Increased Intracranial Pressure

Overview

Increased intracranial pressure is pressure that builds up inside the skull. This puts pressure on the brain. It can happen because of a head injury or other problems, such as a tumor or bleeding in or around the brain. The condition is usually an emergency. If not treated, it can lead to brain injury.

What causes it?

There are many causes for this condition. They may include:

• A traumatic brain injury (TBI).
• A brain tumor.
• A stroke.
• A blood clot or bleeding in or around the brain.
• Increased spinal fluid in the brain (hydrocephalus).
• Infections, such as encephalitis and meningitis.
• Very high blood pressure.

What are the symptoms?

Symptoms may include:

• A headache.
• Vomiting.
• Being very drowsy or not alert.
• Slow, shallow breathing.
• Vision problems.
• Seizures.

How is it diagnosed?

The doctor will do a physical exam and ask about your past health. The doctor may check to see if your pupils are large (dilated). You may have imaging tests, like a CT scan, or other tests to check for the cause. You may have a procedure to check the pressure in your brain.

How is increased intracranial pressure treated?

Treatment helps lower the pressure in your brain. Treatment is usually managed in the intensive care unit (ICU). The doctor will treat the cause of the increased pressure, if possible. This may include removing a blood clot or tumor or treating other problems such as increased fluid in the brain.

Your care team will help you stay comfortable, with your head slightly raised. They will help position you to avoid any strain or rotation in your neck.

You may be given medicines to help lower the pressure in your brain and to manage other problems. You may get medicines to help keep you calm and relaxed (sedated). This can help lower the pressure by slowing down some of your body's functions. If needed, you may take medicines to help control your blood pressure or reduce fever.

The doctor may use a device to check the pressure or drain fluid from your brain. They will also closely watch your blood pressure and other vital signs. You'll probably have imaging tests to help check on your condition.

If needed, the doctor may put you on a ventilator (breathing machine) for a short time. This may help relieve the pressure by helping you breathe faster.

In some cases, surgery is done to remove a small piece of the skull to relieve pressure.