Increased intracranial pressure is a popular diagnosis. This arises dangerous illness both in a child and an adult. Various causes of the disease complicate its treatment, but thanks to modern methods diagnostics, it is possible to get rid of elevated ICP forever. Find out why this disease is dangerous and how to reduce intracranial pressure with medications at home.

What is intracranial pressure

Increased cranial pressure is caused by an increase or decrease in the amount of intracranial fluid - cerebrospinal fluid. It protects the brain and its membranes from damage, provides nutrition, breathing nerve cells. Normally, about 1 liter of cerebrospinal fluid is produced per day. Thanks to normal microcirculation, the functioning of the brain and nerve cells is maintained. ICP healthy person varies from 3-15 m Hg. Deviations from these indicators are dangerous condition and requires treatment.

The following studies will help your doctor diagnose increased intracranial pressure: CT, MRI, cerebrospinal fluid puncture, ultrasound of the head, and fundus examination. The causes of impaired outflow of cerebrospinal fluid are often traumatic brain injuries, inflammatory diseases, sharp jumps height in teenagers nervous tension, tumors, alcohol and vitamin A poisoning, pregnancy. The list of symptoms is very diverse, the main thing is to notice them in time and be properly examined. The main signs of increased ICP are:

• sharp decline peripheral vision, and later the central one;
• frequent headaches;
• disproportionately big head in a child;
• swelling of the face (eyelids, cheekbones) and neck;
• constant nausea and vomiting;
• frequent fatigue, emotional lability or irritability;
• sharp headache when coughing, sneezing, bending over;
• frequent regurgitation (in infants).

How to lower intracranial pressure

If this disease is detected, an experienced doctor will tell you what to do with intracranial pressure in order to prevent hazardous to health consequences. Helping a child or adult requires an integrated approach. Correct and effective treatment aimed at identifying and eliminating the causes of the disease. Integrated approach includes physiological procedures, special gymnastics, drug therapy, folk remedies, diet. All this helps to reduce high blood pressure and return the patient to normal life.

If the original cause was a brain tumor, you will need surgery. Depending on the severity of the disease, the doctor chooses treatment tactics and therapy methods. This can happen in an outpatient clinic or at home. The main thing is not to self-medicate, but to carefully follow the recommendations of your doctor.

Drugs that reduce intracranial pressure

In drug therapy, more than one drug is used to reduce intracranial pressure. Each drug has instructions, which you can read online or at the pharmacy. The following groups of medications are used:

• beta-blockers (Bisoprolol, Analopril, Atenolol, Propranolol);
• alpha-one adrenergic blockers (Losartan, Irbesartan, Doxazosin, Nicergoline);
• angiotensin-converting enzyme inhibitors (Captopril, Capoten);
• Ca channel antagonists (Cordaflex, Amlodipine);
• plasma expanders (Albumin);
• diuretics (Hypothiazide, Spironolactone, Furosemide, Torasemide, Glycerol);
• sedatives(, Notta, motherwort herb);
• vasodilators;
• hormonal drugs(Dexamethasone).

Folk remedies for intracranial pressure in adults

It is possible to treat intracranial pressure in adults with folk remedies. You can find out how to quickly reduce intracranial pressure from your doctor or chiropractor. Traditional methods can be used to treat when the disease has progressed to chronic form. Apply a massage to the neck and head area to relieve vascular tone: it will not raise blood pressure for a long time. Recommended to take soothing herbs– motherwort, valerian, hops. Many folk remedies include the use of honey and bee products. Here are some recipes:

1. Mix equal amounts of dried fruits (dried apricots, raisins) and nuts (walnuts or almonds). Pour the mixture linden honey, consume 30 g on an empty stomach.
2. Take 150 g of lemon juice, 350 g of liquid honey, 2 cloves of crushed garlic. Mix the containers and leave in a dark, cool place for 10 days. Drink a teaspoon in the morning and in the evening after meals.
3. Rub your hands and feet with propolis and mint tincture in a ratio of 10:1. Use this medicine every 2 days.

How to treat intracranial pressure

Correct treatment intracranial pressure depends on its causes. If this is a congenital disease, massage is used and diuretics are used. The best remedy for adults it is peace and limitation of nervous stress. Drugs in tablets for hypertension have shown themselves to be effective: they reduce high vascular tone. The use of plasma substitutes equalizes the pressure between brain tissue and plasma. It is possible to treat ICP if you see your doctor early and follow his instructions. The right medicine can normalize the condition for a long time.

Vasodilators for the brain

Vasodilators for blood pressure help relieve vasospasm and reduce intracranial pressure. They remove the blockage of the outflow of cerebrospinal fluid into the venous network. The following have proven effective in treating this disease:

• No-shpa;
• Eufillin;
• Papaverine hydrochloride;
• Magnesium sulfate;
• drugs nicotinic acid;
• antihypertensive drugs.

Antispasmodics

Many antispasmodic drugs are widely used to treat increased intracranial pressure. They clean well pain syndrome and spasm. These are Tempalgin, Spazmalgon, No-shpalgin. Each tablet contains a vasodilator and analgesic component. Read the instructions carefully before taking the medication, and adhere to the dosage prescribed by your doctor.

Diuretics for intracranial pressure

Diuretics for intracranial pressure help remove excess cerebrospinal fluid from the skull. They relieve swelling from the face and limbs well. Diuretics are for emergency therapy when excess fluid needs to be quickly removed from the body (Furosemide, Lasix) and for complex fluid (Veroshpiron, Diacarb). During treatment, it is necessary to replenish lost potassium and magnesium ions. They are very important for the functioning of the heart muscle and brain. Along with diuretics, you need to take the following tablets: Asparkam, Panangin. Lowering ICP with diuretics is used for all causes of the disease.

Treatment with corticosteroid drugs

If the cause of intracranial hypertension is intoxication (alcohol, chemical products), inflammation meninges, brain tumor - hormonal corticosteroid drugs are used (Hypothiazide, Prednisolone, Dexamethasone). They effectively restore the normal outflow of cerebrospinal fluid and relieve inflammation. They are prescribed to adults and children, the dose is calculated based on weight.

How to relieve intracranial pressure at home

Chronic patients already know the signs when they have increased ICP. These tips will improve your well-being:

• do light massage heads with fingertips;
• apply ice wrapped in a towel to your forehead;
• give up coffee;
• make a special one therapeutic exercises to reduce ICP;
• stick to a special diet, exclude alcohol, fatty spicy foods;
• stop smoking.

Video: reducing intracranial pressure

In addition to blood pressure, there are many indicators that indicate the presence of serious illnesses. Intracranial pressure (ICP) will also tell you a lot. This diagnosis may seem scary, but treatment with specialist consultation is usually successful. The main thing is to contact a medical facility in time so that the disease does not develop into running form. Let's take a closer look at what intracranial pressure is, its symptoms and treatment in adults.

Increased intracranial pressure is the stagnation of cerebrospinal fluid in the skull, in certain areas of it. This liquid is called liquor, it is constantly moving and being renewed. But due to various reasons due to the difficulties of circulation, it penetrates and remains in certain cavities of the brain, thereby causing additional pressure.

Pressure standards vary quite a lot (60-200 mm water column or 3-15 mm Hg).

Liquor is needed for human body, since it is a shock-absorbing agent for possible bruises and injuries.

Brain tissue puts pressure on the fluid, and with changes in this process, the accumulation of cerebrospinal fluid occurs in a certain brain section. This leads to increased intracranial pressure. The accumulation of cerebrospinal fluid is localized depending on the disease leading to this pathology. According to this principle, symptoms also differ.

Doctors distinguish between acute and chronic form intracranial hypertension:

• The acute form appears due to brain damage and hemorrhage. This happens during a stroke. If you don't call ambulance, pathology can lead to death or irreversible consequences for human health, significantly worsening the quality of life. Medicines are powerless here, so craniotomy must be used. With it you can quickly get rid of high blood pressure by removing damaged brain tissue and spilled blood;
• The chronic form usually occurs as a result of neurological diseases. It could also be an infection or a side effect from taking certain medications.

Typically, intracranial pressure increases due to diseases such as:

Symptoms

Symptoms of ICP in adults are as follows:

Signs of intracranial pressure in adults with autonomic dysfunction syndrome:

Stroke-like conditions can lead to fatal outcome. Increased intracranial pressure in this case manifests itself in the following symptoms:

• loss of consciousness, coma;
• pathologies of the respiratory and cardiovascular systems;
• weakening of the arms and legs;
• constant vomiting;
• speech disorder;
• pathologies of the pelvic organs, expressed in incontinence or retention of feces and urine;
• dizziness leading to difficulty walking.

Diagnosis of intracranial hypertension

Basic diagnostic methods in adults:

Treatment of ICH

Let's consider what to do after the disease has been recognized. The doctor determines the treatment of intracranial pressure depending on the cause of the pathology. If an aneurysm, hematoma or tumor is detected, surgery will be required. Excess cerebrospinal fluid is removed using a shunt. For other diagnoses, doctors prescribe conservative treatment.

Medicines and procedures

The following medications are mainly prescribed:

Procedures for intracranial pressure:

• hyperventilation;
• acupuncture;
• massage;
• physical therapy;
• hirudotherapy (treatment with leeches).

Please note: Homeopathy and physiotherapy are not used for brain tumors and head and spinal injuries.

