Increased intracranial pressure is characterized by an increase in the amount of fluid in the brain when a traumatic brain injury or infection occurs (encephalitis, meningitis). The person feels as if something heavy is pressing on the head in the region of the crown. Nausea and vomiting often occur in the morning. With sharp forward bends, dizziness, double vision are noted. After a quick walk or climbing stairs, the heartbeat quickens, a pre-fainting state is felt. Before going to bed, heat in the temples is possible in the absence of elevated temperature, total body tension.

In newborns, the most common cause of increased intracranial pressure is hydrocephalus - congestion a large number fluid in one of the cavities of the brain and swelling of the surrounding tissues. In this case, the size of the head is disproportionate to the body, the skull becomes pear-shaped.

A decrease in ICP occurs due to trauma or abnormal structure of the brain with a violation of the integrity of the bone structure, in which there is a leakage of cerebral fluid. One of the reasons is also uncontrolled long-term use diuretics. Reduces pressure, pinching of the cervical vertebrae and venous dysfunction (vasoconstriction).

Symptoms of low intracranial pressure are: weakness, fatigue, irritability, drowsiness. A person can sleep for 8-10 hours and feel overwhelmed. Heaviness in the head is felt not from above, but from the sides, as if the head is clamped in a vise. Respiratory failure and decreased blood pressure.

Measurement of intracranial pressure

You can find out the indicator of intracranial pressure in newborns using neurosonography - ultrasound of the brain. Due to the abundance of hair on the head, this procedure cannot be performed by adults, therefore, if the patient has the appropriate symptoms, the therapist prescribes a comprehensive examination.

First of all, it is necessary to undergo an examination of the fundus of the eye by an ophthalmologist. In the absence of contraindications, the patient is instilled into the eyes 1-2 drops of a solution of scopolamine (0.25%) or homatropine (1%) to dilate the pupils.

The study is carried out using an electric ophthalmoscope or manually using a special magnifying glass and an ophthalmoscopic mirror. An electric device does not require any additional funds and allows you to get as close as possible to the patient's eye, and the study is carried out manually in a darkened room at a sufficient distance.

The mirror is installed in front of the doctor's right eye, sitting at a distance of 40-50 cm from the subject. The light source (60-100 W matt electric lamp) is positioned behind and to the left of the patient, as in transmitted light examination. After obtaining a uniform glow of the pupil, the researcher places a magnifying glass (usually 13.0 diopters) 7-8 cm in front of the patient's eye, resting his finger on his forehead. The pupil of the researcher, the hole of the mirror, the center of the magnifying glass and the pupil of the subject must be on the same line.

When examining the fundus, the oculist pays attention to the disc optic nerve and condition of retinal vessels. An increase in intracranial pressure is signaled by dilated tortuous vessels and a change in the color, contours, and tissue of the disc.

If there is any suspicion, the patient is referred to a neurologist. A neurologist may prescribe an MRI - magnetic resonance imaging of the brain, rheoencephalography and duplex scanning brachiocephalic arteries, which are responsible for cerebral blood supply. To conduct any of the studies, the patient must have a medical card, data on the previous examination, cotton pajamas or a T-shirt with him.

Since the method of magnetic resonance imaging is based on the visualization of body cavities during absorption and radiation by tissues electromagnetic waves, then before the examination it is necessary to remove jewelry (earrings, chains, beads, piercings, etc.), watches, telephone, magnetic cards. There should be no metal products on clothes (buttons, buckles, fasteners).

The patient in the prone position is placed on a retractable table in a kind of cylindrical capsule surrounded by a circular magnet. A special helmet is put on the head. Around the head are special devices - coils that receive and emit radio waves. During the procedure, the device is strong, so for convenience, the patient is offered headphones with pleasant, calm music. On average, an MRI procedure takes about 45 minutes.

Contraindications for MRI: weight over 150 kg, the presence of metal in the body (pins, bullets, fragments, a pacemaker, vascular and heart prostheses, vascular clips, etc.), claustrophobia, pregnancy, serious condition patient (patients on stretchers and gurneys).

Rheoencephalography is a method of recording changes in the electrical resistance of the brain and soft tissues of the skull when a weak high-frequency alternating current passes through them, which is not felt in any way. The patient is seated in a comfortable chair, suction cups are placed on the head, to which wiring is attached. The light in the room is turned off, and light pulses of different frequencies are sent to the subject. In the cycle of a pulse wave, periodic current oscillations occur, which, after an appropriate amplification, can be displayed graphically in the form of a curve of pulse oscillations of the complex electrical resistance - a rheogram.

Duplex scanning of the brachiocephalic arteries is an ultrasound scan of the common, external, internal carotid and vertebral arteries on the neck. The procedure takes on average about 5-10 minutes and allows you to visually assess the state of the vessels - width, blood flow rate, lumen, etc.

