Is intracranial pressure treated in adults. Diagnosis of intracranial pressure. Decreased intracranial pressure

People quite often do not pay attention to headaches. In a sense, this is facilitated by modern medicines that allow you to drown out the discomfort.

But everyone should understand that its appearance is a signal from the body, saying that not everything is in order with you. Quite often in such patients, the main cause of discomfort is increased intracranial pressure. Symptoms in adults, treatment methods - read about all this in our review.

What is intracranial pressure

Liquor is a cerebrospinal fluid, the excess of which can put pressure on the human brain. It is formed in clusters of small vessels, which are called "sacs" of the human brain.

And it is the pressure of this fluid that has come to be called intracranial. If there is little cerebrospinal fluid, then the pressure will inevitably decrease, but if there is too much of it, then this is exactly the case when doctors diagnose increased intracranial pressure. Symptoms in adults are extremely unpleasant. And yes, it is a dangerous disease.

A healthy person is distinguished by a stable level of fluid in the body, without obvious predominance in one direction or another.

Increased intracranial pressure: symptoms in adults

In addition to the actual high blood pressure, this problem has a number of accompanying symptoms. How does increased in adults manifest the following:

• headache markedly worse in the evening and at night;
• constant feeling of nausea, but no vomiting;
• a person feels weak and lethargic, he becomes irritable much faster;
• the pupil of the eye does not react to light, and the patient himself has “flies” flashing in his eyes;
• one side of the body abruptly loses muscle strength, which strongly resembles paralysis.

Headache with intracranial pressure often becomes more pronounced with sneezing and coughing. The same is to be expected from slopes.

In such cases, if the pain zone turns out to be indefinite, one can expect an increase in pain not in the evening, but in the morning.

Pressure has a significant effect on the optic nerve. The consequences of this can be temporary blindness, fog before the eyes and other manifestations that prevent a person from leading a full-fledged lifestyle.

Even mentally stable people experience discomfort during bouts of high blood pressure. They may experience nervous breakdowns, long periods of depression. The person becomes lethargic, leads a passive lifestyle and is quickly irritated.

Frequent back pain can also be one of the manifestations of the disease.

How to be treated

If you have increased intracranial pressure, treatment should not be shelved. You need to urgently seek help from a specialist. Methods of therapy are quite strongly dependent on the reasons for the appearance of such high pressure. Much also depends on the age of the patient who consulted a doctor.

The main methods of treatment are taking drugs that affect the blood vessels, as well as sedatives and diuretics.

In addition, manual therapy and gymnastics are prescribed.

The patient is put on a specific diet, the essence of which is the use of foods rich in vitamins. It is necessary to avoid taking large amounts of liquid and salt.

In especially severe cases, drainage and the introduction of shunts are indicated - this is necessary to reduce the amount of cerebrospinal fluid.

How to reduce intracranial pressure yourself

If the disease caught you at the wrong time, then you can always deal with it at home. You should not count on a complete cure, but it is quite possible to relieve most of the symptoms. So,

An important role in self-treatment is played by diuretics, such as tincture of hawthorn, rosehip, lavender, etc. They provoke a decrease in intracranial pressure.

It is worth noting that before taking herbal tinctures, it is imperative to consult with your doctor.

Another quite effective massage of two points on the back of the head. To use it, you need to grab your head with your hands so that your thumbs are exactly on the back of your head. After that, it is necessary to make circular movements for several minutes.

Tablets from intracranial pressure

Of course, drug therapy is also used in the treatment of intracranial pressure. It is necessary to pay attention to the fact that drug treatment must necessarily take place under the supervision of a physician. Otherwise, negative and even fatal consequences should be expected.

The usual practice in such cases is the appointment of diuretic drugs like Furosemide or Veroshpiron. If the condition has negatively affected the patient's optic nerve, then he is prescribed corticosteroid tablets for intracranial pressure, such as Prednisolone or Dexamethasone.

Alternative treatment

Is it possible to treat alternative intracranial pressure? Alternative medicine is quite effective, but its main disadvantage is that it only weakens the symptoms that have manifested. In fact, it is almost impossible to cure intracranial pressure with the help of folk remedies. They should be used in cases where it is not possible to get an appointment with the attending physician.

The main weapon against all ailments is herbal infusions and decoctions. Valerian, sage and St. John's wort are mainly used.

Having selected medicinal herbs, they should be poured with boiling water. You need to make sure that the herbs were taken no more than one tablespoon. You need to drink the infusion for one month, drinking a quarter cup three times a day. After a course of herbs, you should take a break from them for a significant period of time.

There are other options. Alcohol tincture is a very popular remedy among the people. It is necessary to take dry clover flowers as a basis, fill them with exactly half of the jar, and fill to the very top with alcohol or vodka. After that, the tincture should be placed in a dark and cool place for two weeks.

When it is ready, it can be taken twice a day, one teaspoon, previously diluted with water.

And finally, tincture of garlic is good for headaches. To make it, you need to take three lemons and pass them through a meat grinder along with the skin. Add three chopped cloves of garlic to the resulting mixture.

After that, the drug should be allowed to settle, and only then you can start taking the medicine in small doses and several times a day.

Intracranial pressure. Which doctor should I contact?

What kind of doctor treats this unpleasant and potentially dangerous disease? First you have to go to a therapist to cut off all possible options. After that, they should issue a referral to a neurologist, but he already knows perfectly well what to do with the disease.

You should not expect that the doctor will be able to cure intracranial pressure instantly. To begin with, you will need to undergo many examinations, including an MRI and an encephalogram. After making sure that you do not have other brain pathologies, the doctor will be able to proceed with standard treatment procedures.

The need for an examination by a therapist is high, since he needs to cut off many other possible diseases. This is very important, because the sooner you can start the right treatment, the easier it will be to defeat the disease.

Medicines for increased intracranial pressure

Some of the drugs fight the manifestations of intracranial pressure, while the rest are aimed at the root cause of the disease.

Medicines for increased intracranial pressure in adults are primarily diuretics. Their main purpose is to help the body get rid of excess fluid. The smaller it is, the faster the pressure will drop.

For example, the drug "Gricerol" effectively copes with this task.

In addition, drugs that expand the human vascular system are actively used. For example, one of the most widely used options is magnesia. It also has an antiarrhythmic effect.

Among some doctors, it is common practice to treat internal cranial pressure according to a certain scheme, which includes nootropics and pills that help stabilize the blood circulation process in the brain.

