Strong intracranial pressure. Increased intracranial pressure: causes and treatment. Intracranial pressure - physiological definition, norm and essence of the concept

The brain tissue is very sensitive to mechanical influences. Therefore, nature has placed the human brain in addition to the bone box (skull) in a protective fluid environment (subarachnoid fluid spaces) and provided it with internal fluid cavities (ventricles). Thus, the brain is actually suspended in a liquid - CSF (other names - cerebrospinal fluid or CSF). Liquor is in the cranial cavity under a certain pressure. It is the pressure of the cerebrospinal fluid on the brain that is called intracranial pressure .

Normal level intracranial pressure very important for human well-being. Increased intracranial pressure is not an independent disease, but a symptom of many neurological diseases.

Causes of increased intracranial pressure

All fluid spaces and ventricles are interconnected by ducts. Liquor constantly circulates. In some parts of the brain, it is secreted, and then flows through the liquor ducts to other parts of the brain, where it is absorbed into the bloodstream. Full renewal of CSF occurs on average 7 times a day.

Excessive accumulation of cerebrospinal fluid causes an increase in its pressure on the substance of the brain. This is called increased intracranial pressure (intracranial hypertension).

Three common causes of chronic increased intracranial pressure:

1. too much liquor is released;
2. CSF is not fully absorbed;
3. the patency of the CSF circulation pathways is impaired.

Increased intracranial pressure and hydrocephalus lead to:

• craniocerebral injury (even a very old one, up to a birth injury, concussion, brain bruises);
• meningitis or encephalitis;
• congenital structural features of the central nervous system(Arnold-Chiari anomaly, idiopathic intracranial hypertension, etc.);
• poisoning (including medication and alcohol);
• circulatory disorders in the vessels of the brain (for example, ischemia, encephalopathy, osteochondrosis cervical spine);
• hypoxia;
• intracranial volumetric processes (tumors of the brain, meninges, hemorrhages in the brain and intracranial hematomas).

Hydrocephalus

If intracranial pressure is increased significantly and for a sufficiently long time, the fluid cavities of the brain can expand - this expansion is called hydrocephalus . Since the cranial cavity is a closed space, the expansion of the fluid cavities of the brain occurs due to a decrease in the mass of the medulla itself. This process can adversely affect health.

MRI scan of a normal brain. The substance of the brain is shown in gray, the cerebrospinal fluid is shown in white. The normal size of the fluid spaces of the brain (they are slit-like). The ventricles are visible inside the brain. Subarachnoid spaces - a white border around the brain.

MRI scans for intracranial hypertension and hydrocephalus. The result of inadequate treatment of increased intracranial pressure. Excessive accumulation of CSF inside the brain (in the form of a butterfly) and outside the brain (wide white border) is visible. The volume of the medulla is reduced - atrophy of the brain from fluid pressure.

Symptoms of increased intracranial pressure

Increased pressure on the substance of the brain can disrupt the functioning of the central nervous system. Hence the characteristic symptoms:

Heaviness in the head or headaches, increasing in the morning or in the second half of the night;
In severe cases, nausea and / or vomiting in the morning is possible;
Vegetative-vascular dystonia (sweating, falling or increasing blood pressure, palpitations, pre-syncope states, etc.) - an almost obligatory symptom;
· Fatigue, "stupefaction", easy exhaustion during work or study loads;
· Nervousness;
· "Bruises" under the gases (if you stretch the skin under the eyes in the "bruise" area, dilated small veins are visible);
Possible decrease in sexual desire, potency;
If the human body is in a horizontal position, the cerebrospinal fluid is released more actively, and absorbed more slowly, so intracranial pressure and its symptoms tend to peak in the second half of the night or in the morning;
Intracranial pressure is the higher, the lower the atmospheric pressure, so the deterioration is associated with a change in the weather.

The diagnosis of intracranial hypertension and hydrocephalus is established by doctors on the basis of characteristic symptoms and based on data from special studies, such as brain tomography.

Diagnostics for suspected increased intracranial pressure (intracranial hypertension), hydrocephalus

Direct measurement of intracranial pressure is possible only by inserting a special needle with a manometer connected to it into the fluid cavities of the skull or spinal canal. That's why direct measurement intracranial pressure due to the invasiveness of the procedure is not applied.

Signs of changes in intracranial pressure in children and adult patients are detected when following procedures examinations:

• neurological examination
• brain MRI
• fundus examination
• performing a lumbar puncture
• x-ray of the bones of the skull
• REG (rheoencephalography)

An increase in intracranial pressure can be said with certainty based on the following data:

Expansion, tortuosity of the fundus veins is an indirect but reliable sign of increased intracranial pressure;
- Expansion of the fluid cavities of the brain and rarefaction of the medulla along the edge of the ventricles of the brain, clearly visible on computed x-ray tomography (CT) or magnetic resonance imaging (MRI);
- Violation of the outflow of venous blood from the cranial cavity, established using ultrasound vascular studies.
- a decrease in the pulse wave on the REG study (on the rheoencephalogram)

How much the brain suffers from an increase in intracranial pressure can be judged by EEG data.

The gold standard for instrumental examination of patients is an assessment of symptoms, brain tomography data and fundus and EEG.

Echoencephalography (Echo-EG) provides indirect and not always reliable data on increased intracranial pressure, it is less reliable than CT and MRI, so this method is rarely used.

intracranial hypertension. Hydrocephalus - treatment

The human brain under the influence of excessive pressure cannot work normally, moreover, there is a slow atrophy of the white medulla, and this leads to a slow decrease in intellectual abilities, disruption of the nervous regulation of work internal organs (hormonal disorders, arterial hypertension and etc.). Therefore, it is necessary to take all measures for the speedy normalization of intracranial pressure.

