This is the condition when the pressure of the cerebrospinal fluid becomes too high. The cerebrospinal fluid functions as a cushion for the brain within the skull and to transport various nutrients to the brain and to remove the waste. Everyday around 500ml of cerebrospinal fluid is produced and the fluid pressure is maintained at the normal rate. The intracranial pressure increases when the body is unable to effectively absorb or drain the cerebrospinal fluid. The acute form of IH can develop suddenly and the long-lasting form of this condition is known as chronic IH.
Causes
The acute IH develops as the result of severe head injury, stroke or from the intracranial bleeding. This can occur suddenly as the result of very high intracranial pressure which can be fatal. This develops as the result of brain swelling or the bleeding into the areas around the brain. The chronic form of this condition is a neurological disorder where the elevated level of cerebrospinal fluid pressure remains high over a period of time. This can occur either as the result of an underlying illness or without a detectable cause (idiopathic intracranial hypertension). Some of the causes of chronic IH include brain tumor, blood vessel abnormalities, a blood clot in the veins of the brain, brain infection and a condition known as hydrocephalus when the fluid accumulate around the brain.
Symptoms
The chronic intracranial hypertension can affect an active person so they are unable to take part in their daily tasks. The common symptoms associated with the intracranial pressure include a severe headache that may be worse in the morning, vision problems such as blurred, double vision or temporary loss of vision, whooshing noise (pulse-synchronous tinnitus) and drowsiness or irritability.
Diagnosis
The individual will be evaluated based on their medical history, a physical examination and with various tests. In addition, a neurological test may also be performed although no localized findings can usually be made. The vision tests such as comprehensive dilated eye exam seek to identify signs of papilledema and the visual field test evaluates the peripheral vision. Imaging tests such as CT scan and MRI will look for the causes by seeking the abnormalities of the brain such as the tumor. A lumbar puncture involves the procedure where a needle is inserted into the CSF-filled sac to collect a sample that will be evaluated for the cause of the intracranial pressure. If the cause is not identified, it may be diagnosed as idiopathic IH.
Treatment
The treatment for the intracranial hypertension is based on the underlying cause. The idiopathic IH are treated by stopping medications that cause the symptoms, with the regular lumbar puncture to remove the accumulated fluid to relieve the pressure, steroid medication to provide relief from headaches or medications to remove the excess fluid from the body. A surgery is usually considered if other forms of treatment are not beneficial. This can include the shunt surgery that diverts the excess fluid to another part of the body or optic nerve sheath fenestration where the nerve connecting to the brain from the eye is opened for the drainage of the excess fluid.
References
http://www.nhs.uk/conditions/intracranial-hypertension/Pages/Introduction.aspx#symptoms
