Definition. Idiopathic intracranial hypertension (IIH) is a condition characterized by increased intracranial (intracranial) pressure, without the presence of a space-occupying lesion or infectious lesion of the brain.
Today, primary IIH syndrome (true IIH) is considered to be a condition that is accompanied by increased intracranial pressure (ICP) without any etiological factors, possibly due to obesity (see below in the “etiology” section). To describe the secondary increased ICP against the backdrop of some rare causes(see further section “etiology”) the term “pseudotumor cerebri” is used. Epidemiological studies (see below) indicate a significantly higher prevalence of IIH compared to pseudotumor cerebri, 90 and 10%, respectively.
Epidemiology. IIH occurs in all age groups, incl. in childhood and old age (most often at the age of 30 - 40 years), in women - approximately 8 times more often than in men (1 case per 100 thousand population and 19 cases per 100 thousand young women with excess body weight ). Data on the prevalence of IIH are currently being revised; according to a basic epidemiological study, the average annual incidence of IIH is 2 cases per 100,000 population. It cannot be ruled out that against the backdrop of the global obesity epidemic, the prevalence of IIH will increase, especially in the target group of young women.
Please note! Previously, a synonym for “IIH” (in addition to “pseudotumor cerebri”) was “benign intracranial hypertension (BICH).” Currently, the use of the term "DHFG" (which was introduced into practice by Foley in 1955) has been abandoned because the latter does not accurately reflect the essence of the process. Benign quality lies only in the fact that it is not tumor process. Considering the sharp decrease in visual functions with the development of secondary atrophy optic nerves, we are not talking about good quality ([ !!! ] with untimely diagnosis, about 2% of patients permanently lose their vision).
Etiology and pathogenesis IIH have not been sufficiently studied. Among the most significant predisposing factors is the role of obesity, mainly in young women (it has been proven that weight loss is one of the most effective methods of treating IIH). The identified significant association of IIH with excess body weight raises new questions regarding the pathogenesis (pathophysiological mechanisms) of this disease. Most theories (pathogenesis) boil down to a discussion of disturbances in venous outflow and/or absorption of cerebrospinal fluid (CSF). However, no evidence has been obtained indicating its excessive secretion. Currently, discussions continue on the role of venous microthrombi, disturbances in the metabolism of vitamin A, fats, and endocrine regulation of sodium and water metabolism in the development of IIH. IN lately As a possible mechanism for the development of IIH, intracranial venous hypertension is increasingly being considered, associated with various stenoses of the dural sinuses (Higgins, 2002; Ogungbo, 2003; Stranding, 2005) and leading to impaired CSF (cerebrospinal fluid) absorption. Constriction most often occurs in distal sections transverse sinus either at the point of transition of the transverse sinus into the sigmoid sinus on one side or on both sides.
The cause of the development of pseudotumor cerebri (secondary intracranial hypertension) is associated with a number of pathological conditions, the list of which continues to grow. The leading place is given to the prothrombophilic status, previous thrombosis of the sinuses and central veins, deficiency of proteins C and S, and post-infectious complications (meningitis, mastoiditis). In rare cases, pseudotumor cerebri develops during pregnancy and when taking oral hormonal contraceptives, including due to disorders of the hemostatic system. The association of some metabolic and endocrine disorders with pseudotumor cerebri continues to be discussed - Addison's disease, hyper-, hypothyroidism, anemia, intake of tetracyclines, vitamin A, lithium salts and anabolic steroids. As a result, we can distinguish 5 main etiological groups of secondary pseudotumor cerebri syndrome: disturbance or block of venous outflow (external or internal compression, thrombophilia, systemic pathology, infectious causes); endocrine and metabolic causes(Addison's disease, hyper-, hypothyroidism, vitamin D deficiency); reception medicines, toxic substances (tetracyclines, amiodarone, cimetidine, retinol, cyclosporine, lithium carbonate, etc.); against the background of withdrawal of certain medications (glucocorticosteroids, gonadotropin hormone, danazol); systemic diseases (sarcoidosis, systemic lupus erythematosus, thrombocytopenic purpura, etc.).
Clinic. IIH syndrome is characterized by the following features (Dandy, 1937, modified by Wall, 1991): [ 1 ] symptoms of intracranial hypertension (including unilateral or bilateral papilledema); with lumbar puncture, an increase in ICP above 200 mm of water is determined. Art.; [ 3 ] absence of focal neurological symptoms(except, in some cases, paresis of the VI pair of cranial nerves); [ 4 ] absence of deformation, displacement or obstruction of the ventricular system; other brain pathology according to magnetic resonance imaging, with the exception of signs of increased cerebrospinal fluid pressure; [ 5 ] despite the high level of ICP, the patient’s consciousness is usually preserved; [ 6 ] absence of other causes of increased ICP.
