Raised intracranial pressure

Symptoms

The symptoms of raised intracranial pressure:

• Headache: more worrying when at night, worse in the morning, and worse on moving head. Most headaches don't mean raised ICP.
• Mental state changes: including lethargy, irritability, slow decision making and abnormal social behaviour. Do a Mental State Examination.
• Vomiting: often without nausea, and occasionally getting worse.
• Pupil changes: including irregularity or dilatation in one eye.
• Fundoscopy stuff: Worrying optic disc changes, losses of venous pulsations, haemorrhages, and other things.
• Nerve stuff: cranial nerve problems, such as unilateral ptosis or third and sixth nerve palsies. In later stages, loss of eye muscles and reflexes.

Other later signs include one sided paralysis, hypertension, widened pulse pressure and slow irregular pulse.

Causes

• Space-occupying lesion - which is a clever of generally saying brain tumour.
• Sub-arachnoid haemorrhage
• Meningitis
• Hydrocephalus
• Venous obstruction

Outcome

There are only three outcomes of raised ICP:

1. Full recovery
2. Brain injury
3. Brainstem death - due to herniation of the brainstem.