The most accurate method for determining intracranial pressure is the surgical insertion of a needle into the spinal canal. However, few people decide on this procedure, since the incorrect insertion of the needle can result in the patient pinching the nerve endings of the vertebrae and subsequent disability.

Advice 2: How to determine intracranial pressure in a child

Intracranial usually occurs due to excess cerebrospinal fluid in the cavity of the skull. Increased intracranial pressure (ICP) in a child is not an independent disease, but a combination of symptoms that are a consequence of the underlying disease. It is quite difficult to identify PVD in a child.

Instruction

Analyze external state and behavior for the following symptoms: anxiety, irritability, accelerated growth, bulging of a large fontanel, formation of a venous network, divergence of cranial sutures, refusal to drink, a symptom of the "setting sun" (eyes "roll out" and are laid down), strabismus, frequent regurgitation. For the older one: fast advance fatigue, mood swings, delay mental development, constant headaches, decrease, vomiting, convulsions.

Contact your doctor to have your child examined. For staging more accurate diagnosis specialists will conduct, in addition to an external examination, ultrasound examination through the fontanelle (neurosonogram). When visiting the doctor's office, lay the diaper on the couch, put the child on it and hold him. Before the examination, the doctor will smear the sensor of the device with a special gel, then he will drive this sensor along the head (fontanelle) of the child. The sensor will send information about the presence or signs of PVD to the computer monitor.

After completing the examination procedure, wipe the baby's head with a napkin. In addition to the neurosonogram, it is possible to use other professional methods examination of the child: examination of the fundus, magnetic resonance imaging, computed tomography.

note

If you suspect increased intracranial pressure in your child, then immediately call a doctor for urgent hospitalization of the baby, since PVD may accompany such serious illness like meningitis, encephalitis, brain tumor and intracranial hemorrhage.

Useful advice

If there is any doubt about the child's diagnosis, then it is advisable to get advice from several more doctors. Once the diagnosis is confirmed, treatment will need to begin.

Inside the skull there is always a certain amount of liquid - cerebrospinal fluid. This fluid that protects the brain from mechanical damage, is under a certain pressure and circulates from one area to another. If the circulation process is disturbed for some reason, cerebrospinal fluid stagnation occurs, and intracranial pressure rises, and this can lead to backfire.

What are the signs that intracranial pressure is increased

Very often, the increase is accompanied by a severe headache, aggravated by turning the head, tilting,. The pain often gets worse in the morning. Because of this, a person does not get enough sleep, feels tired, overwhelmed. The pain is localized in a certain place, for example, in the temporal or occipital region.

Often such headache accompanied by nausea and even vomiting.

With increased intracranial pressure, irritability, weakness, and fatigue often occur. In some cases it happens a sharp decline blood pressure, which can lead to fainting. Hearing often deteriorates, there is tinnitus.

Emerging visual defects may indicate an increase in intracranial pressure. For example, if the peripheral deteriorates, the image becomes, as it were, forked.

The fact that intracranial may be indicated by such external ones as swelling of the skin of the face and eyelids, dark circles under the eyes, increased perspiration.

Finally, one more possible symptom pressure - pain in the upper part of the neck.

If the increase in intracranial pressure is insignificant and occurs rarely, it is relatively harmless. With a regular and significant increase, there is a threat to the health and intellectual abilities of a person, and in the most severe cases- his life. Therefore, in this case, it is urgent to seek help from a specialist.

How to treat increased intracranial pressure

The doctor usually prescribes diuretics. They speed up the process of CSF circulation, thereby preventing its stagnation. If necessary, drugs are also prescribed that improve the blood supply to the brain.

Manual also helps, reducing fluid intake, an orderly daily routine with good rest.

If intracranial pressure is increased due to a head injury, or it is accompanied by very severe pain, which even after taking analgesics, you should immediately contact. In such cases, it is likely that surgery. However, this requires a thorough examination a good specialist. Self-medication is not worth it, it is fraught with serious consequences.

And it is updated, being under a certain pressure. Liquor, in addition to its protective function, supports metabolic processes between the brain and, and also helps to remove brain metabolic products. Normal performance CSF pressure for a person is 5-7 mm Hg, for a small one - 1-2 mm Hg.

If for some reason the circulation of the cerebrospinal fluid is disturbed, this fluid occurs. And then the intracranial pressure increases. Most often this happens due to narrowing of the ducts through which the CSF moves, or metabolic disorders, as a result of which the fluid is poorly absorbed into the blood. A temporary increase in intracranial pressure can occur without CSF stagnation. For example, with a strong or sneezing, that is, tension.

Increased intracranial pressure can also be a symptom or consequence of a number of diseases, including very dangerous ones. Such diseases include stroke, encephalitis, brain tumors (both benign and malignant), meningitis, cerebral hydrocephalus, migraine, poisoning. This phenomenon often occurs with excess weight, an overdose of vitamin A.