In the treatment of increased intracranial pressure, it is important to reduce the excretion and increase the absorption of CSF. Traditionally, it is customary to prescribe diuretics for this purpose. However, the constant use of diuretics is not always acceptable for the patient.

Treatment methods are used to normalize intracranial pressure without drugs. These are special gymnastics to reduce intracranial pressure (used by the patient independently), individual drinking regimen and small changes in nutrition, unloading the venous bed of the head using soft manual therapy methods, acupuncture and physiotherapy.

Thus, a steady decrease in intracranial pressure is achieved without the constant use of diuretics, after which the unpleasant symptoms gradually decrease. The effect is usually noticeable already in the first week of treatment.

Increased intracranial pressure can be cured only if the disease that caused this symptom is treated.

Surgical treatment of hydrocephalus

In very severe cases (for example, CSF block after neurosurgical operations or congenital CSF block), surgical treatment is used. For example, a technology has been developed for implanting tubes (shunts) to drain excess CSF.

PS: Dehydration (vomiting, diarrhea, large blood loss), chronic stress, vegetative-vascular dystonia, depression, neurosis, diseases accompanied by impaired blood circulation in the vessels of the brain (for example, ischemia, encephalopathy, cervical osteochondrosis) lead to a decrease in intracranial pressure (hypotension). ).

Probably all of us periodically experience such problems as mild dizziness, slight headaches, blurred vision, etc. Most often, these problems are associated with increased intracranial pressure. Unfortunately, not everyone gives this disease due attention. But, sometimes such symptoms can, in turn, be signs of much more serious problems: hemorrhages, tumors, hematomas, etc.

Frequent increases in ICP should be a signal that it is time to be examined by a neurologist.

An increase in intracranial pressure is an imbalance between the pressures blood vessels and cerebrospinal fluid inside the cranium in favor of the latter. According to statistics, periodically appearing symptoms of such an ailment occur in 30% of the inhabitants of our planet.

How is intracranial pressure measured in an adult?

• One of the most common procedures comprehensive examination to identify this disease is an examination of the fundus. This procedure is carried out in the optometrist's office. A special solution is instilled into the patient's eyes to dilate the pupils. Then, using an electric ophthalmic mirror, the ophthalmologist should identify the symptoms of ICP. These include: dilated tortuous retinal vessels, changes in eye contours, disc color and tissue
• If the oculist reveals the above ailment, then the patient should go to a neurologist. Most often, this specialist prescribes magnetic resonance imaging of the brain to make a diagnosis. A patient wearing a helmet with wires connected to special sensors is placed in a field created by an electromagnet. The procedure lasts 40-45 minutes. If a person suffers from claustrophobia, then he will not be able to withstand such a procedure.
• You can also identify the presence of a problem using duplex scanning of the brachiocephalic arteries. They are responsible for supplying the brain with blood. Using an ultrasound machine, a specialist visually assesses the dimensions of blood vessels, the speed of blood flow and other important indicators.
• Another procedure by which ICP can be detected is rheoencephalography. A weak alternating current is passed through the patient's brain and the resulting changes in resistance are recorded. At the same time, a weak current that affects the brain is not felt or felt.
• But, the most accurate indicator of intracranial pressure can be achieved with the surgical insertion of a needle into the spinal canal. This procedure can only be carried out by a very experienced specialist. Even a small mistake can lead to a patient's disability

Norm of intracranial pressure in adults

The unit of measure for intracranial pressure is the millimeter of mercury. The norm for a child is 1-2 mm Hg. Art. And the norm for adults is 5-7 mm Hg. Art.

Symptoms of increased intracranial pressure in adults

Symptoms of ICP appear gradually.

• It can be pressing, bursting and pulsating
• Usually such pain appears immediately after waking up after sleep.
• Intracranial pressure increases with sneezing, straining, orgasm, and with a long horizontal position. This may cause nausea and "noise" in the head.
• With ICP, it is impossible to relieve a headache with analgesics.

In addition to a headache, a syndrome is very often a companion of such a problem. autonomic dysfunction. It shows up:

• sudden changes in blood pressure and heart rate
• constipation or bouts of diarrhea
• asthma attacks
• increased salivation
• increased sweating
• dizziness
• pain in the region of the heart
• irritability or apathy

In the most critical condition, an increase in intracranial pressure is accompanied by symptoms that can be life-threatening:

• loss of consciousness up to coma
• loss of muscle strength
• severe dizziness preventing normal movement
• severe vomiting
• diction disorder
• dysfunction of the respiratory and cardiovascular systems
• urinary incontinence

Causes of increased intracranial pressure in adults

During the day, this fluid is completely updated 7 times. If more of this fluid accumulates in one part of the brain than is necessary, the problem described above will occur.

This disease has three most common causes:

• secretion of cerebrospinal fluid occurs faster than the body needs
• cerebrospinal fluid is not fully absorbed
• impaired patency of the cerebrospinal fluid circulation pathways

Each of the above causes of increased ICP can manifest itself due to:

• traumatic brain injury
• infectious diseases (meningitis or encephalitis)
• features of the brain structure obtained at birth
• oxygen starvation
• violations of the outflow of blood from the brain
• poisoning

Why is intracranial pressure dangerous in adults?

