Increased intracranial pressure (ICP) is a rise in pressure around your brain. It may be due to an increase in the amount of fluid surrounding your brain. For example, there may be an increased amount of cerebrospinal fluid that naturally cushions your brain or an increase in blood in the brain due to an injury or a ruptured tumor.
Increased ICP can also mean that your brain tissue itself is swelling, either from injury or from an illness like tumors, infection (like meningitis or encephalitis), or benign intracranial hypertension. Increased ICP can be the result of a brain injury, and it can also cause a brain injury.
Increased ICP is a life threatening condition. A person showing symptoms of increased ICP should get emergency medical help right away.
The signs and symptoms of increased ICP include:
Many of these symptoms can appear with other conditions, but things like confusion and behavior changes are common early signs of increasing intracranial pressure. Your doctor will usually use other symptoms or knowledge of your personal and family medical history to determine the cause of your symptoms.
A red flag for increased intracranial pressure as a cause — and a sign of the need for emergency care — is the development of several of these symptoms at once.
Increased intracranial pressure can also be a sign of other serious and even fatal problems like stroke, a brain tumor, or a recent head injury.
What does increased intracranial pressure feel like?
Some people are born with conditions that lead to increased intracranial pressure, and others can develop this condition after neurologic diseases or injury. While increased ICP is always a medical emergency, some people reach tolerable levels, often aided by things like devices to drain extra cerebrospinal fluid.
There are lots of symptoms that can develop with increased ICP, but people who experience this commonly report things like:
Signs of increased ICP in infants
Symptoms of increased ICP in infants include those for adults, but there are some additional signs unique to babies under 12 months old.
Because the bony plates that form the skull are softer in babies than in older children and adults, they may spread apart in an infant with increased ICP. This is called separated sutures of the skull. Increased ICP can also cause the fontanel, the soft spot on the top of a baby’s head, to bulge outward.
Increased ICP in infants can be the result of injury, like falling off a bed, or it can be a sign of child abuse known as shaken baby syndrome, a condition in which a small child has been roughly handled to the point of brain injury.
If you have reason to suspect that a child is the victim of abuse, you can anonymously call the National Child Abuse Hotline at 800-4-A-CHILD (800-422-4453).
Head trauma is a major cause of increased intracranial pressure, but there are other things that can lead to this problem, too. Other possible causes of increased ICP include:
- infections
- tumors
- stroke
- aneurysm
- hydrocephalus, which is an accumulation of spinal fluid in the brain cavities
- hypertensive brain injury, which is when uncontrolled high blood pressure leads to bleeding in the brain
- hypoxemia, which is a deficiency of oxygen in the blood
- meningitis, which is inflammation of the protective membranes around the brain and spinal cord
- benign intracranial hypertension
Overall, your intracranial pressure usually increases as a direct result of too much fluid inside your skull or some type of inflammation or swelling in your brain.
Can medications cause increased intracranial pressure?
In addition to the injuries and conditions discussed above, there are several medications that can cause increased intracranial pressure, like:
Your doctor will need to know some important information about your family and personal medical history right away if increased ICP is suspected as the cause of your symptoms.
They’ll ask if you recently suffered a blow to the head or if you’ve been diagnosed with a brain tumor. You should also provide your doctor with a list of any medications or supplements you may be taking.
The doctor will then begin a physical exam. This will include a review of your vital signs and a detailed neurological exam investigating things like your:
- pupil reactions
- visual acuity
- movement and coordination
- reflexes
- speech
- balance
They may also measure the pressure of your cerebrospinal fluid using a lumbar puncture, or spinal tap. Images of the brain from a CT or MRI scan may be necessary to confirm the diagnosis or find the cause of increased ICP.
In cases of severe increases in intracranial pressure that usually lead to critical illness, your doctor may need to place an invasive intracranial monitoring tool that will provide a direct reading using a thin tube (catheter), bolt, or sensor placed inside your skull.
This type of monitoring is considered effective for measuring ICP but can also lead to a number of complications like additional injury or infection.