Diuretic drugs have positive influence with high intracranial pressure. Diacarb is considered the most effective. The drug will help remove excess fluid through hard work kidney There is a decrease in the volume of cerebrospinal fluid, which eliminates the manifestations of intracranial pressure. "Diacarb" has a convenient dosage, side effects practically none.

Many drugs are prohibited during pregnancy. Typically, drug treatment in this case is limited to corticosteroids and diuretics.

Folk remedies

Let's look at how to treat intracranial pressure using traditional methods. To prepare Vanga's recipe you will need:

• Corn flour – 1 tbsp. l. ;
• Boiling water – 1/2 cup.

Mix the ingredients and leave for 40 minutes. Pour off the settled liquid so that there is no sediment in the infusion. Take the medicine on an empty stomach and eat after an hour. Then you need to do this before bed two hours before your last meal. Course duration: twice a day, no more than 30 days without a break. During therapy, it is useful to take magnesium or potassium tablets or include more in the diet walnuts, dried apricots, dates, prunes.

For the following folk method you will need:

• Lemon – 1 pc. ;
• Honey – 2 tbsp. l. ;
• Water – 100 ml.

Cut the citrus into two parts and squeeze out the juice. Mix the ingredients and consume within 60 minutes. It is recommended to drink at night, but the mixture may cause sleep problems for some due to ascorbic acid in large quantities. In this case, you can drink the drink in the morning. Take for intense headaches. The duration of the course is 20 days, after which you need to take a ten-day break.

To prepare a decoction of plantain you will need:

• Water – 0.5 l;
• Dry plantain – 3 tbsp. l.

Add herbs to the liquid and keep on the stove for a quarter of an hour. Then let it brew for 30 minutes. Use 4 times a day in a dosage of 50 g.

Will help hot bath with linden. To prepare a decoction for water procedures you will need:

• Boiling water – 2 l;
• Linden blossom - 2 cups.

Mix the ingredients and leave for 40 minutes. The bath should be at a temperature of 50 degrees. Pour the broth into the bath and lie in it for 30 minutes or longer. It needs to be constantly refilled hot water. In the bathroom you need to sit on a height (small chair or inflatable pillow). The body is almost in a vertical position, the legs are 20-30 centimeters below the pelvis. This will help outflow excess liquid from the head area.

To prepare a head mask you will need:

• Alcohol 70% - 50 ml;
• Camphor oil – 50 ml.

Camphor oil can be purchased at any pharmacy. Apply the mixture to the scalp, rubbing a little. Afterwards, put cellophane or a special hat on your head and insulate it with a towel. The mask should be left on all night, and upon waking, rinse with shampoo. After a week of such procedures, the pressure will drop.

To make a mint compress, you need the following ingredients:

• Water – 1 l;
• Mint, crushed – 1 cup.

Place the mixture on the stove for a quarter of an hour, wait until it cools to 50 degrees. Dip a cotton cloth into it and place it on your head. Keep until cool, then change until the broth is finished.

Exercises

Therapeutic exercises can be considered as an alternative to certain medications in drug therapy, and preventative measure in order to reduce the risk of seizures. The specialist selects techniques depending on the diagnosis.

The most famous exercises to help cure ICP:

1. Smoothly tilt your head left and right, touching your ears to your shoulders. Also bend forward and backward, pulling your chin towards the chest area. Then you need to slowly rotate your head to the sides. Each tilt should be about twenty times. At first, pain may appear due to tension in the neck muscles, but then it disappears;
2. Put your hands behind your neck, wrap them around bottom part the back of the head to thumbs were on the neck muscles, which are located at the level of the earlobes. After a quarter of an hour, run your fingers along them up and down. This will help cause blood to flow out of the brain and cause noticeable relief in the back of the head and temples;
3. To perform breathing exercises, you need to take a straight sitting position. Inhale through your nose, holding your breath for a few seconds. Exhale slowly, pursing your lips into a tube. The exercise should continue for several minutes. At this time, you need to pay attention to your feelings.

Nutrition for ICP

With increased intracranial pressure, nutrition should be based on the correct ratio of proteins, fats and carbohydrates. You should also normalize your water balance by reducing or eliminating salt when cooking.

Allowed to eat:

The last meal should be three hours before bedtime. You need to drink 1.5 liters of water per day. Meals are fractional, 5-6 times a day in small portions.

Prohibited products:

• cakes;
• cakes;
• alcoholic drinks;
• pancakes, baked goods and fresh bread;
• chocolate;
• pickles and pickled vegetables;
• smoked dishes;
• spices.

The basics of the diet are agreed upon with the doctor; meal changes are made after consultation. You should not self-medicate - it can be dangerous.

It is recommended to be outside more often - this will help improve blood circulation. Yoga classes will help. It is important to explain to the specialist why you came to class. Increased physical activity with increased intracranial pressure can be harmful. Treatment cannot be delayed; if symptoms are detected, you should immediately consult a doctor.

Increased intracranial pressure or intracranial hypertension- this is an increase in the pressure of the cerebrospinal fluid (CSF), which circulates in the ventricles of the brain, the space between the brain and the skull, and the spinal canal. This condition is not an independent disease; it only accompanies other pathologies.

Everyone has intracranial pressure (ICP), like blood pressure. From a physical point of view, this is the difference between the pressure in the cranial cavity and atmospheric pressure. Intracranial pressure is a subject of much controversy and there are several reasons for this.

• Firstly, what is considered an increase in blood pressure? Norms vary greatly depending on the situation and individual characteristics person. Normal indicators: from 60 to 200 mm of water column or from 3 to 15 mm of mercury.
• Secondly, the amount of pressure is difficult to determine. The only reliable method of measurement is puncture spinal canal or ventricles of the brain. This surgical procedure requires special training and sterility from the doctor. Other research methods, even the most high-tech (CT, MRI), can only reveal indirect signs of intracranial hypertension.
• Thirdly, intracranial pressure increases several times when sneezing, bending forward, straining, physical activity, stress, screaming, crying. At such moments, any person’s blood pressure increases 2-3 times. This is the so-called benign increase in intracranial pressure. It normalizes on its own and does not require treatment. But if a neurologist examines a frightened, crying person infant, then most likely he will see signs of increased intracranial pressure.

This situation has led doctors to diagnose increased intracranial pressure in 70% of newborns and millions of adults. For many of them, treatment is prescribed on a justified basis, without appropriate examination.

In fact, increased intracranial pressure is a serious pathology that is treated in the department intensive care or in intensive care. Fortunately, such cases are very rare.

Anatomy of the central nervous system

The brain is located in the cranium. It is a very delicate substance. For protection, the brain is covered with three membranes: soft, arachnoid and hard.

To ensure brain function, the body produces cerebrospinal fluid, also known as cerebral fluid or cerebrospinal fluid. Its functions: protect the brain from injury from the walls of the skull, ensure its water-electrolyte balance and nutrition. In an adult, its amount reaches 150 ml, which is 10% of the cranial cavity.

To understand the mechanism of increased ICP, it is important to understand the “circulation” of cerebrospinal fluid in the body.

1. Produced
   • in glandular cells of the choroid plexuses in the ventricles of the brain 70%;
   • from the liquid part of the blood that sweats through the walls blood vessels in the ventricles of the brain 30%. It takes up to seven days to completely renew the cerebrospinal fluid;
2. Circulates in
   • The ventricles of the brain. There are 4 ventricles in total: the left and right lateral, the third and the fourth. Liquor flows from the lateral ventricles into the third, from there through the cerebral aqueduct into the fourth ventricle. Through the openings in the fourth ventricle, cerebrospinal fluid enters the subarachnoid space.
   • Subarachnoid space The brain is the space between the soft and arachnoid (arachnoid) membranes of the brain. Over large cracks and the grooves of the brain and at its base there are 6 cisterns containing large number cerebrospinal fluid. Fluid enters the cisterns from the fourth ventricle, where it is absorbed.
   • Spinal canal spine, washing the spinal cord.
3. Absorbed into the blood through the venous sinuses of the arachnoid mater.

To summarize: cerebrospinal fluid is formed from the blood, circulates through special pathways, washing the brain, and is absorbed back into the blood. If a malfunction occurs at any of these stages, then the pressure in the skull increases. Liquid squeezes nerve tissue and stretches the sensitive membranes of the brain, while appearing painful sensations and other symptoms of increased ICP.

Causes of increased intracranial pressure

Congenital pathologies:

• Pathology of the venous sinuses responsible for absorption

There is a lot of cerebrospinal fluid. It occupies a large volume in the skull: the ventricles increase under the pressure of fluid and compress the surrounding brain structures, the size of the head increases significantly, and the sutures between the bones of the skull diverge.

Unfavorable pregnancy:

• Toxicosis during pregnancy
• Difficult, protracted labor
• Umbilical cord entwinement

In these cases, the fetus experiences a lack of oxygen. To ensure the brain breathes, compensatory mechanisms are activated and the production of cerebrospinal fluid increases.

Infections of the central nervous system:
With diseases, swelling occurs and the brain tissue increases in size. At the same time, the effusion of blood plasma through the walls of blood vessels increases, which leads to an increase in the amount of cerebrospinal fluid.

Infectious diseases:

• Mastoiditis

During infections, blood pressure rises. It causes excess production of cerebrospinal fluid. Consequence past diseases Liquor absorption becomes impaired.

Reception medicines:

• Corticosteroids
• Tetracycline antibiotics
• Biseptol
• Nitrofurans
• Retinoids
• Oral contraceptives

These drugs may cause pseudotumor cerebri syndrome. This condition is characterized by cerebral edema, impaired circulation of cerebrospinal fluid and its absorption.