What are the symptoms of increased intracranial pressure

If intracranial pressure is elevated, the person may feel frequent seizures headaches of varying degrees of intensity, tinnitus, visual impairment (first peripheral, later central) and hearing. The pain may radiate to the neck and upper region. Often, an increase in intracranial pressure leads to fatigue, drowsiness, distraction.

In such cases, you should consult a neurologist, undergo necessary examination(for example, magnetic resonance imaging). When the diagnosis is confirmed, it is prescribed. As a rule, it includes taking drugs that improve blood circulation in brain tissues, as well as sedatives, vitamins. For example, with a migraine, "Vazobral", "Imigran" can be prescribed. In any case, the drugs should be prescribed by the attending physician. Do not self-medicate, as you can aggravate the disease.

Intracranial pressure (ICP) is a value that characterizes the pressure of the cerebrospinal fluid (CSF) in the cranial cavity. Normal pressure is approximately uniform throughout the cranial cavity and varies from 3 to 15 mm Hg. Art. In children, it is different: 1.5-6 mm Hg. Art. in newborns and 3-7 mm Hg. Art. in children after one year.

Intracranial pressure can increase significantly during coughing, sneezing, but these rises are short-lived and do not affect the functioning of the body. A long-term increase in these indicators is a pathology that affects the well-being of a person and the quality of his life. Therefore, it is necessary to start treatment on time, otherwise it can lead to serious complications and even death. To know how to lower intracranial pressure, it is necessary to establish what caused its increase.

Causes of deviations from the norm

When the bones of the skull stop growing and finally fuse with each other, the brain and all the tissues surrounding it occupy a certain volume, limited by the bones of the skull. Simply put, the entire contents of the cranium can be divided into three parts: the medulla itself, the cerebrospinal fluid and the blood in the vessels, both arterial and venous.

In some pathologies, a fourth component may also join them: a tumor or hematoma. Since the bones of the skull cannot be moved apart, a change in the volume of one of the components invariably leads to compression of the others and an increase in pressure.

Increased intracranial pressure can occur for various reasons.

One of the most common causes are traumatic brain injuries. When hitting the head, blood vessels can be injured, and blood accumulates in the cranial cavity. It puts pressure on the brain, which causes an increase in pressure. Especially dangerous are open injuries in which a fracture of the bones of the skull occurs, the fragments of which can wedged into the brain.
Inflammatory processes and other causes leading to cerebral edema.
Some types of poisoning and intoxication, in which the volume of blood in the vessels of the brain greatly increases. Often this leads to poisoning with methanol, ethyl alcohol, salts of heavy metals.
High intracranial pressure can cause a number of infectious diseases, such as malaria, as well as some forms of hepatitis.
Ischemic or hemorrhagic stroke - in this case, there is a violation of the blood supply to the brain.
Inflammation of the membranes of the brain (meningitis, encephalitis).
Tumors of the brain.
Thrombosis of cerebral vessels.
Benign intracranial hypertension.
Intracranial pressure in children is most often increased due to birth trauma.

Separately, it should be noted that the cause of increased intracranial pressure in young children can be hydrocephalus, in which too much cerebrospinal fluid accumulates in the child's skull. It can occur due to increased formation of cerebrospinal fluid, due to an obstacle in the way of its outflow, or inflammatory processes in brain tissues.

Since the bones of a child's skull have not yet fused and may move apart under pressure, the most striking sign of hydrocephalus is the rapid growth of the head during the first two years of a child's life. You can notice this already in the first month after birth. Moreover, the head grows unevenly: the cerebral part of the skull greatly increases, while the facial part remains almost normal. Other symptoms include protrusion of the eyeballs, severe visual impairment, and poor hair growth on the head. Without proper treatment, the child begins to lag behind in development. It is imperative to remove excess fluid from the skull.

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Symptoms

When ICP rises above 15 mm Hg. Art., at first the body tries to compensate for the increase in the volume of any of the components of the brain by reducing the volume of the rest. For example, the cerebrospinal fluid from the head space moves to the dorsal space. For a while, this helps, but with a further increase in pressure, compensatory abilities are no longer enough. The pressure can rise both slowly and abruptly, it all depends on what caused it.

If the disease begins slowly, very often the first symptoms of increased intracranial pressure in adults can be overlooked. More precisely, patients believe that they are simply too tired or this is a common reaction to stress and excitement.

The symptoms really look like this:

at first, the head may hurt slightly, sometimes it is accompanied by dizziness;
the patient sometimes feels sick;
vision is impaired, but it goes away on its own and without treatment.

However, elevated intracranial pressure prevents normal operation brain, badly affects the vital functions of the body and, without treatment, leads to the appearance of more vivid symptoms.

There are no specific manifestations of intracranial pressure that are characteristic exclusively for this pathology, therefore, in order to make a diagnosis, it is necessary to carefully examine all the symptoms and conduct a thorough diagnosis.

