Intracranial hypertension (IH) is a build-up of pressure around the brain. It can happen suddenly, for example, as the result of a severe head injury, stroke or brain abscess. This is known as acute IH. It can also be a persistent, long-lasting problem, known as chronic IH.

1. INTRACRANIAL
HYPERTENSION
BRINCELET.M.BIJU
GROUP:733

2. Content
• INTRODUCTION
• CAUSES
• PATHOPHYSIOLOGY
• EPIDEMOLOGY
• ETIOLOGY
• SYMPTOMS
• COMPLICATIONS
• PATHOGENESIS
• DIAGNOSIS
• TREATMENT
• REFERENCE

4. Intracranial hypertension is a clinical entity with a myriad of known and putative etiologies. In
the history of this condition, the name given to the clinical syndrome referred to as PTC
(PseudoTumor Cerebri), IIH (Idiopathic Intracranial Hypertension) or BIH (Benign
Intracranial Hypertension) has varied widely and been the subject of much contention . It
is a disorder of unknown cause that results in raised intracranial pressure (ICP) occurring in
women of childbearing years. Heinrich Quincke, an early pioneer in the use of lumbar
puncture, reported the first recorded cases of intracranial hypertension of unknown cause
in what he described as “meningitis serosa” in 1893; at that time, he posited that inadequate
CSF resorption was responsible for the syndrome, a theory that is still entertained by some
researchers . It is characterized by increased ICP, with its attendant signs and symptoms, in
an alert and oriented patient but without localizing neurologic findings. The term “PTC”
was coined in 1904 by Nonne to describe a condition characterized by symptoms associated
with intracranial tumors with an un usual cours e of remiss ion and subsequently termed
“benign intracranial hypertension"by Foley in 1955

5. Possible causes of chronic intracranial hypertension (IH) include:
• a blood clot on the surface of your brain, known as a chronic subdural
haematomaa brain tumouran infection in your brain, such as
meningitis or encephalitishydrocephalus, where fluid builds up around
and inside your brainabnormal blood vessel, such as an arteriovenous
fistula or arteriovenous malformationa blood clot in one of the veins
of your brain, known as a venous sinus thrombosis.
• Rare causes include a blockage in the circulation of fluid at the
bottom of the skull (Chiari malformation), inflammation of the blood
vessels in the brain (vasculitis) and abnormal skull growth in children
(craniosynostosis).

10. Mechanism by which
transverse sinus
stenosis leads to
increase intracranial
pressure.

11. Symptoms of chronic intracranial hypertension (IH) can include:
• a constant throbbing headache which may be worse in the
morning, or when coughing or straining; it may improve when
standing uptemporary loss of vision – your vision may
become dark or "greyed out" for a few seconds at a time; this
can be triggered by coughing, sneezing or bending
downfeeling and being sickfeeling sleepyfeeling irritable.
• Chronic IH can sometimes result in permanent vision loss,
although treatment can help to reduce the chances of this
happening.

12. Pathogenesis
• In many cases, the cause of chronic IH is unclear. This is known as
idiopathic IH, or sometimes benign IH.It mainly affects women in their 20s
and 30s, and has been associated with:being overweight or obese – most
cases happen in overweight women, although it's not clear whyhormone
problems such as Cushing's syndrome, hypoparathyroidism, an underactive
thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism)certain
medicines including some antibiotics, steroids and the combined
contraceptive pilla lack of red blood cells (iron deficiency anaemia) or too
many red blood cells (polycythaemia)chronic kidney diseaselupus – a
problem with the immune systemBut these are only linked with idiopathic
IH, they're not necessarily causes.

19. How is Diagnosis Made?
The Modified Dandy Criteria for Idiopathic Intracranial Hypertension is the
official criteria used to diagnose IIH. According to the Dandy criteria, an
IIH diagnosis is appropriate if a person:• has signs and symptoms of
increased intracranial pressure, such as papilledema and headache;• has no
localizing findings on neurological examination (Localizing findings are
findings that point to injury of specific brain areas. For instance, a localizing
finding could be the inability to move a certain muscle.);• has a normal
MRI/CT scan with no evidence of venous obstructive disease;• has high
intracranial pressure of 250mm/H2O or above on a spinal tap, with no
abnormalities of cerebrospinal fluid;• is awake and alert; • has no other
cause of increased intracranial pressure found.

20. Intracranial pressure can be measured in millimeters
(mm)/water or centimeters (cm)/water.
• For example, a reading of 200mm/H2O is equal to
20cm/H2O.
• For adults:Normal pressure readings are generally below
200mm/H2O.
• Borderline high pressure readings are between 200-
250mm/H2O.
• Anything above 250mm/H2O is considered a high pressure
reading.For young children:Anything above 200 mm/H2O is
considered a high pressure reading.

21. Medication and Surgery
Both drugs and surgery are used to treat chronic IH. Medical (or Drug)
therapy is generally tried first, but if there is an immediate risk to vision,
chronic pain that cannot be relieved or a poor response to drug therapy,
then surgery is performed. It is not unusual for people with chronic IH to
undergo both drug therapy and surgery in an effort to control their
intracranial pressure.

22. 1. https://ihrfoundation.org/hypertension/info/C31
2. https://www.researchgate.net/publication/330517442_A_REVIEW_OF_I
NTRACRANIAL_HYPERTENSION
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2452989/
4. https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2529-z
5. https://www.slideshare.net/mobile/irfaanshah3/idiopathic-intracranial-
hypertension-42132994
6. https://www.slideshare.net/mobile/anjupaed/idiopathic-intracranial-
hypertension
REFERENCES