Intracranial pressure - symptoms and treatment in adults

Intracranial pressure (ICP) is the pressure inside the skull: in the sinuses of the meninges, in the subarchal and epidural spaces, in 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.

In a healthy person, about a liter of liquor is secreted per day, while intracranial pressure remains normal. This is due to the constant absorption of cerebrospinal fluid in 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 cerebrospinal fluid, conditions of its circulation in the ventricles and the degree of absorption into the venous vessels.

Intracranial pressure may vary throughout the day. Like arterial, it rises and falls as a result of the influence of various factors, and at the same time a person does not feel any discomfort. Pathology is a persistent increase in ICP, which is caused by the accumulation of excessive amounts of CSF (cerebrospinal fluid) in the cranium.

Causes of increased ICP

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

First of all they include:

  1. Bulk brain tumors, both malignant and benign.
  2. Infectious and inflammatory diseases of the brain and its membranes: meningitis, encephalitis.
  3. Thrombosis of the venous sinuses, because of which the circulation of the cerebrospinal fluid is disturbed.
  4. Traumatic brain injuries that caused the formation of large hematomas.
  5. Eclampsia and preeclampsia are forms of late toxicosis of pregnant women, in which blood pressure in a short time reaches critical values.
  6. Ischemic stroke can also cause increased intracranial pressure.
  7. Hydrocephalus - a congenital state, a violation of the outflow of cerebrospinal fluid, which manifests itself in the first days or months of a child's life. The reason may be various factors, for example, infectious diseases transferred by the mother during pregnancy.

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

Symptoms of increased intracranial pressure in adults

In a normal state, the pressure inside the adult's skull should be no higher than 10-15 mm Hg. Its increase to 25-35 mm is considered critical, and in this case, you can lose consciousness. If this process is not stopped, 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 its symptoms.

Symptoms of increased intracranial pressure in adults:

  • frequent headaches, especially in the morning;
  • vomiting, nausea;
  • excessive sweating;
  • cardiopalmus;
  • visual disturbances: double vision, throbbing pain;
  • bruises or minor bruising under the eyes;
  • fatigue, nervousness;
  • deterioration of joint mobility;
  • reduced potency, sexual desire.

When signs of intracranial pressure appeared after a head bruise, falls, and are marked by impaired consciousness, drowsiness, and even fainting, the patient will be suspected 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 its activity, as a result of which intellectual abilities may decrease and the nervous regulation of the internal organs will be disturbed.

Symptoms of intracranial pressure in children

Typically, the symptoms of increased intracranial pressure in children are closely associated with manifestations of hydrocephalus, which is the presence of too much fluid in the ventricles of the brain.
In addition to the visual increase in the size of the head, other symptoms can be noted:

  • excessive pronounced spouting,
  • a strong lag in overall development in relation to peers,
  • excessive anxiety
  • the child spits up too much, and gains little weight,
  • lethargy and drowsiness.
  • Graefe's symptom, when the eyes of a child are not looking straight ahead, but downwards.

Thus, signs of increased intracranial pressure in infants cannot remain unnoticed. Every person who does not have a special medical education is able to determine such an unpleasant affliction of a baby.

Diagnostics

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

  1. General blood analysis;
  2. Blood test for electrolytes;
  3. MRI or CT;
  4. Measurement of CSF pressure (lumbar puncture);
  5. Laboratory study of cerebrospinal fluid;
  6. Differential diagnosis with systemic lupus erythematosus and sarcoidosis.

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

How to measure intracranial pressure

In specialized clinics, invasive techniques can be used to measure pressure inside the ventricles of the brain using specialized pressure sensors:

  1. 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, you can carry out drainage, enter therapeutic drugs.
  2. Sensors for measuring pressure in the parenchyma (Codman, Camino) are inserted in the frontal or temporal area to a depth of 2 cm.
  3. Sensors can be installed subdurally, epidurally, subarachnoid. The procedure has a low risk of brain trauma. However, the measurement accuracy is lower than that of the parenchymal and intraventricular methods.

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

Treatment of intracranial pressure in adults

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

The diet is based on the consumption of foods rich in vitamins, as well as the minimum amount of salt and fluid. Depending on the severity of the disease, invasive (associated with penetration into the body) methods are used.

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, diuretic drugs (diuretics), for example, Diacarb, are common. The drug inhibits carbonic anhydrase 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 removal of excess fluid through the kidneys, which reduces the pressure of the CSF. Before you start taking the drug, you should familiarize yourself with the opinions of professionals to ensure the safety of the prescribed therapy. Also remember that diuretics do not solve the problem when a tumor, hematoma, aneurysm, and other serious causes become the cause of ICP. Do not self-medicate.

Treatment regimen

To eliminate the cause of increased intracranial pressure, use:

  1. In the event that intracerebral formation led to an increase in ICP - aneurysm, tumor, hematoma, after a corresponding additional examination, the removal of the mass of the lesion is performed using surgical intervention.
  2. In case of excessive secretion of cerebrospinal fluid, hydrocephalus produces shunting operations, 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 medical correction of the level of intracranial pressure, use such groups of drugs:

  1. Loop diuretics (furosemide);
  2. Hormonal drugs (dexamethasone);
  3. Diacarb;
  4. Neuroprotectors (glycine).
  5. Osmodiuretiki (mannitol, glycerol), whose action is aimed at reducing the amount of cerebrospinal fluid.

In addition, appointed:

  1. Ventricular puncture, decompression craniotomy are intended to reduce the volume of CSF in the cranial cavity.
  2. The use of manual therapy, hyperbaric oxygenation, controlled arterial hypotension, hyperventilation.
  3. Diet. Limit the amount of fluid and salt entering the body, which corresponds to the diet number 10, 10a.

We also offer to familiarize you with some recommendations that contribute to improving well-being in case of ICP violations at home:

  1. To exclude visiting baths, saunas.
  2. Recommended swimming in a river or pool - this helps reduce intracranial pressure.
  3. Sleep better on high pillows so that the head was elevated, waking up immediately to get up.
  4. Regularly visit the masseur: shown massage the "neck" zone.
  5. Do not eat fatty foods and enter into the diet more healthy foods, vitamins.
  6. Not recommended large physical exertion, you should not lift heavy.
  7. Drink instead of water herbal teas that have a slight diuretic effect.
  8. Avoid traveling by air.
  9. Try not to allow a sharp change of climate, time zones.
  10. Improves well-being the use of foods containing potassium: potatoes, dried apricots, citrus, green vegetables.

Do not try to cure increased ICP yourself at home, without consulting with a specialist, as with an erroneous diagnosis, the use of drugs will be meaningless, but with the real presence of the disease you will lose time and the disease will go into neglected form.

Watch the video: Cerebral Spinal Fluid Disorders: Frequently Asked Questions (January 2020).

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