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Intracranial hypertension (IH), also called increased ICP (IICP) or raised intracranial pressure (RICP), refers to elevated pressure in the cranium. 20–25 mmHg is the upper limit of normal at which treatment is necessary, though it is common to use 15 mmHg as the threshold for beginning treatment.
Idiopathic intracranial hypertension (IIH), previously known as pseudotumor cerebri and benign intracranial hypertension, is a condition characterized by increased intracranial pressure (pressure around the brain) without a detectable cause. [2] The main symptoms are headache, vision problems, ringing in the ears, and shoulder pain.
It can cause complications such as vision impairment due to intracranial pressure , permanent neurological problems, reversible neurological problems, seizures, stroke, and death. [1] However, aside from a few Level I trauma centers, ICP monitoring is rarely a part of the clinical management of patients with these conditions.
Patients may have a history of loss of consciousness but they recover and do not relapse. Clinical onset occurs over hours. Complications include focal neurologic deficits depending on the site of hematoma and brain injury, increased intracranial pressure leading to herniation of brain and ischemia due to reduced blood supply and seizures.
Intracranial pressure monitoring is just one tool to manage ICP. It is used in conjunction with other techniques such as ventilator settings to manage levels of carbon dioxide in the blood, head and neck position, and other therapies such as hyperosmolar therapy, medications, and core temperature. [ 2 ]
Cerebral perfusion pressure, or CPP, is the net pressure gradient causing cerebral blood flow to the brain (brain perfusion).It must be maintained within narrow limits because too little pressure could cause brain tissue to become ischemic (having inadequate blood flow), and too much could raise intracranial pressure (ICP).
Diagnostic methods for hypertensive encephalopathy include physical examination, blood pressure measurement, blood sampling, ECG, EEG, chest X-ray, urinalysis, arterial blood gas analysis, and imaging of the head (CAT scan and/or MRI). Since decreasing blood pressure is essential, anti-hypertensive medication is administered without awaiting ...
Excessive reduction in blood pressure can precipitate coronary, cerebral, or kidney ischemia and, possibly, infarction. [citation needed] A hypertensive emergency is not based solely on an absolute level of blood pressure, but also on a patient's baseline blood pressure before the hypertensive crisis occurs.