The increase in ICP is manifested by intense pain in the head, visual impairment, has a huge impact on the emotional sphere, leads to disability. Symptoms and treatment of intracranial pressure in adults are determined by the underlying pathology that led to the disorder.
Failures in the brain lead to serious consequences. It is a very vulnerable part of the human body. It is located inside the skull, protected by cerebrospinal fluid and three spinal shells. The function of the fluid is not only to protect the brain, but also to ensure its nutrition. The amount of cerebrospinal fluid in an adult reaches 150 milliliters; it occupies about 10% of the internal cavity of the head.
Spinal fluid is formed in the cerebral ventricles. There are four of them. The main part (up to 70%) of the cerebrospinal fluid is produced in special glands, the rest is formed from the sweating of the liquid component of blood through the walls of blood vessels. The full update period is a week.
The cerebrospinal fluid flows out of the lateral ventricles, into the third, then through the cerebral canal into the fourth, followed by the subarachnoid cavity. Here it is absorbed through the veins of the arachnoid. Liquor also circulates through the spinal column and washes the spinal cord. Normally, the pressure during circulation is constant.
In normal intracranial pressure is:
- in babies up to a year and newborns – from 1.5 to 6 mm Hg;
- children from one to fifteen years old – from 3 to 7 mm;
- in adolescents and adults – from 3 to 15 mm.
These indicators are the norm at rest. Any physical effort, including sneezing, screaming, laughing, leads to the fact that the pressure inside the skull becomes higher. Such phenomena are temporary, do not lead to chronic impairment and negative consequences. Permanent barriers to the flow of liquor in the form of vasospasm, their expansion, hematomas, tumors, cysts, edemas lead to these disorders. The accumulated volume of fluid presses on the nervous tissue, stretches the meninges and causes pain.
Researchers identify chronic and acute increased intracranial pressure. Acute appears due to stroke. Chronic occurs due to injury, due to illness, taking certain medications.
Causes and mechanism of development
The cranium is a natural bone restriction for the brain, cerebrospinal fluid and blood located in it. Each of these components takes its place and has a certain amount. Change any of them affects the rest.
Increased pressure may occur due to the following reasons:
- The use of drugs. Vasoconstrictors are aimed at lowering blood pressure, improving blood supply and blood circulation. Their expansion, however, can interfere with the normal flow of cerebrospinal fluid and cause an increase in ICP. Hormonal drugs, antibacterial drugs lead to the appearance of edema.
- Increase in the amount of cerebrospinal fluid. The phenomenon occurs due to the introduction of hypertonic solutions, dysfunction of the glands that produce it, hormonal disruptions.
- The occurrence of obstacles in the path of the current liquor. These include hematomas, swelling, tumors, injuries, aneurysms, blood clots, sclerotic plaques.
- Abnormalities in the kidneys and adrenal glands. Disrupted water-salt balance.
- Diseases of the central nervous system. Such diseases include encephalitis, stroke, meningitis.
- Endocrine pathology. These violations can lead to the release of a larger volume of water in the cerebrospinal fluid and absorption disorder.
- Congenital anomalies. First of all, it is hydrocephalus.
Signs of an increase in ICP in adults are increasing with time. Initially, it is a slight whirling of the head, weak pain. However, in the future, patients are increasingly faced with arching, throbbing pain. It occurs in the morning after a long stay in a horizontal position, accompanied by vomiting. Painkillers against such pain are powerless. Sneezing, strong tension causes noise in the head, nausea.
There are signs of the IRR: the blood pressure changes dramatically, tachycardia occurs, sweating increases, and fainting occurs.
A person becomes irritable, nervous, gets tired quickly. He is irritated by loud noises, any noise, bright light, surrounding. Any contact with the neck or spine causes pain. Libido decreases. The face swells, dark circles appear under the eyes. The reaction of the eyes is disturbed – ghosting appears, the field of vision is limited, blurring occurs, blurring, the pupils become of different sizes, the eyes are always half open. There is pain behind them.
Often patients complain of clouding of consciousness, inability to concentrate attention, hiccups, impairment of hearing.
In children, signs of increased intracranial pressure have their own characteristics.
With an increase in ICP in an infant, a spring is pulsing and pulsing. An important sign is a disproportionate head. Suspect pathology can be found on the head tense veins. The skin is marble with a clearly visible vascular pattern.
The baby cannot close his eyes completely, there are obvious signs of strabismus, the pupils have different sizes. Pens are in a tense state at the chest, the rest of the body is relaxed. He can not suck the breast, often regurgitates.