The main clinical manifestation of the disease is headache(>90%) of varying intensity. Headache is characterized by all the typical features of cephalgic syndrome with increased ICP: more pronounced intensity in the morning, nausea, sometimes vomiting, increased pain when coughing and tilting the head. According to data International Society headache, the cephalgic syndrome in IIH should exactly coincide with the onset of the disease and regress as ICP decreases.
Transient visual disturbances in the form of darkening (fogging) before the eyes occur in 35 - 72% of cases. Symptoms of visual disturbances may precede headaches, and at the onset of the disease manifest themselves in the form of episodes of short-term blurred vision, loss of visual fields, or horizontal diplopia. Other clinical manifestations of IIH include noise in the head (60%), photopsia (54%), retrobulbar pain (44%), diplopia (38%), and progressive decrease in vision (26%). In the neurological status, signs are sometimes noted, often of low severity in the form of limited outward movement of the eyeballs. Ophthalmoscopy reveals bilateral or unilateral papilledema. varying degrees expressiveness. In 10% of cases, this leads to irreversible vision loss, especially if treatment is not started in a timely manner.
Diagnostics. The algorithm for examining patients with suspected IIH and pseudotumor cerebri includes:
full clinical and instrumental neuro-ophthalmological examination (standard) with assessment of visual fields, fundus, optic nerve head using optical coherence tomography (this method together with perimetry are also used to assess the effectiveness of therapy).
MRI of the brain using MR or SCT venography (standard). In complex cases, a study using a contrast agent is indicated. MRI examination is carried out for the following purposes: 2.1. obtaining information about the absence of volumetric processes of any origin in the cranial cavity and at the level of the cervical spinal cord; 2.2. absence of occlusion of the cerebrospinal fluid pathways in the cranial cavity and spinal canal of other origins; 2.3. visualization of the sinuses and great veins to confirm or exclude their thrombosis; 2.4. assessment of the condition and size of the ventricular system (measurement of the ventricular index) and the zone of the periventricular medulla; 2.5. assessing the condition of the liquor spaces (subarachnoid fissures, basal cisterns); 2.6. the presence or absence of an “empty” sella turcica; 2.7. condition of the optic nerves.
If, based on the results of the examinations, signs of increased ICP are obtained, it is advisable to perform a lumbar puncture (recommendation). The purpose of a lumbar puncture is to accurately determine CSF pressure and test for subjective response to CSF clearance. The values of cerebrospinal fluid pressure in patients with IIH exceed normal values in 95% of cases. Most often, the cerebrospinal fluid pressure is increased in the range from 200 to 400 mm aq. Art. (79%), in 30% of patients the water level may exceed 400 mm. Art., and in 11% of them the level may be above 500 mm aq. Art.
The first criteria for IIH were proposed by W. Dandy in 1937 (see the “clinical” section above), but they were subsequently revised to include (Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81:13:1159-1165):
I. IIH with papilledema. A. Papilledema. B. Absence of deviations in neurological status, with the exception of pathology cranial nerves(ChMN). C. Magnetic resonance imaging (MRI) data. Absence of changes in the membranes and parenchyma of the brain according to MRI without/with gadolinium contrast enhancement for patients at risk (young women with excess body weight). No abnormalities according to MRI of the brain without/with gadolinium contrast enhancement and MR venography in all other groups of patients. D. Normal CSF composition. E. Increased CSF pressure during lumbar puncture >250 mmH2O. in adults and >280 water. Art. in children (>250 mm H2O when performing lumbar puncture without anesthesia and in children without excess body weight). The diagnosis of IIH is reliable if all criteria A - E are met. The diagnosis of IIH is considered probable if criteria A - D are positive, but if the CSF pressure is lower than indicated in point E.
II. IIH without papilledema. Diagnosis of IIH in the absence of papilledema is possible if criteria B - E are met and signs of unilateral or bilateral abducens nerve damage are identified. In the absence of signs of papilledema and paresis of the sixth pair of cranial nerves, the diagnosis of IIH can only be presumptive, provided that points B - E and additional MRI criteria are met (at least 3 out of 4): “empty sella turcica”; flattening of the posterior surface eyeball; expansion of the perioptic subarachnoid space with (or without) increased tortuosity of the optic nerve; transverse sinus stenosis.