The most frequent choice of doctors is Nootropil, Pirocetam and Phenotropil. Their main goal is to normalize the patient's thought process and at the same time help him cope with intellectual stress.

"Sermion" and "Cavinton" are already drugs that affect blood circulation. It is worth recalling once again that only a doctor is able to choose the right pills and determine the dosage. Self-treatment in such a delicate field of medicine can lead to such consequences that none of the doctors can reverse.

When to See a Doctor

It is not the slightest difficulty to measure normal pressure, but when it comes to intracranial pressure, here many fall into a stupor. And there is something from.

The most effective way to find out if there is a problem is a puncture. The doctor takes a needle connected to a pressure gauge and then inserts it into the spinal canal. All this requires careful preparation of the patient, which is available only in a hospital setting.

These are not all options. More expensive - MRI. It costs decent money, but it is no less accurate, and there is no need to insert any needles and other things that can scare the patient. And yet, most often, doctors manage with electroencephalography. With its help, it is possible to detect changes in the picture of brain activity, which is also evidence of an increased level of pressure in the brain.

If you once found yourself with an unreasonable headache and nausea, do not delay, consult a doctor. It may be possible to prevent the disease before it passes into more serious phases.

Causes of the disease

Intracranial pressure, the symptoms and treatment of which we examined, can be triggered by many factors, but most often this condition is observed in cases of congenital pathologies and with a variety of inflammations, for example, with meningitis and encephalitis.

At risk are people who are overweight. Such a useful vitamin A at the same time is a substance that can significantly increase your pressure, but this is possible only with an excess of retinol in the body.

Intoxication is another reason for the onset of the disease. Exposure to toxic substances adversely affects the normal functioning of the brain. As a result, serious organic damage can be obtained.

Intracranial pressure in children

Children, no less than adults, are at risk of getting this unpleasant disease, which in the end can have the most negative impact on their level of development and further success in life. Apathy, drowsiness, excessive sensitivity, in some cases even strabismus. All this does not contribute to the learning process, prevents the child from being active and inquisitive.

The consequences of intracranial pressure for a child

The child is at risk of depression, he inevitably lags behind in his studies, does not want to go out with his peers, avoids new acquaintances and even locks himself in his room, because he does not want to participate in any of the classes.

Increased intracranial pressure (symptoms and treatment of the disease depend on the presence of concomitant diseases) can be detected even in infants. Because of him, children learn late to hold their heads, walk and even talk. Therefore, a scheduled examination by specialists, including a neurologist, is not recommended to be skipped and ignored.

To prevent such a disaster from happening to your child, you should carefully listen to their complaints (of course, we are talking about older children, not babies) and, if necessary, take them to the doctor in a timely manner.

Symptoms of intracranial pressure in children

In children, the disease manifests itself in its own way, but there are common symptoms. Anxiety and fatigue, severe headache, nausea and vomiting, strabismus - all this is what you should pay attention to during the period of growth of the child.

In absolutely crumbs, the shape of the head can be deformed and the volume of the head can increase, too frequent regurgitation is observed, and this does not even depend on meals. The child as a whole behaves more restlessly than all other children. And finally, a monotonous cry is another evidence that a small organism suffers from increased intracranial pressure.

The name of the pathology "intracranial pressure", sometimes abbreviated as ICP, speaks for itself. But let's take a closer look at where exactly it increases, what are the symptoms and signs, when a person has increased intracranial pressure, and how is it treated?

Intracranial is called an increase in pressure in the cranium, in particular, when the meninges and its sinuses, subarachnoid and epidural spaces, and some other departments are exposed to it. This phenomenon is caused by cerebrospinal fluid, called "liquor", accumulates or, conversely, its deficiency is formed. As a result of violation of its circulation, fluctuations in intracranial pressure are formed.

In adults people on average during the day formed approximately liter of liquor, which causes no change in pressure. This is due to the continuous absorption of CSF by the venous vessels of the brain. With various deviations, normal absorption does not occur, as a result, the remaining cerebrospinal fluid is excessive for the cavity in which it has accumulated, which leads to an increase in the indicator. The result is increased intracranial pressure. Summing up this part, we can conclude that the degree of intracranial pressure depends on the volume of cerebrospinal fluid, how well it circulates and the correct functioning of its absorption function.

The force with which the CSF presses on the walls of the ventricle can change. For example, like changes in blood pressure (BP), intracranial increases and decreases under the influence of various causes. This is a normal situation in adults up to a certain limit, after which it is fixed sustained excess indicator of ICP, which already refers to pathology.

Where does increased intracranial pressure come from?

Excessive production of cerebrospinal fluid or insufficiency of its consumption does not appear out of nowhere. Among the causes of the disease, the following diseases and disorders of the brain can be distinguished:

• The presence of a bulky brain tumor, which may be malignant or benign
• Inflammatory process of an infectious nature, for example, during meningitis
• Thrombophlebitis in the sinuses, leading to a violation of their lumen and patency
• Consequences of skull injuries, due to which large hematomas appear
• Late pregnancy for women, when toxicosis leads to exorbitant jumps in blood pressure for short periods of time
• Postponed ischemic stroke
• Children and adults may have increased intracranial pressure due to a congenital disorder in the circulation of cerebrospinal fluid, called hydrocephalus, which can manifest from birth. One of its causes is the infectious diseases carried by the pregnant woman.

Often, an increase in ICP occurs after injury leading to rupture of the aneurysm. In addition, pathologies associated with physical changes in the head, for example, due to tumors, serious brain diseases, and even poisoning, can be the cause. In any of the situations described, a different treatment is required, the disease should not be left to chance.

Symptoms when adults have increased intracranial pressure?

The usual indicator is the pressure in the cranium up to 15 millimeters of mercury. This is highly elevated around 30, in such a situation, a person usually faints. With further progression, even brain death is possible. Obviously, the pathology requires an immediate response in both adults and children in order to treat and remove the danger. To do this, you need to know the symptoms and signs of increased intracranial pressure.

The symptoms of this disease are:

• Frequent pain in the head, especially in the morning
• Unreasonable urge to vomit
• Increased sweating
• Increased heart rate at rest
• Problems with the eyes of various kinds, they can double, flicker
• The presence of bruises and small bruises in the eye area
• Man gets tired quickly
• Decreased joint mobility
• Weak potency and libido

If the symptoms described above arose due to a head injury and at the same time there is instability of consciousness, drowsiness, fainting, then it is likely that the brain is damaged. In this situation, you must definitely see a doctor in order to analyze the signs of the disease, diagnose and prescribe treatment.

