Increased temperature with intracranial pressure

What is intracranial pressure?

The term intracranial pressure (ICP) refers to the pressure in the subarachnoid and epidural space, the ventricles of the brain, and the sinuses of the dura mater. The indicator itself is a complex value and depends on the following factors:

• cerebrospinal fluid;
• blood;
• brain pressure.

Strong physical activity and stressful conditions lead to its increase. Usually, a rare increase in intracranial pressure in children does not pose any danger, but a constant increase in pressure can lead to serious problems. The main role in the formation of ICP is played by blood and cerebrospinal fluid, which are constantly in motion. It is the change in the speed of movement of these fluids that affects the level of cranial pressure.

Why is it dangerous?

The first thing to understand is that increased ICP is not an independent disease. This is a pathological condition that occurs against the background of certain factors or diseases. If intracranial pressure in children is not treated at an early age, when the child grows up, he may begin to have serious problems with his studies, he will feel constant fatigue. As you get older, your complaints will only increase. Memory will deteriorate, headaches will often occur, and attention will also decrease significantly. All these manifestations develop against the background of deterioration of cerebral circulation.

ICP norm

Normally, ICP varies from 3 to 15 mm Hg. and depends on the age of the person. So, experts identify the following norms, depending on age:

• in newborns from 1 to 6 mm Hg;
• in children from 3 to 7 mm Hg;
• in adults from 7 to 15 mm Hg.

Moreover, you need to remember that these indicators are applicable only in cases where a person is lying down and at complete rest. Changes in body position, cold, heat, and stressful situations can lead to increased intracranial pressure.

Increased temperature with intracranial pressure

Increased intracranial pressure (ICP) is a dangerous condition that many people face. It can occur in both childhood and adulthood. Women suffer from the disease somewhat more often than men.

Unfortunately, sometimes the symptoms of increased intracranial pressure are not paid attention to, which leads to dire consequences.

Therefore, it is necessary to know well what it is, the symptoms and principles of treatment of the disease in adults and children.

Why does the pressure inside the skull increase? This phenomenon may be due to various factors. But in most cases, high intracranial pressure is associated with a violation of the outflow of cerebrospinal fluid from the cavity inside the skull.

First, it is useful to understand what intracranial pressure is. You should not think that inside the skull there is only a huge number of nerve cells and nothing more.

A significant volume of the brain (more than a tenth) is occupied by cerebrospinal fluid, which is also called cerebrospinal fluid. It is mainly located in the area of ​​the ventricles, located inside the skull, in its center.

Also, part of the cerebrospinal fluid circulates in the space between the soft and arachnoid membranes of the brain. There is also cerebrospinal fluid in the spinal canal.

The functions performed by cerebrospinal fluid are varied. This includes protecting brain tissue from impacts on the skull bones, ensuring water and electrolyte balance and removing harmful substances and toxins from the brain.

Another thing is important - the amount of cerebrospinal fluid determines the pressure inside the skull. Part of the cerebrospinal fluid (more than two thirds) is formed directly in the ventricles, and part is converted from blood circulating in the brain area.

The liquor is completely renewed within a week.

Intracranial pressure is usually indicated in millimeters of mercury or millimeters of water. For adults, the normal value ranges from 3-15 mm Hg. Art.

From a physics point of view, this parameter shows how many millimeters the cerebrospinal fluid pressure exceeds atmospheric pressure. In children, the pressure inside the skull is usually slightly lower than in adults.

If the volume of cerebrospinal fluid circulating in the brain area becomes greater than normal, this usually leads to an increase in intracranial pressure.

Increase in ICP above 30 mm. Hg Art. often leads to irreversible damage to brain tissue and death.

This is why it is important for people to know about ICP levels.

But how to determine it, because, unlike blood pressure, ICP cannot be measured at home? To determine the pressure inside the skull, special instrumental methods are usually used, which are carried out only in a hospital setting. Therefore, characteristic symptoms are often the reason for suspecting the diagnosis of “increased intracranial pressure”.