Treatment. For effective therapy IIH should use a multidisciplinary approach, which includes dynamic observation by a neurologist, ophthalmologist, and the participation of a nutritionist and rehabilitation specialist. Patients must be explained high risk development of complications of IIH, primarily vision loss, in the absence of timely therapy. The main directions of conservative treatment for IIH are weight loss (including the proven effectiveness of bariatric surgery for IIH) and the use of the carbonic anhydrase inhibitor acetazolamide (Diacarb). Second-line drugs for pharmacotherapy of IIH are topiramate, furosemide and methylprednisolone. Topiramate and the loop diuretic furosemide can be used for the development of adverse drug reactions while taking Diacarb (paresthesia, dysgeusia, fatigue, decreased CO2 levels, nausea, vomiting, diarrhea and tinnitus). In addition, weight loss while taking topiramate should be taken into account. Only in cases of refractoriness to drug therapy or a rapidly progressive malignant course of IIH is the issue of surgical neurosurgical treatment with bypass surgery considered (there are currently conflicting data regarding the effectiveness of stenting of the transverse sinuses in patients with IIH and stenosis or occlusion according to MR venography). The method of repeated lumbar punctures is currently used quite rarely.
Read more about IVG in the following sources:
article “Idiopathic intracranial hypertension” by A.V. Sergeev, State Budgetary Educational Institution of Higher Professional Education “First Moscow State Medical University named after. THEM. Sechenov”, Moscow, Russia (Journal of Neurology and Psychiatry, No. 5, 2016);
clinical recommendations “Diagnostics and treatment of benign intracranial hypertension”, discussed and approved at the Plenum of the Board of the Association of Neurosurgeons of Russia, Kazan, 06/02/2015 [read];
article “Idiopathic intracranial hypertension and the place of acetazolamide in treatment” Author: N.V. Pizova, Doctor of Medical Sciences, Prof. department neurology and medical genetics with a course of neurosurgery at the State Budgetary Educational Institution of Higher Professional Education YSMU (Consilium Medicum, Neurology and Rheumatology, No. 01 2016) [read];
article “Initial experience of endovascular stenting of the transverse sinus for idiopathic intracranial hypertension” by A.G. Lugovsky, M.Yu. Orlov, Yu.R. Yarotsky, V.V. Moroz, I.I. Skorokhoda, E.S. Egorova, State Institution “Institute of Neurosurgery named after Acad. A.P. Romodanova NAMS of Ukraine", Kyiv (magazine "Endovascular Neuro-X-Ray Surgery" No. 4, 2014) [read];
article “Benign intracranial hypertension (pseudotumor cerebri)” by Yu.S. Astakhov, E.E. Stepanova, V.N. Bikmul-lin (RMJ, “Clinical Ophthalmology” No. 1 dated 01/04/2001 p. 8) [read];
article (clinical case) “Addison's disease, manifested by idiopathic intracranial hypertension in a 24-year-old woman” D. Sharma et al., Journal of Medical Case Reports, 2010, 4:60 (translation from English by Natalia Mishchenko, published in the medical newspaper “ Health of Ukraine" 03/27/2015, health-ua.com) [read];
article “Benign intracranial hypertension: clinical observations” by R.V. Magzhanov, A.I. Davletova, K.Z. Bakhtiyarova, E.V. Pervushina, V.F. Tunic; Federal State Budgetary Educational Institution of Higher Education "Bashkir State Medical University" of the Ministry of Health of the Russian Federation, Ufa, Russia; GBUZ "Republican clinical hospital them. G.G. Kuvatova", Ufa, Russia (journal "Annals of Clinical and Experimental Neurology" No. 3, 2017) [read]
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Key Features
Idiopathic intracranial hypertension ( IVG) (other names: pseudotumor cerebri or benign intracranial hypertension and a whole series of outdated names) is a mixed group that includes various states characterized by elevated ICP in the absence of evidence of an intracranial mass lesion, HCF, infection (eg, chronic fungal meningitis) or hypertensive encephalopathy.
Some authors (though not all) do not include patients with intracranial hypertension due to dural sinus thrombosis. IIH is a diagnosis made by exceptions. There are juvenile and adult form. The pathogenesis is not completely known.