With such an ailment, the ducts and fluid cavities may increase in size (hydrocephalus). The skull is a closed cavity. With an increase in the ducts of the cerebrospinal fluid, the mass of the medulla decreases. Which can lead to critical consequences for health and normal life.

• If this does not happen very quickly, then the brain may have time to adapt to such changes. But, at the same time, he will “express” his dissatisfaction in the form of pain
• The more often such an ailment manifests itself, the more the sufferer will have a headache. This usually happens in the morning hours. Also, an increase in ICP can lead to rapid fatigue, loss of efficiency, apathy and drowsiness.
• People who have this disease often become susceptible to painful sensitivity to changes in atmospheric pressure, weather changes.
• With increased intracranial pressure, an adult may experience memory loss, visual impairment and general malaise.
• But, do not think that this problem can only cause discomfort, but does not threaten life. A frequent increase in intracranial pressure over time can lead to the fact that the body can no longer cope with such a load.
• The expansion of the channels and cavities of the brain, which occurs with an increase in ICP, can cause compression of the cerebral hemispheres and destruction of vital areas
• The most serious cause of the above problem is the blockage of the cerebrospinal fluid ducts due to the formation of a tumor.

Can raised intracranial pressure be cured?

But, in order to live a long and happy life, you need to carefully listen to your body. If you have symptoms of increased ICP, you should visit a neurologist. With early detection of a problem with this disease, you can cope and normalize your health.

How to treat increased intracranial pressure?

• Treatment of increased ICP begins with finding out the reasons that led to this disease. If it was not possible to find out the cause of such an ailment, then measures are taken to remove excess cerebrospinal fluid from the body
• If the cause of this disease is a tumor, then measures are taken to remove it surgically or chemotherapy. Also surgical intervention may be needed for intracerebral hematoma or aneurysm
• If the cause of increased ICP is an infectious disease, then antibiotic therapy is indicated.

With any of the above factors that led to the described disease, patients need to:

• avoid baths and saunas
• reduce salt and fluid intake
• avoid fried and fatty foods
• do physical therapy
• include diuretic drinks in your diet
• exclude physical activity
• eliminate stress and overexertion as much as possible
• always get enough sleep and deal with stress

People who have symptoms of increased intracranial pressure should stop bad habits. Manual therapy, acupuncture, laser therapy and other procedures can help in the treatment of this disease.

To reduce the amount of cerebrospinal fluid, diuretics are indicated.

also in drug treatment medications such as:

With a sharp exacerbation of the described disease, urgent hospitalization and treatment in a hospital are required.

Worked well to reduce symptoms of high ICP physiotherapy. With its help, you can not only alleviate the course of this ailment, but also reduce the dosage of the medications used in the treatment.

The following exercise helps to reduce ICP. A round cylindrical stick with a diameter of 3-4 cm is taken. It must be brought behind the back. Then lean against the neck and move from the back of the head to the shoulders for 15 minutes. You need to repeat this exercise 3-4 times a day.

In the most difficult cases, surgery may be required to help patients diagnosed with elevated ICP. These may include the following procedures:

• Installation of a shunt for the outflow of cerebrospinal fluid
• Hematoma removal
• Enlargement of the cranium by excision of the bone
• Excretion of cerebrospinal fluid

Each of these types of operations has many limitations and complications. Therefore, they are resorted to in extreme cases.

Decreased intracranial pressure in adults

Low ICP is also a cause of great trouble. Every fifth person in the world suffers from hypotension. An illness that can lead to a heart attack.

The causes of low intracranial pressure are most often problems with blood vessels. Because of which the brain will not receive enough oxygen and nutrients in the proper volume. The reasons for such a violation in the body can be:

• avitaminosis
• chronic fatigue
• intoxication
• infections
• allergic reactions
• bad habits
• depression and stress
• cervical osteochondrosis

Also, low ICP can be the cause of hormonal failure in the body.

Like increased intracranial pressure, hypotension has many symptoms. And the more of them appear at the same time, the more serious the problem. These symptoms include:

• loss of working capacity
• fast fatiguability
• dizziness
• pain in the heart
• heaviness in the stomach
• flashes before the eyes
• fainting

Often, low intracranial pressure is the result of pregnancy or menstruation in women. Adolescents at the time of rapid growth also have this problem.

Treatment of low ICP is developed individually for each case. In this case, the following treatment options can be selected:

• prescribing medications
• herbal medicine and homeopathy
• physiotherapy procedures
• physiotherapy

If the symptoms of low ICP in a person are detected for the first time, then he is prescribed physical exercise aerobic type. Also, a daily regimen is drawn up, which hypotensive patients should follow. It includes:

• healthy sleep (at least 8 hours a day)
• occasional visit to the pool
• daily contrast shower
• gymnastics
• good rest

• acupressure
• sodium chloride baths
• magnetotherapy
• cryotherapy
• reflexology
• iodine-bromine baths
• self-massage of the upper part of the neck
• electrosleep;
• darsonvalization of the neck, head and heart zone
• electroplated collar
• breathing air with a high ozone content

Thanks to these procedures, you can increase blood circulation and increase vascular tone.

If the symptoms of low ICP are not the first time, then the reception is indicated medications based on caffeine and other substances that stimulate blood flow in the body.

As an alternative medicines this problem can be treated with herbal preparations with a tonic effect:

• Chinese lemongrass tincture
• hawthorn tincture
• Lure Tincture
• Eleutherococcus tincture
• Ginseng tincture

But even with the treatment of such means, it is necessary to consult with your doctor.

