Increased cerebral pressure

Introduction

The skull contains the brain, which is also surrounded by fluid. This fluid is also found in the spaces between the two halves of the brain. These spaces are called cerebrospinal fluid spaces, and the fluid is called cerebrospinal fluid (German: Liquor).

The cerebrospinal fluid protects the brain from shocks and is supposed to nourish the brain cells, but this has not been sufficiently researched. The cerebral fluid flows through the cerebrospinal fluid spaces at a certain pressure. This pressure is called intracranial pressure (ICP).

After the cerebrospinal fluid has flowed through the cerebrospinal fluid spaces, it is absorbed and fed into the venous bloodstream. Normally, the intracranial pressure is located at values of 5 to 15 mmHg. If the values rise above this, the cerebral pressure is increased and is accompanied by various complaints and symptoms.

Symptoms

The typical symptoms that patients with increased intracranial pressure develop are usually mild at the beginning and can easily be associated with a gastrointestinal (gastrointestinal tract) cause. Nausea may occur with increased intracranial pressure, and vomiting may also occur. As a further gastrointestinal symptom the patient may develop a loss of appetite.

Another complex of symptoms refers to the area of the head and the whole body. The patient with brain edema often has headaches and suffers from fatigue. Furthermore, attention and the ability to concentrate are reduced (vigilance disorder).

In addition, the patient may be restless. Furthermore, special symptoms are possible. Here the decorative rigidity is to be called.

The spastic bending posture (flexion posture) of the arms and the simultaneous extensional rigidity of the legs is called decorative rigidity. Decorticulatory rigidity occurs as a result of changes in the brain (disinhibition of certain regions) due to increased intracranial pressure. Another specific symptom is decerebral rigidity: this refers to a spastic extension of the arms and legs, also as a result of disturbances in the brain caused by increased intracranial pressure.

The main symptoms of increased intracranial pressure are headaches, vomiting and a congestive papilla. The congestion papilla must be diagnosed by an ophthalmologist through a reflection of the back of the eye. Headache, vomiting and papilledema are collectively known as the ICP triad.

If the increased intracranial pressure is not recognized as the trigger for the symptoms, the symptoms may increase with dizziness and paralysis of the eye muscles. In addition, consciousness may become increasingly clouded and the patient may eventually fall into a coma. An increased intracranial pressure usually becomes symptomatic very quickly (from a pressure increase of >22mmHg; physiologically, an intracranial pressure of 5-15mmHg is physiological), but initially it is often initially mild, rather general complaints that can easily be falsely attributed to the gastrointestinal tract.

Thus, in addition to nausea and vomiting, a loss of appetite may also be noticeable. Oedema in the tissue of the optic nerve (the so-called congestion papilla), which can be noticed in an eye examination (ophthalmoscopy), is also characteristic and groundbreaking in diagnostics. Further symptoms can be paralysis of the eye muscle with visual disturbances and respiratory disturbances (Biot respiration).

In addition, the Cushing reflex can cause an increase in blood pressure and a decrease in heart rate. If the cerebral pressure remains untreated and continues to rise, there are also disturbances of consciousness, which can sometimes extend to coma.

  • Increased fatigue
  • Headaches
  • A feeling of uneasiness
  • Dizziness and
  • Attention Disorders

If an increased intracranial pressure causes neck stiffness in addition to the usual symptoms such as headaches, nausea and vomiting, this may be an indication of the presence of meningitis as the cause of the increase in intracranial pressure.

Photophobia and the occurrence of fever would also fit this diagnosis. Meningitis is an absolute medical emergency and should result in immediate medical consultation! If the symptoms consist only of headaches and stiff neck and there is no fever, it is more likely that the neck muscles are tense than the cause of the symptoms.

This in turn is usually the result of one-sided physical strain or predominantly sedentary professional activity without sufficient physical exercise. ICP signs are clinical symptoms and examination findings that indicate the presence of increased ICP.Often the first signs of an increase in intracranial pressure are misinterpreted as a gastrointestinal infection. In addition to headaches, nausea and vomiting, loss of appetite and fatigue are among the most important signs of ICP. In contrast, however, some affected persons also feel an unusual restlessness. In the case of a long-term presence of increased intracranial pressure, the optic nerve may be impaired, so that visual disturbances (reduction of visual acuity) as well as the congestion papilla (see above), which can be detected by an eye examination, are also counted among the intracranial pressure signs.