Endocrine disorders:

• Adrenal insufficiency
• Hepatic encephalopathy

Metabolic disorders lead to increased blood pressure. Under such conditions, it is filtered into the cerebrospinal fluid more water. At the same time, absorption is impaired due to high pressure in the veins. It is believed that these changes are triggered by an increase in estrogen levels.

Brain swelling caused by brain injury:

• Open and closed craniocerebral injuries
• Neurosurgical operations

In the space between the arachnoid and soft shells blood enters the brain, it damages the villi, which are responsible for the absorption of fluid into the venous system. It happens that this vein becomes blocked by a blood clot or atherosclerotic plaque and stops taking liquor.

Symptoms and signs of increased intracranial pressure

1. Headache without specific localization. The pain intensifies when bending over, coughing, sneezing, turning the head, when the outflow of cerebrospinal fluid is disrupted. The pain is bursting and intensifies in the morning. This is explained by the fact that the horizontal position increases blood flow to the head and increases the production of cerebrospinal fluid.
2. Congestive optic disc, hemorrhages in the form of flames. The veins of the fundus are tortuous and congested with blood, the pulsation of blood in the veins is reduced or absent altogether - these are the results of stagnation in venous system.
3. Visual impairment:
   • double vision
   • short-term fogging
   • intermittent blindness
   • peripheral vision impairment
   • uneven pupils
   • decreased response to light

It occurs when pressure on the visual centers in the brain stem increases and the optic nerve is compressed.

• Inability to close eyelids or the "setting sun" symptom. The eye remains open constantly. When looking down between closed eyelids, it is noticeable top edge iris as a result of the eyeball protruding outward.
• Dark circles under the eyes. Upon closer examination, it turns out that they are caused by congestion of small veins under the skin of the lower eyelid.
• Nausea and vomiting not associated with food intake. Vomiting is sometimes gushing and does not bring relief, unlike migraine attacks. This symptom is caused by irritation of the nerve endings of the vomiting center located in the medulla oblongata.
• Attacks of sweating, chills– consequences of disturbances in the functioning of the autonomic nervous system.
• Irritability, lethargy, fatigue, workload. Oppression mental functions- these are signs pyramidal insufficiency, which occurs when the medulla oblongata and cortex are compressed cerebral hemispheres.
• Depression and mood instability- are the result of compression of the hypothalamus and the centers responsible for the formation of emotions in the hypothalamus.
• Back pain associated with increased pressure in the spinal canal
• Muscle paresis– may occur on one limb or one half of the body. Muscle weakening, similar to paralysis, occurs when the nerve cells of the motor centers in the brain or spinal cord are damaged.
• Dispnoe – shortness of breath, accompanied by a feeling of lack of air. Occurs when squeezed respiratory center in the medulla oblongata.
• Increased sensitivity skin– hyperesthesia. The sensation of “running goosebumps” occurs when the stem sensory nuclei are irritated.

Diagnosis of the causes of increased intracranial pressure

1. Spinal (lumbar) puncture and cerebral fluid studies.

   Insertion of a puncture needle into the space between the arachnoid (arachnoid) and soft membranes spinal cord in the lumbar region.

   To perform the procedure, you need to lie on your side and press your knees to your chest. The puncture is made between the 3rd and 4th lumbar vertebrae. The spinal cord ends higher, at the level of the 2nd vertebra, so the doctor cannot damage it. The skin is treated with antiseptics and anesthetized with a 2% novocaine solution. That's why this procedure although unpleasant, but not painful.

   After the needle is inserted into the spinal canal, cerebrospinal fluid is released from the cannula. To measure its pressure, a pressure gauge is connected to the needle. Its scale shows the pressure level. In the supine position, up to 150 mm of water is considered normal. Art. Foreign doctors do not consider an increase in pressure to 240 mm of water to be a pathology. st when the person is feeling normal. IN sitting position pressure above 250-300 mm.
   
   Signs of intracranial hypertension in the study of cerebrospinal fluid:

   • The cerebrospinal fluid pressure exceeds the norm by 3 times;
   • Yellowish green tint fluids – with meningitis and encephalitis, yellow with cyst rupture;
   • An increase in the number of cells (leukocytes, eosinophils): high cytosis (more than 150 in 1 ml) indicates hypertension caused by meningitis, moderate cytosis of 10-100 cells occurs with chronic irritation of the meninges, syphilis, arachnoiditis.
   • Increased level protein (more than 0.33 g/l) indicates a tumor or infectious process, too much low content talks about hydrocephalus;
   • The presence of bacteria indicates the infectious nature of the increase in ICP. Meningococci, pneumococci, staphylococci, helminth larvae, and fungi are found in the cerebrospinal fluid.
   • Heterogeneity of the cerebrospinal fluid – with tuberculous meningitis a film of fibrin fibers forms on the surface of the cerebrospinal fluid; coagulation of the cerebrospinal fluid can be caused by a tumor; a sediment of fibrin flakes falls out during purulent meningitis.


2. Ophthalmoscopy or fundus examination

   The ophthalmologist directs a light beam through the pupil onto the retina of the eye. This makes it possible to find out what is happening “inside the eye.” Often, before the examination, drops are instilled to dilate the pupil to see the peripheral parts of the retina.

   Signs of increased ICP during fundus examination:

   • Edema, hyperemic (reddened) optic nerve nipple. This picture is caused non-inflammatory edema;
   • Tortuosity and congestion of the fundus veins;
   • Absence of blood pulsation in the vessels of the retina;
   • The retina is covered with multiple hemorrhages caused by the rupture of overcrowded vessels.


3. MRI (magnetic resonance tomography) heads

   The study is based on the action of a nuclear magnetic resonator (NMR). This device takes into account the response of the nuclei of hydrogen atoms in tissues to exposure to a magnetic field. The device converts the impulses of atoms into an image. With its help it is possible to obtain a high-precision image. The procedure does not require the administration of contrast or radioactive substances, and has a very low radiation exposure.

   The tomograph looks like a pipe or tunnel. The patient lies down on a table and is placed inside the tube. The study lasts about half an hour. During this time, you must remain still. Any movement can ruin the quality of the pictures. Therefore, children are given anesthesia or sedatives.

   CT scanner creates a series x-rays to visualize the pattern of lesions in the skull and medulla. This method is not used often due to X-ray exposure and the need to inject contrast agents into blood vessels. Besides computed tomography diagnoses changes in the skull, with a long-term increase in ICP; in the early stages it is less informative.

   Symptoms of increased ICP during computed tomography.

   • Areas of brain damage larger than 0.5 cm. These can be neoplasms, cysts, areas of softening after a stroke;
   • Swelling of brain tissue;
   • Displacement of brain structures due to cerebrospinal fluid pressure on them;
   • Rarefaction of the medulla around the ventricles;
   • Strengthening the pattern of finger impressions;
   • Skull suture dehiscence;
   • Compression or expansion of the ventricles.
4. Electroencephalography

   This is a method for studying the bioelectrical activity of the brain. Using sensitive equipment, the electrical potentials that arise during brain activity are measured through the scalp.

   The pulses are recorded as a graphical curve. This makes it possible to study the frequency, amplitude and shape of impulses from each part of the brain, and the coherence of the work of its different parts.

   Increased intracranial pressure is indicated by:

   • The appearance of rhythms with high frequency: Beta-1, Beta-2, Gamma;
   • Diffuse changes bioelectric activity of the brain;
   • Excitation various structures brain: cortex, middle sections, etc.
   • Paroxysms (excitement) occurring in different areas brain, which intensify against the background of tests.
   These changes indicate irritation of various brain structures when they are compressed.
5. Neurosonography or ultrasound of the head

   This research method is suitable for children of the first year of life. It is possible to examine the state of the brain through open fontanelles. This method widely available, harmless and painless, but gives many false positive results.

   Signs indicating increased ICP:

   • Expansion of the size of the ventricles;
   • Expansion of the external liquor spaces between the membranes of the brain;
   • Pseudocysts;
   • Expansion of the space surrounding the optic nerve.
   Additionally, Doppler sonography of cerebral vessels may be prescribed. The study is a type of ultrasound diagnostic and allows you to identify disorders in cerebral circulation that lead to an increase in cerebrospinal fluid pressure:
   • Increase in pulsation index. It expresses the ratio of the difference between systolic (when the heart contracts) and diastolic (when the heart relaxes) blood flow speeds to the average speed in the cerebral artery. Normally it is 0.8-0.9. The higher the index, the higher the pressure in the cranial cavity.
   • Stagnation of blood in the venous sinuses;
   • Thrombosis venous vessels;
   • Increasing the speed of venous blood flow.

Let us remind you that when performing an ultrasound, the errors of the device and the qualifications of the specialist play a big role. Therefore, if the child’s well-being is not impaired, then the identified signs require observation rather than treatment.

Treatment of increased intracranial pressure

Treatment of intracranial hypertension is aimed at eliminating the cause of the increase in pressure. For benign hypertension, when there is no threat to the patient’s life, drug therapy, massage and physical therapy. However, if there is a threat of compression of brain tissue, surgical treatment will be required.