The most urgent goal of treatment is to reduce the pressure inside your skull. This can be done in a number of ways, including:
- placing a shunt through a small hole in the skull or in the spinal cord to drain excess cerebrospinal fluid
- using medications like mannitol and hypertonic saline to lower pressure
- sedation to reduce anxiety and neurological responses
- removing part of the skull to allow your brain space to expand without damage (craniotomy)
- slowing neurological function to reduce damage
- inducing hypothermia to bring down your overall body temperature and slow metabolism
The next step in treating increased ICP is to figure out what caused the problem in the first place. If your increased intracranial pressure was caused by things like an infection or stroke, those underlying problems will need to be treated alongside your increased ICP.
Resolving whatever caused the problem will help reduce pressure from continuing to increase.
You can’t prevent increased ICP, but you can prevent head injury.
Always wear a helmet when you bike or play contact sports. Wear your seatbelt when driving and keep your seat back as far as possible from the dashboard or the seat in front of you. Always buckle children into a child safety seat.
Falling at home is a common cause of head injury, especially in older adults. Avoid falls at home by keeping floors dry and uncluttered. If necessary, install handrails.
Delayed treatment or failure to reduce intracranial pressure can cause temporary brain damage, permanent brain damage, long-term coma, or even death.
The sooner you seek treatment to reduce pressure on your brain, the better the outcome. The use of invasive intracranial monitoring devices is associated with a better prognosis, especially when your increased ICP was caused by a traumatic brain injury.
Overall, your prognosis will depend somewhat on what caused your elevated ICP. If your ICP increase is caused by a congenital issue, your cerebrospinal fluid levels can be managed effectively in many cases to avoid fatal complications.
However, in cases of traumatic brain injury and other conditions that can drive your ICP to severely high levels, the outcome can be fatal.
Signs of severe problems from increased ICP and a poor prognosis include things like:
- a physical shift of your brain on imaging scans
- abnormal positioning (posturing) of your limbs or body
- development of other neurologic complications like diabetes insipidus or poor temperature control
- poor pupil responses
- a lack of basic neurological responses
Elevated intracranial pressure is a medical emergency in nearly every case. No matter what the cause of the pressure increase, it can lead to brain damage and other fatal complications if pressure increases become too high.
There are times when this problem can develop as part of a chronic or congenital condition, but when it happens suddenly, quick medical care is needed to avoid a fatal outcome.
If you experience a sudden intense headache, lose consciousness, or have other unexplained neurological conditions, seeking immediate medical care is the best way to avoid fatal complications.
Increased intracranial pressure is a medical term that refers to growing pressure inside a person’s skull. This pressure can affect the brain if doctors do not treat it.
A sudden increase in the pressure inside a person’s skull is a medical emergency. Left untreated, an increase in the intracranial pressure (ICP) may lead to brain injury, seizure, coma, stroke, or death.
With prompt treatment, it is possible for people with increased ICP to make a full recovery.
In this article, we look at the symptoms, causes, and treatments of increased ICP.
The symptoms of increased ICP can vary depending on a person’s age.
Infants with increased ICP may have different symptoms to older children or adults with the condition, as discussed below.
Symptoms in adults
Share on PinterestSymptoms of increased ICP can include headache, sleepiness, and blurred vision.
Symptoms of increased ICP in adults include:
- pupils that do not respond to light in the usual way
- headache
- behavior changes
- reduced alertness
- sleepiness
- muscle weakness
- speech or movement difficulties
- vomiting
- blurred vision
- confusion
As raised ICP progresses, a person may lose consciousness and go into a coma. High ICP may cause brain damage if a person does not receive emergency treatment.
Symptoms in infants
Infants with increased ICP may show some of the same symptoms as adults. In addition, the shape of their heads may be affected.
Infants still have soft plates in their skull that fibrous tissue called skull sutures knit together. Increased ICP may cause the skull sutures to separate and the soft plates to move apart.
Increased ICP in infants may also cause their fontanel to bulge out. The fontanel is the soft spot on the top of the skull.