Folk remedies for intracranial pressure in adults

Folk remedies for the problem described are not a panacea. And you can't expect miracles from them. But, with their help, you can provide the body with good support. Facilities traditional medicine In addition to their effectiveness, they have another important quality. They do not burden the liver and stomach.

• Also, to treat this ailment, you can use a compress of alcohol and camphor oil. To do this, take these components of the compress in equal parts, soak in this mixture soft tissue and apply it on the head before going to bed. To enhance the effect on top, you can wrap your head with cellophane
• Well helps to cope with the described problem tincture of clover inflorescences on vodka. You can do it yourself. Such flowers need to be insisted for two weeks. Then you need to dilute 10 ml of the resulting tincture in a glass of water and drink once a day.
• Another remedy for high intracranial pressure is a decoction of mulberry. To do this, 20 grams of branches of this plant are poured with a liter of water and boiled for half an hour. It is necessary to drink a glass of this decoction before meals.
• A mixture of lemon and garlic before bed (about 30 ml) will also help relieve the symptoms of increased ICP.
• Birch sap is also shown to solve this problem.
• Another proven remedy is a tincture of mint, hawthorn, valerian, eucalyptus and motherwort on vodka. To do this, herbs are mixed in equal proportions. For one tablespoon of this collection, you need 500 ml of vodka. It is necessary to insist such a remedy within 24 hours. To relieve the symptoms of high intracranial pressure, you need to take 20-25 drops of this remedy.

Intracranial pressure: reviews

Kira. I had a violation of the exchange of fluids in the region of the base of the skull. Nothing helped. Until I turned to a well-known osteopath. He examined me and said that he pointed out a slight injury to the cervical region, which could cause such a problem. After several sessions, the injury was removed. Intracranial pressure as if removed by hand.

Sveta. As a teenager, I had terrible headaches due to ICP. Examination showed that the veins are dilated, which leads to a different amount of blood entering and leaving. They gave injections. Very sore. But she survived. After such a course, I almost forgot about the problem.

Video. How to DECREASE intracranial pressure? Mini massage

Many of us do not attach importance to such symptoms as minor headaches, slight dizziness, blurred vision ... But these manifestations of increased intracranial pressure (abbreviated as ICP) may indicate severe structural damage to the substance of the brain tissue, mainly in children (tumor, hemorrhage, hematoma, ). That is why such great attention is paid by neurologists to the problems of intracranial hypertension, or increased ICP.

What is intracranial pressure?

Intracranial pressure is a quantitative indicator that reflects the strength of the effect of cerebrospinal fluid on brain tissue. The normal value of ICP is in the range from 100 to 151 mm of water, which corresponds to 10 - 17 mm Hg.

Methods for determining intracranial pressure

Assessment of the level of intracranial pressure can be made in the following ways:

• the introduction of a catheter into the lumen of the spinal canal or the ventricles of the brain, followed by the attachment of a pressure gauge that works by analogy with a mercury thermometer;
• the use of methods of both computer and magnetic resonance imaging;
• ultrasound examination of the brain (synonym: neurosonography) in children under the age of 1 year;
• echoencephaloscopy;
• examination of the picture of the fundus with the definition of a typical clinic - swelling of the optic nerve head, fuzzy contours, pallor.

Before measuring intracranial pressure, it is important to decide on the research method. In children infancy preference is given to neurosonography and echoencephaloscopy. Patients who have suffered an acute violation of cerebral circulation are prescribed a tomographic examination, an assessment of the state of the fundus by an ophthalmologist.

Causes leading to increased intracranial pressure

Conditions that cause high intracranial pressure include:

• an increase in the brain in volume due to edema, inflammation;
• education a large number cerebrospinal fluid in hydrocephalus;
• the presence of mass formation (tumor, hematoma, foreign body) in the cranial cavity;
• an increase in blood content in the dilated vessels of the brain in case of poisoning and intoxication.

The main diseases accompanied by an increase in ICP:

• disorders of cerebral circulation of various origins (ischemic and hemorrhagic strokes);
• traumatic damage to the brain tissue (concussion and contusion of the brain);
• inflammatory changes in the membranes with meningitis, encephalitis and ventriculitis;
• intoxication with salts of heavy metals, methanol or ethyl alcohol, vapors of toxic gases;
• tumors not only of the substance, but also of the membranes of the brain, sub- and epidural hematomas;
• developmental anomalies (Arnold-Chiari, Dandy-Walker);
• benign intracranial hypertension;
• hydrocephalus.

It should be noted that the symptoms of increased intracranial pressure in infants in 90% of cases are due to birth trauma.

Common symptoms characteristic of intracranial hypertension

In the case of increased intracranial pressure, the symptoms are characterized by diversity and polymorphism. The clinical picture of the disease in children and adults is different. The leading signs that accompany an increase in ICP are:

• headache, which occurs mainly in the morning during awakening, localized both in the frontal, temporal, and occipital regions, which has a pressing or arching character;
• nausea and vomiting;
• drowsiness;
• impaired memory, attention and thinking;
• dizziness;
• rise or fall in blood pressure;
• bradycardia - a rare pulse;
• sweating;
• visual impairment due to edema of the papilla of the optic nerve up to blindness.

