Increased intracranial pressure
Increased intracranial pressure is a rise in the pressure inside the skull that can result from or cause brain injury.
ICP; Intracranial pressure - increased; Intracranial hypertension; Acute increased intracranial pressure; Sudden increased intracranial pressure
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:
- Separated sutures
- Bulging of the soft spot on top of the head (bulging fontanelle)
Older children and adults:
Signs and tests
A health care provider will usually make this diagnosis at the patient's bedside in an emergency room or hospital. Primary care doctors may sometimes spot early symptoms of increased intracranial pressure such as headache, seizures, or neurological problems.
An MRI or CT scan of the head can often determine the cause 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 inside the brain.
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:
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.
- Permanent neurological problems
- Reversible neurological problems
Calling your health care provider
A health care provider will usually make this diagnosis in an emergency room or hospital.
This condition usually cannot be prevented. If you have a persistent headache, blurred vision, changes in your level of alertness, neurological problems, or seizures, seek medical attention as soon as possible.
Ling GSF. Traumatic brain injury and spinal cord injury. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 422.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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