Separately, it is worth noting that Cushing's triad, the classic symptom complex of increased ICP: increased blood pressure, respiratory failure and bradycardia. It appears when there is a breakthrough in the body's compensatory capabilities, and it can no longer cope with high blood pressure.

Signs of increased intracranial pressure differ in adults and children. This happens not only because an adult can tell what hurts him, how exactly it happens, when the pain appeared and how other symptoms manifest themselves, but also because in children the bones of the skull have not yet grown together and may be a little move apart, increasing the volume of the cranial space, as well as with the immaturity of some systems and organs of the child.

Manifestation of ICP in an adult:

The first and most striking symptom of increased cranial pressure is a headache. Usually it appears in the morning, as soon as a person woke up, sometimes he might not even get out of bed. The pain is of a pressing, bursting nature, as if something is pressing on the bones of the skull from the inside. It is aggravated by tilting the head, during coughing or sneezing. Painkillers won't take it off. It is localized usually in the frontal part of the head, sometimes in the temporal or occipital. Sometimes it can be pulsating.
Often, increased intracranial pressure is accompanied by nausea and vomiting. Its difference from vomiting in case of poisoning is that it does not bring relief to the patient.
Another symptom of increased ICP is blurred vision. It occurs due to the fact that the optic nerves are compressed. Manifestations may be in the form of double vision, fuzzy outlines of objects, pupils may react poorly to light and be slightly dilated. Edema of the optic nerve appears with a prolonged increase in ICP.
Dark circles appear under the eyes. This happens due to the fact that small vessels on the lower eyelids are filled with blood.
Increased fatigue, irritability, the patient may experience bouts of fear. Mood changes frequently, depression may occur.
There is bradycardia, that is, the heart begins to beat more slowly.

In addition to these symptoms, autonomic disorders may be signs of increased intracranial pressure in adults:

dizzy;
saliva is produced much more than usual;
constipation or diarrhea may occur;
blood pressure during the day can either increase or decrease;
sweating increases, there may be fever or, conversely, chills;
sometimes there is increased sensitivity of the skin on the palms and feet;
periodically the patient experiences suffocation - it occurs if it is squeezed respiratory center in the medulla oblongata;
there are complaints of pain in the abdomen and chest;
pain can also occur in the back if the pressure of the cerebrospinal fluid in the spinal canal increases.

You should not drown out these symptoms with painkillers, because without timely treatment, sometimes increased intracranial pressure in adults can be accompanied by symptoms of a pre-stroke condition:

appears severe dizziness and the headache gets worse.
impaired speech and coordination of movements;
the patient may lose consciousness, sometimes up to a coma;
there is indomitable vomiting;
incontinence of urine and feces;
breathing is disturbed;
paresis of the limbs - limbs can be affected individually or half of the body can be affected.

If such symptoms appear, treatment of increased intracranial pressure should begin immediately, otherwise a fatal outcome is not ruled out.

Increased intracranial pressure in childhood accompanied by other symptoms:

In the smallest, the bones of the skull that have not yet grown together diverge, and the distance between them increases.
Large and small fontanelles swell, sometimes their pulsation is visible.
The behavior of the child changes: he becomes lethargic or, conversely, irritable, often cries for no apparent reason.
Vomiting "fountain" is observed, everything that he ate remains outside. Sometimes vomiting may not be related to food.
There is trembling of the chin.
There may be strabismus, sometimes the eyeballs bulge out slightly under pressure.
Convulsions appear.

Diagnostics

Before starting the treatment of intracranial pressure, it is necessary to conduct a correct diagnosis and find out the causes of its occurrence.

For diagnosis use:

Lumbar puncture, during which cerebrospinal fluid is taken for examination. To do this, a needle is inserted into the spinal canal in the lumbar region.
Perform an eye examination.
Head MRI.
Computed tomography of the head.
Electroencephalography is used to study the activity of the brain.
Neurosonography or ultrasound of the head. It is carried out only for small children whose fontanelles have not yet closed. For adolescents and adults, it makes no sense to carry out this procedure.

In addition to these manipulations, the measurement and monitoring of ICP is important. It is not always carried out. The decision on the need for his appointment is made by doctors, based on the clinical picture, the causes of intracranial pressure, as well as the severity of the course of the disease.

Methods for measuring ICP

inside the skull in several ways. The choice of method depends on the clinical situation, experience and preferences of the attending physician, since most of of these procedures is associated with a violation of the integrity of the bones of the skull and the introduction of catheters into the brain.