Symptoms of intracranial pressure in children

Increased intracranial pressure in children, the symptoms of which may appear in the first minutes and hours after birth, often leads to the development of serious complications. Knowing the key signs of the disease, you can early stages establish the correct diagnosis and prescribe to the child proper treatment(cm. ).
Symptoms that indicate high ICP in children include:

• bulging of large and small fontanelles, as well as their pulsation;
• divergence of the skull bones with an increase in the size of the sutures;
• a change in the child's behavior: drowsiness, lethargy, or, conversely, irritability, tearfulness;
• repeated vomiting ("fountain"), which does not bring relief;
• visual impairment;
• oculomotor disorders in the form of strabismus, limited range of motion eyeballs;
• violation of the level of consciousness, in severe cases, the development of a coma is possible;
• convulsive syndrome;
• increase in the size of the head circumference;
• decrease in strength in the limbs up to complete immobility;
• regurgitation while eating.

There are two options for development clinical picture intracranial hypertension:

• sudden onset of symptoms of the disease with impaired consciousness to the level of deep coma; the probability of death is 92%;
• gradual onset of symptoms.

What is hydrocephalus?

Hydrocephalus is an excessive accumulation of cerebrospinal fluid in the cranial cavity and is accompanied by an increase in intracranial pressure. The following conditions lead to the occurrence of hydrocephalus:

• an increase in the formation of cerebrospinal fluid (fluid that surrounds the brain) with tumors of the vascular plexuses;
• the formation of obstacles in the way of the outflow of cerebrospinal fluid;
• inflammatory process in the brain tissue.

Symptoms of hydrocephalus in children

The leading symptom characteristic of hydrocephalus in a child is a progressive increase in head size before the age of two years. The main symptoms of hydrocephalus in newborns due to increased intracranial pressure include:

• intensive growth of the head by the end of the first month;
• sparse hairline;
• disproportionate large forehead;
• exophthalmos - protrusion of the eyeballs;
• progressive decrease in visual acuity due to developing atrophy of the optic nerves;

Hydrocephalus in children of other age periods is accompanied by neuroendocrine disorders, delayed psychomotor development, head twitches with a frequency of 2-4 times per second.

Symptoms of increased intracranial pressure in adults

With an increase in intracranial pressure, symptoms in adults develop gradually in most cases. A headache comes to the fore, which has the following parameters:

• character - pressing, bursting, compressing, occasionally - pulsating;
• time of occurrence - in the morning after waking up, which is associated with an increase in ICP;
• provoking factors - the horizontal position of the body, coughing, sneezing, straining, overextension of the head;
• accompanying symptoms - nausea and vomiting, noise in the head;
• not relieved by analgesics.

In second place in frequency with an increase in intracranial pressure is the syndrome of autonomic dysfunction, which is accompanied by:

• fluctuations in blood pressure and pulse during the day;
• violation of intestinal motility with the development of constipation or, conversely, diarrhea;
• hypersalivation - increased salivation;
• humidity skin, especially in the palmar and plantar surfaces;
• attacks of suffocation;
• dizziness;
• a feeling of fear, anxiety, irritability, apathy, drowsiness;
• pain in the heart, abdomen.

Much less often, increased intracranial pressure may be accompanied by the development of stroke-like conditions that threaten the patient's life. In such cases, the following symptoms are observed:

• impaired consciousness up to coma;
• severe dizziness and unsteadiness when walking;
• decreased strength in the limbs;
• speech disorder;
• indomitable vomiting;
• violation of the functioning of the pelvic organs in the form of incontinence or retention of urine and feces;
• dysfunction of the cardiovascular and respiratory systems.

What is benign intracranial hypertension?

Benign (idiopathic) intracranial hypertension is one of the most understudied pathological conditions in modern neurology and neurosurgery. This disease is typical for overweight women and children. Numerous studies have failed to determine the cause.

With benign intracranial hypertension, the same symptoms are observed that are characteristic of increased intracranial pressure. It should be noted that with this disease, spontaneous recovery occurs a few months after the first manifestations.

Complications that can be caused by increased intracranial pressure

A life-threatening condition is a sudden increase in intracranial pressure, leading to death (death) in the absence of appropriate treatment. Other complications associated with high ICP include:

• infringement of the cerebellum in the large occipital foramen, which is accompanied by a violation of breathing, a decrease in strength in the limbs, a disorder of consciousness;
• epileptic syndrome;
• decreased vision up to blindness;
• violation of mental functions;
• ischemic or hemorrhagic stroke.

Modern methods of treatment of increased intracranial pressure

Treatment begins after establishing the cause that led to the development of the disease.

Stage one - Elimination of the cause of the disease.

• In the event that an intracerebral formation has led to an increase in intracranial pressure - a tumor, hematoma, aneurysm, after an appropriate additional examination, surgery is performed in urgent order(removal of volume education).
• In the case of excessive secretion of cerebrospinal fluid in hydrocephalus, bypass surgery is performed, the purpose of which is to create an additional outflow path for the cerebrospinal fluid, which leads to a decrease in intracranial pressure.

Stage two - Drug correction of the level of intracranial pressure.
For this purpose, the following groups of drugs are used:

• osmodiuretics (mannitol, glycerol), the action of which is aimed at reducing the amount of cerebrospinal fluid;
• loop diuretics (furosemide);
• hormonal drugs (dexamethasone);
• diacarb;
• neuroprotectors ().

Stage three - Medical manipulations.
Ventricular puncture, decompression craniotomy are designed to reduce the volume of cerebrospinal fluid in the cranial cavity.
Stage four - Diet therapy.
Limit the amount of fluid and salt entering the body, which corresponds to diet No. 10, 10a.
Stage five - The use of manual therapy techniques, hyperbaric oxygen therapy, controlled arterial hypotension, hyperventilation.

Very rarely, during enhanced treatment, reduced intracranial pressure may occur, the symptoms of which are:

• drowsiness;
• weakness;
• headaches, aggravated by head movements;
• dizziness;
• nausea and vomiting.