It must be remembered that increased intracranial pressure serious illness, it can lead to death. In addition, as a result of the regularity of the negative impact, a decrease in intellectual abilities, failures in the control of the nervous system and internal organs can occur. The result can be various disorders and additional diseases.

Symptoms of increased ICP in children

The manifestation of the first signs in a child is often associated with a disease such as hydrocephalus, or dropsy of the brain. It manifests itself in infants almost from birth and occurs due to excessive accumulation of cerebrospinal fluid in the ventricles due to difficulty moving from the place of its secretion.

Due to underdevelopment and weakness skull in children, their head is usually enlarged. In addition, the following symptoms are present:

• The fontanel is strongly pronounced and protrudes
• Compared to peers, the child is more retarded
• Constant concern
• Low body weight for her age, frequent vomiting
• The child is lethargic and sleepy
• Graefe's sign is present. This is a situation where children's eyes look down instead of looking straight ahead.

Signs and symptoms that the infant has increased intracranial pressure are well visually identifiable, which facilitates the diagnosis and speeds up the transition to treatment.

Diagnostics

In order to prescribe treatment, it is important to conduct a diagnosis in order to determine the causes and degree of increased intracranial pressure. Typically, diagnosis includes a series of examinations and laboratory tests. For an accurate diagnosis, you need to have results:

• Complete blood count
• The indicator of electrolytes in the blood
• Computed or magnetic resonance imaging
• Measurements of pressure exerted by the cerebrospinal fluid (determined by puncture in the lumbar region)
• Various laboratory analyzes of cerebrospinal fluid
• Differentiated diagnosis from other diseases with similar symptoms

Treatment is prescribed by considering the overall clinical picture and the results of the above examinations.

Measurement of intracranial pressure

Specialized methods involve invasive measurement index in the ventricles of the brain. Based on the signs of the disease, it does this with special sensors, for example:

• A hydraulic venticular system is used when a catheter with a probe is inserted into the ventricular cavity. The procedure also involves the introduction of medicinal drugs.
• With the help of a sensor that measures the pressure in the parenchyma, which is inserted in the temple or forehead.
• Measurement devices can be installed subdural, epidural, or subarachnoid, which reduces the risk of brain injury during measurement, but the accuracy is lower.

The most often indicative ICP is measured indirectly, for this, a lumbar puncture is taken at the level of the lower back.

Treatment of intracranial pressure in adults

If the diagnosis confirmed the desired pathology, then the treatment tactics will depend on what was the reason for the increase. In addition, for adults, the age factor matters. In general, therapy includes the use of diuretics, sedatives, vascular drugs. In addition, manual therapy, diet therapy, as well as special gymnastic complexes are often prescribed.

Some treatment is aimed only at relieving the symptoms of the disease to make you feel better. In others, the underlying cause is treated.

Symptomatic therapy is carried out with the help of diuretics. These drugs have a pronounced diuretic effect, due to which the inhibition of carbonic anhydrase of the brain occurs, leading to a decrease in the production of cerebrospinal fluid. It is produced in a smaller volume, and, accordingly, increased intracranial pressure is excluded.

Such therapy consists in eliminating excess fluid in the body with the help of greater activation of the kidneys. However, it must be remembered that taking diuretic drugs can have dangerous consequences, they have a wide range of side effects, so their self-administration is not allowed. In addition, diuretic treatment is only suitable if the excess CSF is not caused by a tumor, hematoma or aneurysm.

Treatment tactics

Increased intracranial pressure in adults and children is caused by various reasons. To eliminate them, apply:

• If the increase in the indicator is caused by the existence of an intracerebral pathological formation, for example, aneurysms, tumors, hematomas, then a surgical operation is performed to remove it.
• If the reason lies in the increased activity in the production of cerebrospinal fluid, then a surgical intervention is performed, the task of which is to bypass and create a complementary path through which the cerebrospinal fluid will flow.

Thus, a decrease in ICP by surgical methods is ensured.

If the treatment is prescribed with medications, then it is usually used:

• Loop diuretics
• Hormonal means
• diakarbom
• Neuroprotectors
• Osmodiuretics

In addition, it can often find application:

• Taking a ventricular puncture and a decompression craniotomy procedure that removes excess fluid from the skull
• Manual therapy, controlled arterial hypotension and others
• Special diet leading to fluid and salt restriction

Preventive measures and what to do if there is an increase in ICP?

Below we list a number of simple tips on how to improve your well-being if an exacerbation occurs and how to prevent this if the patient is at risk:

• Do not visit the bath and sauna
• Go swimming
• Use a high pillow while sleeping at night. After waking up, do not lie down for a long time.
• Systematically conduct a professional massage of the "collar" area
• Refuse fatty foods, eat more fruits and vegetables, avoid a lack of various vitamins
• Limit maximum physical activity
• When consuming liquids, the choice is to make in favor of herbal tea, which has a mild diuretic effect.
• Avoid sudden changes in ambient pressure, such as when taking off and landing in an airplane
• Eliminate sudden changes in the surrounding climate
• Try to eat more foods rich in potassium. Examples of these are ordinary potatoes, dried apricots, citrus fruits, green vegetables.

It is important to know that self-treatment in both adults and children (infants) of high intracranial pressure will at least not give a significant result. However, it can do a lot of damage. As soon as the first signs appear, for effective therapy, you need to see a doctor who will ask about the symptoms, send you for the necessary diagnostics, and only after that will prescribe adequate therapeutic measures.

Content:

Intracranial pressure is the pressure inside the human skull. For example, in the ventricles of the brain, sinuses of the dura mater, subarachnoid and epidural space. At the time of intracranial pressure in any of the above parts of the skull, an accumulation or lack of cerebrospinal fluid (CSF) occurs, which is provoked by a violation of its circulation. This liquid is always under a certain pressure and is systematically updated, due to circulation from one area to another. As a rule, the update process lasts a week, but sometimes there are violations. If the cerebrospinal fluid accumulates in one place, then the intracranial pressure rises, the cerebrospinal fluid decreases - the pressure decreases.