Physiotherapy for increased intracranial pressure

1. Electrophoresis with aminophylline. 10 procedures, lasting 15-20 minutes. Introduction of aminophylline into collar area improves nutrition of the brain, which suffers from oxygen starvation. Eufillin normalizes the functioning of brain vessels, which ensures the necessary absorption of lymph.
2. Magnet for the collar area. Magnetic fields reduce vascular tone, thereby helping to normalize blood pressure. They also reduce the sensitivity of brain tissue to oxygen deficiency, which occurs with intracranial hypertension. In addition, the magnet has a pronounced anti-edematous effect, reducing swelling of the nervous tissue.
3. Massage of the cervical-collar area and spine. The course of treatment is 15-20 massages. This is enough to improve churn venous blood from the cranial cavity. Then self-massage is performed 2 times a day for 15 minutes:
   • Palms are placed on top part the back of the head and pass them from top to bottom. From the back of the head along the neck and to the collarbones;
   • Use the fingertips of both hands to massage the lower edge occipital bone. Perform circular movements, periodically stroking the neck from top to bottom;
   • Massage the points at the base of the skull using circular movements. This should cause moderate pain.
4. Therapeutic exercise and swimming, race walking, table tennis, badminton. Dosed physical activity increases the tone of the muscles of the cervical-brachial region, thereby eliminating muscle spasm. “Tightened” muscles can compress the vessels that drain blood from the brain. All exercises are performed slowly and smoothly. Each is repeated for 2-3 minutes, gradually increasing the number of repetitions.
   • Maximum extension of the head forward and down;
   • Sliding the chin down the sternum and back;
   • As you inhale, lift your chin up and hold your breath for 5 seconds. Exhale slowly - the head drops to the chest;
   • Head tilts. Try to touch your right ear to your right shoulder, then do the same left side;
   • Let's look ahead. The tip of the nose remains motionless, and the chin moves up and to the right. Then the head returns to starting position. The chin rises up and to the left;
   • Keep your head straight, slowly turn it to the right until it stops, and then to the other side.
5. Acupuncture. Impact on reflex zones eliminates vascular spasm, normalizes metabolic processes and the functioning of the nervous system as a whole. However, despite thousands of years of experience, the effectiveness of this method remains unproven.
6. Circular shower. The shower unit sprays thin jets onto the skin. During this procedure, water jets have a temperature effect and activate sensitive receptors. This increases muscle tone and normalizes blood circulation, ensuring the outflow of venous blood from the cranial cavity.

Drug treatment for increased ICP

Drug treatment for increased ICP is necessary when the diagnosis is confirmed instrumental methods studies, symptoms are present and there is a pathology that causes intracranial hypertension.

Group of drugs	Mechanism of action	Representatives	Directions for use
Diuretics	Reduced cerebrospinal fluid production due to inhibition of chloride ion transport.	Acetazolamide (Diacarb)	Adults: 125-250 mg every 8-12 hours. Children: 100 mg/kg/day.
		Furosemide	Adults: 20-40 mg 1-2 times a day, children: 1 mg/kg/day. It is considered the most effective joint reception these two drugs.
Medicines containing potassium	They improve tissue metabolism and electrolyte balance, which ensures normal nutrition of the brain. Prescribed for stroke and traumatic brain injuries that cause brain swelling.	Asparkam	10 ml of solution is administered intravenously with a solution of glucose or sodium chloride.
Corticosteroids	Prescribed for meningitis and brain tumors. Eliminate swelling associated with intoxication and allergic reactions.	Dexamethasone	The average dose is 2-5 mg per day in 2 divided doses.

Clinical studies proven ineffective Such drugs are often prescribed for the treatment of increased ICP:

• homeopathic remedies: Notta, Neurohel;
• nootropic drugs: Piracetam, Nootropil, Picamilon, Pantogam, Encephabol;
• drugs that improve cerebral circulation: Cavinton, Cinnarizine, Sermion.

Surgeries for increased intracranial pressure

The operation is the only in an efficient way treatment of intracranial hypertension caused by hydrocephalus and other congenital pathologies, tumors and injuries.

Bypass surgery

Indications	Types of surgery	Mechanism of action	How it is produced
1. Hydrocephalus 2.Cysts producing cerebrospinal fluid 3. Blockage of the cerebrospinal fluid outflow tract	Ventriculoperitoneal shunt drainage of cerebrospinal fluid from the ventricles of the brain into abdominal cavity	When the pressure in the skull rises above normal, a valve opens, draining excess cerebrospinal fluid into the tube system. The valve prevents the cerebrospinal fluid from flowing back into the brain and blood from entering it. Disadvantages: due to the small diameter of the catheter, it can become clogged and fail; children will have to undergo several surgeries as they grow.	The doctor inserts a silicone catheter through a hole in the skull. One end of it is immersed in the ventricle of the brain, and the other is brought out of the skull. To drain the cerebrospinal fluid, a system of silicone tubes and valves is created. It is carried out under the skin. Depending on the type of bypass, the outlet end of the system is fixed in the abdominal cavity or in the right atrium. The progress of the operation is monitored using x-rays.
	Ventriculoatrial shunt drainage of excess cerebrospinal fluid into the right atrium

Puncture

Indications	Species	Mechanism of action	How it is produced
The need to ensure the outflow of cerebrospinal fluid from the ventricles Obtaining cerebrospinal fluid for analysis Measuring intracranial pressure Administration of drugs	Ventricular puncture	Excess cerebrospinal fluid is drained from the ventricle of the brain through a long needle. Disadvantages: the risk of complications is up to 40-50%, repeated puncture may be required.	Cut soft fabrics and make a small hole in the skull. A special catheter is inserted through it to a depth of 5 cm. When he gets to the right lateral ventricle, it is attached to a sterile reservoir. The container is fixed 20 cm above the patient’s head. Thus, a normal level of intracranial pressure is maintained and excess cerebrospinal fluid is collected.
	Lumbar puncture	Removal of excess cerebrospinal fluid from the spinal canal. Advantage – minimal probability mechanical damage brain	The needle is inserted between the 2nd and 3rd lumbar vertebrae, after anesthetizing with a solution of novocaine. The needle cannula is connected to a sterile reservoir through a rubber tube. This measure helps prevent bacteria from entering the spinal canal.

Endoscopic surgery

Indications	Species	Mechanism of action	How it is produced
Post-traumatic increase in ICP The need to remove the shunt system Complications of bypass surgery	Endoscopic perforation of the third ventricle floor	Using modern endoscopic equipment, a channel is created between the bottom of the ventricle and the subarachnoid cisterns. Complications rarely occur after this intervention; there is no need for repeated operations.	The instruments used are rigid neuroendoscopes equipped with micro-instruments: a video camera, scissors, a catheter, and forceps. In the bottom of the third ventricle, a catheter is used to form a channel for the outflow of cerebrospinal fluid into the brain cisterns.

Alternative treatment for increased intracranial pressure

Treatment with folk remedies is effective if the depression of the cerebrospinal fluid has increased due to obesity, osteochondrosis cervicothoracic region spine, impaired outflow of venous blood or chronic stress.

In this case, the purpose of using folk remedies is to normalize the functioning of the nervous system, improve blood circulation and reduce the production of cerebrospinal fluid.

Decoction of mulberry branches. Young mulberry branches ( mulberry tree) are collected in mid-summer, dried, chopped into pieces 1.5-2 cm in length. To prepare a decoction, 2 tbsp. raw materials are poured into an enamel pan, poured into a liter cold water, bring to a boil. Boil over low heat for 20 minutes, leave for an hour. Strain and take 1 glass 3 times a day before meals. The course of treatment is 21 days. Folic and ascorbic acid, tocopherol, choline, manganese, zinc and high concentration antioxidants can improve the functioning of nerve cells. After 7-10 days, headaches decrease.

Alcohol tincture mixture. To prepare this product you need:

• hawthorn tincture 100ml
• motherwort tincture 100ml
• valerian tincture 100ml
• peppermint tincture 25ml
• eucalyptus tincture 25ml

Tinctures can be bought at the pharmacy. They are poured into a dark glass container, mixed and 10 cloves are added and left to infuse for 2 weeks. Take 25 drops on a lump of sugar or in a tablespoon of water, 3 times a day, 20 minutes before meals. The mixture has a calming effect and eliminates spasm of the veins responsible for the absorption of cerebrospinal fluid.

Decoction of black poplar buds. 2 tbsp. spoons of kidneys pour 2 glasses of water. Bring to a boil, reduce heat and simmer for 15 minutes. Cool and take 0.5 cups 3 times a day on an empty stomach. The duration of treatment is 3 weeks, after 20 days the course is repeated. Thanks to its diuretic and sedative effect, it is possible to improve general health and reduce the amount of cerebrospinal fluid.

Consequences of increased intracranial pressure

• Stop cerebral circulation . Occurs when the cerebrospinal fluid pressure reaches 400 mm of water. Art. In this case, the cerebrospinal fluid compresses the blood vessels and nervous tissue and stops metabolic processes in the brain. Arises ischemic stroke. Neurons of the brain die, its tissue softens.

• Compression of brain tissue with chronic increased ICP. Leads to the death of cortical nerve cells and white matter, which can cause behavioral changes and emotional sphere. When pressure increases, the cerebellum most often suffers, which is manifested by impaired coordination of movements and decreased strength of the limbs.
• Damage to brain stem structures. Increased ICP causes displacement of various brain structures. In this case, the brain stem, which includes the middle and medulla oblongata, pons and cerebellum. Upper sections the brain stem is wedged into the hemispheres, and the lower ones are pinched in the foramen magnum. At the same time, they are developing characteristic symptoms: temperature decrease, slowdown heart rate, symmetrical dilation of the pupils without reaction to light, decreased muscle tone, impaired reflexes.
• Visual impairment. Cerebrospinal fluid accumulates in the canal around the optic nerve and puts pressure on it. Pressure leads to the death of nerve fibers and swelling of the optic nerve nipple, located in the retina. In the future inflammatory phenomena spread to the retina itself, causing visual impairment and blindness.
• Epileptic syndrome. When certain areas of the brain are compressed, foci of convulsive activity occur. In this case, a person experiences seizures that resemble epilepsy. They are short-term and have a favorable outcome.