Treatment of increased intracranial pressure should be comprehensive.

What to do if you have symptoms of increased intracranial pressure?

Below is an algorithm of actions that all patients with symptoms of increased ICP should follow.

• Calm down. It must be remembered that at present there are many methods to normalize the level of intracranial pressure without a threat to life.
• Seek an appointment with a neurologist who will prescribe a list of examinations (CT or MRI, ultrasound, X-ray, examination by an ophthalmologist).
• Strict adherence to all doctor's recommendations (diet, taking medications, if necessary - surgical treatment). Failure to comply with prescriptions can result in death.

5 myths about increased intracranial pressure

• Myth one: in patients with elevated ICP, recovery is observed with age, so there is no need for any treatment.

This is one of the biggest misconceptions. Persistent and prolonged exposure of cerebrospinal fluid to the substance of the brain leads to the development of the above complications.

• Myth two A: Intracranial hypertension is an incurable disease.

Availability a wide range drugs, methods surgical treatment refutes this fact. Elimination of the cause that caused the increase in ICP leads to a complete recovery.

• Myth three: the tendency to increase intracranial pressure is genetically determined and is inherited.

Currently, there are no studies confirming the hereditary theory of the development of the disease.

• Myth four: children suffering from increased intracranial pressure are mentally retarded and have low level I.Q.

Wrong point of view.

• Myth five: You can normalize the level of ICP only by taking medications.

False fact, since in some cases surgical treatment may be required.

Increased intracranial pressure: facts and figures

• The leading cause of increased ICP in children under 1 year of age is hydrocephalus.
• Idiopathic intracranial hypertension occurs with a frequency of 1 to 2 cases per 100,000 population.
• Even 200 years ago, scientists drew attention to the problem of increased intracranial pressure; the issue has not been fully studied so far, research continues.
• In the world there are several dozens of medical associations dealing with issues of intracranial hypertension.
• Every tenth child at the appointment with a pediatric neurologist has high level intracranial pressure.
• The number of people suffering from increased intracranial pressure is approaching 100,000,000.
• According to the data evidence-based medicine, herbal preparations do not have any effect on the level of ICP, respectively, cannot be used for treatment. Similar information is available for homeopathic medicines.
• Patients who managed to normalize the level of ICP should visit a doctor every two years to prevent the development of a relapse of the disease.

Intracranial pressure (ICP) is a value that characterizes the pressure of the cerebrospinal fluid (CSF) in the cranial cavity. Normal pressure is approximately uniform throughout the cranial cavity and varies from 3 to 15 mm Hg. Art. In children, it is different: 1.5-6 mm Hg. Art. in newborns and 3-7 mm Hg. Art. in children after one year.

Intracranial pressure can increase significantly during coughing, sneezing, but these rises are short-lived and do not affect the functioning of the body. A long-term increase in these indicators is a pathology that affects the well-being of a person and the quality of his life. Therefore, it is necessary to start treatment on time, otherwise it can lead to serious complications and even death. To know how to lower intracranial pressure, it is necessary to establish what caused its increase.

Causes of deviations from the norm

When the bones of the skull stop growing and finally fuse with each other, the brain and all the tissues surrounding it occupy a certain volume, limited by the bones of the skull. Simply put, the entire contents of the cranium can be divided into three parts: the medulla itself, the cerebrospinal fluid and the blood in the vessels, both arterial and venous.

In some pathologies, a fourth component may also join them: a tumor or hematoma. Since the bones of the skull cannot be moved apart, a change in the volume of one of the components invariably leads to compression of the others and an increase in pressure.

Increased intracranial pressure can occur for various reasons.

• One of the most common causes are traumatic brain injuries. When hitting the head, blood vessels can be injured, and blood accumulates in the cranial cavity. It puts pressure on the brain, which causes an increase in pressure. Especially dangerous are open injuries in which a fracture of the bones of the skull occurs, the fragments of which can wedged into the brain.
• Inflammatory processes and other causes leading to cerebral edema.
• Some types of poisoning and intoxication, in which the volume of blood in the vessels of the brain greatly increases. Often this leads to poisoning with methanol, ethyl alcohol, salts of heavy metals.
• High intracranial pressure can cause a number of infectious diseases, such as malaria, as well as some forms of hepatitis.
• Ischemic or hemorrhagic stroke - in this case, there is a violation of the blood supply to the brain.
• Inflammation of the membranes of the brain (meningitis, encephalitis).
• Tumors of the brain.
• Thrombosis of cerebral vessels.
• Benign intracranial hypertension.
• Intracranial pressure in children is most often increased due to birth trauma.

Separately, it should be noted that the cause of increased intracranial pressure in young children can be hydrocephalus, in which too much cerebrospinal fluid accumulates in the child's skull. It can occur due to increased formation of cerebrospinal fluid, due to an obstacle in the way of its outflow, or inflammatory processes in brain tissues.

Since the bones of the child's skull have not yet fused and can move apart under pressure, the most bright sign hydrocephalus is a rapid increase in the size of the head during the first two years of a child's life. You can notice this already in the first month after birth. Moreover, the head grows unevenly: the cerebral part of the skull greatly increases, while the facial part remains almost normal. Other symptoms include protrusion of the eyeballs, severe visual impairment, and poor hair growth on the head. Without proper treatment, the child begins to lag behind in development. It is imperative to remove excess fluid from the skull.

