Increased Intracranial Pressure
What is increased intracranial pressure?
Increased intracranial pressure refers to a serious condition in which there is an increase in fluid pressure inside the skull, whether blood or cerebrospinal fluid. Cerebrospinal fluid is produced in cavities located deep within the brain known as ventricles. This fluid fills the ventricles and flows into the spinal cord and out into the subarachnoid space where it absorbed. The subarachnoid space is a space between the layers of the membrane that cover the brain and spinal cord.
Normally, cerebrospinal fluid is absorbed as quickly as it is made, so that the amount stays relatively constant. Increased intracranial pressure occurs when something blocks the flow or absorption of the fluid, or if an excess amount of fluid is produced. As the pressure of the fluid increases, the ventricles enlarge and the brain is pressed against the skull, damaging the brain tissue.
Increased intracranial pressure usually generates severe headache, but feeling like you have head pressure or a headache does not necessarily mean that you have increased intracranial pressure. Most headaches are not caused by increased intracranial pressure, although a severe headache is one of the symptoms of the condition.
Causes of increased intracranial pressure include serious diseases and conditions, such as hydrocephalus, which is an increase in the volume of cerebrospinal fluid that surrounds the brain and spinal cord. Increased intracranial pressure can also be due to diseases or conditions that create abnormally high pressure within the skill, such as a brain tumor or swelling of brain tissue due to encephalitis, an inflammation of the brain often caused by a viral infection. Increased intracranial pressure can also be caused by bleeding into or on the brain due to such conditions as a serious head injury or hemorrhagic stroke.
Symptoms of increased intracranial pressure may include lethargy, vomiting, seizures, vision changes, and behavior changes. The headache that may occur with increased intracranial pressure is often described as the “worst headache of my life.” Increased intracranial pressure and its underlying cause are diagnosed by performing a complete neurological assessment and certain testing procedures, such as a spinal tap, CAT scan (also known as a CT scan or CT), or MRI.
Seek immediate medical care (call 911) if you, or someone you are with, experience a head injury or have an unexplained or sudden severe headache, paralysis, difficulty speaking, difficulty moving any part of the body, seizure, change in vision, or change in level of alertness, such as passing out.
In addition, seek immediate medical care (call 911) for a head injury in an infant or toddler or for such symptoms as vomiting coupled with drowsiness or lethargy, or bulging of the soft spot on top of the head (fontanel).
What other symptoms might occur with increased intracranial pressure?
Feeling like you have head pressure or having a headache does not necessarily mean that you have increased intracranial pressure, which is caused by a serious condition, such as a hemorrhagic stroke or brain tumor. Although headache is one possible symptom of increased intracranial pressure, the majority of headaches are not caused by increased intracranial pressure.
Serious symptoms that might indicate a life-threatening condition
Seek immediate medical care (call 911) if you, or someone you are with, have had a head injury or have any of these symptoms of increased intracranial pressure:
Abnormal pupil size or nonreactivity to light
Bleeding from the ear after head injury
Bruising and swelling around the eyes
Change in consciousness, lethargy, or passing out
Confusion or disorientation
Double vision or other visual symptoms
Seizure or convulsion
Sudden changes or problems with vision
Worst headache of your life
Symptoms that might indicate a serious or life-threatening condition in infants or toddlers include:
Abnormal pupil size or nonreactivity to light
Bulging of the soft spot on top of the head (fontanel)
Drowsiness or lethargy
Not feeding or responding normally
What causes increased intracranial pressure?
Increased intracranial pressure is a serious condition in which there is higher than normal pressure inside the skull. Causes include:
Brain aneurysm rupture (weak area in a brain blood vessel that can rupture and bleed)
Brain tumor causing pressure within the head
Encephalitis (inflammation of the brain commonly due to a viral infection)
Hydrocephalus (high levels of fluid in the brain or “water on the brain”)
Intracranial hypertension (abnormally high pressure of the cerebrospinal fluid in the skull)
Questions for diagnosing the cause of increased intracranial pressure
To diagnose and best treat your condition, your doctor or licensed health care provider may ask you several questions related to your condition including:
Have you experienced any recent head injury or trauma?
Do you have a headache or any pain or discomfort?
In what part of the head do you feel pain or discomfort?
What other symptoms do you have?
The potential complications of increased intracranial pressure and its underlying causes are serious and possibly life threatening. Once the underlying cause of increased intracranial pressure is diagnosed, it is important for you to follow the treatment plan you and your health care professional design specifically for you to reduce the risk of potential complications including:
Adverse effects of treatments that lower cerebrospinal fluid pressure
Disability and poor quality of life
Permanent brain damage, including intellectual and cognitive deficits and difficulties moving and speaking