Intracranial pressure: symptoms and treatment in adults
Minor headaches or dizziness, people often do not pay attention to these complaints, however, they may indicate increased intracranial pressure. This article describes the nature of the breach, the reasons of its development, manifestations and treatment.
What is intracranial pressure (ICP)?
Intracranial pressure – a measure that indicates the force with which the cerebrospinal fluid presses on the brain tissue. The growth level can not be called a separate disease, as it is only a manifestation of other pathological conditions. The normal ICP is 3 to 15 mm Hg. article the Level of intracranial pressure to 35 mm Hg. the article is critical and can cause the death of brain cells.
As a rule, in adults is a violation of the rarely recorded. Basically it is typical for newborn infants and is associated with congenital abnormalities (e.g., hydrocephalus). In addition, the high ICP observed in cases when pregnant women had morning sickness or other conditions that cause oxygen starvation of the fetus.
What happens from high intracranial pressure in adulthood?
Among the main pathologies accompanied by high intracranial pressure, it should be called:
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- Infectious diseases of CNS (e.g. meningitis, encephalitis or lesions of brain structures on the background of concomitant syphilitic infection). In such diseases there is swelling of brain tissue and grows effusions of plasma through the vascular wall, which leads to an increase in the volume of cerebrospinal fluid.
- Infectious diseases of other organs (e.g., bronchitis, otitis, gastroenteritis). In the presence of infection in the body increases HELL, and this, in turn, provokes more active secretion of the cerebrospinal fluid and in violation of its absorption.
- The reasons for the increased ICP also include the presence of benign or malignant tumors, abscesses, hematomas or clusters of worms in the brain.
- Etiological importance is the intake of certain medicines (especially corticosteroids and antibiotics) that can cause brain swelling, impaired circulation and absorption of CSF.
- Common causes of intracranial hypertension – endocrine disorders hyperthyroidism, obesity, adrenal insufficiency.
- Damage and swelling of the brain due to traumatic brain injury, stroke, neurosurgical operative interventions. I must say that in some cases, as a result of head injuries can determine a low intracranial pressure (e.g., when damage to the bones of the skull and the membranes of the brain, which are accompanied by leakage of cerebrospinal fluid).
- Severe poisoning and intoxication, which increases the amount of blood in the vessels of the brain.
- Poor circulation in the brain of different origin (e.g. ischemic or hemorrhagic strokes).
It is worth noting that women often have to register so-called benign intracranial pressure, in which the composition of the CSF remains unchanged, and the signs of hydrocephalus or certain lesions in the brain do not reveal. Typically, this type of idiopathic intracranial pressure are recorded among women of childbearing age without apparent reason. In some cases the etiological role attributed to prolonged intake of oral contraceptives.
Pregnant women can also register fluctuations in ICP. This is due to hormonal changes in the body and functional restructuring of the cardiovascular and nervous systems, but may point to the secondary nature of the hypertension (for example, the presence of vascular disorders, systemic infections, neuralgia, metabolic changes in the body).
The increase in ICP is characterized by polymorphism of clinical manifestations. Foremost among complaints out headache. It has a compressive or bursting character mostly appears in the morning after waking up. Pain onset provokes coughing and sneezing. Register and related complaints, such as tinnitus, nausea and vomiting. A characteristic feature of headache in intracranial pressure is that it can not be removed analgesics. In second place in the clinic high intracranial pressure are symptoms of autonomic dysfunction:
- oscillations of heart rate and blood pressure;
- violation of intestinal peristalsis;
- enhanced secretion of saliva (sialorrhea);
- excessive sweating, especially in palms and foot;
- fear, drowsiness, anxiety;
- abdominal pain and in the region of the heart.
Signs of increased intracranial pressure include blurred vision. Patients report double vision or transient blurred. You may experience intermittent blindness, seen from the point reduced reaction to light, changes in peripheral vision and irregularity of the pupils.
