Intracranial Hypertension Syndrome 2024/2025 PDF

INTRACRANIAL HYPERTENSION SYNDROME GENERAL PATHOLOGY. 3rd year of Medicine 2024/2025 Dr Ana Checa-Ros, MD, PhD Department of Medicine & Surgery INDEX 1. Definition 2. Etiology 3. Pathophysiology 4. Clinical Manifestations 5. Important Tip for the Clinical Practice 1. Definition Intracranial h...

INTRACRANIAL HYPERTENSION SYNDROME GENERAL PATHOLOGY. 3rd year of Medicine 2024/2025 Dr Ana Checa-Ros, MD, PhD Department of Medicine & Surgery INDEX 1. Definition 2. Etiology 3. Pathophysiology 4. Clinical Manifestations 5. Important Tip for the Clinical Practice 1. Definition Intracranial hypertension is a spectrum of neurological disorders that cause pressure within the skull to be elevated (normal intracranial pressure (ICP) < 20mmHg) The cranium is a rigid structure that contains three components: brain; cerebrospinal fluid; and blood An increase in the volume of one component will result in a decrease in volume in one or two of the other components 2. Etiology Mass Effect Tumour Abscess Oedema Haemorraghe Epidural Haemorraghe Subdural Haemorraghe Increase in CSF Hydrocephalus Idiopathic Benign Intracranial Hypertension  Subdural Haemorraghe Compression due to astrocytoma Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 35891 Case courtesy of Dr Roberto Schubert, Radiopaedia.org, rID: 16279 3. Pathophysiology The harmful effects of increased ICP are primarily due to vasculature compression: 01 02 03 1) Compression of 2) The decreased blood flow 3) Diminished blood flow also vessels decreases blood flow decreases oxygen delivery, means decreased delivery of and provokes ischaemia increasing the permeability of substrates to the neurons, the capillaries and allowing which finally swell still more fluid leakage Pathophysiology of increased intracranial hypertension Decreased delivery of substrates to the neurons, allowing the neurons to swell Neurons Ischaemia alters the permeability of the blood-brain barrier  4. Clinical Manifestations 1) Headache (derived 2) Vomiting (not preceded by nausea) 3) Visual abnormalities (due to from compression of structures) papilledema, as there is increased pressure of the CSF surrounding the optic nerve) 5. Important tip for the clinical practice Always perform neuroimaging before lumbar puncture if there is any suspicion of increased intracranial hypertension Lumbar puncture produces a rapid decompression; the sudden decrease in ICP leads to herniation of structures (structures moving to a different location in the brain)