Symptoms of increased intracranial pressure

When intracranial pressure increases, symptoms typically include a number of commonly observed signs:

• headache,
• visual disturbances,
• dizziness,
• absent-mindedness,
• memory impairment,
• drowsiness,
• instability of blood pressure (hypertension or hypotension),
• nausea,
• vomit,
• lethargy,
• fast fatiguability,
• sweating,
• chills,
• irritability,
• depression,
• mood swings,
• increased skin sensitivity,
• pain in the spine,
• breathing disorders,
• dyspnea,
• muscle paresis.

If you occasionally experience any of these signs, then, naturally, this is not evidence of increased intracranial pressure. Symptoms of increased pressure inside the skull may be similar to symptoms of other ailments.

The most common symptom indicating the disease is headache. Unlike migraine, it affects the entire head at once and is not concentrated on one side of the head.

Most often, pain with high ICP is observed in the morning and night hours. Pain with increased intracranial pressure can intensify when turning the head, coughing, sneezing.

Taking analgesics does not help relieve pain.

The second most common symptom of increased intracranial pressure is problems with visual perception - double vision, blurred objects, decreased peripheral vision, attacks of blindness, fog before the eyes, decreased reaction to light. These signs of increased intracranial pressure are associated with compression of the optic nerves.

Also, under the influence of increased ICP, the shape of the eyeball may change in the patient. It may bulge so much that the patient is unable to close the eyelids completely. In addition, blue circles made up of congested small veins may appear under the eyes.

Nausea and vomiting are also common symptoms of increased intracranial pressure. As a rule, vomiting does not bring relief to the patient.

It should be borne in mind that intracranial pressure can briefly increase (2-3 times) even in healthy people - for example, when coughing, sneezing, bending, physical activity, stress, etc. However, the ICP should quickly return to normal. If this does not happen, then this is evidence of a chronic increase in intracranial pressure.

Signs of increased intracranial pressure in young children

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How does the disease manifest in young children? Unfortunately, infants cannot tell their parents about their feelings, so they have to rely on indirect symptoms of intracranial pressure. These include:

• lethargy;
• cry;
• poor sleep;
• vomit;
• seizures;
• involuntary eye movements;
• swelling and pulsation of the fontanelle;
• increase in head size (hydrocephalus);
• uneven muscle tone – some muscles are tense and some are relaxed;
• protrusion of a network of blood vessels under the scalp.

On the other hand, symptoms such as nosebleeds, stuttering, occasional shuddering during sleep, and increased excitability, as a rule, do not indicate increased pressure inside the child’s skull.

Diagnosis of increased intracranial pressure

To directly measure pressure inside the skull, complex instrumental methods that require highly qualified physicians, sterility and appropriate equipment are used, which are often unsafe. The essence of these methods is puncture of the ventricles and insertion of catheters into the areas where cerebrospinal fluid circulates.

A method such as puncture of cerebrospinal fluid from the lumbar spine is also used. In this case, both pressure measurements and a study of the composition of the cerebrospinal fluid can be carried out. This method is necessary if there is reason to suspect the infectious nature of the disease.

Safer diagnostic methods have become more widespread:

• ultrasonography,
• magnetic resonance examination,
• CT scan.

As a result of these studies, it is possible to identify changes in the structure of the brain and surrounding tissues, indicating increased intracranial pressure.

These changes include:

• increase or decrease in the volume of the ventricles of the brain,
• swelling,
• increasing the space between the shells,
• tumors or hemorrhages,
• displacement of brain structures,
• dehiscence of the sutures of the skull.

Encephalography is also an important diagnostic method. It allows you to determine disturbances in the activity of various parts of the brain characteristic of increased ICP. Doppler ultrasound of blood vessels helps to detect blood flow disturbances in the main arteries and veins of the brain, congestion and thrombosis.

An important diagnostic method is fundus examination. In most cases, it can also detect increased intracranial pressure.

With this syndrome, symptoms appear such as enlargement of the vessels of the eyeball, swelling of the place where the optic nerve approaches the retina, and small hemorrhages on the retina.

After determining the degree of development of the disease, the doctor must inform the patient about how best to treat it.

