What is in-skull hypertension? How to recognize?

Article by Dr. Nguyen Cong Hoa – Department of Active Resuscitation – Share99 Times City International Health Hub

This article presents an approach to increased in-skull pressure (ICP) built on the type of answer to the question. This is not a comprehensive review of a complex topic, but an "easy-to-access quick overview" to provide practical information on increased biology, pathology and ICP management to busy practitioners.

In cranial pressure (ICP) is usually recorded in millimeters of mercury (mmHg), ICP in adults is usually 5 – 10 mmHg, in children 3 – 7 mmHg, and in babies 1.5 – 6 mmHg. The mmHg value is equal to 1.36 to determine the equivalent value in cmH2O of this value obtained when using the measuring mandive at the puncture of the spinal cord. ICP varies day by day and is affected by changes in position, position, and pressure fluctuations in other compartments (e.g., Valsalva manipulation will significantly increase ICP at rest). Increased ICP can be defined in many ways, but in the level it usually refers to pressures greater than 20 – 25mmHg for more than 5 minutes.

The skull is fixed hard containing 3 main components – brain tissue, cerebral blood and cerebral fluid (CSF). The Monro-Kellie doctrine states that the total in vicranial volume is the same and therefore the increase in any one of this composition must be offset by an equivalent decrease in the other two.

Under normal conditions, the pressure in the cranial space is in an balanced state. If the pressure from one component increases, clear by reducing the mass of another component and increasing the ICP afterwards. This usually involves shifting the cerebral and vein blood out of the skull to compensate for the increased volume. When it can no longer be compensated, it leads to a brain hernia.

Increased ICP is the last common path to death or disability in most conditions of emergency brain damage. Increased ICP is also treatable. .

Brain perfusion pressure (CPP) is the difference between medium arterial pressure (MAP) and ICP. CPP = MAP – ICP.

CPP is the main factor that determines cerebral blood flow (CBF). Most often, CBF is combined with the metabolic needs of tissue, with normal flow greater than 50 ml / 100g / min. Less than 20ml / 100g / min is considered the is issy local threshold. Brain automation maintains CBF between a CPP range of about 50 -150 mmHg. In addition to these rangees, CBF becomes pressure dependent.

Increased incranial pressure (ICP) is an increase in pressure around the patient's brain. It may be due to an increase in the amount of fluid around the brain. For example, there may be a natural increase in the amount of cerebral fluid that increases the brain of the person or increases the amount of blood in the brain due to injury or ruptured tumors.

Increased ICP can also mean that the patient's brain tissue is swollen, due to injury or by diseases such as epidence. Increased ICP can be the result of brain injury, and it can also cause brain injury.

Increased ICP is a life-threatening condition. A person with symptoms of increased ICP must receive emergency medical assistance immediately.

Signs of increased ICP include:

• Headache
• Nausea
• vomit
• Hypertension
• Decreased sense
• Confusion about time, and then location, confusion
• Double view, blurry vision
• The son does not react to changes when shining light
• Weak breathing
• Convulsions
• Loss of consciousness
• Coma

These signs may point to other serious conditions besides an increase in ICP, such as a stroke, brain tumor or recent head injury .

Cerebral vascular accidents are the most common cause of increased ICP. Other possible causes of increased ICP include:

• be infected
• Tumors
• Head injuries
• Aneurysm rupture
• epilepsy
• Convulsions
• Hydrocephalus
• Brain damage caused by hypertension, especially when uns controlled high blood pressure leads to bleeding in the brain
• Hypoxia, which is a deficiency of oxygen in the blood
• Meningitis

The doctor will need to know some important information about the medical history of the patient immediately. The doctor will ask if the patient has recently had a cerebral vascular accident, or a trauma to the head or has been diagnosed with a brain tumor. The doctor then examines, can check the patient's blood pressure and see if there is an increase in HA. The doctor can also measure the pressure of the cerebral fluid using a spinal cord puncture, or a transcranial doppler ultrasound. CT scans or cranial MRI may be necessary to determine the diagnosis.

The most urgent goal of treatment is to reduce the pressure inside the patient's skull. The next goal is to address the cause. Effective treatments to relieve pressure include emergency unemployment. Taking mannitol and saline medications can also relieve pressure, anti-concussion sedatives, Corticoids in brain tumors.

Less common treatments for the treatment of increased ICP include:

• Open cranium pressure reduction
• Deep anesthesia, muscle relaxion
• Command hypothermia

ICP increases cannot be prevented, but each person can prevent head injuries:

• Always wear a helmet when cycling or playing contact sports. Wear a seatbel strap while driving and hold your seat as far away as possible from the dashboard and steering wheel or seat in front of you. Always fasten your child's seatbeln in your child's seat.
• Falls at home are a common cause of head injuries, especially in older adults. Avoid falls at home by keeping the floor dry and clutter-free. If necessary, install handy.
• Treatment of hypertension, brain aneurysms so as not to suffer a stroke of brain haemorrhage.
• Take anti-seizure medications regularly so as not to suffer prolonged seizures.
• Treatment of brain tumors.

Share99 International Health Hub with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in neurological examination and treatment, patients can be assured of examination and treatment at the Health Hub.

To register for examination and treatment at Share99 International Health Hub, you can contact Share99 Health System nationwide, or register for an online examination HERE.

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