Frequently Asked Questions

What to do to prevent increased intracranial pressure?

• Maintain a daily routine. It is important to alternate mental and physical activity. Night sleep should last at least 7-8 hours. It is advisable to set aside about 30 minutes for afternoon rest. Limit the time spent watching TV and computer to 1 hour a day.
• Do physical exercise. Visit the pool 3-4 times a week. Fast hiking on fresh air 1.5-2 hours or cycling, yoga classes, breathing exercises. Stretch your neck muscles several times a day for 10-15 minutes. At a slow pace, turn and tilt your head, write out eights or letters of the alphabet with your head. Athletic loads increase ICP, so weightlifting, jumping, and sprinting are not recommended.
• Pass sanatorium treatment at resorts specializing in diseases of the circulatory system: “Stavropol” (Krasnodar Territory), “ Sosnovy Bor"(Ulyanovsk region), "Solnechny" ( Nizhny Novgorod region).
• Carry out therapy for the underlying disease. Main directions: fight against hypertension, atherosclerosis, hormonal disorders.
• Follow a diet. Must be observed drinking regime– up to one and a half liters of fluid per day. Increase your intake of potassium and magnesium salts. These elements are found in buckwheat, beans, cashew nuts, dried apricots, kiwi, seaweed. It is advisable to reduce the amount of salt, animal fat, confectionery, alcohol. This diet helps reduce overweight body, which is the prevention of increased ICP.
• Stop smoking, nicotine causes vasospasm and interferes with the absorption of cerebrospinal fluid.
• Avoid overheating. Avoid going to the bathhouse and avoid being in the open sun for long periods of time. Take antipyretics if your body temperature exceeds 38 degrees. An increase in temperature entails a rise in blood pressure and increased production of cerebrospinal fluid.
• Raise the head end of the bed by 30-40 degrees to improve venous outflow from the cranial cavity.

Is surgery performed for increased intracranial pressure?

Surgical treatment of increased intracranial pressure is resorted to if it is not possible to normalize the patient’s condition with the help of medications.

Indications to perform surgery with increased ICP:

• Progressive hydrocephalus;
• Inefficiency drug treatment And spinal tap;
• Reduced visual acuity due to damage to the optic nerve;
• The optic disc is enlarged, has the appearance of a mushroom cap and protrudes 2 diopters into the vitreous;
• Resistance to the outflow of cerebrospinal fluid is more than 10 mm Hg/ml/min;
• Increased ICP as a result of open traumatic brain injury;
• Benign and malignant neoplasms brain and meninges.

Method of operation.

Bypass surgery is the most common today. The essence of the operation: through a system of catheters, discharge excess cerebrospinal fluid into the abdominal cavity. To do this, the abdominal cavity is opened and a thin shunt - a silicone catheter - is inserted. Channels are formed under the skin through which catheters are advanced to the head. A small hole is made in the skull, to the right of the midline of the skull, through which a catheter is inserted into the fourth ventricle. It is connected to the bypass pathways of cerebrospinal fluid circulation.

The procedure lasts 2-3 hours, takes place under general anesthesia. Disadvantages: the risk of complications reaches 40-60%, it is necessary to constantly monitor whether the patency of the shunt is impaired, high probability repeated operations.

Modern Western medicine is moving towards endoscopic operations. Using a neuroendoscope, low-traumatic surgery– bottom perforation III ventricle. Its advantages: the procedure takes 20-30 minutes and the risk of complications is minimal; there is no need for repeated operations. Through the bottom of the ventricle, an outflow of cerebrospinal fluid is formed into the cisterns of the base of the brain.

What does a patient with increased ICP look like, photo?

There are no adult patients external symptoms increase in ICP. Protrusion can give away the disease eyeballs and uneven pupil dilation.

Characteristic features can be seen in newborns suffering from intracranial hypertension associated with hydrocephalus:

• Pathological increase in head size;
• The skin on the fontanel is taut and shiny when the child is calm and in an upright position;
• A congested network of blood vessels appears under the scalp;
• Eyes roll down.

Is acupuncture effective for high intracranial pressure?

Acupuncture– a method of influencing reflex points of the body using special medical needles. This procedure improves blood circulation and eliminates vascular spasm, improves the functioning of the nervous system, and relieves pain caused by increased blood pressure.

Acupuncture can improve the condition of a patient with elevated ICP, but it cannot eliminate the cause of its occurrence.

Acupuncture is useless if the pressure of the cerebrospinal fluid has increased as a result of inflammatory processes, congenital pathologies, neoplasms or traumatic brain injuries.

What are the signs of intracranial pressure in infants?

Symptoms that should force parents to immediately seek help from a pediatric neurologist:

• Convex pulsating fontanel in a child in calm state;
• Attacks of freezing, clenching, limpness, convulsions;
• Involuntary eye movements;
• Asymmetry of the pupils;
• Repeated jerking various parts bodies;
• The divergence of the sutures between the bones of the skull and their mobility;
• Uneven muscle tone – dystonia. Some muscles are relaxed, like soft dough, others are too tense;
• Lethargy.

The following are not signs of increased intracranial pressure in children:

• Walking on toes;
• Trembling of the chin and hands;
• Startling in sleep;
• Nosebleeds;
• Translucent vessels on the face and scalp - marble leather;
• Tearfulness;
• Stuttering;
• Increased excitability.

In addition, any abnormalities detected on an ultrasound or encephalogram do not prove the presence of intracranial hypertension in a child. For example, pseudocysts and ventricular dilatations may be features anatomical structure. They do not increase ICP and do not affect the well-being and development of the child.

Parents remember that a baby who really has increased intracranial pressure is so bad that he needs immediate hospitalization. This condition is impossible not to notice. And jerks and sleep disturbances happen to everyone from time to time. healthy children due to the immaturity of the nervous system.

What are the signs of intracranial pressure in newborns?

Symptoms of increased ICP in newborns:

• Increased sensitivity of the skin - hypersthesia. Light touching of the skin can cause a crying fit in the baby;
• Protrusion of the eyeballs. The child cannot close his eyelids completely. When he sleeps, you can see the iris of his eye;
• Disproportionately large size heads;
• Protrusion and pulsation of the large fontanelle. This symptom can be explained by an increase in the pressure of the cerebrospinal fluid, pressing on the skull from the inside and the pulsation of blood in the overcrowded vessels.
• Crowded venous network under the scalp, which causes a bluish tint to the skin;
• Ophthalmological changes: convergent strabismus and difference in pupils due to compression of the optic and abducens nerves;
• Muscular dystonia. Muscle tone can be significantly increased - the newborn presses his arms to his chest. Other muscles, on the contrary, are relaxed.
• The child does not suckle well. Due to lack of sleep and crying, the newborn is constantly overtired, he does not have enough strength to suck;
• Excessive regurgitation caused by overexertion of the abdominal muscles

If a child has one or more of the listed signs, Urgent consultation with a pediatric neurologist is required. These signs indicate that your blood pressure may be elevated. But a diagnosis cannot be made based on these symptoms alone. The right solution in this case is examination and systematic observation. If symptoms progress, treatment is necessary.

), intracerebral fluid and the volume of blood circulating through the cerebral vessels.

Currently, in everyday life, the term “intracranial pressure” means an increase or decrease pressure in the skull, accompanied by a number of unpleasant symptoms and deterioration in quality of life.

Due to the widespread use of various visual methods diagnostics (ultrasound, tomography, etc.), the diagnosis of “increased intracranial pressure” is made very often, although in most cases this is unfounded. After all, an increase or decrease in intracranial pressure is not an independent separate disease(except for very rare idiopathic intracranial hypertension), and the syndrome accompanying various pathologies, capable of changing the volume of cranial structures. Therefore, it is simply impossible to consider “intracranial pressure” as a disease in itself and treat it exclusively.

You need to know that intracranial pressure can increase or decrease to critical values ​​at which clinical symptoms, in a limited number of cases and only in the presence of other very serious diseases that are the causative factor of such changes. Therefore, we will consider the essence of the concept of “intracranial pressure” and as a diagnosis available in the domestic medical practice, and as a pathophysiological term denoting a strictly defined syndrome.

Intracranial pressure - physiological definition, norm and essence of the concept

So, the cranial cavity has a certain volume in which there are three structures - blood, brain and cerebral fluid, each of which creates a certain pressure. The sum of the pressures of all three structures located in the cranial cavity gives the total intracranial pressure.

Normal intracranial pressure at rest in humans of different ages fluctuates within the following limits:

• Adolescents over 15 years of age and adults – 3 – 15 mmHg. st;
• Children aged 1 – 15 years – 3 – 7 mmHg. Art.;
• Newborns and infants up to one year - 1.5 - 6 mm Hg. Art.

The indicated values ​​of intracranial pressure are typical for a person who is at rest and does not make any physical effort. However, in moments of sudden tension of a large number of muscles, for example, when coughing, sneezing, loud scream or an increase in intra-abdominal pressure (straining due to constipation, etc.), intracranial pressure for a short period of time can increase to 50 - 60 mm Hg. Art. Such episodes of increased intracranial pressure usually do not last long and do not cause any disturbances in the functioning of the central nervous system.

