Increased intracranial pressure

Increased intracranial pressure is a relatively common neurosurgical disease. There are many reasons for this, such as inflammation in the brain, fluid accumulation in the brain, or trauma to the brain, etc., which can easily cause increased pressure in the brain, which is quite harmful to patients. We know that the importance of brain tissue to the human body is self-evident. Once the brain is under pressure, it can often lead to more serious lesions.

Causes of increased intracranial pressure

⑴. The volume of the contents of the cranial cavity increases, such as an increase in the volume of brain tissue (cerebral edema), an increase in cerebrospinal fluid (hydrocephalus), obstruction of intracranial venous return or excessive perfusion, an increase in cerebral blood flow, and an increase in intracranial blood volume. ⑵. Intracranial space-occupying lesions make the intracranial space relatively smaller, such as intracranial hematoma, brain tumor, brain abscess, etc. ⑶. Congenital malformations reduce the volume of the cranial cavity, such as craniosynostosis and basilar skull invagination.

Increased intracranial pressure can be divided into two categories:

1. Diffuse intracranial hypertension is caused by the narrow cranial cavity or the increase in the volume of brain parenchyma. Its characteristics are that the pressure in various parts of the cranial cavity and between the sub-cavities increases evenly, and there is no obvious pressure difference, so there is no obvious displacement of brain tissue. The increased intracranial pressure caused by diffuse meningoencephalitis, diffuse cerebral edema, communicating hydrocephalus, etc. seen clinically all belong to this type.

2. Focal increase in intracranial pressure is caused by localized expansive lesions in the brain. The pressure at the lesion site increases first, causing the nearby brain tissue to be squeezed and shifted, and the pressure is transmitted to distant places, resulting in a pressure difference between the intracranial cavities. This pressure difference causes the displacement of the ventricles, brainstem and midline structures. Depending on how fast the lesion develops, increased intracranial pressure can be divided into three categories: acute, subacute and chronic: (1) Acute increased intracranial pressure: seen in intracranial hematoma, hypertensive cerebral hemorrhage, etc. caused by acute craniocerebral injury. The disease progresses rapidly, the symptoms and signs caused by increased intracranial pressure are severe, and vital signs (blood pressure, respiration, pulse, body temperature) change dramatically. (2) Subacute intracranial hypertension: The disease progresses rapidly, but it is not as urgent as acute intracranial hypertension, and the reaction of increased intracranial pressure is milder or not obvious. Subacute increase in intracranial pressure is more common in rapidly developing intracranial malignant tumors, metastatic tumors and various intracranial inflammations. (3) Chronic increased intracranial pressure: The disease progresses slowly, and there may be no symptoms and signs of increased intracranial pressure for a long time. The disease progresses with changes from time to time. It is more common in slow-growing benign intracranial tumors, chronic subdural hematoma, etc.

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