The most reliable and commonly used method is currently considered to be the insertion of a special flexible catheter into the anterior horn. lateral ventricle brain. The advantage of this method is that, if necessary, cerebrospinal fluid can be pumped out through the catheter, and drugs can be injected directly into the ventricular cavity. Carrying out this measurement requires compliance with the rules of asepsis and antisepsis, so as not to introduce an infection.
Another common method is the use of a subdural probe. In this case, a hole is made in the skull bone through which the probe is inserted so that its tip is in the subdural or subarachnoid space. Advantage this method lies in the fact that the sensor is quite easy to install and at the same time the probability of injuring the brain tissue is quite small.
There are others modern methods ICP measurements using systems with intraparenchymal sensors. Their advantage lies not only in the relative safety and ease of installation, but also in the fact that they are easy to set up and help measure ICP even when severe swelling brain.
It is also possible to measure ICP without violating the integrity of the skull bones. These methods are based on the fact that when intracranial pressure changes, the eardrum. However, this method is possible only if the structure of the middle ear and brain stem is not disturbed. Non-invasive methods also include transcranial dopplerography - an ultrasound technique that determines ICP by the speed of blood flow in the vessels of the brain.

Treatment

If you find signs of intracranial pressure in yourself, you should not delay going to the doctor, as this is fraught with serious complications. Proper Treatment can be prescribed after the patient has passed diagnostic procedures and established the cause of the increase in ICP.

Treatment of ICP includes several points.

If possible, eliminate the cause high blood pressure. If it is caused by some kind of formation (for example, a tumor, hematoma), surgery is performed to remove it.
If too much cerebrospinal fluid has accumulated in the skull, a bypass or puncture is performed and created additional path for the outflow of liquor. This allows you to slightly reduce the pressure.
Prescribe drugs that reduce intracranial pressure: hormones, osmodiuretics, neuroprotectors, loop diuretics. Tablets and other types medicines are selected for each patient individually, taking into account the peculiarities of the course of the disease.
An important step in treatment is the appointment of the right diet. Restriction of fluid and salt allows both to reduce ICP and not to allow it to rise further.
When the threat to life is left behind, and maintenance therapy is needed. At this stage, physiotherapy, massage will be useful.

Treatment attempts folk remedies without asking for medical care can not only cause irreparable harm to health, but also miss the moment when drug treatment and surgery can still help. Similar treatment possible only at the stage of rehabilitation and with the permission of the attending physician.

Usually, the treatment of increased ICP takes several months and requires annual monitoring in the future, since relapses of the disease can occur.

Sometimes during intensive reduction of ICP or with a combination drug therapy and surgery may be observed reduced intracranial pressure. The patient becomes lethargic, drowsiness, headache and dizziness increase. There is nausea and vomiting. This state requires immediate treatment.

Content:

Intracranial pressure is the pressure inside the human skull. For example, in the ventricles of the brain, the sinuses of the solid meninges, subarachnoid and epidural space. At the moment of intracranial pressure in any of the above parts of the skull, an accumulation or lack of cerebrospinal fluid (CSF) occurs, which is provoked by a violation of its circulation. This liquid is always under a certain pressure and is systematically updated, due to circulation from one area to another. As a rule, the update process lasts a week, but sometimes there are violations. If the cerebrospinal fluid accumulates in one place, then the intracranial pressure rises, the cerebrospinal fluid decreases - the pressure decreases.

Causes and symptoms of increased intracranial pressure

An increase in intracranial pressure is an accumulation of excess cerebrospinal fluid, which gradually puts pressure on the brain. This disease is not “independent”, but a symptom of other ailments, such as:

Meningitis and encephalitis;
congenital anomalies;
Bruises, injuries, concussions (even past prescription or with congenital trauma);
Poisoning (drug and alcohol);
hypoxia;
Hematomas and intracranial hemorrhages;
Intracranial processes (tumors of the brain or its membrane);
In the vessels of the brain, blood supply is disturbed.

Symptoms of increased intracranial pressure are:

increased sweating;
Nausea and vomiting;
Headaches, especially severe in the morning;
"Bruises" under the eyes (pulling the skin, you can see small bruises);
Cardiopalmus;
Blurred vision, throbbing pain, double vision.

Please note that during weather changes and atmospheric pressure, manifestations of these symptoms are possible.

Causes and symptoms of low intracranial pressure

CSF leakage leads to a decrease in intracranial pressure. The reasons for this may be: narrowing of the artery of the brain, neoplastic diseases. Also, a decrease in pressure can occur after a head injury, with prolonged vasoconstriction, brain tumors, and when taking diuretic drugs for a long time.

Symptoms of this phenomenon:

Irritability;
Drowsiness;
Nausea and vomiting;
Headaches, especially worse when sitting.

Signs and symptoms of intracranial pressure in children

Parents of newborn babies should be alerted by frequent regurgitation with a "fountain", regardless of food intake, and obvious violations of the movement of the eyeballs. Prolonged "bloating" of the fontanel and an increased gap between its sutures are outward signs ailment. In the normal state, the fontanel should be slightly sunken.

