Intracranial hypertension: what is it?
Intracranial hypertension (ICH) is a pathological increase in pressure inside the skull. This condition is uncommon and can have many different causes. ICH can be acute or chronic. Acute ICH develops, usually due to trauma, stroke or infectious diseases of the brain.
Chronic intracranial hypertension is a severe long-term illness caused by some underlying illness. If chronic ICH is caused by the accumulation of fluid in the skull or brain tumor, may also need urgent treatment. However, in some cases, apparent reasons for the increase in intracranial pressure (ICP) can be found. In this case we talk about idiopathic ICH. The term «idiopathic» means no known cause of this condition.
What is it – idiopathic (benign) ICH?
Idiopathic ICH is a disease of unknown etiology, which most often occurs in women of childbearing age with obesity. In the medical literature for this disease used by several terms – idiopathic or benign ICH, and pseudotumor of the brain. As the increased intracranial pressure may lead to development of some complications, I prefer to use the term «idiopathic» and not «benign».
Doctors do not fully understand the link between excess weight and increase ICP, and decrease body mass can sometimes help relieve symptoms. Idiopathic ICH is also associated with:
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- hormonal disorders – lack of vitamin D, disorders of the adrenal, parathyroid and thyroid;
- taking certain medicines, including Tetracycline, corticosteroids, oral contraceptives;
- this polycythemia – the presence of the patient for the increased number of red blood cells;
- iron deficiency anemia;
- violation of the kidneys;
- systemic lupus erythematosus (a disease of the immune system).
How does chronic ICH?
Patients with this disease experience:
- Strong throbbing headaches, worse in morning, stress, and cough associated with nausea and vomiting, oblegayuschie sometimes in a standing position. Such features of headache in hypertension (high blood pressure).
- Changes in vision associated with swelling of the optic nerves. The patient may suffer from blurred vision, it’s hard for him to watch TV or read. Increased ICP can result in permanent visual impairment, so after the examination the ophthalmologist may need urgent treatment.
The individual may also feel sleepy, tired or irritated, you may suffer from nausea and vomiting. Sometimes he can hear a whistling noise in the ears.
How to diagnose ICH?
The diagnosis is established after excluding all other possible causes of increased intracranial pressure. To do this, hold:
- neurological examination, which does not detect any problems with the nerves, spinal cord or brain;
- examination by an ophthalmologist, who can show impairment;
- computer or magnetic-resonant tomography, the results of which can be normal; indirect Mr signs of ICH – the lack of expansion of the ventricles and other spaces containing fluid in the skull in the presence of elevated intracranial pressure;
- a lumbar puncture, which can be used to measure the pressure of cerebrospinal fluid.
How to treat chronic ICH?
Many patients try to cope with increased intracranial pressure folk remedies, unnecessarily putting his health in danger. Do not cheat yourself by looking at the word «benign» in the diagnosis of this disease can lead to very serious consequences (eg, loss of vision).
Treatment depends on the disease called increased intracranial pressure. If the patient is obese, it is important to reduce your weight. This often helps ease or eliminate symptoms without any medical intervention.
The patient can assign the following drugs:
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- diuretics – drugs that remove excess fluid from the body;
- a short course of Prednisolone (a corticosteroid drug) to relieve headaches, especially when there is a danger of loss of vision.
To extract excess cerebrospinal fluid from the cavities of the skull and spine of the patient with ICH, you may need regular lumbar punctures. This procedure consists of taking sample of liquid in the lower back using a needle and syringe.
If the weight loss and the medication has not alleviated ICH, you may want to consider surgery. The patient is offered surgery, in which a catheter (thin, flexible tube) is inserted into the fluid-filled space in the brain or spinal cord to withdraw the excess fluid to another part of the body. Many patients bypass surgery provides long term relief from the symptoms of the disease. To maintain perspective sometimes spend the fenestration of the optic nerve, that is, make incisions on its shell to reduce the pressure therein.
Could it be ICH in a child?
Although the prevalence of this disease among children is unknown, it is still they have found. Usually in children under the age of 6 are able to detect the specific cause of increased ICP. Idiopathic ICH is more common in adolescents older than 11 years. Children, like adults, are at risk of vision loss. They usually complain of headaches and vomiting, blurred vision and diplopia. Less common are irritability, dizziness and tinnitus. As in adults, treatment is aimed at reducing ICP and preserve vision.