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Headache, weakness, fatigue, decreased performance - these signs may indicate, among other things, a change intracranial pressure. It should be understood that it varies depending on the physiological and psychological state of a person, so there is a wide range of normal indicators. It is impossible to measure it at home, so when the first symptoms appear, you should contact for a full diagnosis. The Clinical Institute of the Brain has all the conditions for checking intracranial pressure, and there is also a staff of specialists who will prescribe effective treatment upon detection of pathology. Untimely provision of medical care is dangerous for health, because in conditions of insufficient blood supply to certain parts of the brain, the level of their functioning gradually decreases.

Physiological norm and definition of intracranial pressure

The human skull is a cavity in which the brain is located. To protect it from injury, as well as to maintain its normal operation, there are departments filled with liquid. First of all, the liquid fraction is represented by blood, which is in the vessels. There is also liquor (spinal, or cerebrospinal fluid). It is synthesized in special vascular plexuses and enters the skull through the spinal canal, then is in the ventricles of the brain and is removed through the venous sinuses. This fluid is necessary for the transport of oxygen and nutrients, which are used by brain cells to maintain performance.

Intracranial pressure is a complex value that consists of several factors:

• pressure of the brain (normally, it occupies no more than 85% of the space of the skull);
• blood - up to 8%;
• cerebrospinal fluid - up to 7%.

Blood and cerebrospinal fluid are in constant motion. If the blood circulates through the vascular bed, then the spinal fluid moves through the ventricles of the brain and through the spinal canal. These fractions are continuously synthesized, enter the cranium and move further along the vascular bed. When they are in the skull, they put pressure on the interior of the vessels and ventricles of the brain. For this reason, intracranial pressure is present in every person, and its value can change every minute. An increase or decrease in this indicator may indicate both pathology and normal physiological processes in the human body.

Causes of violation of the pressure norm

In the CIS countries, increased intracranial pressure is a common diagnosis. It is put for various disorders of the central nervous system for adults and children, and a simple set of therapeutic procedures allows you to quickly normalize the condition and maintain it in the future. However, a change in ICP is actually a symptom of a number of dangerous diseases that are not treated at home. When making a diagnosis, it is important to pay attention to the patient's complaints, collect a complete picture and determine whether the pressure inside the skull is pathologically reduced or increased and threatens human health. In most cases, if ICP is really elevated, the patient has a number of additional clinical signs that can be used to identify serious disorders of nervous activity.

Increased intracranial pressure

Increased intracranial pressure - dangerous phenomenon. It accompanies diseases that threaten the life of the patient. These include:

• inflammatory diseases of the membranes of the brain, including infectious origin (meningitis);
• serious poisoning with toxins - while there is an increase in the amount of blood in the vessels of the brain and its stagnation;
• traumatic brain tissue injuries (closed craniocerebral trauma);
• various neoplasms in the cranial cavity;
• hematomas located between the membranes of the brain;
• hydrocephalus - dangerous disease, which is characterized by a violation of the outflow of spinal fluid and its accumulation in the ventricles of the brain;
• severe metabolic disorders (advanced forms of diabetes mellitus).

In children under 10-11 years of age, any signs intracranial hypertension often associated with birth trauma. Indeed, this factor in history can provoke cerebral hypoxia and various neurological disorders. However, it is important to exclude the possibility of developing hydrocephalus - this disease manifests itself in early age and is characterized by a rapid increase in head volume. Since the anatomical norm may differ in children (a large head is not a cause for concern), the diagnosis is made on the basis of frequent measurements of head circumference and analysis of its growth rate. Signs of increased intracranial pressure in adults are a reason to undergo an examination and exclude the possibility of neoplasms in the cranial cavity.

pressure drop

Decreased intracranial pressure - less dangerous state. This indicator decreases in certain situations that can be corrected by a set of procedures or by taking medications. Surgical intervention is not required. Reasons for its decline include:

• the production of spinal fluid in insufficient quantities or the acceleration of its reabsorption into the blood;
• increasing the permeability of the barrier, which ensures the exchange of fluid between the cells of the central nervous system and the bloodstream;
• decreased tone of blood vessels;
• diseases of the spinal column, especially the index of intracranial pressure is affected by the cervical region;
• any conditions that are accompanied by pathological dehydration of the body: poisoning, taking diuretics, allergic reactions, and others.

In some diseases, there is a decrease in the rate of blood circulation through the vessels of the brain. They can also be the result of birth trauma, vascular pathologies, congenital anomalies structures of the brain. With untimely treatment, this condition can also cause dangerous complications.

Signs of pathology

Changes in intracranial pressure affect the general condition of the patient. Often this is preceded by trauma or blows to the head, complications during childbirth, as well as diseases of the meninges. In this case, the patient cannot lead a normal life, and the symptoms of an increase or decrease in ICP are not stopped by taking medications. Such patients are treated in a hospital setting. Overlook pathological changes this indicator in children is also impossible. In addition, in the absence of a reason, the pressure cannot increase or decrease and stop at a critical level for the child - serious reasons are needed for this.

The physiological basis of pain during an increase or decrease in pressure, as well as other signs, is an insufficient supply of blood to the brain and various violations its circulation. If the fluid is retained in the vessels and cerebral ventricles, the tissues are under constant pressure, which can provoke a gradual necrosis (death) of the cells. Hypoxia (insufficient oxygen supply) and nutritional deficiency are also observed - this is the cause of impaired brain activity or loss of reflexes, depending on the location of the damaged area of ​​​​brain tissue.