It is recommended to measure the circumference of the child's head every month. A disproportionate or large head, its rapid growth, a bulging forehead are the first symptoms of increased intracranial pressure. The restless behavior of the baby also speaks of this disease: a sick child often “on the same note” monotonously and monotonously screams for several hours in a row. If the correct diagnosis is not made in time, then the child will significantly lag behind his peers in development (holding his head, crawling, sitting later).

In older children, increased intracranial pressure will cause severe headaches, convulsions, fatigue, strabismus, nausea, and vomiting. The child may complain of double vision, eye pain, and bright flashes before the eyes. Also noted in children is irritability, refusal to play, tearfulness, apathy, drowsiness, etc.

Diagnosis of intracranial pressure

Guided only by the symptoms, as well as when examined by a neurologist, it is impossible to understand whether there is intracranial pressure. For a correct diagnosis, diagnostic procedures must be performed. modern medicine determines intracranial pressure by indirect and direct methods.

Direct method for diagnosing intracranial pressure

Procedures within the framework of the direct method are rather complicated and are carried out only when intracranial hypertension cannot be established in any other way, since during such manipulations the needle is inserted into the ventricle of the brain or into the spinal canal. TO direct method includes spinal puncture and puncture of the ventricles of the brain.

Indirect method for diagnosing intracranial pressure

Most often, the diagnosis of low or increased intracranial pressure is established on the basis of indirect methods:

Visit to an ophthalmologist. With intracranial pressure, the outflow of blood from the eyes is disturbed, as a result of which edema of the optic disc is formed and the retinal veins expand.
Ultrasound of the brain, which determines the width of the ventricles of the brain. Most often, this procedure is carried out for children who still have an open fontanel.
CT (computed tomography) and MRI (magnetic resonance imaging). If necessary, before the procedure, enter into the bloodstream contrast agent. These manipulations will detect changes that increase intracranial pressure - an enlarged ventricle of the brain, thinning of brain tissue, etc.
EEG (electroencephalography) measures the functioning of the brain. In case of detection of violations of the performance of the brain, we can talk about increased intracranial pressure.

Treatment of intracranial pressure

Before starting treatment, the main diseases that caused the occurrence of increased intracranial pressure should be identified and cured, since the pressure itself is treated secondary.

Choose the dose and mode of fluid intake;
Take diuretics;
Drink teas and herbs that have a diuretic effect;
Perform therapeutic exercises that help normalize blood pressure, but without heavy physical exertion;
Adhere to a diet with limited salt and fatty foods;
Avoid saunas and baths;
Sleep on high pillows;
Go in for swimming, which helps to reduce ICP;
Systematically massage the "collar" zone;
Avoid flying in air transport;
Eat foods containing potassium - green vegetables, citrus fruits, dried apricots, potatoes;
Do not abruptly change the climate and time zones.

Reduced intracranial pressure should be treated with fluid stimulation (CSF) by normalizing the water and electrolyte balance. In case of non-receipt positive results it is necessary to close the hole through which part of the cerebrospinal fluid is pumped out. This is done with the help of surgery.

Watch a video about the types of intracranial pressure:

And finally, remember that the most accurate method for measuring intracranial pressure is the introduction of a catheter into the lateral ventricle of the brain, in the place where the cerebrospinal fluid is located. Another method is the subdural screw, which measures pressure in the subdural space.

Cranial pressure is the force that acts on the bones inside the skull. Pressure is caused by the presence of soft tissues in the skull, which include:

all nervous tissue;
cranial nerves;
arteries and veins;
ventricles of the brain;
hard, soft and arachnoid shells;
liquor and blood.

These components are in an ideal proportion for a person. This maintains intracranial pressure and allows all brain structures to work properly.

The pressure inside the skull is a physiological and dynamic phenomenon. It can vary within the normal range (from 5 to 15 mm Hg). These figures vary depending on clinical condition a person, his innate individual parameters of the organism and even the position of the body. So, standing on your feet, the pressure takes on a negative value of "-5 mm Hg."

Pathology occurs when intracranial pressure indicators deviate from the norm, and adaptive defense mechanisms cannot resolve it. The pressure inside the skull is considered elevated when its value exceeds 16-18 mm Hg.

The human nervous system has learned to defend itself against surges in intracranial pressure by such mechanisms:

An increase in blood pressure with a jump in intracranial. The vessels of the brain narrow - this reduces blood flow and partially prevents from a stronger increase in pressure inside the skull.
Cushing reflex. It lies in the fact that the heart rate decreases reflexively and the number of breaths per minute decreases.

However, these mechanisms temporarily "save" the brain from damage. With high intracranial pressure (more than 20 mm Hg), such a protective reaction is ineffective.

Increased pressure of the brain and its components causes pathology - intracranial hypertension.

The disease damages nerve tissue. This is clearly represented by the formula:

Brain tissue volume + CSF volume + blood volume = constant.
The volume of brain tissue = the volume of the intracellular environment + the volume of the extracellular environment.

