Intracranial pressure - symptoms and treatment in adults

Intracranial pressure (ICP) is the pressure inside the skull: in the sinuses of the cerebral membrane, in the subarchnoid and epidural spaces, the ventricles of the brain.Its fluctuations are associated with impaired circulation of cerebrospinal fluid (CSF) in certain parts of the skull, which leads to its accumulation or lack.

A healthy person releases about a liter of liquor per day, while intracranial pressure remains normal. This is explained by the constant absorption of cerebrospinal fluid into the venous vessels of the brain. In pathological cases, the cerebrospinal fluid is not absorbed where it is needed and its excess mass creates pressure on the walls of the ventricles of the brain. In these cases, the diagnosis is "increased intracranial pressure." Thus, the ICP index depends on the amount of CSF, the conditions of its circulation in the ventricles and the degree of absorption into the venous vessels.

Intracranial pressure may vary throughout the day. Similar to the arterial, it rises and falls as a result of the influence of various factors, and the person does not feel any discomfort. Pathology is a persistent increase in ICP, which is due to the accumulation in the skull of an excess of cerebrospinal fluid (cerebrospinal fluid).

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The causes of increased ICP

Why there is increased intracranial pressure, and what is it? There are several diseases that often cause an increase in intracranial pressure.

First of all, they are:

Volumetric brain tumors, both malignant and benign.
Infectious and inflammatory diseases of the brain and its membranes: meningitis, encephalitis.
Thrombosis of venous sinuses, because of which the circulation of the cerebrospinal fluid is impaired.
Craniocerebral injuries that caused the formation of large hematomas.
Eclampsia and preeclampsia are forms of late toxicosis of pregnant women, in which arterial pressure in a short time reaches critical values.
Ischemic stroke can also cause increased intracranial pressure.
Hydrocephalus is a congenital condition, a violation of the outflow of liquor, which manifests itself in the first days or months of the child's life. The cause may be various factors, for example, mothers transferred during pregnancy, infectious diseases.

Increased ICP in adults often occurs as a result of head injuries and rupture of an aneurysm, as well as in the form of consequences of such serious diseases as meningitis, encephalitis, tumors in the cranial cavity. In addition, the cause of increased intracranial pressure may be the presence of an anomaly Arnold Chiari, hypoxia, a violation of blood outflow and severe poisoning.

Symptoms of increased intracranial pressure in adults

In normal state, the pressure inside the adult's skull should not be more than 10-15 mmHg. Its rise to 25-35 mm is considered critical, and in this case it is possible to lose consciousness. If this process is not stopped, then it can lead to brain death. Therefore, it is very important to be able to determine the increase in intracranial pressure in an adult by his symptoms.

Symptoms of increased intracranial pressure in adults:

frequent headaches, especially in the morning;
vomiting, nausea;
increased sweating;
cardiopalmus;
visual impairment: double vision, throbbing pain;
bruises or slight bruising under the eyes;
fast fatigue, nervousness;
deterioration of mobility of joints;
decreased potency, sexual desire.

When signs of intracranial pressure appeared after a head injury, falls and are expressed by a disturbance of consciousness, drowsiness and even fainting, the patient will be suspected of brain damage. In this case, you should immediately seek medical help.

Increased intracranial pressure is a serious threat to the life of the patient. Regular pressure on the brain disrupts his activity, as a result of which intellectual abilities may decrease and the nervous regulation of the internal organs' functioning is disturbed.

Symptoms of intracranial pressure in children

Usually, the symptoms of increased intracranial pressure in children are closely related to manifestations of hydrocephalus, which is the presence of too much fluid in the ventricles of the brain.
In addition to visually increasing the size of the head, other symptoms can be noted:

excessive pronounced bulging fontanel,
a strong lag in the overall development in relation to peers,
excessive anxiety,
the child spews too much, and little gaining weight,
lethargy and drowsiness.
Gref's symptom, when the child's eyes are not looking directly in front of him, but down.

Thus, the signs of increased intracranial pressure in the baby can not go unnoticed. Everyone who does not have a special medical education, is able to identify a child such an unpleasant affliction.

Diagnostics

Before you figure out how to treat high intracranial pressure, you need to correctly diagnose. Therefore, the diagnosis of intracranial hypertension in adults is prescribed:

General blood analysis;
Blood test for electrolytes;
MRI or CT;
Measurement of CSF pressure (lumbar puncture);
Laboratory examination of cerebrospinal fluid;
Differential diagnosis with systemic lupus erythematosus and sarcoidosis.

