options for aftercare. The person concerned is primarily dependent on a quick and above all on an early diagnosis with the subsequent treatment, so that a further deterioration of the symptoms is prevented. Self-healing does not occur in this disease, so early diagnosis of the increase in intracranial pressure is paramount.

The treatment of increased intracranial pressure always depends on the exact cause and is usually carried out by means of surgery or chemotherapy. The patient has to rest a lot during therapy and take care of his body. Efforts or stressful and physical activities should be avoided in order not to strain the body unnecessarily.

In many cases, it is also necessary to take medication, whereby care must be taken to ensure the correct dosage. If questions or ambiguities arise, a doctor should always be contacted first. Psychological treatment is also often necessary, although relatives or parents can also take part in this treatment. In most cases, the life expectancy of those affected is significantly reduced by the increase in intracranial pressure.

You can do that yourself

An increase in intracranial pressure is a serious disease, so that the patients are in mortal danger. Therefore, self-help measures alone do not do justice to the seriousness of the increase in intracranial pressure and should be avoided in any case unless they have been discussed with a doctor. In order to increase the personal chances of a cure, the patient turns to a specialist as quickly as possible in their own interest. After the diagnosis and the treatment plan, the patient has the opportunity to have a positive influence on the prognosis of the increase in intracranial pressure through certain behavior.

Although the symptoms are different for each patient, they generally have a severe impact on quality of life. It is therefore in the self-interest of those affected to reduce everyday obligations and allow themselves a high degree of rest. Sport is usually no longer practicable to the usual extent, and certain types of sport should be avoided altogether. If the patient would like to continue doing sports, he must clarify this with the doctor treating him in any case. The increase in intracranial pressure can be treated with medication and surgical interventions, whereby the affected patient always follows all medical instructions.