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Intracranial hypertension


Intracranial hypertension is a rare disease and is defined as the increase of pressure within the skull. The skull is made of three elements: the brain tissue, the cerebrospinal fluid that bathes the tissue and the blood vessels that supply blood to tissue cells. The skull is unstretchable due to its bone structure; if one of these three compartments sees its volume increased and if the other elements do not decrease their own, the overall pressure increases. Thus, in cases of brain tumors, hematomas secondary to shock, increase in the amount of cerebrospinal fluid, or cerebral thrombosis, which prevent the blood from draining, intracranial hypertension may occur.


Intracranial hypertension is characterized by:
  • headache, especially in the morning and when supine;
  • nausea or vomiting, often described as "projectile";
  • sight disorders such as blurred vision, double vision;
  • disorders of consciousness, which can evolve into a coma.


To diagnose intracranial hypertension, it is important to perform a detailed assessment, both clinical and neuroradiological. Computed tomography is the first review to be carried out and may be accompanied with a brain MRI to better visualize lesions or with cerebral MR angiography to observe the venous sinus and possible cerebral thrombosis. A eye exam by an ophthalmologist is sometimes performed.


Intracranial hypertension is treated by emergency, depending on the advanced clinical symptoms and the results of further tests. In the case of the rapid formation of symptoms, emergency surgery by an external ventricular bypass will reduce the pressure on the brain structures that may be responsible for irreversible damage. After this diversion or in other less serious cases, the cause will be treated as a priority and will often make it possible to reduce intracranial hypertension. In the case of a tumor, a biopsy may be performed to identify and allow for appropriate treatment. In the case of cerebral venous thrombosis, anticoagulants are given.