What is intracranial hypertension?
Intracranial hypertension refers to a build-up of pressure around the brain. There are a few different kinds of intracranial hypertension:
Acute intracranial hypertension
- Occurs suddenly due to instances such as severe head injuries, stroke or brain abscess.
Chronic intracranial hypertension
- Persistent and long-lasting symptoms.
- Can have identifiable causes, or be idiopathic in some cases.
Idiopathic intracranial hypertension
- No clear cause – a very rare condition.
Idiopathic intracranial hypertension occurs in only 1 in 10 000 people, however it is 20x more common in women who are overweight .
How will having intracranial hypertension affect me?
If intracranial hypertension is not properly diagnosed and treated early, it has serious and life-threatening complications. Complications can include: stroke, seizures, blindness and even death.
Many people find relief of symptoms when treated properly, but a number of patients find that after treatment, some symptoms still persist and have a large impact on their lives.
What does having intracranial hypertension feel like?
People who are experiencing intracranial hypertension will most likely experience one or more of the following symptoms:
Constant throbbing headaches (can be mild or severe)
Blurred or double vision
Temporary loss of vision
Ringing in the ears (Tinnitus)
Neck and shoulder pain
Problems with moving around and taking
How is intracranial hypertension diagnosed?
To confirm a diagnosis of intracranial hypertension, your doctor might refer to your medical history, family medical history, and analyse the symptoms you are experiencing. You might also be referred to a neurologist, to carry out a neurological exam. In this exam, your senses, reflexes, balance and mental status will be tested.
A spinal tap or lumbar procedure might be performed, to extract a sample of your cerebrospinal fluid for testing, or measure the pressure of this fluid.
CT scans may be done to examine the large veins that carry the blood from the brain. MRI scans may also be done to create X-ray images of your head and brain and check for any abnormalities.
What are the conditions related to intracranial hypertension?
Acute intracranial hypertension is caused by a sudden accident, or even stroke, that causes growing pressure within the skull.
Chronic intracranial hypertension may be idiopathic (no known cause), but can also be caused by:
Hydrocephalus (accumulation of cerebrospinal fluid in the brain)
Infections such as encephalitis and meningitis
Blood clot on the brain surface (chronic subdural haematoma)
Blood clot in a vein in the brain (venous sinus thrombosis)
Arteriovenous fistula or arteriovenous malformation
How is intracranial hypertension treated?
Treatment of intracranial hypertension depends on the cause, if the cause has been identified. Medicines may be introduced, to reduce the excess fluid in the brain (diuretics), or to reduce the production of cerebrospinal fluid. The goal of most treatments is to preserve your eye functions and ensure that visual loss doesn’t happen.
The main surgery options for intracranial hypertension include:
Shunt surgery (cerebrospinal fluid diversion)
- Plastic tubing is placed surgically in spaces in the brain or in the lower back, to drain excess cerebrospinal fluid from the brain.
Optic nerve sheath fenestration
- Slits are cut in the covering of the optic nerve behind the eyeball to allow cerebrospinal fluid to escape into the surrounding eye tissue, to be absorbed.
Intracranial venous sinus stenting
- Placing wire mesh tubes, or stents, into the narrowed veins in the brain which widens them and allows blood to flow with less resistance.
These procedures can offer relief to your symptoms, but also carry the risk of some surgical complications. If you suspect that you have intracranial hypertension, book an appointment with your doctor to run some tests and find out more.
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