Causes and symptoms of increased intracranial pressure

An increase in intracranial pressure is an accumulation of excess cerebrospinal fluid, which gradually puts pressure on the brain. This disease is not “independent”, but a symptom of other ailments, such as:

• Meningitis and encephalitis;
• congenital anomalies;
• Bruises, injuries, concussions (even past prescription or with congenital trauma);
• Poisoning (drug and alcohol);
• hypoxia;
• Hematomas and intracranial hemorrhages;
• Intracranial processes (tumors of the brain or its membrane);
• In the vessels of the brain, blood supply is disturbed.

1. increased sweating;
2. Nausea and vomiting;
3. Headaches, especially severe in the morning;
4. "Bruises" under the eyes (pulling the skin, you can see small bruises);
5. Cardiopalmus;
6. Blurred vision, throbbing pain, double vision.

Please note that during weather changes and atmospheric pressure, manifestations of these symptoms are possible.

Causes and symptoms of low intracranial pressure

Symptoms of this phenomenon:

• Irritability;
• Drowsiness;
• Nausea and vomiting;
• Headaches, especially worse when sitting.

Signs and symptoms of intracranial pressure in children

It is recommended to measure the circumference of the child's head every month. A disproportionate or large head, its rapid growth, a bulging forehead are the first symptoms of increased intracranial pressure. The restless behavior of the baby also speaks of this ailment: a sick child often “on the same note” monotonously and monotonously screams for several hours in a row. If the correct diagnosis is not made in time, then the child will significantly lag behind his peers in development (later to hold his head, crawl, sit).

In older children, increased intracranial pressure will cause severe headaches, convulsions, fatigue, strabismus, nausea, and vomiting. The child may complain of double vision, eye pain, and bright flashes before the eyes. Also noted in children is irritability, refusal to play, tearfulness, apathy, drowsiness, etc.

Diagnosis of intracranial pressure

Guided only by the symptoms, as well as when examined by a neurologist, it is impossible to understand whether there is intracranial pressure. For a correct diagnosis, diagnostic procedures must be performed. Modern medicine determines intracranial pressure by indirect and direct methods.

Direct method for diagnosing intracranial pressure

Indirect method for diagnosing intracranial pressure

1. Visit to an ophthalmologist. With intracranial pressure, the outflow of blood from the eyes is disturbed, as a result of which edema of the optic disc is formed and the retinal veins expand.
2. Ultrasound of the brain, which determines the width of the ventricles of the brain. Most often, this procedure is carried out for children who still have an open fontanel.
3. CT (computed tomography) and MRI (magnetic resonance imaging). If necessary, a contrast agent is injected into the bloodstream before the procedure. These manipulations will detect changes that increase intracranial pressure - an enlarged ventricle of the brain, thinning of brain tissue, etc.
4. EEG (electroencephalography) measures the functioning of the brain. In case of detection of violations of the performance of the brain, we can talk about increased intracranial pressure.

Treatment of intracranial pressure

• Choose the dose and mode of fluid intake;
• Take diuretics;
• Drink teas and herbs that have a diuretic effect;
• Perform therapeutic exercises that help normalize blood pressure, but without heavy physical exertion;
• Adhere to a diet with limited salt and fatty foods;
• Avoid saunas and baths;
• Sleep on high pillows;
• Go in for swimming, which helps to reduce ICP;
• Systematically massage the "collar" zone;
• Avoid flying in air transport;
• Eat foods containing potassium - green vegetables, citrus fruits, dried apricots, potatoes;
• Do not abruptly change the climate and time zones.

Watch a video about the types of intracranial pressure:

), intracerebral fluid and the volume of blood circulating through the cerebral vessels.

Currently, in everyday life, the term "intracranial pressure" means an increase or decrease pressure in the cranium, accompanied by a number of unpleasant symptoms and a deterioration in the quality of life.

Due to the widespread use of various visual diagnostic methods (ultrasound, tomography, etc.), the diagnosis of "increased intracranial pressure" is made very often, although in most cases this is unreasonable. After all, an increase or decrease in intracranial pressure is not an independent separate disease (with the exception of a very rare idiopathic intracranial hypertension), but a syndrome that accompanies various pathologies that can change the volume of the structures of the cranium. Therefore, it is simply impossible to consider "intracranial pressure" as a disease on its own and treat it exclusively.

It is necessary to know that intracranial pressure can rise or fall to critical values ​​at which clinical symptoms develop, in a limited number of cases and only in the presence of other very serious diseases that are a causal factor in such changes. Therefore, we will consider the essence of the concept of "intracranial pressure" both as a diagnosis available in domestic medical practice and as a pathophysiological term denoting a strictly defined syndrome.

Intracranial pressure - physiological definition, norm and essence of the concept

Normal intracranial pressure at rest in people of different ages varies within the following limits:

• Adolescents over 15 years old and adults - 3 - 15 mm Hg. st;
• Children aged 1 - 15 years - 3 - 7 mm Hg. Art.;
• Newborns and infants up to one year old - 1.5 - 6 mm Hg. Art.

In the presence of chronic long-term diseases that cause an increase in intracranial pressure(for example, brain tumors, etc.), its values ​​​​can reach 70 mm Hg. Art. But if the pathology develops slowly, then intracranial pressure rises gradually, and the person tolerates this condition quite normally, without making any complaints for a long time. This is due to the inclusion of compensatory mechanisms that ensure normal health and the functioning of the central nervous system. Symptoms of increased intracranial pressure in such cases begin to appear only when the compensation mechanisms cease to cope with the ever-increasing intracranial pressure.

The measurement and principle of formation of intracranial pressure are quite different from those for arterial blood pressure. The fact is that each structure present in the cranium (brain, fluid and blood) occupies a certain volume of the cranial cavity, which is determined by its size and therefore cannot be changed. Due to the fact that the volume of the cranial cavity cannot be changed (increased or reduced), the ratio of the sizes of each of the three structures of the cranium is constant. Moreover, a change in the volume of any structure is necessarily reflected in the other two, since they must still fit in the limited and unchanged space of the cranial cavity. For example, if the volume of the brain changes, then there is a compensatory change in the amount of blood and cerebral fluid, since they need to fit in the limited space of the cranial cavity. This mechanism of redistribution of volumes within the cranial cavity is called the Monro-Kelly concept.