According to the results of diagnosis, and also depending on the severity of the course and the severity of symptoms of intracranial pressure, a treatment regimen is determined.

How to measure intracranial pressure

In specialized clinics, invasive methods of measuring the pressure inside the ventricles of the brain using specialized pressure sensors can be used:

The pressure in the cerebral ventricles is measured by the hydraulic ventricular system. A catheter connected to the sensor is inserted into the ventricles. During the procedure, it is possible to drain, administer medications.
Sensors for measuring the pressure in the parenchyma (Codman, Camino) are introduced in the frontal or temporal zone to a depth of 2 cm.
The sensors can be installed subdural, epidural, subarachnoid. The procedure has a low risk of brain trauma. However, the accuracy of measurements is less than in parenchymal and intraventricular methods.

However, in most cases, intracranial pressure is measured indirectly by measuring the pressure in the spinal subarachnoid space at the waist level (using a spinal puncture).

Treatment of intracranial pressure in adults

With the diagnosis, increased intracranial pressure, treatment in adults depends on the causes of the disease, age, and may include diuretics, sedatives and vascular drugs. In addition, prescribe manual and dietotherapy, as well as gymnastics.

The diet is built taking into account the consumption of vitamin-rich foods, as well as the minimum amount of salt and liquid. Depending on the severity of the disease, apply invasive (associated with penetration into the body) methods.

Some of these methods are designed only for symptomatic relief of the patient's condition. Others can cure the root cause of the disease. As for symptomatic treatment with drugs, diuretics, such as Diacarb, are a common remedy. The drug inhibits the carboanhydrase of the brain, which leads to a decrease in the formation of cerebrospinal fluid and intracranial pressure. Accordingly, the associated symptoms are removed. Diacarb is prescribed to reduce benign intracranial pressure.

In general, the mechanism of action of diuretic drugs is based on the excretion of excess fluid through the kidneys, which reduces the pressure of the CSF. Before you start taking the drug, it is worth to familiarize with the opinion of professionals to make sure of the safety of the prescribed therapy. Also remember that diuretics do not solve the problem, when the cause of ICP are swelling, hematoma, aneurysm and other serious causes. Do not take self-medication.

Treatment Scheme

To eliminate the cause of increased intracranial pressure, use:

In the event that an increase in ICP resulted in intracerebral formation - an aneurysm, a tumor, a hematoma, after the corresponding preobsledovaniya perform the removal of voluminous education through surgical intervention.
In the case of excessive secretion of cerebrospinal fluid in hydrocephalus, shunt operations are performed, the purpose of which is to create an additional outflow pathway for the cerebrospinal fluid. This leads to a decrease in ICP.

For the purpose of medicamentous correction of the level of intracranial pressure, these groups of drugs are used:

Loop diuretics (furosemide);
Hormonal preparations (dexamethasone);
Diakarb;
Neuroprotective agents (glycine).
Osmodiuretiki (mannitol, glycerol), whose action is aimed at reducing the amount of cerebrospinal fluid.

In addition, it is appointed:

Ventricular puncture, decompression craniotomy are designed to reduce the volume of CSF in the cranial cavity.
Using manual therapy, hyperbaric oxygenation, controlled arterial hypotension, hyperventilation.
Diet. Limit the amount of fluid and salt entering the body, which corresponds to diet No. 10, 10a.

Also, we offer to familiarize with some recommendations that contribute to improving the well-being of VCHD violations at home:

To exclude visiting of a bath, a sauna.
Recommended swimming in the river or pool - this helps reduce intracranial pressure.
Sleep better on high cushions, so that the head is raised, waking up immediately to get up.
Regularly visit the masseur: a massage of the "collar" zone is shown.
Do not eat fatty foods and enter into the diet more useful foods, vitamins.
Do not recommend large physical exertion, do not lift heavy.
Drink instead of water herbal teas, which have a mild diuretic effect.
Avoid traveling by air.
Try not to allow a sharp change in climate, time zones.
Improves the health of eating products containing potassium: potatoes, dried apricots, citrus fruits, green vegetables.

Do not try to cure elevated ICP yourself at home, without consulting a specialist, since with an erroneous diagnosis the use of medicines will be meaningless, and if you have a real illness, you will lose time and the illness will go to a neglected form.