Causes of increased intracranial pressure in children

Increased intracranial pressure in a child over a long period of time usually indicates the presence of some disease. These include the following pathologies:

• brain tumors;
• hydrocephalus;
• hemorrhage due to a closed craniocerebral injury;
• poisoning by toxins that can pass through the blood-brain barrier;
• acute infections affecting the head, such as encephalitis or meningitis.

If we talk about children in the first year of life, then their increased blood pressure may be associated with early overgrowth of the fontanel. It is important to remember that increased intracranial pressure in a child is normal in the first months of life.

How to measure?

The main method of measuring intracranial pressure in a newborn is a lumbar puncture or direct recording of pressure in the ventricles of the brain.

The following group of additional instrumental methods is also used:

• Neuroimaging of brain structures - computed tomography, magnetic resonance imaging. These studies reveal expansion of the subarachnoid space, changes in the size of the ventricles;
• Neurosonography is an ultrasound examination of the child’s brain, which reveals enlargement of the ventricles and moderate expansion of the subarachnoid space;
• Echoencephaloscopy is a method that uses ultrasound to diagnose a pathological focus in the skull. The method evaluates the displacement of the midline structures of the brain, the deviation of which indicates the presence of cerebral pathology.
• Ultrasound examination of the vessels of the head can reveal retinal angiopathy and congestion in the optic discs.

The results of these studies confirm the presence of intracranial hypertension.

Helpful information

In addition to the listed methods for recording increased intracranial pressure, consultation with specialists is necessary - a neurologist, neurosurgeon, ophthalmologist, pediatrician.

Signs of increased intracranial pressure in a child

Depending on the cause, signs of intracranial pressure in children may vary. However, it is possible to identify characteristic manifestations of this condition depending on the age of the child. If we talk about children in the first year of life, the following manifestations are typical:

• lethargy, drowsiness;
• tearfulness;
• irritability;
• poor weight gain;
• increased head circumference. This symptom indicates hydrocephalus, which is one of the common causes of congenital increased ICP;
• neurological symptoms, for example, Graefe's symptom, which occurs against the background of a disturbance in the functioning of the oculomotor nerve, in particular, when the eyeball deviates downward, a white strip of the sclera will be visible just below the upper eyelid;
• overdeveloped venous network of the head;
• swelling of the fontanelle;
• developmental delay.

Often, one or more of the symptoms described above are observed. Often mothers turn to the pediatrician with the problem of developmental delay. A child with increased intracranial pressure begins to sit or walk later.

When it comes to older children, the following complaints come first:

• headache;
• blurred vision;
• inattention;
• memory loss;
• nausea and dizziness;
• fast fatiguability;
• poor learning ability;
• sudden change of mood;
• increased sweating.

The most common sign that helps to suspect intracranial pressure in a child is headache. Children may complain that they have a severe headache in the morning or during physical or mental stress. Also, a child with increased intracranial pressure will complain of poor vision. This complaint is typical for children over 4 years of age.

It is worth noting that most of the manifestations increase at night. This is due to a slowdown in venous outflow during the period when the child is in a lying position. Slowing blood flow leads to blood filling and, therefore, increased pressure inside the skull.

Many mothers mistakenly consider some complaints to be symptoms of increased ICP. This is not surprising, because over many years it has become popular among pediatricians to present this diagnosis as an independent diagnosis, justifying any disturbances in the functioning of the nervous system. Thus, the following complaints are not a sign of increased intracranial pressure in children:

• long closure of the fontanelle;
• tiptoeing;
• trembling of the chin or hands;
• poor appetite;
• nosebleeds;
• hyperactivity syndrome.

Thus, hyperactivity syndrome is in no way associated with intracranial pressure in the child. Most often, its cause lies in poor nutrition or complicated childbirth, which led to hypoxic brain damage. In any case, if the above complaints are detected in a child, you must immediately seek help from a specialist. Early initiation of treatment will help avoid serious complications and quickly return the child to normal life.

How is intracranial pressure measured?