In a child older than 1-2 months, symptoms of an increase in ICP are increasing. In calm condition the spring is pulsing strongly. The bones of the skull diverge. Observed convulsive attacks. Eyes not fully closed – in a dream it is easy to notice the white sclera. The child suddenly stops, goes limp.
The extremities twitch involuntarily, while the muscles are weak and soft. Baby sluggish, drowsy, irritable. There is a bad weight gain, developmental delay. The head grows very fast.
Children over 1 year old
The children stutter after a year, startle in a dream, often cry, walk on their toes, are very excitable. They have a trembling chin, pens, often bleeding from the nose. Often complain of very strong headaches and pain behind the eyes, a split of visible objects, feel discomfort in the area of the sockets. Children are weak, sluggish, weeping, nothing interests them, they get tired quickly.
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The most informative ways to check whether the patient’s intracranial pressure is increased are spinal puncture and ophthalmologic examination.
Puncture is done in the lumbar region in the cavity between the soft and arachnoid membrane of the spinal cord. The place of the future puncture is disinfected, an injection of a 2% novocaine solution is made nearby. The needle is inserted between the third and fourth vertebrae. There is no risk to touch the spinal cord, since it ends higher. A pressure gauge is connected to the needle to measure pressure.
The following properties of the cerebrospinal fluid may indicate intracranial hypertension and its causes:
- The pressure is much higher than normal.
- Yellow or green color. This is a sign of rupture of a cyst, encephalitis, or meningitis.
- The number of eosinophils and leukocytes above normal. A change in the formula of cerebrospinal fluid suggests meningitis, arachnoiditis, or syphilis.
- The change in the rate of protein. The increase is caused by an infection or tumor, a decrease by hydrocephalus.
- Detection of bacteria. This is a sign of an infectious pathology.
- Heterogeneous composition. Sediment is formed during meningitis, coagulation – with malignant neoplasms.
In order to measure intracranial pressure, I use special sensors that record the mechanical pressure exerted on them.
Both of these methods are invasive and can lead to complications. One of them is reduced intracranial pressure due to a sudden loss of cerebrospinal fluid.
Often for diagnosis using data from an ophthalmologic examination. It allows you to check the end of the optic nerve, the pulse in the vascular pattern of the retina, to detect the overflow of blood veins, hemorrhages.
If an increase in ICP is suspected, an MRI is required. The study allows you to see tumors, edema, blood clots, changes in the ventricles of the brain, the shape of the Turkish saddle, subarachnoid space.
Computed tomography with the introduction of iodine substance allows you to make a series of images in which you can see areas of neoplasm, swelling, changing the location of the brain structures, the divergence of cranial sutures, determine the change in the shape of the ventricles, the rarefaction around them of the brain substance.
Electroencephalography allows to measure electrical impulses, to clarify their frequency, appearance. In the resulting images, Beta-1 and 2 and Gamma-rhythms, paroxysms, and changes in brain activity speak in favor of increased pressure.
Doppler ultrasound reveals signs of an increase in the difference between the hemodynamic velocity with a contraction of the heart muscle and its relaxation. During the study, you can see blood clots, congestion of venous blood, an increase in its speed.
For children up to twelve months, neurosonography is performed – ultrasound through a large spring.
In order to reduce intracranial pressure, medical preparations, traditional medicine, methods of surgical intervention are used. This is mainly symptomatic treatment.
The choice of medication is determined depending on the cause of the high intracranial pressure. In any case, diuretics are prescribed, allowing to remove excess fluid from the body, reduce the formation of CSF, and normalize its absorption. Use tablets Diacarb, Furosemide, Veroshpiron.
Many diuretics remove beneficial substances with water. To restore potassium is assigned Asparkam. It helps to improve metabolism, electrolyte metabolism, normalizes nutrition of the brain.
Nootropic drugs, such as Nootropil or Pantogam, contribute to the restoration of blood supply.
To eliminate the swelling that appeared during neoplasms and meningitis, due to allergies or intoxication, hormone preparations help. This group includes Prednisolone, Dexamethasone.
Additionally, patients are prescribed medications to help strengthen the vascular walls – Cavinton, Sermion. Apply vitamins and sedatives – tinctures with valerian or motherwort.
For the treatment of intracranial pressure in adults, operations are performed. They are shown with the ineffectiveness of conservative therapy, developing hydrocephalus, a strong pathology of the optic nerve. Shunting, ventricular puncture and endoscopic intervention are performed.
When shunting install a special catheter with a system of valves and tubes made of silicone. The growth of intracranial pressure leads to the opening of the valve and the output of the CSF in the tubes. The valve does not let the cerebrospinal fluid pass back and out of the cerebral ventricles leads it into the stomach cavity. Children operation is carried out several times.