Thus, if there is an increase in the volume of one of the structures of the cranial cavity, then the other two must decrease, since their total total volume must remain unchanged. Among the three structures of the cranial cavity, the brain itself has the least ability to compress and reduce the occupied volume. That is why the cerebral fluid (CSF) and blood are structures that have sufficient buffer properties to ensure the maintenance of a constant and unchanged total volume of tissues in the cranial cavity. This means that when the volume of the brain changes (for example, when a hematoma or other pathological processes appear), the blood and cerebrospinal fluid must "shrink" to fit in the limited space of the cranium. However, if a person develops any disease or condition in which the amount of cerebrospinal fluid or blood circulating through the vessels of the brain increases, then the brain tissues cannot “shrink” so that everything fits in the cranial cavity, as a result of which there is an increase in intracranial pressure.

The problem of measuring intracranial pressure is very difficult, since there are a very small number of indirect parameters, the values ​​of which can be used to judge the pressure in the cranium with any certainty. Currently, according to the Monroe-Kelly concept, it is believed that there is a relationship and interdependence between the value of intracranial pressure and mean arterial pressure, as well as cerebral perfusion pressure, which reflects the intensity and speed of cerebral blood flow. This means that the value of intracranial pressure can be indirectly judged by the value of cerebral perfusion pressure and mean arterial pressure.

Determining the diagnosis of "intracranial pressure"

So, increased or decreased intracranial pressure (ICP) is not an independent disease, but is only a syndrome that accompanies some different pathologies. That is, intracranial pressure always appears as a result of some disease and therefore is not an independent pathology. In fact, ICP is a sign of an independent disease that provoked an increase in pressure in the cranial cavity.

In principle, any organic lesions of the brain (tumors, hematomas, injuries, etc.) and disorders of cerebral circulation sooner or later lead to an increase or decrease in intracranial pressure, that is, to the development of the syndrome in question. Since intracranial pressure is a syndrome that accompanies various pathologies, it can develop in a person of any age and gender.

Given the fact that intracranial pressure is a syndrome, it should be treated only in combination with the treatment of the underlying disease that caused the pressure change in the cranial cavity. Self-isolated treatment of exclusively intracranial pressure is not only useless, but also harmful, since it masks the symptoms and allows the underlying disease to progress, develop and damage brain structures.

Unfortunately, at present, in practical public health, the term "intracranial pressure" is often used precisely as an independent diagnosis and is treated in a variety of ways. Moreover, the diagnosis of "increased intracranial pressure" is carried out on the basis of test data, examinations and patient complaints, which are not signs of ICP either individually or in combination. That is, in practice, there is a situation of overdiagnosis, namely, the frequent detection of intracranial hypertension that does not actually exist in a person. Indeed, in reality, intracranial hypertension develops very rarely and with a limited number of serious diseases.

Most often, the diagnosis of intracranial hypertension (synonyms are also used to indicate the condition - hypertension syndrome, hypertensive-hydrocephalic syndrome, etc.) is made on the basis of ultrasound data (NSG - neurosonography), tomography, EchoEG (echoencephalography), EEG (electroencephalography), REG (rheoencephalography) and other similar studies, as well as non-specific symptoms that a person has (for example, headache, etc.).

In the course of these studies, the expansion of the ventricles of the brain and the interhemispheric fissure is often detected, as well as other dubious signs that are interpreted as undoubted evidence of the presence of increased intracranial pressure. In fact, the results of these studies are not signs of increased intracranial pressure, therefore, such a diagnosis cannot be made on their basis.

The only studies on the basis of which increased intracranial pressure can be suspected are the assessment of the condition of the fundus and the measurement of cerebrospinal fluid pressure during the production of a lumbar puncture. If the doctor detects swelling of the optic disc during the study of the fundus, then this is an indirect sign of increased intracranial pressure, and in this case it is necessary to conduct additional examinations in order to identify the underlying disease that led to ICP. In addition, if a high pressure of the cerebrospinal fluid is detected during a lumbar puncture, then this is also an indirect sign of ICP, in the presence of which additional examinations should also be carried out to identify the disease that caused the increase in intracranial pressure.

Thus, if a person is diagnosed with increased intracranial pressure not on the basis of data from an examination of the fundus or a lumbar puncture, then it is false. In this case, it is not necessary to treat the identified "pathology", but you should contact another specialist who can understand the complaints and conduct a high-quality diagnosis.

It must also be remembered that intracranial pressure is not an independent disease, but only one of the syndromes characteristic of the development of various severe brain pathologies, such as, for example, hydrocephalus, tumors, craniocerebral injuries, encephalitis, meningitis, brain hemorrhages and etc. Therefore, its diagnosis should be treated carefully and carefully, since the actual presence of ICP also means the presence of a severe disease of the central nervous system, which must be treated, as a rule, in a hospital setting.

Diagnosis of "increased intracranial pressure" (doctor's opinion) - video

Increased intracranial pressure - pathogenesis

With any mechanism, an increase in intracranial pressure occurs gradually, since at the initial stages, compensatory mechanisms are activated that keep pressure within normal limits. During this period, a person may feel completely normal and not feel any unpleasant symptoms. After some time, the compensatory mechanisms are exhausted and there is a sharp jump in intracranial pressure with the development of severe clinical manifestations requiring hospitalization and treatment in a hospital.

In the pathogenesis of increased intracranial pressure, the leading role is played by blood flow, as well as the amount of blood in the vessels of the brain. For example, the expansion of the carotid or vertebral arteries leads to increased blood supply to the vessels of the brain, which provokes an increase in intracranial pressure. If this condition is observed frequently, then intracranial pressure is constantly elevated. Narrowing of the carotid and vertebral arteries, on the contrary, reduces blood flow to the brain, which leads to a decrease in intracranial pressure.

Thus, it is clear that vasodilators, including antihypertensives, increase intracranial pressure. And vasoconstrictor drugs, on the contrary, reduce the value of intracranial pressure. Given this factor, it must be remembered that increased intracranial pressure cannot be reduced with antihypertensive agents and treated with drugs that improve and increase cerebral blood flow (for example, Cinnarizine, Vinpocetine, Cavinton, etc.).

In addition, intracranial pressure depends on the amount of cerebrospinal fluid produced by the structures of the nervous system. The amount of cerebrospinal fluid can also be affected by the osmotic pressure of the blood. For example, with intravenous administration of hypertonic solutions (their concentrations are higher than physiological ones) of glucose, fructose, sodium chloride and others, there is a sharp increase in the osmotic pressure of the blood, as a result of which, to reduce it, fluid begins to flow out of the tissues, including brain structures. In this case, part of the cerebrospinal fluid goes into the systemic circulation in order to dilute the blood and reduce osmotic pressure, as a result of which intracranial pressure decreases rapidly and sharply.