4 diagnostic criteria:
Epidemiology
Clinical presentation
· subjective symptoms (complaints)
A. G/B (most common symptom): 94-99%. Sometimes stronger in the morning
B. dizziness: 32%
C. nausea: 32%
D. visual acuity impairment
E. diplopia (more common in adults, usually as a result of sixth nerve palsy): 30%
F. pulsating noise in the head: 60%
G. retrobulbar pain when moving the eyeball
· objective symptoms (usually limited to the visual system only)
A. papilledema: almost 100% (sometimes unilateral)
B. abducens nerve palsy: 20%
C. enlarged blind spot (66%) and concentric narrowing of peripheral visual fields (blindness is very rare at initial presentation)
D. visual field defect: 9%
E. in the infantile form there may be only an increase in head circumference, which often goes away on its own and requires only observation without special treatment
F. suspicious absence of disturbance in the level of consciousness despite high ICP.
Greenberg. Neurosurgery
Every person experiences a headache sooner or later. A fairly common cause of frequent pain is intracranial hypertension. Increased intracranial pressure may result from an increase in the volume of cerebrospinal fluid, blood, or interstitial fluid in the brain. The pathology is dangerous and requires timely treatment.
The term "intracranial hypertension" is used primarily by doctors. People far from medicine are more accustomed to calling the disorder “high intracranial pressure.”
Increased pressure in the skull may be due to:
Intracranial pressure (ICP) is an important indicator for every person. Intracranial hypertension syndrome is a dangerous neurological pathology that can lead to serious consequences.
Intracranial hypertension according to ICD-10 is designated as G93.2 when it comes to benign pathology.
Intracranial hypertension can be either a congenital or acquired disease. Children encounter this pathology no less often than adults. No person is immune from intracranial hypertension, so it is important to be able to recognize specific symptoms and consult a doctor in a timely manner. If you suspect increased intracranial pressure, you should first visit a neurologist and undergo all examinations.
The main reason for the development of intracranial hypertension is a change in the amount of cerebrospinal fluid or impaired circulation of cerebrospinal fluid. Such disorders may be associated with traumatic brain injuries, spinal injuries, and neurological pathologies.
Poor circulation of cerebrospinal fluid leads to increased intracranial pressure
The second most common cause of this type of hypertension is circulatory disorders. Intracranial hypertension may occur due to venous blood stagnation. Impaired blood flow to the brain with subsequent stagnation of blood in the venous region leads to an increase in the total volume of circulating blood in the skull. The result is a slowly growing headache and the development of a number of neurological disorders.
In the case of brain tumors, the volume and density of brain tissue increases, which also leads to increased pressure inside the skull.
All these pathological processes are a consequence of:
Quite often, the cause of the development of intracranial hypertension is cranial trauma, indirect signs of which the patient may not immediately detect. In this case, due to the injury, the normal circulation of cerebrospinal fluid is disrupted and intracranial pressure gradually increases. Concussions as a result of an accident or a strong blow, severe blows to the head, bruises of the skull and hematomas can lead to the development of this dangerous pathology.
Intracranial injuries sustained during an accident may not be noticed at first and manifest themselves later as increased blood pressure.
Cerebrovascular accident leading to the development of ICH (intracranial hypertension) in adult patients is caused by a stroke. The cause may also be thrombosis of the meninges.
Malignant and benign neoplasms lead to an increase in the amount of brain tissue, which can also result in increased pressure inside the skull. ICH is often diagnosed when cancer has metastasized to the brain.
Inflammatory pathologies affecting the brain develop in people regardless of age. Meningitis, meningoencephalitis, encephalitis and brain abscess all lead to an increase in the volume of cerebrospinal fluid and increased intracranial pressure.
Neurological disorders that provoke changes in the circulation of cerebrospinal fluid or venous stagnation may be the result of severe alcohol intoxication, heavy metal or carbon monoxide poisoning.
Separately, there is an increase in intracranial pressure in people with pathologies of the cardiovascular system. Congenital heart defects and severe disorders of the cardiovascular system can lead to impaired blood circulation in the brain, resulting in increased intracranial pressure.
Pathologies of the cardiovascular system affect the normal functioning of the brain
ICH can be either a congenital or acquired pathology. No one is immune from this disorder; increased intracranial pressure is equally common in people of different age groups. While in adult patients the cause is often injuries or acquired pathologies, in children the disorder is most often congenital.
Causes of ICH in children:
Infections suffered by a woman during pregnancy can also cause increased intracranial pressure. A special place is occupied by neuroinfections, which in infants manifest themselves with a whole neurological symptom complex, including increased intracranial pressure.