Increased intracranial pressure manifested as symptom of «setting sun» – the patients cannot close the eyelids. Due to overflow with blood small blood vessels under the skin of the lower eyelid, under the eyes appear dark circles. When examining the fundus, detects hemorrhages in the retina. In complex cases of retinopathy against the background of high intracranial pressure cause retinal detachment, which ends in complete blindness.
Among other manifestations it is necessary to specify the expression of emotions (associated with the compression of the structures in the hypothalamus that are responsible for emotion), back pain due to pressure in the spinal canal, as well as paresis and hyperesthesia in the defeat of the cells of motor and sensory centers in the brain.
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The high pressure of the CSF is able to trigger uncultivatable condition, which may present a danger to the life of the patient. Thus the patient noted disturbances of consciousness, significant dizziness, uncontrollable vomiting and impaired speech. Observed dysfunction of the respiratory and cardiovascular systems, as well as disruption of pelvic organs (incontinence or, conversely, delay of feces, urine).
What are the risks of ICP?
The appearance of the above complaints should consult a doctor in order to measure the pressure of cerebrospinal fluid. You cannot self-medicate, since this violation can provoke strokes, various mental disorders, loss of vision, seizures, respiratory disorders and sensitivity in the limbs.
How to measure VChD?
For this purpose the following diagnostic tests:
What can be examined further? For a more thorough diagnosis of patients recommend CT or MRI. Survey data help to visualize edema, hematoma or other lesions in brain tissue, thrombosis of vessels, expansion of the ventricles or shift of brain structures due to pressure of the CSF.
To what doctor to address if there are signs of high intracranial pressure? Treatment of such violations engaged neurologist. In addition, the patient is recommended to be examined by an ophthalmologist and if necessary an endocrinologist, infectious disease specialist or oncologist, depending on the etiology of disorders.
Therapy is carried out in stages. What to do in the first place? First of all, you should eliminate predisposing factors and concomitant disorders that affect the pressure of the CSF. So, to get rid of intracranial hypertension in the presence of tumors, hematomas, or other intracerebral education is possible only through emergency surgery. When excessive secretion of cerebrospinal fluid shunt operation is recommended to create additional outflow pathway of cerebrospinal fluid.
In other cases, intracranial pressure rid of with medication. Mostly osmotic and loop diuretics, hormonal drugs Diakarb, neuroprotective agents (Glycine), drugs containing potassium (they improve the metabolism in tissues, which stimulates the brain). To reduce swelling of brain tissue can assign Glycerin, which is taken orally. Can administered injections of magnesium sulfate and vitamins.
Rapidly reduce intracranial pressure help special medical manipulations (e.g. decompressive craniotomy, or ventricular puncture). To further effectively reduce intracranial pressure is impossible without the observance of proper diet with restriction of salt and fluid (diet No. 10).
How to increase the effectiveness of drug treatment? It should be combined with physiotherapy. To reduce intracranial pressure to use electrophoresis with Aminophylline, the influence of magnetic fields on the collar area, and a massage that improves the flow of blood from the skull. At home patients are encouraged to carry out self-massage. To do this in a circular motion to grind the bottom edge of the nape, hold your palms down the back of my head or to massage the point of the skull base.
To lower ICP is possible with acupuncture and circulatory soul. When exposed to the reflex points decreases vascular spasm, normalizes metabolism and the functional state of HC, increases muscle tone and improves venous outflow. A positive effect on the condition of patients physiotherapy and gymnastics, swimming and walking.
How to remove ICP folk remedies?
There are many recipes that help to fight with high intracranial pressure, however, it is worth remembering that folk remedies only ease the condition of the patient, but do not eliminate the causes of hypertension, so a doctor’s consultation is required. The most commonly used a decoction of lavender, infusion of flowers of clover, tincture of Valerian and peppermint, eucalyptus and rose hips. To treat this disease traditional methods should be used with caution. It is important to carefully monitor the health of patients and when it worsens, immediately consult a doctor.