In clinical practice, you can often hear neurosurgeons mentioning cranial hypertension when explaining the condition to families, especially in critical conditions, so what exactly is cranial hypertension? Intracranial pressure is the pressure generated by the contents of the cranial cavity on the wall of the cranial cavity, also known as cerebral pressure. In the lateral position, the normal intracranial pressure is 0.7~2.0kPa (5~15mmHg) in adults and 0.5~1.0kPa (3~7.5mmHg) in children. If the volume of normal cranial contents (brain tissue, cerebrospinal fluid, and cerebral blood volume) increases, or if abnormal contents (such as intracranial occupying lesions, etc.) break through the compensatory energy of the cranial cavity, “cranial hypertension” will occur. “. Headache, vomiting and optic papilledema are the three main symptoms of the increased intracranial pressure syndrome. The clinical manifestations of the increased intracranial pressure syndrome include the following four aspects: (1) triad of intracranial hypertension including headache; vomiting; and optic papilloedema. (2) Alteration of vital functions The main vital functions of human body, such as consciousness, mental, respiration, circulation and body temperature, are closely related to brain function, which can be altered to different degrees during cranial hypertension. When cranial hypertension develops rapidly, the changes of vital functions are obvious and develop rapidly; in chronic cases, there may be no changes or only mild changes. (3) Signs of neurological damage: cranial hypertension can be caused by diffuse cerebral hypoxia, axial displacement of the brainstem, local vascular or cranial nerve strain or extrusion, direct compression of brain tissue by brain herniation, etc., and corresponding neurological signs can appear. The common ones include mild spreading nerve palsy and diplopia, abnormal eye position, slightly protruding eyes, asymmetric pupil size, paroxysmal blurred vision or visual field defects, asymmetric tendon reflexes, and positive pathological reflexes. If cranial hypertension worsens, brain herniation may occur. (4) Visceral comorbidities: Severe cranial hypertension may result in visceral comorbidities due to hypothalamic and brainstem dysfunction. The more common ones include upper gastrointestinal bleeding, neurogenic pulmonary edema, acute renal failure, uremia, cerebral sodium retention and cerebral sodium depletion syndrome. Acute intracranial pressure increase can be divided into acute and chronic intracranial pressure increase according to the process. In comparison, acute intracranial pressure increase is more dangerous than chronic intracranial pressure increase because acute intracranial pressure increase is more likely to break through the body’s own regulation of intracranial pressure and cause brain herniation. However, when chronic intracranial hypertension develops to a certain degree, it can also go beyond the range of self-regulation and cause brain herniation and even lead to death. Therefore, whether it is acute or chronic intracranial pressure increase, it should be treated promptly. The most fundamental principle of treatment is to go to the etiology of the disease. When it is too late to conduct various examinations to determine the etiological diagnosis and the patient is already in a more serious emergency, temporary symptom management should be done first (1) General symptomatic treatment principles 1) Once a patient is considered to have increased intracranial pressure, he/she should be hospitalized for observation and treatment, paying close attention to changes in consciousness, pupils, blood pressure, pulse, respiration, body temperature, etc. If necessary, do intracranial pressure monitoring. 2) Give ordinary diet to awake patients. Frequent vomiting patients should be temporarily prohibited from eating and drinking to prevent aspiration pneumonia; daily intravenous fluids should be given, the amount should be determined according to the needs of the condition, pay attention to the nutritional situation and electrolyte supplementation. 3) Pay attention to the timely treatment of some factors that promote further increase of intracranial pressure. If the respiratory tract is not open and the sputum is difficult to cough up, tracheotomy should be done to keep the respiratory tract open, prevent respiratory tract infection and reduce the occurrence of pneumonia. If you have urinary retention, catheterize in time. If the stool is constipated, use open-cell anal irrigation or laxative, etc. (2) Principles of treatment for the etiology of increased intracranial pressure 1) Non-surgical treatment. Non-surgical treatment for increased intracranial pressure is mainly dehydration and hypotensive treatment, including the application of various dehydrating drugs, hormone therapy, hibernation and hypotensive treatment, etc.; in addition, preoperative or postoperative radiotherapy and chemotherapy for intracranial tumors, immunotherapy, anti-infection therapy, hyperbaric oxygen therapy, anti-seizure therapy and rehabilitation therapy, etc. 2) Surgical treatment. The purpose is to remove the lesion as much as possible, and strive for the surgery should be able to release or at least partially release the compression of the lesion on the main functional structures; for patients with hydrocephalus, the method of shunting cerebrospinal fluid can be adopted to achieve the purpose of treatment.