In the presence of chronic long-term current diseases, causing an increase intracranial pressure(for example, brain tumors, etc.), its values ​​can reach 70 mm Hg. Art. But if the pathology develops slowly, then the intracranial pressure increases gradually, and the person tolerates this condition quite normally, without making any complaints for a long time. This occurs due to the inclusion of compensatory mechanisms that ensure normal well-being and functioning of the central nervous system. Symptoms of increased intracranial pressure in such cases begin to appear only when the compensation mechanisms cease to cope with the increasingly increasing intracranial pressure.

The measurement and principle of formation of intracranial pressure are quite different from those for blood pressure. The fact is that each structure present in the cranium (brain, fluid and blood) occupies a certain volume of the cranial cavity, which is determined by its size and therefore cannot be changed. Due to the fact that the volume of the cranial cavity cannot be changed (increased or decreased), the ratio of the sizes of each of the three structures of the cranium is constant. Moreover, a change in the volume of any structure necessarily affects the other two, since they must still fit into the limited and unchanged space of the cranial cavity. For example, if the volume of the brain changes, then a compensatory change in the amount of blood and brain fluid occurs, since they need to fit into the limited space of the cranial cavity. This mechanism redistribution of volumes inside the cranial cavity is called the Monroe-Kelly concept.

Thus, if the volume of one of the structures of the cranial cavity increases, then the other two should decrease, since their total total volume should remain unchanged. Among the three structures of the cranial cavity, the brain itself has the least ability to compress and reduce the occupied volume. That is why brain fluid (CSF) and blood are structures that have sufficient buffering properties to ensure the maintenance of a constant and unchanged total volume of tissue in the cranial cavity. This means that when the volume of the brain changes (for example, when a hematoma or other pathological processes appears), the blood and cerebrospinal fluid must “shrink” to fit into the limited space of the cranium. However, if a person develops any disease or condition in which the amount of cerebrospinal fluid or blood circulating through the vessels of the brain increases, then the brain tissue cannot “shrink” so that everything fits in the cranial cavity, as a result of which intracranial pressure increases.

The problem of measuring intracranial pressure is very difficult, since there are a very small number of indirect parameters, the values ​​of which can be used to reliably judge the pressure in the cranium. Currently, according to the Monroe-Kelly concept, it is believed that there is a connection and mutual dependence between the value of intracranial pressure and mean arterial pressure, as well as cerebral perfusion pressure, which reflects the intensity and speed of cerebral blood flow. This means that the value of intracranial pressure can be indirectly judged by the value of cerebral perfusion pressure and mean arterial pressure.

Determining the diagnosis of “intracranial pressure”

The diagnosis of “intracranial pressure” in everyday life usually means intracranial hypertension. We will also use this term in this sense when considering what constitutes a diagnosis of “intracranial pressure” in practice.

So, increased or decreased intracranial pressure (ICP) is not an independent disease, but is only a syndrome that accompanies some various pathologies. That is, intracranial pressure always appears as a result of some disease and therefore is not an independent pathology. In fact, ICP is a sign of an independent disease that provokes an increase in pressure in the cranial cavity.

In principle, any organic lesions brain (tumors, hematomas, injuries, etc.) and cerebrovascular accidents sooner or later lead to an increase or decrease in intracranial pressure, that is, to the development of the syndrome in question. Since intracranial pressure is a syndrome that accompanies various pathologies, it can develop in a person of any age and gender.

Considering the fact that intracranial pressure is a syndrome, it should be treated only in combination with therapy for the underlying disease that caused the change in pressure in the cranial cavity. Independent isolated treatment exclusively intracranial pressure is not only useless, but also harmful, since it masks symptoms and allows the underlying disease to progress, develop and damage brain structures.

Unfortunately, at present in practical healthcare the term “intracranial pressure” is often used as an independent diagnosis and is treated in a wide variety of ways. Moreover, the diagnosis of “increased intracranial pressure” is made on the basis of data from tests, examinations and patient complaints, which are not signs of ICP, either individually or in aggregate. That is, in practice, a situation has developed of overdiagnosis, namely the frequent detection of intracranial hypertension that actually does not exist in a person. Indeed, in reality, intracranial hypertension develops very rarely and in a limited number of serious diseases.

The most common diagnosis is intracranial hypertension (synonyms are also used to denote the condition - hypertension syndrome, hypertensive-hydrocephalic syndrome, etc.) is diagnosed on the basis of ultrasound data (NSG - neurosonography), tomography, EchoEG (echoencephalography), EEG (electroencephalography), REG (rheoencephalography) and other similar studies, as well as nonspecific symptoms that a person has (for example, headache, etc.).

In the course of these studies, dilatation of the ventricles of the brain and the interhemispheric fissure, as well as other dubious signs are often detected, which are interpreted as undoubted evidence of the presence of increased intracranial pressure. In fact, the results of these studies are not signs of increased intracranial pressure, so such a diagnosis cannot be made on their basis.

The only tests on the basis of which increased intracranial pressure can be suspected are assessment of the condition of the fundus and measurement of cerebrospinal fluid pressure during lumbar puncture. If the doctor detects swelling of the optic disc during a fundus examination, then this is an indirect sign of increased intracranial pressure, and in this case it is necessary to carry out additional examinations in order to identify the underlying disease that led to ICP. Moreover, if during lumbar puncture is discovered high blood pressure cerebrospinal fluid, then this is also an indirect sign of ICP, in the presence of which additional examinations also need to be carried out to identify the disease that caused the increase in intracranial pressure.

Thus, if a person is diagnosed with increased intracranial pressure not on the basis of fundus examination or lumbar puncture, then it is false. In this case, there is no need to treat the identified “pathology”, but you should contact another specialist who can understand the complaints and conduct a high-quality diagnosis.

It is also necessary to remember that intracranial pressure is not independent disease, but only one of the syndromes characteristic of the development of various severe pathologies of the brain, such as, for example, hydrocephalus, tumors, traumatic brain injuries, encephalitis, meningitis, cerebral hemorrhages, etc. Therefore, its diagnosis must be treated carefully and carefully, since the actual presence of ICP also means the presence serious illness The central nervous system, which needs to be treated, usually in a hospital setting.

Diagnosis of "increased intracranial pressure" (doctor's opinion) - video

Increased intracranial pressure - pathogenesis

An increase in intracranial pressure can occur by two main mechanisms - occlusive-hydrocephalic or due to an increase in brain volume due to tumors, hematomas, abscesses, etc. The occlusal-hydrocephalic mechanism of increasing ICP is based on changes in blood flow in the vessels of the brain, when blood flow increases and worsens outflow. As a result, the vessels of the brain are filled with blood, its liquid part is soaked into the tissue, causing hydrocephalus and swelling, which, accordingly, is accompanied by an increase in intracranial pressure. Increased intracranial pressure with volumetric formations in the brain occurs due to an increase in the number of brain tissues.

With any mechanism, the increase in intracranial pressure occurs gradually, since initial stages compensatory mechanisms are activated that keep the pressure within normal limits. During this period, a person may feel completely normal and not feel any unpleasant symptoms. After some time, the compensatory mechanisms are exhausted and sharp jump intracranial pressure with the development of severe clinical manifestations requiring hospitalization and treatment in a hospital setting.

In the pathogenesis of increased intracranial pressure, the leading role is played by blood flow, as well as the amount of blood in the vessels of the brain. For example, expansion of the carotid or vertebral arteries leads to increased blood supply to the vessels of the brain, which provokes an increase in intracranial pressure. If such a condition is observed frequently, then the intracranial pressure is constantly increased. Narrowing of the carotid and vertebral arteries, on the contrary, reduces blood flow to the brain, which leads to a decrease in intracranial pressure.

Thus, it is obvious that vasodilators, including antihypertensives, contribute to an increase in intracranial pressure. Vasoconstrictor drugs, on the contrary, reduce the value of intracranial pressure. Considering this factor, it must be remembered that increased intracranial pressure cannot be reduced with antihypertensive drugs and treated with drugs that improve and enhance cerebral blood flow (for example, Cinnarizine, Vinpocetine, Cavinton, etc.).

In addition, intracranial pressure depends on the amount of cerebrospinal fluid produced by the structures of the nervous system. The amount of cerebrospinal fluid can also be influenced by the osmotic pressure of the blood. For example, when intravenous administration hypertonic solutions (their concentrations are higher than physiological) glucose, fructose, sodium chloride and others there is a sharp increase osmotic pressure blood, as a result of which, to reduce it, fluid begins to leak from tissues, including from brain structures. In this case, part of the cerebrospinal fluid goes into systemic blood flow in order to ensure blood dilution and a decrease in osmotic pressure, as a result of which intracranial pressure quickly and sharply decreases.

Accordingly, injection into a vein hypotonic solutions with concentrations below physiological leads to reverse effect– a sharp increase in intracranial pressure, since excess fluid is forced out of the blood into tissues, including the brain, to normalize osmotic pressure.

Reduced intracranial pressure - pathogenesis

A decrease in intracranial pressure occurs when the volume of cerebrospinal fluid or blood circulating through the cerebral vessels decreases. The volume of cerebrospinal fluid decreases when cerebrospinal fluid leaks in volumes exceeding its production, which is possible with traumatic brain injuries. Blood volume decreases with prolonged and persistent vasoconstriction, which results in decreased total quantity blood delivered to the brain.

