Increase in intracranial pressure

A Increase in intracranial pressure can be life-threatening and in severe cases requires urgent 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 with increased intracranial pressure.

What is an increase in intracranial pressure?

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

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

The norm in 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). With an internal cranial pressure between 10 and 20 Torr, there is a slight increase in intracranial pressure, up to 30 Torr the pressure increase is, by definition, moderate. In addition, the doctor speaks of a strong or more than 40 Torr of a very strong increase in intracranial pressure.

causes

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

This head injury, also called Compressio cerebri (brain compression), always leads to cerebral hemorrhage (hematoma) or cerebral edema (edema: water accumulation in the body). Because of the increase in both parts of the fluid, the intracranial pressure also increases.A cerebral hemorrhage in the course of a stroke is also due to these two factors.

Increased intracranial pressure can also occur when tumors or abscesses develop in the brain and compress healthy tissue. A swelling of the meninges also increases the pressure in the skull, as is the case with meningitis (meningitis).

But even a sunstroke is a meningeal irritation - in this case from 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 death. However, this case usually only occurs if the increase in intracranial pressure remains completely untreated. Patients with this disease suffer primarily from severe headaches. These can also spread to the ears or even the back and lead to pain there as well.

The headache is often associated with vomiting or nausea, and people generally feel sick and exhausted. There is also a slowed pulse and disorders of consciousness. There are tingling sensations and disorders of the blood circulation, which can complicate the patient's everyday life.

In many cases, the increase in intracranial pressure leads to paralysis of the eye muscles and thus to severe visual problems or to complete blindness. In general, the increase in intracranial pressure leads to high blood pressure, which has a very negative effect on the health of the person concerned. This can also lead to a heart attack from which the person affected 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 & course

A Increase in intracranial pressure has symptoms such as headache, nausea and vomiting, fatigue and dilated pupils and bradycardia (slow pulse). In the event of these signs, the doctor will ask about the history (accident, loss of consciousness?) And inquire about other symptoms (stiff neck, fever in case of meningitis).

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

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

Complications

If the intracranial pressure is increased, the patient will die if left untreated. Because of this, the condition needs to be treated by a doctor immediately. There is also severe damage to the brain that is irreversible and can lead to complications even after the treatment. In most cases, those affected primarily have severe headaches.

These can spread to other regions of the body and cause discomfort there. It is not uncommon for vomiting and nausea to occur. Patients have a slow pulse and may have lost consciousness. A fall can lead to various complaints.

As a rule, the patient's resilience is also reduced and everyday life is made more difficult. Visual disturbances can also occur. In severe cases, the patient falls into a coma. The treatment for increased intracranial pressure is usually based 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, the treatment takes place with the help of medication. There are no complications. However, late treatment can cause irreversible consequential damage.

When should you go to the doctor?

People who suddenly suffer from unspecific headaches and a feeling of pressure in the head area should consult a doctor. If other symptoms such as nausea and vomiting or dizziness occur, medical advice must be sought immediately. Acute complaints in the head and cardiovascular system indicate a serious illness that needs to be investigated and treated if necessary. An increase in intracranial pressure also manifests itself in high blood pressure and eye muscle paralysis. If the symptoms mentioned occur at the same time, the sick person must alert the emergency services.

In severe cases, first aid measures must be carried out until the emergency doctor arrives. A longer stay in hospital is then usually indicated. An increase in intracranial pressure often occurs in connection with a traumatic brain injury. Abscesses in the brain, meningitis or sunstroke are possible triggers. Anyone who belongs to 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. In case of doubt, the person concerned should be taken to the nearest hospital immediately.

Doctors & therapists in your area

Treatment & Therapy

A Increase in intracranial pressure the doctor will deal with the elimination of the respective cause. If there is a brain tumor, it is surgically removed if possible. This is followed by chemotherapy or radiation.

After a stroke or traumatic brain injury, doctors first exhaust all opportunities offered by drug treatment in order to alleviate an acute increase in intracranial pressure. Pharmaceuticals similar to cortisone (glucocorticoids) also act as anti-inflammatory agents to reduce swelling. At the same time, water-boosting agents (diuretics) are part of the medication as well as osmotherapeutics. These are some types of sugar that cause fluid to shift in the tissue and divert the edematous volumes into the blood.

In severe cases, the increase in intracranial pressure must be addressed using minimally invasive or surgical techniques. Then the doctor either performs a ventricular drainage or, as a last resort, a decompression craniectomy. Parts of the brain skull are removed, which lowers the pressure on the brain. The neurosurgeons use the bone fragments again after the illness has been overcome.

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

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Outlook & forecast

In the case of an increase in intracranial pressure, the prospect of a cure is tied to the causal disease. If there is swelling inside the head after an accident or fall, the increase in intracranial pressure is a consequence of the injury. If no vessels or tissue have been damaged, the swelling gradually recedes within a few days and the increase in intracranial pressure is minimized. After a short time, a complete recovery and freedom from symptoms can be expected.

If a tumor is present, the prognosis is poor. 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 triggers a tightness inside the head and can lead to the bursting of various vessels and permanent tissue damage. This creates a life-threatening situation for the patient, which in severe cases leads to premature death.

Basically, the longer the pressure persists and the higher it is, the prognosis worsens significantly. In addition to being fatal, the patient can suffer from a comatose state or permanent dysfunction. The movement sequences or disorders of the cardiovascular system and respiratory activity are the lifelong consequences.

prevention

One Increase in intracranial pressure To counteract in prophylaxis means to avoid the triggers. General measures for a healthy lifestyle can reduce the risk of a stroke, accidents are hardly calculable. Only observing the appropriate safety guidelines - for example at the workplace - is recommended. In this context, reference is made to the use of a bicycle helmet.

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

With an increase in intracranial pressure, in most cases there are very few or even no follow-up measures available to those affected. The affected person is primarily dependent on a quick and above all on early diagnosis with the subsequent treatment, so that a further worsening of the symptoms is prevented. Self-healing does not occur with this disease, so that the early diagnosis of increased intracranial pressure is in the foreground.

The treatment of the increase in intracranial pressure is always based on the exact cause and is usually carried out by surgery or chemotherapy. The affected person has to rest a lot during the therapy and take care of his body. Exertion or stressful and physical activities are to be avoided in order not to strain the body unnecessarily.

In many cases it is also necessary to take medication, whereby it is important to ensure the correct dosage. Should questions or ambiguities arise, a doctor should always be contacted first. Psychological treatment is also not infrequently necessary, although relatives or parents can also participate in this treatment. In most cases, the life expectancy of the person affected is significantly reduced due to the increase in intracranial pressure.

You can do that yourself

An increase in intracranial pressure is a serious disease that puts the patient's life in danger. Therefore, self-help measures alone do not do justice to the seriousness of the increase in intracranial pressure and must be avoided in any case as long as they have not been discussed with a doctor. In order to increase the personal chances of a cure, the patient turns to a specialist as soon as possible in his own interest. After the diagnosis and the treatment plan, the patient has the opportunity to use certain behaviors to have a positive influence on the prognosis of the increase in intracranial pressure.

Although the symptoms are different for each patient, they generally have a strong impact on quality of life. It is therefore in the self-interest of the person concerned to reduce everyday obligations and allow themselves a high degree of rest. Sport is usually no longer practicable to the usual extent; certain types of sport must be avoided entirely. If the patient wishes to continue doing sports, he must clarify this with the attending physician in any case. The increase in intracranial pressure can be treated with medication and surgical interventions, whereby the patient concerned generally adheres to all medical instructions.