Increasing the value of one of these components leads to intracranial hypertension- this compresses the brain, which damages its structures. In childhood (up to the first year), this is compensated by diverging seams. However, after the closure of all fontanelles and the ossification of the skull, this mechanism stops working.

Causes

The pressure inside the head rises due to such reasons:

Volumetric processes in the brain: tumors, hygroma, foreign object in the cranial cavity, hydrocephalus in children.
Pathological conditions: violation of the outflow of cerebrospinal fluid, cerebral edema, venous blood stasis.
Inflammatory diseases:,.
Acute conditions: hemorrhagic stroke, .

Symptoms

An increase in craniocerebral pressure leads to the development of intracranial hypertension syndrome. General symptoms compression:

Increasing headache. Patients complain of a bursting character pain syndrome which makes you wake up during sleep. Cephalgia is aggravated by coughing, urinating and defecation.
Dizziness and nausea. Also vomiting, sometimes with relief.
Disorders of consciousness according to the stem type: stunning, lethargy, drowsiness, apathy and indifference.
Convulsive seizures.
Autonomic disorders: loss of appetite, sweating, increased blood pressure, cold fingers and extremities, pain in the heart.
Symptoms in adults: decreased libido, erectile dysfunction.

External and Clinical signs compression:

Edema of the optic disc.
Increased cerebrospinal fluid pressure.
Swelling of the legs. Hands swell less often.
Increased skeletal muscle tone.

Mental functions are upset:

Attention decreases, memory deteriorates, the pace of thinking slows down.
Irritability, excitability.
Switching between inhibition and excitation is slowed down in nervous system. This is manifested by difficulty in waking up after sleep.

At strong rise craniocerebral pressure, the structures of the brain are displaced and a dislocation syndrome occurs. The clinical picture depends on the displaced structure. For example, when shifting oblong of the brain, respiratory functions are disturbed and cardiovascular activity: the number of heart beats per minute decreases and the respiratory rhythm is disturbed.

Intracranial pressure may be congenital pathology. In this case, the following symptoms dominate the clinical picture:

The size of the head is disproportionate to the body.
Pulsation of fontanelles and their protrusion.
Violation oculomotor nerve: children cannot raise their eyes.
Increased skeletal muscle tone.

In preschool children and school age there are difficulties in learning: they absorb information worse due to bad memory and reduced concentration.

Diagnostics

An increase in intracranial pressure is the responsibility of neurologists. On an objective examination, the following factors are taken into account:

mental state: consciousness, the adequacy of the reaction to the stimulus, the patient's involvement in the world around him;
neurological history: state of reflexes, pupillary reaction to light, presence of convulsions and preservation of sensitivity;

Bottom eyeball studied by an ophthalmologist. It reveals swelling of the optic nerve.

Instrumental research methods will help visualize the cause of the pathology. Applicable:

. The method detects hemorrhagic stroke and changes in the size of the ventricles. If an infection is suspected, a contrast agent is injected into the blood - it helps to exclude or confirm a violation of the blood-brain barrier
. It is prescribed if there is a suspicion of blood clots in the veins of the brain.
. It is prescribed if there is no obvious reason for the increase in craniocerebral pressure.

Treatment and prevention

In treatment the main objective- eliminate the cause, as it determines the course of therapy. But when in short terms it is impossible to establish the etiology of the disease, it is urgent to eliminate the existing symptoms.

Emergency care includes the administration of diuretics (water pills). This frees the brain from excess fluid. Mannitol is administered in large doses intravenously. For an additional effect, Furosemide is introduced. These funds stabilize the rheological properties of blood and unload the vessels of the brain.

First aid for an unknown cause also includes cerebrospinal fluid control. To do this, puncture spinal cord and release liquor. If necessary, they pierce the ventricles of the brain and release fluid from them - this is the most urgent way to unload.

Symptomatic therapy is determined by the clinical picture. For example:

Convulsive seizures are stopped by anticonvulsants: Sibazon or Lorazepam.
In case of respiratory failure, the patient is connected to piece ventilation of the lungs.

To prevent intracranial hypertension, it is necessary to prevent and treat the underlying disease that led to an increase in pressure inside the skull, so there are no specific prevention measures. However, keeping general recommendations, you can prevent the load on the brain:

Control the amount of water drunk per day: no more than 1.5-2 liters.
Blood pressure control.
Diet: reduce the amount of salt and salty foods.

If a person suffers from severe headaches, it is possible that intracranial pressure is increased. It is not an independent disease, but alarm symptom, which indicates impaired cerebral circulation, vascular pathologies. Effective treatment cranial pressure includes medication, active lifestyle.

How to determine intracranial pressure

If you systematically remind yourself pressing pain in the back of the head and temples, a health problem exists. An unpleasant attack of VHF disturbs the patient immediately after waking up in the morning, and is stable throughout the day. Other signs of progressive pathology are dizziness, nausea, vomiting, increased drowsiness, increased sweating.