Accordingly, the introduction of hypotonic solutions with concentrations below physiological into a vein leads to the opposite effect - a sharp increase in intracranial pressure, since excess fluid is displaced from the blood to normalize osmotic pressure in tissues, including the brain.

Reduced intracranial pressure - pathogenesis

Usually, intracranial hypotension develops slowly, as a result of which a person does not feel any pathological symptoms for a long time. But in rare cases, with a sharp decrease in the intensity of cerebral circulation, the rapid formation of intracranial hypotension is possible, which is a critical condition, called brain collapse and requires immediate hospitalization in a hospital for its relief.

How to measure (check) intracranial pressure?

Unfortunately, despite the advances in science and technology, at present, intracranial pressure can only be measured insertion of a special needle into the ventricles of the brain or spinal canal. Further, cerebrospinal fluid begins to flow through the needle and the simplest manometer is connected to it, which is a glass tube with millimeter divisions. The cerebrospinal fluid is allowed to flow freely, as a result of which it occupies a certain volume of the manometer. After that, intracranial pressure is determined in the simplest way - the number of millimeters on the manometer is fixed, which is occupied by the leaked cerebrospinal fluid. The final result is expressed in millimeters of water column or mercury column.

This method is called intraventricular pressure monitoring and is the gold standard for measuring ICP. Naturally, the method can only be used in a hospital setting and only if indicated, since it is invasive and potentially dangerous. The main danger of the method lies in the risk of infectious complications that may occur due to the introduction of pathogenic microbes into the cranial cavity. In addition, a needle inserted into the ventricles of the brain may be blocked due to tissue compression or blockage by a blood clot.

The second way to measure intracranial pressure is called direct and is monitoring using sensors. The essence of the method is the introduction of a special chip into the ventricles of the brain, which transmits data on the mechanical pressure on it to an external measuring device. Accordingly, the direct method of measuring ICP can also be used only in a hospital setting.

Both methods are invasive, complex and dangerous, and therefore they are used only when life is threatened against the background of severe brain damage, such as contusion, edema, craniocerebral injury, etc. Thus, it is obvious that methods that would allow accurate to measure intracranial pressure in a polyclinic does not exist. After all, it is not advisable to do a puncture of the brain or spinal canal to measure intracranial pressure in the absence of a threat to life, since the complications of manipulation can be very serious.

However, at present there is a survey method that allows you to judge the level of intracranial pressure by indirect signs - this is fundus examination. If, during the examination of the fundus, edematous visual discs and dilated tortuous vessels are detected, then this is an indirect sign of increased intracranial pressure. In all other cases, the absence of edema of the visual discs and blood filling of the fundus vessels indicates a normal level of intracranial pressure. That is, the only more or less reliable indirect sign of increased intracranial pressure is the characteristic changes in the fundus. Accordingly, in a wide practice in a polyclinic, only an examination of the fundus of the eye can be used to assess intracranial pressure - a method that, by indirect signs, can detect increased ICP.

Diagnostics

All other imaging methods (ultrasound of the brain, electroencephalography, tomography, echoencephalography, etc.), which are very widely used at the present time, do not even make it possible to indirectly judge the magnitude of intracranial pressure. The fact is that all the signs revealed during these examinations, mistakenly taken for symptoms of increased intracranial pressure (expansion of the ventricles of the brain and the interhemispheric fissure, etc.), in fact, are not. These methods are necessary to clarify and identify the cause that provoked an increase in intracranial pressure.

That is, in a polyclinic, in order to detect increased intracranial pressure, it is necessary to perform the following examination algorithm: firstly, an examination of the fundus is performed. If there are no edematous visual discs and tortuous, dilated veins in the fundus, then intracranial pressure is normal. In this case, no additional studies are needed to assess ICP. If edematous visual discs and tortuous, dilated veins are found in the fundus, then this is a sign of increased intracranial pressure. In this case, additional examinations should be performed to identify the cause of the increase in ICP.

Methods such as ultrasound of the brain (neurosonography) and tomography will determine the cause of increased intracranial pressure, but will not say anything about the magnitude of ICP. Echoencephalography, rheoencephalography and electroencephalography do not provide any data on the magnitude of intracranial pressure, since they are intended to diagnose completely different conditions. So, echoencephalography is a method that is intended exclusively for detecting large formations in the brain, for example, tumors, hematomas, abscesses, etc. Echoencephalography is not suitable for any other diagnostic purposes, and therefore it is inappropriate and useless to use it to detect ICP.

Rheoencephalography and electroencephalography are also methods that in no way can help in assessing intracranial pressure, since they are intended to identify various pathological foci in brain structures, such as, for example, epileptic readiness, etc.

Thus, it is obvious that for the diagnosis of increased intracranial pressure, it is necessary to conduct an examination of the fundus. It is not necessary to conduct all other examinations (NSG, EchoEG, EEG, REG, etc.), which are often and widely prescribed at present, since they do not provide any indirect data to judge ICP. Ultrasound of the brain in infants, which is currently incredibly common, does not allow us to judge the level of ICP, so the results of this study should be viewed with a certain degree of skepticism.

If intracranial pressure increases gradually, then the person suffers from constant headache, nausea with vomiting, persistent hiccups, drowsiness and visual impairment.

Signs of increased intracranial pressure in children older than one year and adolescents

• The child is exhausted, gets tired quickly, constantly wants to sleep;
• Apathy and indifference to activities that previously aroused a keen interest in the child;
• Irritability and tearfulness;
• Visual impairment (constriction of the pupils, strabismus, double vision, "flies" before the eyes, inability to focus the gaze);
• Exhausting headache, especially severe in the second half of the night and in the morning;
• Bluish circles under the eyes. If you stretch the skin in circles, then dilated capillaries will become visible;
• Nausea and vomiting not associated with food intake, especially frequent in the morning at the height of the headache;
• Twitching of arms, legs and face;
• Pain behind the eyes of a pressing nature.

Signs of increased intracranial pressure in infants under one year old

• Headache;
• Nausea, vomiting and regurgitation, not associated with food intake and occurring mainly in the morning;
• Strabismus;
• Congestive discs of the optic nerves in the fundus;
• Violation of consciousness (the child is inhibited, as if stunned);
• Bulging and tension of the fontanel with divergence of the sutures of the bones of the skull.