According to the nature of the course and the reasons for its development, intracranial hypertension is divided into two types - chronic and idiopathic.
Chronic intracranial hypertension is called ICH with clearly identified causes, characteristic symptoms and course. It can be triggered by traumatic brain injury, birth trauma, inflammation of the meninges, or cancer.
Idiopathic is called ICH, the causes of which cannot be reliably determined. In this case, factors provoking the development of the disease can be various pathologies that only indirectly relate to the brain or spinal cord or the circulatory system.
Idiopathic or benign intracranial hypertension is diagnosed mainly in women over the age of 20 years. Doctors associate the risks of developing this form of intracranial hypertension with excess weight, hormonal and metabolic disorders, since the vast majority of patients are obese young women with menstrual disorders.
Presumably, idiopathic intracranial hypertension is a secondary symptom of the following pathologies:
Also, idiopathic ICH can be a consequence of long-term therapy with corticosteroids and tetracyclines.
Having understood what ICH is in adults and children, you should be able to promptly recognize the symptoms of intracranial hypertension in order to seek medical help in time.
With intracranial hypertension, symptoms depend on how much intracranial pressure has increased.
The main symptom of the disease is headache. Moderate intracranial hypertension is characterized by intermittent rather than constant headaches. In severe forms of the disorder, the headache is generalized, spreading to the entire head, and pain is observed daily.
Headache is the main symptom of intracranial hypertension
In addition to headaches, intracranial hypertension is characterized by the following symptoms:
Indirect signs of intracranial hypertension are weight loss, the appearance of bruises under the eyes, decreased libido, and less commonly, seizures.
With increased intracranial pressure, signs of vegetative-vascular dystonia may be observed. This symptom complex has more than 100 specific signs, including angina, shortness of breath, blurred vision and tinnitus.
Patients with ICH suddenly notice increased weather sensitivity, and headache peaks may occur at the time of a sharp increase in atmospheric pressure.
Headache with ICH worsens at night and immediately after sleep. This is due to an increase in the volume of brain fluid in the supine position. During the day, the headache spreads throughout the skull, the intensity of the pain syndrome may change. Quite often, simple analgesics do not have the expected therapeutic effect in ICH.
In adult patients, intracranial hypertension may be accompanied by sudden surges in blood pressure. During the day, your health may change several times. Patients often complain of attacks of disorientation, lightheadedness, flickering of spots before the eyes and a feeling of their own heartbeat.
The symptoms of benign hypertension are somewhat different from the chronic form of the disease. If, with chronic ICH, the patient constantly suffers from headaches, intensifying at night, the pain syndrome with benign intracranial hypertension subsides at rest and intensifies with movement. The peak of headaches occurs during heavy physical activity.
The main feature of chronic intracranial hypertension is a disturbance of consciousness, a change in character, and a deterioration in the cognitive functions of the brain. With benign ICH, such symptoms are completely absent; the disorder is manifested only by a headache, which intensifies during exercise.
If you suspect intracranial hypertension, you should consult a neurologist. First, the doctor will conduct a questioning, check reflexes and examine the patient. To confirm the diagnosis, it is necessary to undergo several hardware tests. First of all, Doppler ultrasound of intracanal vessels is prescribed to exclude cerebral circulatory disorders.
Signs of intracranial hypertension are clearly visible using MRI - magnetic resonance imaging. This examination is the most informative. To exclude inflammatory pathologies, the patient must undergo a general and biochemical blood test. To exclude injuries to the skull and the development of ICH due to injuries, radiography of the skull and cervical spine may be recommended.
Intracranial pressure is measured by lumbar puncture. This is a traumatic and unsafe procedure, during which a burr hole is made in the skull, so it is prescribed only in particularly severe cases. Usually, hardware tests are sufficient to make a diagnosis. To determine the composition of the cerebrospinal fluid, a study of cerebrospinal fluid may be prescribed. Material for analysis is taken by performing a lumbar puncture.
When intracranial pressure increases, an important diagnostic step is to exclude autoimmune pathologies, for example, lupus erythematosus, which can cause the development of idiopathic or benign ICH.
MRI is an informative and non-traumatic diagnostic method
For intracranial hypertension, treatment depends on the cause of the disorder. Treatment of intracranial hypertension and ICP in adults begins with differential diagnosis to identify the exact causes of the disease.
If the cause is tumor neoplasms, the patient is indicated for surgical intervention. Removal of the tumor quickly normalizes intracranial pressure by reducing the amount of brain fluid, so additional medications are not required to normalize ICP. However, this is only true for benign tumors, since malignant pathologies cannot always be removed surgically.
