Intracranial pressure: symptoms, treatment, signs
"Intracranial pressure" — this term can be seen quite often, especially in children's clinics. Usually it is understood as a pathological condition – increased intracranial pressure. It can be quite unpleasant and dangerous phenomenon, but not everyone understands what it means.
What is increased intracranial pressure?
The brain is the organ is extremely delicate and fragile. Even minor damage can cause severe pathologies and disorders. So nature has taken care of its reliable protection. He is strong inside the skull, which protects it from external mechanical damage.
Increased intracranial pressure in medicine also called intracranial hypertension.
And as extra protection, the brain is surrounded by a layer of a special liquid – CSF. In fact, he "suspended" it without touching the sides of the skull.
The skull is a fixed number of liquor. Because the amount of its stable, as well as the size of the brain in norm, then it depends on the amount of liquor depends on intracranial pressure.
Liquor, aka spinal or cerebral fluid, is formed in several ways: propotional (leakage) of plasma in certain areas of the blood vessels in the brain, as well as from secretions of special glands. It circulates in the subarachnoid space, bathing the brain and then is reabsorbed to other vessels.
Causes of increased intracranial pressure
Because the skull volume is constant, the pressure depends on two factors – volume of the brain and the amount of cerebrospinal fluid. If these figures are within the boundaries of the norm, and the pressure is normal values.
Thus, it is possible to identify several mechanisms of increased intracranial pressure:
- The increase in volume of the brain: the formation of a tumor, benign or malignant.
- Increased production of CSF.
- The deterioration of reabsorbtsii of liquor.
- The disturbance of liquor circulation.
Theoretically, there is a fifth factor – the reduction in volume of the cranium, but this is only possible in newborn babies whose skull bones have not yet fused. But this – separately.
Factors such as these can not arise by themselves, they are the result of a number of diseases.
Diseases causing increased intracranial pressure
You must understand that the increased intracranial pressure is not an independent disease, but a symptom of a severe and dangerous conditions.
There are several diseases that most oftencause increased intracranial pressure. In the first place these include:
Manifests itself as increased intracranial pressure
It should be noted that there are many manifestations of high intracranial pressure. They are quite diverse and may relate to different systems:
- Strong, long lasting and
Diagnostic methods of intracranial pressure
The measurement of the intracranial pressure is associated with a number of difficulties. The skull that protects the brain also are unable to study it.
Today there are only a few methods of direct measurement of intracranial pressure. This can be spinal puncture, which introduced a needle connected to a conventional pressure gauge and pressure created by outflowing CSF determine the intracranial pressure.
Another method is the introduction of a sensor directly in the subarachnoid space.
Of course, this diagnosis is associated with a number of difficulties and is a potential threat to the health of the patient, so use it infrequently.
Even measured intracranial pressure is not too informative. Doctors of the post-Soviet space is considered the norm value in the range of 100-200 units, their American colleagues recognized even broader in scope.
Therefore, the diagnosis of increased intracranial pressure had to rely on indirect methods of diagnosis:
- Ultrasound of the brain. This method allows to study the structure of the brain, and quite rude, but to determine the magnitude of increased intracranial pressure. But to hold it only to children with neurosim fontanel.
- The study of the fundus. One of the consequences of increased intracranial pressure is papilledema. An indirect sign is the absence of pulsation of the retinal vessels and typical hematoma.
- Magnetic resonance imaging. Using MRI it is possible in detail to study the structure of all parts of the brain. This allows to detect their deformation, characteristic of increased intracranial pressure. Also, this method of diagnosis helps to see the tumor, to determine their volume and location.
- Electroencephalography. This method allows to obtain only indirect evidence, but the presence of characteristic signs of intracranial hypertension, these data give greater confidence in the preliminary diagnosis.
- A blood test. Inflammatory diseases of the brain, which cause an increase of CSF, also shown characteristic changes in the blood composition, in particular, the increase in the number of white blood cells.
These methods give only an indirect result, but if you receivethe data are consistent with the clinical picture, the diagnosis can be considered confirmed.
Treatment of increased intracranial pressure
If intracranial pressure is beyond the norm, it can lead to serious consequences, and headaches are the least of our problems.
Due to the fact that some parts of the brain are shifted, there are dislocation syndromes – a number of States, each of which threatens health and human life. With further increase can disrupt cerebral blood flow, seizures, confusion up to coma and death.
For the treatment of increased intracranial pressure are a number of methods:
- Diuretics. Diuretics promote the flow of fluid from the body, partially solving the problem of increased intracranial pressure, but its effectiveness is not too high.
- Manual therapy. In venous stasis the problem can be solved therapeutic massage and other methods of manual therapy.
- Bypass. In case of emergency and a significant amount of liquor, your only option is to remove some of the liquid. This can be done through spine puncture or implantation of a shunt.
It should be noted that these measures do not eliminate the root cause of increased intracranial pressure, so it is important to choose the right case treatment.
Increased intracranial pressure in children
The topic today is dedicated to a huge amount of material, so the increased intracranial pressure in children should tell apart. In recent years, pediatric neurologists and pediatricians put this diagnosis in almost half of the newborns.
In the US, Europe and many other countries, the diagnosis of "increased intracranial pressure in children" put in a few cases.
This problem is fairly lengthy, and to understand it you need to carefully. On the one hand, children do after the birth of the intracranial pressure may be somewhat higher. This is due to the deformation of the skull bones after the passage of patrimonial ways, the stress of moving from one environment to another, the rapid growth of the brain. This condition is a physiological norm and there is no specific treatment requires, good enough sleep and walks.
At the same time, there are rare occasions when due to pathology of the brain fluid drainage from the brain. This disease is called hydrocephalus and is a congenital disorder which manifests itself already in the first days or weeks of life.
And only in rare cases of intracranial pressure, the child is elevated enough to pose a threat to health, but it is not a consequence of hydrocephalus.In other cases, we can talk more about the features of development that does not require any special treatment.
- Strong, long lasting and