Increased intracranial pressure
Alternative names:
ICP; intracranial pressure - increased; intracranial hypertension
Symptoms:
Infants:
- bulging fontanelle
- sutures on head have separated - indicating excess pressure
in skull
Older children and adults:
Note: Slow increases are tolerated fairly well in young children
before they become symptomatic.
Adults tolerate increased intracranial pressure less well.
Signs and tests:
Intracranial pressure is measured in millimeters of mercury
(mm Hg) or millimiters of water (mm H20). The upper limits
of normal are 150 mm Hg or 200 mm H20. Intracranial pressure
is best measured directly by placing an intracranial pressure
monitor through a small hole in the skull and into the brain.
Sometimes a spinal tap
(lumbar puncture) may
be performed. This test can measure ICP, but may not be safe
in all ICP raising processes. Particularly if there is risk
of imminent herniation, or if there is a mass lesion in the
back of the brain (posterior fossa), lumbar puncture is best
avoided. A brain CT (computer tomography) scan, which can
reveal abnormalities in the brain, should be done to look
for causes of raised ICP.
Update Date: 05/08/00
Lyle J. Dennis, MD Fellow in Critical Care Neurology and Epilepsy
and Electroencephalography Columbia-Presbyterian Medical Center
VeriMed Healthcare Network
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