With internal hematomas, blood flows into the skull, which leads to increased pressure. If an MRI reveals such a disorder, a minimally invasive operation is performed to remove the leaked blood. The result is rapid normalization of intracranial pressure.
Inflammatory diseases of the meninges are treated with antibacterial drugs. Medicines are administered by drip or injection into the subarachnoid space. When performing such a puncture, a small part of the cerebrospinal fluid is removed for further analysis, and a small wound is formed at the puncture site. Removing part of the cerebrospinal fluid helps to instantly reduce intracranial pressure to normal values.
For intracanal pathology such as benign intracranial hypertension, specific treatment is not carried out; it is enough to identify and eliminate the cause, which may be autoimmune or hormonal disorders. In overweight women, intracranial pressure gradually decreases as they lose weight, and headaches go away.
Benign intracranial hypertension often develops during pregnancy. In this case, no treatment is prescribed; the pressure will return to normal after childbirth, as the amount of fluid in the brain tissue and throughout the body decreases.
There is no specific therapy aimed at reducing intracranial pressure. ICH is treated by eliminating the cause that triggered the increase in the amount of cerebrospinal fluid and the increase in intracranial pressure. Diuretics can be used to reduce the amount of circulating fluid. The following drugs are prescribed:
The drugs are taken in short three-day courses, with a break of two days. The exact dosage is selected by the doctor individually for each patient. During pregnancy, your doctor may prescribe a diet and a reduction in the amount of fluid you take to reduce intracranial pressure.
Taking diuretics allows you to remove excess fluid from the body and lower blood pressure. At the same time, the rate of cerebrospinal fluid production decreases, which means intracranial pressure gradually drops. This is only true if the cause of intracranial hypertension is an increase in the volume of cerebrospinal or cerebral fluid, but not trauma, hematoma or tumor.
For benign ICH, fluid intake should be reduced to one and a half liters per day. This applies not only to regular drinking water, but also to any liquid dishes, including juices and soups. At the same time, diet and physical therapy are prescribed, leading to a decrease in intracranial pressure.
Adult patients may be prescribed physiotherapeutic treatment methods - magnetic therapy or electrophoresis of the cervical-collar area. It is advisable to use such methods when the symptoms of ICH are moderate.
It is important to get rid of excess water in the body
Increased intracranial pressure is a dangerous condition that can progress. If conservative treatment does not bring the expected result, they resort to surgical methods, the purpose of which is to reduce the production of cerebrospinal fluid. For this purpose shunting is used.
The shunt is inserted into the cerebrospinal fluid space through an opening. The other end of the artificial vessel is brought into the abdominal cavity. Through this tube, excess cerebrospinal fluid is constantly drained into the abdominal cavity, thereby reducing intracranial pressure.
Bypass surgery is rarely used, as the procedure is associated with a number of risks. Indications for bypass surgery:
Bypass surgery is an emergency measure that is used in the absence of alternatives.
ICH is a dangerous pathology that requires timely diagnosis and treatment. Otherwise, chronic ICH can lead to complications, some of which are incompatible with life.
One of the most likely complications with high intracranial pressure is compression of the optic nerve head with subsequent atrophy, which leads to complete and irreversible loss of vision.
High intracranial pressure can lead to the development of a cerebral stroke. This complication can be fatal. Severe intracranial hypertension leads to damage to brain tissue, which leads to disruption of nervous activity and can threaten the death of the patient.
In especially severe cases, the disease leads to the development of hydrocephalus. High cerebrospinal fluid pressure on the brain leads to loss of vision, respiratory failure, deterioration of cardiac activity, and the development of convulsive seizures. There are cases where intracranial hypertension became the impetus for the development of epilepsy.
The prognosis depends on how early treatment is started. With uncomplicated intracranial hypertension, even with timely measures taken, no one is immune from negative consequences. Possible development of mental disorders, changes in speech, paralysis. Among the neurological disorders that are observed with intracranial hypertension are impaired reflex activity, short-term paresis, and local impairment of skin sensitivity. If the cerebellum is affected due to high pressure, problems with coordination of movements may develop.
With benign ICH, the prognosis is favorable. Timely contact with a neurologist, diuretic therapy and treatment of the cause of increased intracranial pressure can get rid of headaches without negative consequences. In other cases, the prognosis depends on the timeliness of therapy and which areas of the brain are damaged due to ICH.