To determine intracranial pressure, it is necessary to perform CT and MRI, pass a series of blood tests, undergo a study of cerebrospinal fluid, measure cerebrospinal fluid pressure, and correctly differentiate the diagnosis. Accompanied by high intracranial pressure and other symptoms that reduce the quality of life of the patient. Therefore, the diagnosis must be comprehensive.

Norm of intracranial pressure

Doctors at any age of the patient take note of the HPV indicator, especially if its value does not correspond to acceptable limits. The norm of intracranial pressure is determined age category Therefore, its level in the older generation and children differ markedly. If we talk about an adult organism, the permissible limit in medicine is 5-7 mm Hg. Art.

How to treat intracranial pressure

Before transgressing to intensive care, it is important to find out why in the body occurs characteristic disease. With VHD, doctors do not exclude such dangerous diseases such as vascular aneurysm, hydrocephalus, stroke, benign neoplasms in my head malignant tumor, craniocerebral injuries, hematomas and other causes of impaired blood circulation.

It is required to treat intracranial pressure comprehensively, starting with the elimination of the provoking factor. Effective drugs and their daily dosages are prescribed to the patient individually, since other pathologies of the hematopoietic organs may be present. Additionally prescribe therapeutic diet with mandatory withdrawal from daily menu salt, fatty and fried foods, excessive fluid volume.

Tablets from intracranial pressure

If frequent attacks occur, they can bring the patient to immediate hospitalization with the need for resuscitation. It is difficult to cure the pathology, therefore, the treatment of intracranial pressure in adults is aimed at ensuring a period of remission, its extension for an indefinite period. List effective pills from intracranial pressure is presented below:

Nootropics to improve memory, blood outflow: Nootropil, Piracetam, Pantogam.
Preparations for stimulating cerebral circulation: Sermion, Cinnarizine, Cavinton.
Hormonal preparations in relatively small doses: Dexamethasone, Dexamed, Dexazon.
Diuretic drugs for removing excess fluid: Diacarb, Diamox, Diuremid.
Osmodiuretics to reduce the volume of cerebrospinal fluid with its increased volume: Mannitol, Glycerol.
Antiglaucoma drugs to prevent complications associated with impaired cerebral circulation: Azopt, Trusopt.
Hypertensive drugs to control blood pressure, keep its mark on acceptable level: Dopamine, Epinephrine, Angiotensinamide.
A complex of vitamins to increase the elasticity of the vascular walls: Ketonal Duo, Neurovitan, Neurobion, B-50, the use of medicinal herbs.
Ventricular puncture for measurement and reduction of CSF volume in the cranium in complicated clinical presentations.
Manual therapy, hyperbaric oxygen therapy, hyperventilation are introduced as ancillary treatments for intracranial pressure.
Methods alternative medicine, for example, folk treatment hawthorn, acupuncture.

If the attacks have become permanent, and the person suffers from severe headaches and signs of dyspepsia with existing therapy, it is urgent to change the treatment of intracranial pressure in adults. It is important to choose drugs that are efficiently absorbed into the systemic circulation and distributed throughout the body up to the brain. Otherwise, the positive dynamics is in no hurry to move, moreover, it is not excluded serious complications with health.

Diuretics for intracranial pressure

In this clinical picture, the presence of diuretics is mandatory, which stabilize water balance organism. Getting rid of excess water necessary to prevent venous and arterial stagnation, normalize blood pressure, formation and excretion bad cholesterol and products of intoxication. Diuretics with intracranial pressure form the basis of intensive care, they are distinguished by their multifaceted action in the body. Below are especially effective drugs from intracranial pressure in adults with a diuretic effect.

Glycerol for intracranial hypertension

If picked in time effective medicine from intracranial pressure in adults, the spread of chronic form a characteristic ailment in a weakened organism. In this case, improvements can be expected in the near future, sustainable therapeutic effect. Glycerol for intracranial hypertension is available in the form of a therapeutic solution and suppositories, active ingredient is glycerin. This active substance not only suppresses acute attack intracranial pressure, but also fights disorders intraocular pressure.

Daily doses depend on the patient's age, general health, presence of chronic diseases. Glycerol suppositories are prescribed rectally, daily dose- 1 suppository after meals once a day for 7-10 days. Regular sessions help to reduce not only intracranial pressure, but also reduce the amount of cerebrospinal fluid, and exclude the formation of cerebral edema. Use the drug for extensive areas of damage, but first seek help from your doctor.

Treximed

To finally get rid of unbearable migraine attacks and areas of necrosis in the cerebral cortex, doctors offer different medical methods, but Treximed is especially effective as a powerful decongestant and anesthetic. If symptoms of high intracranial pressure appear, the instructions for the use of Treximed come to the aid of the patient, which describes in detail how to take the medicine to reduce symptoms, to see the desired result. Provided that daily doses are observed, this method of treatment really works.