Spontaneous increase in intracranial pressure

2021-08-26 03:40 PM

Increased intracranial pressure (ICP) associated with spontaneous elevation of intracranial pressure can cause optic nerve edema and lead to loss of vision. 

Spontaneous increase in intracranial pressure

Define

Pseudotumor (spontaneous increase in intracranial pressure) occurs when the pressure inside the skull (intracranial pressure) increases for no apparent reason. Symptoms mimic those of a brain tumor, but the tumor is not present. Spontaneous elevation of intracranial pressure can occur in children and adults, but it is most common in obese women of childbearing age.

When no underlying cause can be discovered for the increase in ICP, idiopathic ICP may also be referred to as idiopathic ICP.

Increased intracranial pressure associated with spontaneous elevation of intracranial pressure can cause optic nerve edema and lead to loss of vision. Medicine can usually relieve this pressure, but in some cases, surgery is needed.

Symptoms

Spontaneous raised intracranial pressure, signs and symptoms may include:

Moderate to severe headache, which may originate behind the eyes, awakens sleep and is aggravated with eye movement.

There are music pulses in the ear, during the heartbeat.

Nausea, vomiting, or dizziness.

Blurred vision or limited vision.

Temporary blindness, which lasts only a few seconds and affects one or both eyes (obscuring vision).

Hard to see one side.

Double vision (dual vision).

Seeing light flashes (photopsia).

Neck, shoulder, or back pain.

Causes

The exact cause of spontaneous raised intracranial pressure in most cases is unknown, but it may be associated with cerebrospinal fluid excess in the bony constriction of the skull.

The brain and spinal cord are surrounded by cerebrospinal fluid, which acts as a cushion to protect these vital tissues from injury. This fluid is produced in the brain and eventually absorbed into the bloodstream. The increased intracranial pressure of idiopathic ICP may be a result of a problem in the absorption process.

In general, intracranial pressure increases when the skull exceeds its capacity. For example, a brain tumor often increases intracranial pressure because there is no room for it. The same will happen if the brain expands or if there is too much cerebrospinal fluid.

Recent evidence suggests that the majority of people with idiopathic raised intracranial pressure have narrowing of the two large sinuses in the brain (transverse sinuses), but it is unclear whether the narrowing is a cause or effect of this condition. .

Risk factors

The following factors are associated with spontaneous elevation of intracranial pressure:

Obesity

Spontaneous raised intracranial pressure occurs in 1 in about 100,000 in the general public. Obese women under the age of 44 are nearly 20 times more likely to develop these disorders.

Medicine

Substances associated with the pseudotumor brain include:

Growth hormone.

Oral contraceptives.

Tetracyclines.

Stop steroids.

Excess vitamin A.

Health issues

The following conditions and diseases are associated with spontaneous pseudotumor intracranial hypertension:

Addison's disease.

Head injury.

Kidney disease.

Lupus.

Lyme disease.

Mononuclear.

Polycystic ovary syndrome.

Sleep apnea.

Hypoparathyroidism.

Complications

Up to 10 percent of people with spontaneous raised intracranial pressure experience a gradual worsening of vision and may eventually become blind. Even if symptoms have resolved, it can recur - even months or years later.

Tests and diagnostics

Eye examination

If idiopathic raised intracranial pressure is suspected, the ophthalmologist will look specifically at the optic disc - at the back of the eye. Will also undergo an inspection of the markets to see if there are blind spots in sight.

Brain scan

CT or MRI can rule out other problems that can cause similar symptoms, such as brain tumors and blood clots.

Lumbar puncture

A lumbar puncture, which involves inserting a needle between two vertebrae in the lower back, can identify high pressure inside the skull.

Treatments and drugs

Spontaneous raised intracranial pressure usually initiates drug therapy to control symptoms. Encourage weight loss for obese individuals. If vision loss is more severe, surgery to relieve pressure on the optic nerve or to reduce intracranial pressure may be necessary. When the spontaneous elevation of intracranial pressure is present, regular vision testing is required.

Medicine

Drugs for the treatment of high blood pressure. One of the first drugs is usually acetazolamide (Diamox), a glaucoma medication that reduces cerebrospinal fluid production by at least 50 percent. Side effects can include stomach upset, fatigue, tingling in the fingers, toes, mouth, and kidney stones.

Diuretic. If acetazolamide alone is not effective, it is sometimes combined with furosemide (Lasix), a potent diuretic that reduces fluid retention by increasing urine output.

Migraine pain reliever. Medications commonly prescribed for migraine relief can sometimes alleviate the severe headache that often accompanies pseudotumor brain tumors.

Surgery

Neural membrane perforation procedure. This procedure cuts a window into the membrane that surrounds the optic nerve. This allows the fluid to escape. Vision stabilizes or improves in more than 85 percent of cases. Most people who have this procedure notice benefits to both eyes. However, this surgery is not always successful and may even increase vision problems.

Cerebrospinal fluid drainage. Surgery inserts a tube - called a shunt - into the brain or spine to help drain excess cerebrospinal fluid. This tube is under the skin to reach the abdomen, draining excess fluid. Symptoms improve in more than 80 percent of people who undergo this procedure. But shunts can become clogged and often require additional surgery to keep them working properly. Complications can include pressure headaches and infections.

Lifestyle and remedy

Obesity in women significantly increases the risk of pseudotumor brain. In fact, a weight gain of at least 5 percent of body weight can increase the risk - even in women who are not obese. Losing extra weight and maintaining a healthy weight can help reduce your risk of developing this disorder.

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