The following is a list of medical conditions and other causes that can lead to increased ICP:
In infants, high ICP may be the result of child abuse.
If a person handles a baby or infant too roughly, it may cause them to develop a brain injury. This is known as shaken baby syndrome.
One source has estimated that between 1,000 and 3,000 children in the United States experience shaken baby syndrome each year. The condition may arise if an adult shakes a baby violently to stop them crying.
Anyone who suspects a child may be experiencing abuse can contact the National Child Abuse Hotline anonymously at 1-800-4-A-CHILD (1-800-422-4453).
Share on PinterestA doctor may request a CT scan to diagnose increased ICP.
If a person has the symptoms of increased ICP, they should see a doctor straight away. This is a medical emergency and may lead to brain injury if a person does not receive rapid treatment.
A doctor will measure the ICP in millimeters of mercury (mm/Hg). The normal range is less than 20 mm/Hg. When ICP goes above this, a person may be experiencing increased ICP.
To diagnose increased ICP, a doctor may ask if a person has:
- experienced a blow to a head
- a previous diagnosis of a brain tumor
Then, the doctor may carry out the following tests:
- neurological exam to test a person’s senses, balance, and mental state
- spinal tap that measures cerebrospinal fluid pressure
- CT scan that produces images of the head and brain
After these initial tests, the doctor may use an MRI scan to examine a person’s brain tissue in more detail.
If a person has a diagnosis of increased ICP, a doctor will immediately work to reduce the pressure inside the skull to lessen the risk of brain damage. They will then work to treat the underlying cause of the increased pressure.
Treatment methods for reducing ICP include:
- draining the excess cerebrospinal fluid with a shunt, to reduce pressure on the brain that hydrocephalus has caused
- medication that reduces brain swelling, such as mannitol and hypertonic saline
- surgery, less commonly, to remove a small section of the skull and relieve the pressure
A doctor may give the person a sedative to help reduce anxiety and lower their blood pressure. The person may also need breathing support. The doctor will monitor their vital signs throughout their treatment.
In rare cases, the doctor may put a person with high ICP into a medically induced coma to treat their condition.
Complications of increased ICP include:
- brain damage
- seizure
- stroke
- coma
Without proper treatment, increased ICP can be fatal.
A sudden increase in ICP is a medical emergency and can be life-threatening. The sooner a person receives treatment, the better their outlook. Many people respond well to treatment, and a person who has experienced increased ICP can make a full recovery.
Increased ICP is not always preventable, but it is possible to reduce the risk of some underlying conditions that may lead to increased ICP. We explore how below.
Stroke
Stroke may cause increased ICP. A person can reduce their risk of stroke in the following ways:
- taking steps to lower high blood pressure
- stopping smoking
- managing blood sugar levels
- controlling cholesterol levels
- exercising regularly
High blood pressure
High blood pressure may cause increased ICP. A person can maintain healthy blood pressure by:
- losing weight if overweight or maintaining a healthy weight
- avoiding drugs that increase blood pressure
- eating a healthful, balanced diet
- reducing salt intake
- exercising regularly
Head injury
A head injury may cause increased ICP. Some examples of how a person can reduce their risk of head injury include:
- avoiding extreme sports or dangerous activities
- always wearing a helmet for activities such as riding a bike
- always wearing a seatbelt when in a car
Increased ICP is when the pressure inside a person’s skull increases. When this happens suddenly, it is a medical emergency. The most common cause of high ICP is a blow to the head.
The main symptoms are headache, confusion, decreased alertness, and nausea. A person’s pupils may not respond to light in the usual way.
A person with increased ICP may need urgent treatment. The immediate aim of treatment is to bring down the pressure on their brain tissue, which helps to reduce the risk of brain damage.
Without proper treatment, this condition may lead to seizure, coma, stroke, or brain damage. In severe cases, increased ICP can be fatal. Rapid treatment may improve a person’s outlook. Making a full recovery with timely treatment is possible.
Increased ICP is not always preventable, but a person can reduce their risk of some causes through lifestyle changes.