INTRACRANIAL PRESSURE: CAUSES, SYMPTOMS, DIAGNOSIS AND TREATMENT METHODS

Аннотация

Intracranial pressure (ICP) is a pathological condition in which the pressure inside the skull increases, significantly affecting brain function. The main causes of this condition include hydrocephalus, brain tumors, head trauma, and intracranial hemorrhages. The diagnosis of increased intracranial pressure is carried out through clinical examinations and modern imaging techniques such as CT and MRI. Treatment involves diuretics, surgical interventions, and supportive therapies. This article analyzes the various causes of intracranial pressure, its pathophysiological mechanisms, andmodern treatment approaches. Keywords: intracranial pressure, hydrocephalus, brain tumor, intracranial hemorrhage, head trauma, diuretics, decompressive surgery Аннотация Внутричерепное давление (ВЧД) – это патологическое состояние, при котором давление внутри черепа увеличивается, что существенно влияет на функционирование мозга. Основные причины этого состояния включают гидроцефалию, опухоли мозга, травмы головы и внутричерепные кровоизлияния. Диагностика повышенного внутричерепного давления проводится с помощью клинических осмотров и современных методов визуализации, таких как КТ и МРТ. Лечение включает диуретики, хирургические вмешательства и поддерживающую терапию. В данной статье рассматриваются различные причины внутричерепного давления,его патофизиологическиемеханизмыисовременные методылечения. Ключевые слова: внутричерепное давление, гидроцефалия, опухоль мозга, внутричерепное кровоизлияние, травма головы, диуретики, декомпрессивная хирургия Intracranial pressure (ICP) is the force exerted by cerebrospinal fluid (CSF) and blood within the skull. Under normal conditions, ICP in adults ranges from 7 to 15 mmHg (0.9-2 kPa). If this pressure exceeds 20 mmHg, it is considered dangerous and requires immediate medical intervention. The skull is a closed cavity, and any increase in volume inside it leads to brain compression, impaired blood circulation, and neuronal damage. Therefore, understanding the causes, diagnosis, and treatment of increased intracranial pressure is of great importance. 98,7:ROTCAFTCAPMI.SECNEICS LACIDEM,5202, yraurbeF,5emuloV gro.srehsilbupcimedaca.www I. CAUSES OF INCREASED INTRACRANIAL PRESSURE Intracranial pressure (ICP) is regulated by the balance between brain tissue volume, cerebrospinal fluid (CSF), and cerebral blood flow. Any disturbance in this balance can lead to an increase in ICP, causing significant neurological damage. The main causes of increased ICP can be categorized into six major groups: 1. Increased Cerebrospinal Fluid Volume (Hydrocephalus) Hydrocephalus is a condition in which cerebrospinal fluid accumulates excessively in the brain ventricles, leading to increased intracranial pressure. The human brain produces about 500 mL of CSF per day, with a normal circulating volume of about 150 mL at any given time. If CSF production increases, absorption decreases, or its outflow is obstructed, hydrocephalus develops. Types of Hydrocephalus 1.Communicating Hydrocephalus Occurs whenCSFabsorption bythearachnoid villiisimpaired. Causes includemeningitis, subarachnoid hemorrhage, andpost-inflammatory scarring. 2.Non-communicating (Obstructive) Hydrocephalus Occurs dueto aphysical blockagein theCSFpathways, preventing normal flow Commoncauses includebrain tumors, congenital malformations (e.g., aqueductal stenosis), andcysts. 3.Normal Pressure Hydrocephalus (NPH) Aspecial form seen inelderly patients, characterized bygait disturbances, urinary incontinence, and cognitivedecline despitenormal CSFpressure measurements. 4.Ex-vacuo Hydrocephalus Resultsfrom brain atrophy where ventricular enlargement occurs as a compensatory mechanism. Seen in Alzheimer’s disease andother neurodegenerativeconditions. 98,7:ROTCAFTCAPMI.SECNEICS LACIDEM,5202, yraurbeF,5emuloV gro.srehsilbupcimedaca.www 2. Brain tumors Brain tumors, whether benign or malignant, can cause increased ICP by occupying space within the rigid cranial vault. The global incidence of primary brain tumors is around 10 per 100,000 people per year, with gliomas and meningiomas being the most common. Mechanisms of ICP increase due to tumors Direct compression of brain tissue and ventricles, leading to obstruction of CSF pathways. Induced cerebral edema due to tumor-induced inflammation. Tumor hemorrhage, which can further exacerbate pressure. Increased vascular permeability, causing fluid leakage into the brain parenchyma. Tumors in critical locations, such as the posterior fossa or third ventricle, are particularly dangerous due to their ability to rapidly increase ICP. 3. Intracranial Hemorrhages Intracranial hemorrhages cause rapid and often life- threatening increases in ICP due to the accumulation of blood within the brain or its surrounding spaces. TypesofHemorrhages leading to increased ICP 1.Epidural Hematoma Usually caused bytraumaleading torupture ofthe middlemeningeal artery. Symptomsinclude alucid interval followed byrapid neurological