Lumbar and ventricular puncture is accompanied by the withdrawal of excess CSF from the canal of the spinal cord and ventricles. During this operation, medications are injected, pressure is measured, a sample of cerebrospinal fluid is taken. The risk of complications occurs when removing CSF from the ventricles, the frequency of their occurrence – 50%.
If the shunting caused complications or the need arose to remove previously established structural elements, endoscopic surgery is performed. It is also shown to eliminate the effects of injury. During the operation, create a channel between the ventricular bottom and brain tanks. The operation is considered relatively safe, after it rarely complications occur.
To normalize the work of the brain, improve its blood supply, reduce the synthesis of cerebrospinal fluid in cervical osteochondrosis, venous stasis, obesity, and stress use folk remedies. It is impossible to treat them with the underlying disease, but they will effectively relieve some of the symptoms.
The diuretic effect of black poplar buds has a diuretic effect. In 400 ml of pure water, 2 tablespoons of vegetable raw materials are boiled, taken in half a glass before meals 3 times a day. The course lasts 3 months. After 20 days, it is repeated.
Spasm of the veins helps to eliminate the mixture of tincture of motherwort, valerian, hawthorn, eucalyptus and peppermint. The first three components are used in 100 ml, the last two in 25 ml.
Reducing pain in the head will help the reception of decoction of mulberry branches for three weeks. The twigs are cut in July, dried, cut into pieces no longer than 2 cm. Dry raw materials are boiled at a slow temperature of 20 minutes, then they are allowed to brew for an hour and drink 200 ml three times a day on an empty stomach.
Plantain infusion will help reduce the pressure. Half a liter of boiling water is poured over 3 dessert spoons of the plant powder, insisting for half an hour. Take three times a day before meals.
Massage from a mixture of flower pollen and honey will help ease the condition. The composition is prepared from the ratio of 2 parts of pollen to 1 part of honey. Before use, the mixture is left in the dark for seven days. By readiness rubbed into the nose, neck and neck.
To improve the condition of the patient allow a variety of physiotherapy, massage, acupuncture. Electrophoresis is done on the neck and shoulders with eufillin. This allows you to improve the nutrition of the brain, normalize the absorption of lymph. A magnet is also placed on the shoulders. Its properties stabilize pressure, reduce tone, relieve cramps, reduce swelling.
Massage is performed on the spine and in the neck and collar area. One course lasts up to 3 weeks. After the treatment at home, it is recommended to do self-massage. It may include three exercises. Palms hold from the occipital region to the clavicle. Press down with your fingers and make circular movements of the lower part of the occiput, from time to time they stroke and massage the neck.
Acupuncture relieves vascular spasms, normalizes metabolism in the brain. Normalization of outflow of venous blood contributes to the adoption of a circular shower.
Increased intracranial pressure leads to serious consequences. Liquor presses on the tissue of the brain, artery, vein, leads to arrest of blood circulation. The patient is diagnosed with ischemic stroke, characterized by the death of nerve cells.
Stable increased ICP leads to gradual cell death of white and gray matter. Patients have signs of different types of encephalopathy. Behavior changes, coordination is disturbed, emotional and mental activity suffers.
Because of the pathology, there is a displacement of brain elements, damage to its trunk. There is a heart rhythm disorder, hypotonia.
A high level of cerebrospinal fluid leads to damage to the nerve responsible for vision, causing impairment and even blindness. Appear epileptic seizures.
It is possible to improve the prognosis of quality of life only if the exact cause of the pathology is discovered in time and the treatment is started.
The following measures will help reduce the risk of an increase in ICP:
- fluid intake not more than 1.5 liters per day;
- salt restriction;
- avoiding alcohol and nicotine;
- taking potassium containing products;
- neck and shoulder massage 2 times a year;
- taking prescribed medications;
- treatment of chronic diseases;
- rejection of vasodilator drugs;
- wash only in cool or warm water.
It is recommended to sleep at least 8 hours a day, avoid overheating, do not go to the sauna, bath, be careful in the summer heat. During the night rest you need to sleep on a thick thin pillow, the room must be ventilated. Useful moderate physical activity – jogging, cycling, yoga, swimming pool. Every day, it is recommended to do exercises for the neck muscles.
It is important to exclude activity associated with endurance testing, sharp bending, and lifting. It is advisable not to use elevators and abandon flights in aircraft.
Increased intracranial pressure occurs due to impaired circulation of cerebrospinal fluid due to the occurrence of obstructions, hydrocephalus, diseases of internal organs, and hormonal disruptions. The disorder is characterized by severe headaches, fatigue, visual impairment. For the treatment using drugs, physiotherapy, folk remedies, surgery.