Treatment

General principles for the treatment of intracranial pressure

That is, the main treatment for ICP is the treatment of the disease that caused the increase in intracranial pressure. In this case, ICP itself is not intentionally reduced, since this will happen spontaneously when the causative factor is eliminated. However, if intracranial pressure is increased to critical values, when there is a threat of herniation of the brain and the development of complications, then it is urgently reduced with the help of various medications. It must be remembered that a direct reduction in ICP is an emergency measure that is used only when there is a threat to life in a hospital setting.

At high risk of increased intracranial pressure, for example, against the background of chronic diseases that can cause ICP (congestive heart failure, consequences of stroke and traumatic brain injury, etc.), the following recommendations should be observed:

• Limit salt intake;
• Minimize the amount of liquid consumed (drink no more than 1.5 liters per day);
• Periodically take diuretics (Diakarb, Furosemide or Triampur);
• Do not visit baths and saunas, do not be in the heat;
• Wash with warm or cool water;
• Sleep in a well-ventilated area;
• Sleep with a raised head end (for example, on a high pillow);
• Do not engage in sports activities associated with endurance training and weight lifting (running, somersaults, weightlifting, etc.);
• Avoid going down the elevator;
• Avoid air travel
• Periodically massage the collar zone;
• Include foods containing potassium in the diet (dried apricots, potatoes, fruits, etc.);
• Treat existing hypertension, epilepsy and psychomotor agitation;
• Avoid the use of vasodilators.

The common practice of treating increased intracranial pressure with diuretics is incorrect, since their isolated use without eliminating the cause of ICP will not give the expected results, but, on the contrary, may aggravate the situation due to dehydration

Intracranial pressure in a child (in infants, in older children): causes, symptoms and signs, diagnostic methods. Intracranial hypertension due to hydrocephalus: diagnosis, treatment - video

Folk methods of treatment

So, the following folk recipes are most effective with increased intracranial pressure:

• Pour a tablespoon of leaves and branches of mulberry with a glass of boiling water, leave for one hour, then strain and take the infusion in a glass three times a day;
• Pour a teaspoon of poplar buds with a glass of water and heat for 15 minutes in a water bath. Ready broth strain and drink during the day;
• Mix an equal amount of camphor and alcohol, and apply as a compress to the head at night;
• Mix in equal volumes hawthorn, motherwort, valerian and mint. Boil one teaspoon of the mixture of herbs with boiling water and drink instead of tea during the day.

Folk recipes for intracranial pressure - video

Increased intracranial pressure (ICP) is a phenomenon that can be a symptom of dangerous diseases of the cardiovascular or nervous systems. Pathology is manifested by headache, dizziness and a complex of additional symptoms, which many patients do not pay attention to. ICP is not a disease, but a quantitative indicator that can be measured using special equipment. Treatment is prescribed according to the results of the examination, based on the specific diagnosis and age of the patient.

What is intracranial pressure

It has a complex structure and is reliably protected by the bones of the skull. Inside the skull is constantly present cerebrospinal fluid, or cerebrospinal fluid. It plays the role of a shock absorber and prevents damage to brain tissue during impacts. In addition, it supplies oxygen and nutrients, and then waste products are excreted through the venous system. Liquor is located in different parts of the cranium:

• in the region of the ventricles of the brain and the interhemispheric fissure;
• between the meninges - soft and arachnoid;
• in the spinal canal.

Cerebral hypertension is excessive fluid pressure on brain tissue. This can occur with various disorders of the outflow of cerebrospinal fluid, blockage of blood vessels, as well as functional changes in nerve tissues. Intracranial hypertension (ICH) is caused by the fact that the brain is in a hard cranium. If the amount of CSF fluid increases, it has no outlet and compresses the soft brain tissues and blood vessels.

Why is intracranial pressure dangerous?

Chronic hypertension can lead to dangerous consequences. An increase in the volume of the skull is impossible, so the fluid will constantly squeeze the brain. As a result of such exposure, the blood supply to its membranes deteriorates, and foci of tissue necrosis appear. Violation of cerebral circulation affects the work of all organ systems.

This condition will be especially dangerous during pregnancy. Cerebral vascular insufficiency affects the blood supply to the fetus and can cause hypoxia. There is also a risk of fetal abnormalities, premature birth and complications during labor.

However, a short-term deviation from intracranial pressure is considered normal and is not a cause for concern.

In children, hypertension can provoke serious pathologies of physical and mental development. It can be congenital or associated with injuries, taking certain groups of drugs, or acquired diseases. An increase in pressure in younger children causes a delay in the formation of reflexes, strabismus, convulsions and other dangerous pathologies of internal organs.

How to measure intracranial pressure

There are no ways to check intracranial pressure at home in an adult or a child. This condition can be suspected independently by characteristic clinical signs, and the diagnosis is carried out by a doctor. Among the methods for determining this indicator, the following can be distinguished:

• measurement of CSF pressure by inserting a catheter into the lumen of the spinal canal;
• CT or MRI;
• in newborns - ultrasound examination of the brain;
• ophthalmic methods - examination of the fundus.

One of the most accurate methods is to measure the amount of cerebrospinal fluid. The catheter is inserted into the spinal space at the level of the belt. There is also an invasive technique, and the study is carried out using special sensors. They are injected directly into the ventricles, into the parenchyma of the frontal or temporal lobe, and also into the spaces between the meninges.

Causes of increased intracranial pressure

All causes of intracranial hypertension can be divided into congenital or acquired. In the first case, its symptoms are found in a child at a younger age. They may be associated with birth trauma, fetal hypoxia during pregnancy, or anomalies in the structure of the brain with signs of hydrocephalus.

In an adult, the causes of increased intracranial pressure may be associated with the following factors:

• neoplasms in the tissues of the brain;
• infectious diseases of the brain, which are accompanied by inflammation of its membranes;
• the appearance of blood clots, leading to a violation of the outflow of venous blood from the cranial cavity;
• injuries that are accompanied by the formation of large hemorrhages;
• toxicosis in pregnant women;
• strokes.

The causes of circulatory disorders in the brain are not necessarily serious chronic diseases. The condition may be associated with excess weight, a sedentary lifestyle, or poisoning. In any case, it is important to diagnose and, based on the results of the examination, determine what provoked hypertension.