Typically, intracranial hypotension develops slowly, as a result of which the person does not feel any symptoms for a long time. pathological symptoms. But in in rare cases at sharp decline intensity of cerebral circulation, intracranial hypotension can quickly form, which is a critical condition called brain collapse and requires immediate hospitalization to relieve it.

How to measure (check) intracranial pressure?

Despite its apparent simplicity, measuring intracranial pressure is a serious problem, since there are simply no devices that would allow this to be done easily, safely and quickly. That is, analogues of a tonometer that measures blood pressure There is no blood suitable for use to record intracranial pressure.

Unfortunately, despite the achievements of science and technology, currently it is possible to measure intracranial pressure only insertion of a special needle into the ventricles of the brain or spinal canal. Next, cerebrospinal fluid begins to flow through the needle and the simplest manometer is connected to it, which is a glass tube with millimeter divisions applied. The cerebrospinal fluid is allowed to flow freely, as a result of which it takes up some of the volume of the manometer. After this, intracranial pressure is determined in the simplest way - the number of millimeters on the manometer that is occupied by the leaked cerebrospinal fluid is recorded. Final result expressed in millimeters of water or mercury.

This method is called intraventricular pressure monitoring and is the gold standard for measuring ICP. Naturally, the method can only be used in a hospital setting and only if indicated, since it is invasive and potentially dangerous. The main danger of the method is the risk infectious complications, which can occur due to the introduction of pathogenic microbes into the cranial cavity. In addition, a needle inserted into the ventricles of the brain may become blocked due to tissue compression or blockage by a blood clot.

The second method of measuring intracranial pressure is called direct and is monitoring using sensors. The essence of the method is to introduce a special chip into the ventricles of the brain, which transmits data about mechanical pressure on it to an external measuring device. Accordingly, the direct method of measuring ICP can also only be used in a hospital setting.

Both methods are invasive, complex and dangerous, and therefore they are used only when life is threatened against the background of severe brain damage, such as contusion, swelling, traumatic brain injury, etc. Thus, it is obvious that methods that would allow accurate measuring intracranial pressure in a clinic does not exist. After all, it is not advisable to perform a puncture of the brain or spinal canal to measure intracranial pressure in the absence of a threat to life, since complications of the manipulation can be very serious.

However, there is currently an examination method that allows one to judge the level of intracranial pressure by indirect signs, - This fundus examination. If, during an examination of the fundus, edematous visual discs and dilated tortuous vessels, this is an indirect sign of increased intracranial pressure. In all other cases, the absence of swelling of the optic discs and blood filling of the fundus vessels indicates normal level intracranial pressure. That is, the only more or less reliable indirect sign of increased intracranial pressure is characteristic changes fundus. Accordingly, in widespread practice in a clinic, only fundus examination can be used to assess intracranial pressure - a method that, based on indirect signs, allows one to identify increased ICP.

Diagnostics

As already said, the only way, available in a clinic and allowing to identify precisely increased intracranial pressure, is an examination of the fundus. That is why the syndrome of increased intracranial pressure, both in a child and an adult, can be diagnosed solely on the basis of the results of a fundus examination, provided that swollen optic discs with dilated and tortuous vessels have been identified.

All other imaging methods (ultrasound of the brain, electroencephalography, tomography, echoencephalography, etc.), which are very widely used at present, do not even allow indirect judgment of the magnitude of intracranial pressure. The fact is that all the signs revealed during these examinations, which are mistakenly taken for symptoms of increased intracranial pressure (expansion of the ventricles of the brain and interhemispheric fissure, etc.), in fact are not such. These methods are necessary to clarify and identify the cause that provoked the increase in intracranial pressure.

That is, in a clinic setting, to detect increased intracranial pressure, it is necessary to perform the following examination algorithm: first, the fundus is examined. If there are no swollen optic discs and tortuous, dilated veins in the fundus, then intracranial pressure is normal. In this case, any additional research It is not necessary to assess ICP. If the fundus reveals swollen optic discs and tortuous, dilated veins, then this is a sign of increased intracranial pressure. In this case, it is necessary to carry out additional examinations to identify the cause of the increase in ICP.

Methods such as ultrasound of the brain (neurosonography) and tomography will help determine the cause of increased intracranial pressure, but will not say anything about the magnitude of ICP. Echoencephalography, rheoencephalography and electroencephalography do not provide any data on the value of intracranial pressure, since they are intended for diagnosing completely different conditions. Thus, echoencephalography is a method that is intended exclusively for detecting large formations in the brain, for example, tumors, hematomas, abscesses, etc. Echoencephalography is not suitable for any other diagnostic purposes, therefore, using it to detect ICP is impractical and useless.

Rheoencephalography and electroencephalography are also methods that in no way can help in assessing intracranial pressure, since they are intended to identify various pathological foci in brain structures, such as, for example, epileptic readiness, etc.

Thus, it is obvious that to diagnose increased intracranial pressure it is necessary to conduct a fundus examination. It is not necessary to carry out all other examinations (NSH, EchoEG, EEG, REG, etc.), which are often and widely prescribed at present, since they do not provide any indirect data to judge ICP. Ultrasound of the brain in infants, which is incredibly common nowadays, does not allow one to judge the level of ICP, so the results this study should be viewed with a certain amount of skepticism.

If intracranial pressure increases gradually, then the person suffers from constant headache, nausea with vomiting, persistent hiccups, drowsiness and blurred vision.

Signs of increased intracranial pressure in children older than one year and adolescents

Signs of increased intracranial pressure in children over one year of age and adolescents are the following symptoms:

• The child is exhausted, gets tired quickly, constantly wants to sleep;
• Apathy and indifference to activities that previously aroused keen interest in the child;
• Irritability and tearfulness;
• Visual impairment (constriction of the pupils, squint, double vision, spots before the eyes, inability to focus);
• Debilitating headache, especially severe in the second half of the night and in the morning;
• Bluish circles under the eyes. If you stretch the skin in circles, dilated capillaries will become visible;
• Nausea and vomiting not associated with food intake, especially frequent in the morning at the height of the headache;
• Jerking of arms, legs and face;
• Pressing pain behind the eyes.

Signs of increased intracranial pressure in infants under one year of age

Signs of increased intracranial pressure in infants under one year of age include the following symptoms:

• Headache;
• Nausea, vomiting and regurgitation not associated with food intake and occurring mainly in the morning;
• Strabismus;
• Stagnant discs optic nerves on the fundus;
• Impaired consciousness (the child is inhibited, as if stunned);
• Bulging and tension of the fontanel with separation of the sutures of the skull bones.

In infants, intracranial pressure can be suspected only if all of the above signs are present in combination. If there are only some signs, then they are symptoms not of increased ICP, but of another condition or disease.

Treatment

General principles of treatment of intracranial pressure

Treatment of intracranial pressure is carried out differently depending on the cause that provoked the appearance of the syndrome. For example, in case of hydrocephalus, excess cerebrospinal fluid is pumped out from the cranial cavity, in case of a tumor, a neoplasm is removed, in case of meningitis or encephalitis, antibiotics are given, etc.

That is, the main treatment for ICP is the treatment of the disease that causes increased intracranial pressure. In this case, ICP itself is not intentionally reduced, since this will happen spontaneously when eliminated causative factor. However, if intracranial pressure is increased to critical values, when there is a threat of brain herniation and the development of complications, then it is urgently reduced with the help of various medications. It must be remembered that a direct decrease in ICP is emergency measure, used only when there is a threat to life in a hospital setting.

At high risk increased intracranial pressure, for example, in the background chronic diseases that can cause ICP (congestive heart failure, consequences of stroke and traumatic brain injury, etc.), The following recommendations should be followed:

• Limit salt intake;
• Minimize the amount of fluid consumed (drink no more than 1.5 liters per day);
• Periodically take diuretics (Diacarb, Furosemide or Triampur);
• Do not visit baths and saunas, do not be in the heat;
• Wash with warm or cool water;
• Sleep in a well-ventilated area;
• Sleep with the head end elevated (for example, on a high pillow);
• Don't engage sports loads related to endurance training and weight lifting (running, somersaults, weightlifting, etc.);
• Avoid going down the elevator;
• Avoid air travel;
• Periodically massage the collar area;
• Include foods containing potassium in your diet (dried apricots, potatoes, fruits, etc.);
• Treat existing hypertension, epilepsy and psychomotor agitation;
• Avoid the use of vasodilators.

These recommendations will help minimize the risk of increasing intracranial pressure to critical levels that require hospitalization.

The widespread practice of treating increased intracranial pressure with diuretics is incorrect, since their isolated use without eliminating the cause of ICP will not give the expected results, but, on the contrary, can aggravate the situation due to dehydration

Administration of glucocorticosteroids hormones (Dexamethasone, Prednisolone, etc.).

If there is a high risk of increased ICP due to chronic diseases, it is recommended to periodically take diuretics (Diacarb, Furosemide or Triampur) and sedatives (Valerian, hawthorn tincture, Afobazol, etc.).

Intracranial pressure in a child (in infants, in older children): causes, symptoms and signs, diagnostic methods. Intracranial hypertension due to hydrocephalus: diagnosis, treatment - video

Traditional methods of treatment

Traditional methods cannot cure intracranial pressure, but it is quite possible to reduce the risk of it sharp increase to critical values. That is, traditional methods can be considered as additional to the measures recommended for people prone to increased intracranial pressure and indicated in the treatment section.

