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Intracranial pressure (ICP) is the pressure inside the skull and thus in the brain tissue and cerebrospinal

fluid (CSF). The body has various mechanisms by which it keeps the ICP stable, with CSF pressures varying by about 1 mmHg in normal adults through shifts in production and absorption of CSF. Intracranial hypertension, commonly abbreviated IH, IICP or raised ICP, is elevation of the pressure in the cranium. ICP is normally 715 mm Hg; at 2025 mm Hg, the upper limit of normal, treatment to reduce ICP may be needed. Increase Intracranial Pressure * Increased intracranial pressure is a rise in the pressure inside the skull that can result from or cause brain injury. * Increase intracranial Pressure or hypertension is when intracranial pressure exceeds 15 mmHg, with a pressure range of 10-20 mm mercury possibly requiring intervention. Pressures over 30mm mercury warrant (demand) immediate attention. * Any increase in volume of one component without decrease of another will result in IICP. Causes, Incidence and Risk Factors *Increased intracranial pressure can be due to a rise in cerebrospinal fluid pressure. It can also be due to increased pressure within the brain matter caused by a mass (such as a tumor), bleeding into the brain or fluid around the brain, or swelling within the brain matter itself. *An increase in intracranial pressure is a serious medical problem. The pressure itself can damage the brain or spinal cord by pressing on important brain structures and by restricting blood flow into the brain. Many conditions can increase intracranial pressure. Common causes include: Aneurysm rupture and subarachnoid hemorrhage Brain tumor Encephalitis Head injury Hydrocephalus (increased fluid around the brain) Hypertensive brain hemorrhage Intraventricular hemorrhage Meningitis Subdural hematoma Status epilepticus Stroke Symptoms Infants: Drowsiness Separated sutures on the skull Bulging of the soft spot on top of the head (bulging fontanelle) Vomiting Older children and adults: Behavior changes Decreased consciousness Headache

Lethargy Neurological symptoms, including weakness, numbness, eye movement problems, and double vision Seizures Vomiting

Exams and Tests *An MRI or CT scan of the head can usually determine the cause of increased intracranial pressure and confirm the diagnosis. *Intracranial pressure may be measured during a spinal tap (lumbar puncture). * It can also be measured directly by using a device that is drilled through the skull or a tube (catheter) that is inserted into a hollow area in the brain called the ventricle.

Treatment Sudden increased intracranial pressure is an emergency. The person will be treated in the intensive care unit of the hospital. The health care team will measure and monitor the patient's neurological and vital signs, including temperature, pulse, breathing rate, and blood pressure. Treatment may include: Breathing support Draining of cerebrospinal fluid to lower pressure in the brain Medications to decrease swelling Rarely, removal of part of the skull If a tumor, hemorrhage, or other underlying problem has caused the increase in intracranial pressure, the cause should be treated as appropriate. For information regarding treatment for certain causes of increased intracranial pressure, see: Hydrocephalus Normal pressure hydrocephalus

Outlook (Prognosis) Sudden increased intracranial pressure is a serious and often deadly condition. If the underlying cause of the raised intracranial pressure can be treated, then the outlook is generally better. If the increased pressure pushes on important brain structures and blood vessels, it can lead to serious, permanent problems or even death. Possible Complications Death Permanent neurological problems Reversible neurological problems Seizures Stroke