Raised intracranial pressure
Hidden edits. Some edits not affecting the appearance of this article have been suppressed.
Updates to Article Attributes
Body
was changed:
Raised intracranial pressure is a pathological increase in the intracranial pressure in the cranium and is a medical emergency.
Clinical presentation
The symptoms and signs of raised intracranial pressure are often non-specific and insidious in onset:
- headache
- drowsiness
- anorexia
-
visual disturbances
- blurred vision: often the first manifestation noted by patients
- visual field loss: early finding
- visual acuity is usually preserved
- double vision
-
"greying out of vision" a.k.a. transient visual obscurations
- commonly occur with changes in posture
- papilloedema
- neck/back pain
- nausea and/or vomiting
- convulsions
- pulsatile tinnitus
- blackouts
- decreased GCS/coma
Pathology
Aetiology
- congenital
- iatrogenic
- neurosurgery
- therapeutic agents
- idiopathic intracranial hypertension (IIH)
- infection
- meningitis
- encephalitis
- abscess
- empyema (epidural/subdural)
- trauma
- neoplasms
- primary
- metastases
- cerebrovascular
- dural sinus thrombosis
- aneurysm
- arteriovenous malformation (AVM)
- intracranial haemorrhage
- extradural
- subdural
-
intracerebralsubarachnoid -
intraventricularintracerebral - intraventricular
Radiographic features
It follows from the Monro-Kellie doctrine that as the CSF pressure inside the skull increases, the brain and blood volume have to accommodate this, resulting in the phenomenon of mass-effect, explaining the findings of raised intracranial pressure on cross-sectional brain imaging:
- effacement of the ventricles, basal cisterns and other CSF spaces
- brain herniation
- loss of grey-white matter differentiation
Treatment and complications
Specific treatment relates to the underlying aetiology.
Complications
- permanent loss of vision
- permanent loss of neurological functions
- death
-<p><strong>Raised intracranial pressure</strong> is a pathological increase in the pressure in the cranium and is a medical emergency. </p><p> </p><h4>Pathology</h4><h5>Aetiology</h5><ul>- +<p><strong>Raised intracranial pressure</strong> is a pathological increase in the <a href="/articles/intracranial-pressure">intracranial pressure</a> and is a medical emergency. </p><h4>Clinical presentation</h4><p>The symptoms and signs of raised intracranial pressure are often <a href="/articles/non-specific">non-specific</a> and insidious in onset:</p><ul>
- +<li>headache</li>
- +<li>drowsiness</li>
- +<li>anorexia</li>
- +<li>visual disturbances<ul>
- +<li>blurred vision: often the first manifestation noted by patients</li>
- +<li>visual field loss: early finding</li>
- +<li>visual acuity is usually preserved</li>
- +<li><a href="/articles/diplopia">double vision</a></li>
- +<li>"greying out of vision" a.k.a. transient visual obscurations<ul><li>commonly occur with changes in posture</li></ul>
- +</li>
- +<li><a href="/articles/papilloedema">papilloedema</a></li>
- +</ul>
- +</li>
- +<li>neck/back pain</li>
- +<li><a href="/articles/investigating-nausea-and-vomiting-summary">nausea and/or vomiting</a></li>
- +<li>convulsions</li>
- +<li><a href="/articles/pulsatile-tinnitus">pulsatile tinnitus</a></li>
- +<li>blackouts</li>
- +<li>decreased <a href="/articles/glasgow-coma-scale-1">GCS</a>/coma</li>
- +</ul><h4>Pathology</h4><h5>Aetiology</h5><ul>
- +<li>empyema (<a href="/articles/epidural-empyema">epidural</a>/<a href="/articles/subdural-empyema">subdural</a>)</li>
-<li>neoplasms</li>- +<li>neoplasms<ul>
- +<li>primary</li>
- +<li>metastases</li>
- +</ul>
- +</li>
-<li>extradural</li>-<li>subdural</li>-<li>intracerebral</li>-<li>intraventricular</li>-<li> </li>- +<li><a href="/articles/extradural-haemorrhage">extradural</a></li>
- +<li><a href="/articles/subdural-haemorrhage">subdural</a></li>
- +<li><a href="/articles/subarachnoid-haemorrhage">subarachnoid</a></li>
- +<li><a href="/articles/intracerebral-haemorrhage">intracerebral</a></li>
- +<li><a href="/articles/intraventricular-haemorrhage">intraventricular</a></li>
- +</ul><h4>Radiographic features</h4><p>It follows from the <a href="/articles/monro-kellie-hypothesis">Monro-Kellie doctrine</a> that as the CSF pressure inside the skull increases, the brain and blood volume have to accommodate this, resulting in the phenomenon of mass-effect, explaining the findings of raised intracranial pressure on cross-sectional brain imaging:</p><ul>
- +<li>effacement of the ventricles, basal cisterns and other CSF spaces</li>
- +<li>brain herniation</li>
- +<li>loss of grey-white matter differentiation</li>
- +</ul><h4>Treatment and complications</h4><p>Specific treatment relates to the underlying aetiology.</p><h5>Complications</h5><ul>
- +<li>permanent loss of vision</li>
- +<li>permanent loss of neurological functions</li>
- +<li>death</li>
References changed:
- 1. Mollan SP, Spitzer D, Nicholl DJ. Raised intracranial pressure in those presenting with headache. (2018) BMJ (Clinical research ed.). 363: k3252. <a href="https://doi.org/10.1136/bmj.k3252">doi:10.1136/bmj.k3252</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30287521">Pubmed</a> <span class="ref_v4"></span>
- 1. Mollan SP, Spitzer D, Nicholl DJ. Raised intracranial pressure in those presenting with headache. (2018) BMJ (Clinical research ed.). 363: k3252. <a href="https://doi.org/10.1136/bmj.k3252">doi:10.1136/bmj.k3252</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30287521">Pubmed</a> <span class="ref_v4"></span>
- 1. raised intracranial pressure in patients with headache
Systems changed:
- Central Nervous System
Updates to Synonym Attributes
Title
was added:
Raised ICP
Type
was set to
Synonym.
Visible
was set to
.
Content
was set to
.
Updates to Synonym Attributes
Title
was added:
Intracranial hypertension
Type
was set to
Synonym.
Visible
was set to
.
Content
was set to
.
Unable to process the form. Check for errors and try again.