Increased Intracranial Pressure

What Is Increased Intracranial Pressure (ICP)?

Increased intracranial pressure (ICP) is a rise in pressure around your brain. It may be due to an increase in the amount of fluid surrounding your brain. For example, there may be an increased amount of the cerebrospinal fluid that naturally cushions your brain or an increase in blood in the brain due to an injury or a ruptured tumor.

Increased ICP can also mean that your brain tissue itself is swelling, either from injury or from an illness such as meningitis. Increased ICP can be the result of a brain injury. Alternately, it can cause a brain injury.

Increased ICP is a life-threatening condition. A person showing symptoms of increased ICP must get emergency medical help right away.

What Are the Symptoms of Increased ICP?

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The signs of increased ICP include:

  • headache
  • nausea
  • vomiting
  • increased blood pressure
  • decreased mental abilities
  • confusion about time, and then location and people as the pressure worsens
  • double vision
  • pupils that don’t respond to changes in light
  • shallow breathing
  • seizures
  • loss of consciousness
  • coma

These signs could indicate other serious conditions besides increased ICP, such as a stroke, a brain tumor, or a recent head injury.

Signs of Increased ICP in Infants

Increased ICP in infants can be the result of child abuse, especially shaken baby syndrome, a condition in which a small child has been roughly handled to the point of brain injury. If you have reason to suspect that a child is the victim of abuse, you can anonymously call the National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453).

Symptoms of increased ICP in infants include those for adults, as well as some additional signs unique to babies less than 12 months old. Because the bony plates that form the skull are softer in babies than in older children and adults, they may spread apart in an infant with increased ICP. This is called separated sutures of the skull. Increased ICP can also cause the fontanel (the soft spot on the top of a baby’s head) to bulge outward.

What Are the Causes and Risk Factors for Increased ICP?

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A blow to the head is the most common cause of increased ICP. Other possible causes of increased ICP include:

  • infections
  • tumors
  • stroke
  • aneurysm
  • epilepsy
  • seizures
  • hydrocephalus, which is an accumulation of spinal fluid in the brain cavities
  • hypertensive brain injury, which is when uncontrolled high blood pressure leads to bleeding in the brain
  • hypoxemia, which is a deficiency of oxygen in the blood
  • meningitis, which is inflammation of the protective membranes around the brain and spinal cord

How Is Increased ICP Diagnosed?

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Your doctor will need to know some important information about your medical history right away. They will ask if you recently suffered a blow to the head or if you have been diagnosed with a brain tumor. The doctor will then begin a physical exam. They will check your blood pressure and see if your pupils are dilating properly.

They may also measure the pressure of your cerebrospinal fluid using a lumbar puncture, or spinal tap. Images of the brain from a CT or MRI scan may be necessary to confirm the diagnosis.

What Are the Treatments for Increased ICP?

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The most urgent goal of treatment is to reduce the pressure inside your skull. The next goal is to address any underlying conditions.

Effective treatments to reduce pressure include draining the fluid through a shunt, or small hole, in the skull or via the spinal cord. The medications mannitol and hypertonic saline can also lower pressure. They work by removing fluids from your body. Because anxiety can make increased ICP worse by raising your blood pressure, you may receive a sedative as well.

Less common treatments for increased ICP include:

  • removing part of the skull
  • taking medicines to induce coma
  • deliberately chilling the body, or induced hypothermia

Can Increased ICP Be Prevented?

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You can’t prevent increased ICP, but you can prevent head injury. Always wear a helmet when you bike or play contact sports. Wear your seatbelt when driving and keep your seat back as far as possible from the dashboard or the seat in front of you. Always buckle children into a child safety seat.

Falling at home is a common cause of head injury, especially in the elderly. Avoid falls at home by keeping floors dry and uncluttered. If necessary, install handrails.

What Is the Outlook for Someone with Increased ICP?

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Delayed treatment or failure to reduce intracranial pressure can cause temporary brain damage, permanent brain damage, long-term coma, or even death.

The sooner you seek treatment to reduce pressure on your brain, the better the outcome. 

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