Increased intracranial pressure, caused by conditions such as brain hemorrhage or tumor growth, can damage the brain and decrease blood supply. Symptoms include headaches, vomiting, and dilated pupils. Treatment involves hospitalization, medication, and draining cerebrospinal fluid.
The brain, along with its blood vessels, cerebrospinal fluid, and spinal cord, are all contained within the bony walls of the skull. Normally, the pressure within the skull, known as intracranial pressure, is regulated to stay within certain limits. Increased intracranial pressure, when pressure within the skull has risen above the normal range, is potentially dangerous because the brain can be damaged, both by direct pressure on its tissues and by the effects of increased pressure on blood vessels leading to a decrease in blood supply to the brain. Possible causes of increased intracranial pressure include a brain hemorrhage, a tumor, or an increase in the amount of cerebrospinal fluid circulating around the brain. Increased intracranial pressure is usually treated as an emergency and the patient is placed on a ventilator while fluid is drained from the skull.
Normal intracranial pressure depends on brain volume remaining constant. At the same time, cerebrospinal fluid is continuously being created and absorbed to maintain a constant level, and the blood flowing through the brain is regulated to stay within normal limits. As intracranial pressure begins to rise, more fluid is initially absorbed, lowering CSF pressure in an attempt to return the overall pressure within the skull to its previous level.
If the pressure continues to increase, it reaches a critical point where changes in the cerebrospinal fluid can no longer compensate for the increase. The person may have a dilated pupil and typically experience headaches and vomiting. There may be an increase in blood pressure in the arteries, slow and irregular heartbeats, and difficulty breathing. As the condition progresses, part of the brain may be pushed out through the opening at the bottom of the skull and blood flow through the brain begins to fail. These changes normally lead to brain death if left untreated.
A number of conditions can give rise to increased intracranial pressure. Some do this by enlarging the brain itself, such as the swelling of brain tissue seen in diseases such as meningitis or the growth of a tumor. Other conditions increase pressure by taking up space around the brain, such as hemorrhage following a head injury or hemorrhagic stroke, or a buildup of cerebrospinal fluid that can be caused by excessive production or blocked drainage.
Treatment of increased intracranial pressure involves hospitalization and intensive care. The patient is usually placed on a ventilator to assist with breathing, and medications are given to combat swelling in the brain, while cerebrospinal fluid is drained from the skull to lower the pressure inside. If there are treatable causes of high blood pressure, such as a tumor or blood clot that can be removed, these are treated as soon as possible.
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