Intracranial hypertension is an acute neurological and surgical condition, which can lead to brain herniation if not treated in time or improperly treated, and in serious cases, it can endanger the patient’s life in a short time and lead to death requiring emergency treatment.
The normal cranial cavity is a closed organ, consisting of brain tissue, cerebrospinal fluid and cerebral blood flow, all three of which are in a constant state. Under normal conditions, the blood supply to the brain is quite abundant, cerebral blood flow accounts for 20% of the whole body blood volume, about 1200 ml of blood enters the cranium every minute, and the dependence of brain cells on oxygen is great. The normal adult intracranial pressure is 80-180mmH2O (6-13.5mmHg), when the intracranial pressure exceeds this value, intracranial hypertension is formed.
It can be divided into two kinds: diffuse and focal.
1. Diffuse intracranial pressure increase: It is commonly seen in subarachnoid hemorrhage, encephalitis, cerebral edema, etc. This type of pressure increase is less likely to cause brain herniation, and the neurological function recovers faster after the pressure is relieved.
2. Focal intracranial pressure increase: There is a more obvious pressure difference between the intracranial cavities, causing displacement of brain tissue leading to brain herniation formation, hemorrhage and edema in the damaged neural tissue, and slow recovery of function.
Neurosurgeons have struggled with cranial hypertension all their lives, removing tumors to relieve tumor-induced cranial hypertension; shunt surgery to drain cerebrospinal fluid into the abdominal cavity to reduce cranial hypertension; trauma and brain hemorrhage to remove bone flaps also relieve cranial hypertension.
Clinical manifestations of increased intracranial pressure: 1. Headache: The mechanism of headache may be due to the stimulation of meninges, blood vessels or nerves by pulling, squeezing or inflammatory changes.
2.Vomiting: It is often seen in severe headache, and the typical manifestation is jet vomiting not accompanied by nausea and not related to diet.
3.Other manifestations: disorders of consciousness, manifested as decreased level of consciousness, lethargy, coma, unable to wake up.
In case of increased intracranial pressure caused by intracranial hematoma, cerebral contusion, tumor, hydrocystic tumor (hygroma), hydrocephalus or cranial pneumatosis, surgical treatment should be considered first. Surgery is the most direct and effective way!