Types of ICP

Cerebral hypertension can be benign or malignant. In the first case, it is provoked by overweight and other factors that do not pose a danger to the patient's life. When the cause is eliminated, benign intracranial hypertension resolves on its own.

Malignant ICH occurs with neoplasms of the brain, which compress the venous sinuses and prevent the outflow of CSF. In infants, intracranial pressure may be slightly elevated after childbirth, but it often normalizes with age.

Symptoms of intracranial hypertension

Treatment of this symptom should be timely, so it is important to know how intracranial hypertension manifests itself in an infant, an older child, or in adults. The first signs that are the reason for a mandatory visit to the doctor may be:

• dizziness and headaches of different localization;
• speech and memory disorders, decreased concentration;
• increased sweating, not associated with physical activity;
• increase or decrease in blood pressure;
• fast or slow pulse;
• visual impairment, which is a symptom of optic disc edema.

In children, the pathology manifests itself with similar signs. Of particular difficulty is the diagnosis of this disease in newborns who cannot yet complain of specific symptoms. Signs in a child often become excessive activity, irritability or sleep disturbances.

In children under one year old, symptoms of intracranial pressure may be accompanied by a visual increase in the skull. In less severe cases, the child lags behind peers in growth and development, becomes restless or lethargic, and slowly gains weight. Another sign of ICP in children under 1 year old is Graefe's symptom. In this case, the child focuses his eyes not directly in front of him, but below.

Diagnosis of the disease

Hypertension of the brain is a phenomenon that cannot be diagnosed without additional examination. For this, invasive or non-invasive methods are used, with the help of which it is possible to assess the degree of CSF pressure on soft tissues and the functional state of the brain. For adult patients, the following diagnostic methods may be informative:

• blood analysis;
• computed tomography (CT) - a method that allows you to visualize signs of intracranial hypertension;
• examination of cerebrospinal fluid pressure by lumbar puncture.

After birth, it is imperative to conduct examinations to detect hypertension in infants. At this age, it is still possible to perform diagnostics by ultrasound. Normal intracranial (intracranial) pressure ranges from 10 to 17 mm. rt. Art.

Treatment

The main goal of treatment is to reduce intracranial pressure. The first stage of therapy is getting rid of the main cause of the pathology. At this stage, an operation may be needed, during which the surgeon will remove the neoplasm in the brain tissue. Otherwise, treatment is carried out with medicines of different groups. Additionally, with increased intracranial pressure, massage or physiotherapy may be needed.

Methods on how to reduce intracranial pressure at home quickly will be symptomatic. To do this, after the diagnosis, the doctor must prescribe medications that you can take on your own when another attack occurs. It is not recommended to choose medicines on your own. In addition, the dosage will differ between adults and children.

There are several ways to bring down intracranial pressure at home. These include taking diuretics, folk remedies, or massage. It is worth remembering that the treatment is based on getting rid of the cause of hypertension, so all ways to quickly reduce intracranial pressure should be discussed with your doctor.

Surgical intervention

Some patients may need surgery. If, after spinal puncture, it is established that CSF is produced in excessive quantities, it is necessary to create additional ways for its outflow.

To do this, special shunts are installed in the cranial cavity, leading to the organs of the digestive tract. Fluid flows freely over them and does not accumulate around the brain. If such an operation is performed on a child, as the child grows, the shunt must be changed.

Medical therapy

Conservative treatments are pills that reduce the level of fluid pressure in the cranial cavity. They may belong to different groups:

• diuretics - diuretic drugs that help reduce the amount of fluid in the body;
• steroidal anti-inflammatory drugs;
• osmotic diuretics (glycerol);
• neuroprotectors;
• diacarb.

All these drugs have a complex effect on the patient's body. They strengthen the walls of blood vessels, which improves blood circulation in the brain. In addition, their action is aimed at removing excess fluid from the body, which can also reduce the level of ICP.

Folk methods of treatment

Traditional medicine is recipes based on medicinal herbs and natural products. Not all methods are safe and approved by doctors, but some of them can be used in addition to the main therapy regimen. For example, motherwort tincture has a calming effect, dilates blood vessels and relieves spasms. It is also helpful to include foods high in potassium in the diet: potatoes, citrus fruits, and dried fruits.

Possible complications with ICP

If treatment is not started on time, intracranial hypertension progresses and can lead to dangerous complications. These include:

• mental pathologies associated with disruption of the brain;
• violations of motor coordination due to pressure of the cerebrospinal fluid on the cerebellum;
• malfunctions of the cardiovascular system, arrhythmias;
• the appearance of epileptic seizures;
• deterioration of vision.

Cerebral edema is a dangerous condition that affects the functioning of all organ systems. It especially affects the development of a child at a younger age, but adult patients also suffer from manifestations of this pathology. Symptoms of the development of edema are a violation of motor and visual functions, coordination of movements, attention and memory. In children, there is a delay in the formation of reflexes and a general lag in growth and development.

Forecast

The prognosis for intracranial hypertension depends on its cause and timeliness of treatment. At a younger age, this symptom is diagnosed in a large number of children, but as they grow older, it disappears. In adults, benign hypertension does not pose a health risk, but attention should also be paid to its treatment. In malignant forms, the success of therapy depends on the complexity of the operation and additional factors. In any case, it is not pressure indicators that pose a great danger to life, but the reasons that cause them.

What not to do with high ICP

There are a number of contraindications for patients with ICH. In particular, many are concerned about the question of whether it is possible to play sports with intracranial pressure, and what loads should be avoided. If this symptom appears, serious sports will have to be abandoned for the duration of treatment, and active walks in the fresh air, on the contrary, will improve blood circulation.

There are also some food restrictions. All fatty, fried foods, alcohol and sweets should be excluded from the diet. Salt and sugar intake should be strictly regulated. There is no exact answer to the question whether it is possible to drink coffee with intracranial pressure. It depends on the variety and quality of the product. A soluble product worsens the condition of the vessels and can provoke an aggravation of the situation. If you use high-quality coffee beans, this will not affect your health.

An increase in intracranial pressure is a phenomenon that needs to be discussed with a specialist. It does not present with typical symptoms. All signs of hypertension can also indicate a stroke or other dangerous pathologies of the cardiovascular system. Treatment is prescribed based on the results of the examination. In most cases, it is enough to adjust the lifestyle and nutrition, and, if necessary, take a number of drugs. The operation is prescribed only in extreme cases.