So, the following folk recipes are most effective for increased intracranial pressure:

• Pour a tablespoon of mulberry leaves and branches into a glass of boiling water, leave for one hour, then strain and take a glass of infusion three times a day;
• Pour a teaspoon of poplar buds into a glass of water and heat for 15 minutes in a water bath. Strain the finished broth and drink throughout the day;
• Mix an equal amount of camphor and alcohol, and apply as a compress to the head at night;
• Mix in equal volumes hawthorn, motherwort, valerian and mint. Brew one teaspoon of the herbal mixture with boiling water and drink it instead of tea throughout the day.

Traditional recipes for intracranial pressure - video

Before use, you should consult a specialist.

Intracranial pressure is a measure of the level of cerebrospinal fluid pressure on the brain. If, as a result of determining the pressure, its increase was revealed, this may mean the development of pathological process in any part of the brain - a tumor, extensive hemorrhage, hematoma, hydrocephalus and others. All these diseases pose an immediate danger to human health and life. Therefore, it is important to know the symptoms of increased intracranial pressure in order to promptly seek professional medical help.

Causes of increased intracranial pressure

High intracranial pressure can occur due to various reasons. For example, a spontaneous increase can be observed in the following pathologies:

• inflammation and swelling of the brain;
• cerebrospinal fluid is formed in large quantities - this sign is characteristic of hydrocephalus;
• presence of a tumor, hematoma or foreign body in the cranial cavity;
• poisoning and intoxication of the body, in which the dilated vessels of the brain contain a large amount of blood.

In addition, there are a number of diseases that inevitably lead to increased intracranial pressure:

• hemorrhagic or ischemic strokes and, in general, any disorders of cerebral circulation;
• injuries to brain tissue - for example, bruises or concussions of varying degrees;
• meningitis, encephalitis, ventriculitis - these pathologies are accompanied by inflammation of the membranes of the brain;
• poisoning with poisonous gas and any toxic substances;
• subdural and epidural hematomas;
• hydrocephalus;
• pathologies of the development and structure of the brain of a congenital nature.

For more details about the causes of increased intracranial pressure, see the video review:

Symptoms of intracranial pressure in adults

Increased intracranial pressure manifests itself quite severe symptoms. The main one is, which has certain characteristics:

• by nature - bursting from the inside, pressing. Very rarely, increased intracranial pressure is accompanied by throbbing pain;
• time of appearance - morning, literally immediately after waking up and getting out of bed;
• moments of intensification - coughing, sneezing, bending forward.

Increased intracranial pressure is accompanied by nausea and vomiting, and hallmark is the lack of effect when taking analgesics. The pathology in question is accompanied by vegetative-vascular dystonia, which will manifest itself with the following symptoms:

• variable blood pressure – decreases/increases during the day;
• bowel dysfunction - may be chronic constipation or persistent diarrhea (diarrhea);
• increased salivation;
• increased sweating in the palms and soles;
• attacks of suffocation occur periodically;
• disturbance of the psychoemotional state - appear unreasonable fears, anxiety, irritation, nervousness;
• regular dizziness;
• pain in the abdomen, imitation of a heart attack.

High intracranial pressure may occasionally be accompanied by stroke-like symptoms:

• impairment/loss of consciousness – the patient may fall into a coma;
• walking is impaired, the person moves with a staggering gait;
• speech is impaired;
• uncontrollable vomiting begins;
• urinary incontinence appears, in some cases spontaneous bowel movement occurs;
• breathing is impaired.

Symptoms of increased intracranial pressure in infants

Please note: The symptoms of high intracranial pressure will be very different in adults and children. For young patients it will be typical following signs the pathological condition in question:

• divergence of the skull bones, swelling of the small and large fontanelles - this is typical for infants;
• a radical change in the child’s behavior – either moodiness and irritability appear, or severe drowsiness and apathy towards the environment;
• regardless of food intake, uncontrollable vomiting may appear (literally like a fountain);
• the function of the eyeballs is impaired - vision decreases, sudden strabismus may appear;
• the chin constantly trembles - tremor;
• consciousness is impaired, the child may fall into a long coma;
• convulsive syndrome occurs spontaneously;
• head circumference increases.

The pediatrician talks about how serious the increase in intracranial pressure is in children:

Possible complications

Increased intracranial pressure, in the absence of professional help, can provoke the development of serious complications:

• a sharp decrease in the level of vision, up to complete blindness - cerebrospinal fluid puts pressure on the area of ​​\u200b\u200bthe brain tissue responsible for the functions of the visual organs;
• disturbance of consciousness and immobilization of the patient - pressure is placed on the cerebellum, it may be pinched;
• epilepsy;
• dysfunction of the part of the brain that is responsible for mental state sick;
• stroke – ischemic or hemorrhagic.

A particularly dangerous condition is when the increase in intracranial pressure occurs suddenly and develops rapidly - it usually ends in death.

Treatment of intracranial pressure

Treatment of high intracranial pressure occurs in several stages:

First. The cause of the development of the pathological condition is determined and measures are taken to eliminate it. For example, if the cause is a tumor, hematoma or extensive hemorrhage, then it is necessary to carry out surgical removal neoplasms. In case of diagnosis inflammatory process in brain tissue, antibacterial therapy is prescribed.

Please note: in case of high intracranial pressure due to hydrocephalus, a shunt is performed - this creates an additional “path” through which excess cerebrospinal fluid will exit the skull.

Second. Selected individually drug therapy, which is designed to correct the level of intracranial pressure. The following groups of drugs can be used:

• funds hormonal action– dexamethasone;
• osmodiuretics (they are designed to reduce the amount of cerebrospinal fluid) - glycerol and/or mannitol;
• group of neuroprotectors – glycine;
• loop diuretics – furosemide;
• diacarb.

Third. At this stage, decompensated carniotomy is performed, ventricular puncture is a medicinal procedure/manipulation that helps to significantly reduce the amount of cerebrospinal fluid in the skull.

Fourth. Implies purpose dietary nutrition, which is based on the principle of limiting the amount of liquid and salt entering the body.

Fifth. This is the so-called rehabilitation period - the patient’s condition has already been stabilized, the threat to life has passed and everything can be used possible methods treatment. Sessions of homeopathic therapy will be effective; acupuncture has proven itself to be effective; it is appropriate to carry out hyperbaric oxygen therapy and hyperventilation.

Please note: if the treatment was carried out in an intensive mode, several methods of therapy were used at once - for example, antibacterial and bypass surgery at the same time, then the patient may develop side effects:

• intense headaches, often occurring when actively moving the head;
• nausea/vomiting that occurs regardless of meal time;
• severe dizziness, up to short-term loss of consciousness.

These phenomena mean a too sharp decrease in intracranial pressure, which requires an immediate response from the attending physician - the treatment regimen will have to be adjusted. The duration of treatment for increased intracranial pressure varies, but usually this period is 3-6 months. After going through a long rehabilitation period the patient must register with a doctor and undergo preventive examinations– relapses of the pathological condition in question, unfortunately, occur quite often.

Traditional medicine

Please note: It is impossible to completely cure increased intracranial pressure solely with recipes from the category of traditional medicine - visiting a doctor and obtaining prescriptions for drug treatment is necessary. But when the first signs of the pathology in question appear, you can significantly alleviate your condition using the following methods:

1. Take soothing teas with mint and lemon balm. Even if you suspect you have high intracranial pressure, worry, anxiety and nervousness will only worsen the condition.
2. Adjust your diet - try to limit the amount of liquid and salty/pickled/smoked foods you consume.
3. Drink decoctions of rosehip and hawthorn instead of plain water - these are natural diuretics that will reduce the amount of fluid in the body.
4. Take 20 drops of alcohol tincture from clover flowers daily. To prepare it you need to pour into liter jar 2 cups of dry ingredient, fill it all with water up to half the jar and top up pure alcohol. The medicine must be infused for at least 10 days.
5. Use a mixture of tinctures. Buy ready-made alcohol tinctures valerian, motherwort, hawthorn and eucalyptus, mix them and take 10-15 drops twice a day.

Important: treatment with tinctures can only be carried out by adults, the duration of their use is at least 2 weeks in a row. Then you need to take a break from treatment (7 days) - during this time you can calmly be examined and get the doctors’ verdict.

If necessary, treatment can be continued according to the same regimen. If symptoms of high intracranial pressure appear, you can use the simplest compress recipe - mix medical alcohol and camphor oil in equal quantities. This mixture should be applied to the head, lightly rubbing it into the skin, cover/insulate the head and maintain the procedure for 15 minutes.

You need to apply at least 10 such compresses, one for each day. Traditional medicine should not be considered as the only option in the treatment of increased intracranial pressure. All of the recipes listed can be used as additional measures during complex therapy.

Some features of the condition under consideration

Many people believe that with age, high intracranial pressure stabilizes “on its own,” so there is no specific treatment you don't have to do it. This is a fatal mistake - given pathological condition will only progress and negatively affect brain activity. But there is no need to panic - if increased intracranial pressure is an acquired condition and not congenital, then it is completely curable - there are quite a lot modern methods effective therapy.

Increased intracranial pressure is a direct cause mental retardation and may have genetic roots - this is a wrong opinion. If treatment was carried out on time, until no irreversible changes occurred in the brain, then the condition does not in any way affect the mental, mental and physical abilities of the patient. Hereditary factor this state has not been confirmed by any study.

Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category.