At elevated pressure

High blood pressure is manifested by a pronounced complex of symptoms that affect all life processes. They can be combined with additional clinical signs characteristic of a particular disease. The symptom complex indicating an increase in ICP includes:

• pain in the head, which are of a pressing character and extend to all areas, often appear immediately after waking up and increase during the day;
• sleep disturbances, insomnia;
• failure of standard headache medications;
• nausea and vomiting, decreased heart rate;
• a sharp decrease in vision, the inability to focus on small objects for a long time, memory impairment and concentration.

With a headache that occurs due to serious pathologies of intracranial pressure, the patient observes bed rest. With physical activity, attacks of dizziness, loss of consciousness, memory lapses may occur. Peripheral vision disorders are also periodically manifested, the appearance of dark spots and "flies" in the field of view - a consequence of the permanent pressure of the liquid on optic nerve. With an exacerbation, the situation worsens, normal reflex responses to stimuli may partially disappear.

In children, behavioral problems and hyperactivity are often associated with increased intracranial pressure. However, these diagnoses may not be related. An increase in ICP in infants is indicated by symptoms such as bulging of the fontanel, a rapid increase in head circumference, and divergence of the bones of the skull. One more alarm symptom- this is too slow overgrowth of the fontanel. If these signs appear in combination with general apathy or excitability, bad dream, the absence of congenital reflexes - this may indicate pathological fluid pressure inside the skull.

Under reduced pressure

Decreased intracranial pressure can also be determined by clinical signs. Symptoms are not as pronounced as with an increase in this indicator, but also affect the patient's well-being and performance. If the pressure inside the skull does not meet the standards, this leads to the following consequences:

• headaches, which are especially aggravated by raising the head;
• frequent mood swings, lethargy, apathy, irritability;
• simultaneous decrease in blood pressure if the syndrome is caused by a general fluid deficiency in the body;
• headaches, dizziness, fainting may occur after minor physical exertion;
• decreased visual acuity, the appearance of dark spots before the eyes;
• nausea, abdominal pain;
• possible pain in the region of the heart, which extend to the chest.

First aid for sharp decline intracranial pressure is to take the correct position. Lying on your back with your head down, the outflow of fluid is difficult, so the pressure is partially restored. This factor may also be of diagnostic value - when lifting the head and in a sitting or standing position, the pain intensifies, and when lying on the back, it decreases slightly.

Diagnostic methods

It is impossible to measure intracranial pressure at home. The only thing the patient can help himself with is to detect the symptoms in time and consult a doctor for a detailed diagnosis. It should be understood that the procedures for measuring ICP are complex, require special equipment and sufficient qualifications of medical personnel. All these conditions are available at the Clinical Institute of the Brain, which specializes in the problems of diagnosing and treating pathologies of nervous activity.

The only way to accurately determine the indicator of intracranial pressure is a puncture of the cerebrospinal fluid. The technique is invasive and is used only in difficult cases. To do this, it is necessary to make a puncture in the lumbar region (into the canal spinal cord) or ventricles of the brain. Liquor, which constantly circulates in these spaces, will begin to flow out, and its pressure can be measured. The value is measured in mm of water column, and its norm is from 60 to 200 mm. These data are indicative if the patient is in the supine position.

There are also additional diagnostic techniques that allow you to assess the state of the brain, its ventricles and vascular bed without invasive intervention. These include:

• Ultrasound of the brain - the procedure is performed only for children who have not experienced a fusion of the fontanel, and in adults it is impossible due to the density of the bones of the skull;
• CT or MRI of the brain - analysis can be done at any age, while the data are quite informative and allow you to get a complete three-dimensional image of any area under study;
• echoencephalography - a type of ultrasound examination, with which you can determine the degree of filling and pulsation of the cerebral arteries.

It is impossible to diagnose increased intracranial pressure only on the basis of the clinical picture. However, all these data must be provided to the doctor during the initial examination. On their basis, the specialists of the Clinical Institute of the Brain will prescribe all the necessary diagnostic steps that will allow you to fully assess the patient's condition.

Treatment and prognosis

Therapeutic measures are prescribed based on the results of the diagnosis. First of all, it is important to get rid of the cause that provokes excessive fluid pressure on the cranium. If this phenomenon is caused by traumatic brain injuries, the patient is shown complete rest, sparing nutrition, and taking anti-inflammatory drugs. In some cases, surgical intervention is necessary (in the presence of hematomas between the membranes of the brain, as well as in the presence of injuries that require surgical treatment). The operation is also prescribed for the detection of various neoplasms in the brain tissues, prone to rapid growth.

A separate set of measures is carried out in the diagnosis of hydrofecalia in a child. To remove excess fluid, a shunt is installed through which it flows into abdominal cavity and the pressure returns to normal. The operation is repeated as the child grows, and the patient is constantly under observation. In some children, the need for artificial removal of fluid gradually disappears.

Drug therapy for ICP pathologies is secondary. However, drugs are prescribed to eliminate symptoms and to make the patient feel better. The following medicines may be helpful:

• hormonal anti-inflammatory drugs;
• neuroprotectors and substances for stimulating blood circulation in the brain - the effectiveness of this group has not been proven, despite its widespread use;
• loop diuretics (diuretics) - drugs that stimulate the excretion of excess fluid;
• osmodiuretics - including reduce the production of cerebrospinal fluid.

The Clinical Brain Institute specializes in the diagnosis and treatment of diseases of the central nervous system. Increased intracranial pressure is not a separate disease, but a symptom that indicates a number of pathologies. Experienced specialists will accurately determine the cause of such a violation, as well as its severity and possible consequences. It should be understood that only timely appeal for medical care can guarantee successful treatment and return to normal life without headaches.