Measuring intracranial pressure in a child is a very difficult issue. Modern doctors actively use invasive and non-invasive measurement methods. The choice of method directly depends on the disease that led to the development of increased ICP. The following invasive methods for measuring cranial pressure are distinguished:

1. Ventricular drainage. Considered the “gold standard” for measuring ICP. Drainage is installed through surgery. In 6% of cases, bleeding may develop during this manipulation. The name of the method is due to the location of the catheter in the ventricle of the brain.
2. Intraparenchymal method. The measurement is possible using sensors located in the parenchyma of the frontal lobe of the brain.
3. Subarachnoid drainage.
4. Subdural drainage.
5. Epidural drainage.
6. Spinal tap.

Installation of drainage and sensors is possible only by specially trained doctors, under general anesthesia, so intracranial pressure in children is rarely performed using invasive techniques.

It should be noted that non-invasive methods do not have sufficient accuracy, but they allow one to get an approximate idea of ​​the level of ICP in a child. There are two groups of non-invasive methods for determining cranial pressure, namely:

• based on the morpho-functional characteristics of the cranial organs;
• based on determining the functional characteristics of the skull bones, cerebrospinal fluid, and blood vessels.

The first group includes the following examinations:

1. Study of the condition of the fundus vessels. This is because these vessels are a direct reflection of what is happening with blood circulation in the brain.
2. Diameter of the optic nerve head. This indicator directly depends on the level of ICP.
3. Measurement of pressure of the venous outflow from the retina.
4. Study of the condition of the inner ear.
5. Measurement of blood flow in the jugular vein.

The group of methods for studying ICP, depending on functional characteristics, includes the following:

1. Echoencephalography. To put it simply, this concept refers to ultrasound of the brain. This method cannot directly measure the level of cranial pressure, but it allows one to suspect diseases leading to intracranial hypertension.

2. MRI and CT. Some of the most modern diagnostic methods available at the moment. Calculation of ICP can be done by assessing the intracranial contents. Despite their effectiveness, these examinations are used quite rarely, which is explained by the high cost and the inability to measure pressure in this way on a daily basis.
3. Angiography. Assessment of the condition of the spinal arteries. Allows you to indirectly suspect an increase in intracranial pressure in a child.
4. Dopplerography. Ultrasound examination of the condition of blood vessels. To determine ICP, special sensors are used, placed in the temporal or occipital region.

Thus, measuring ICP is an extremely complex procedure that is impossible without qualified medical care. The choice of examination method directly depends on the severity of the patient’s condition. Usually, non-invasive methods are sufficient for a specialist to confirm the diagnosis of intracranial hypertension in a child. If they do not provide a complete picture of the disease, and the manifestations of hypertension increase, it is necessary to use invasive methods.

If you notice signs of intracranial pressure in a child, you should immediately seek help from a doctor. This will allow you to start treatment in a timely manner and avoid serious complications.

Treatment methods

In order to treat increased ICP in a child, it is necessary to determine the cause that led to hypertension. Also, the changes that occur in the child’s body are important for the doctor. If the main indicators are normal, treatment will be exclusively conservative. When it comes to significant hydrocephalus, surgical treatment may be necessary to install a shunt.

Typically, to normalize ICP levels in a child, the doctor may prescribe the following medications:

• Diuretics;

• Neuroprotectors;
• Nootropics.

Diuretics are very serious medications that can only be taken after being prescribed by a doctor. It is important to strictly follow all recommendations and dosage of the drug, since if used incorrectly, it can significantly harm the child.

Nootropics are necessary to improve cerebral circulation. They are best taken in combination with neuroprotectors necessary to stimulate the functioning of nerve cells. In addition to the use of medications, your doctor may prescribe a course of therapeutic massage or special exercises.

Traditional methods of treating ICP in children are also popular. It is important to remember that alternative medicine can only be used with the permission of the attending physician. Popular folk methods for treating high blood pressure include the following:

• decoctions of motherwort and valerian;
• mint tea;
• hawthorn decoction;
• swimming with clover, string, immortelle;
• Birch juice;
• washing your hair with camphor oil.

If a child is faced with intracranial hypertension, he must watch what he eats. It is necessary to limit the amount of liquid entering the body, and also remove fried foods and salt from the diet. Vitamins are extremely important for treating ICP, so you need to eat more fresh vegetables and fruits.

Thus, treating ICP in a child is a complex, complex process. This is why it is so important to immediately seek help from your doctor if you notice signs of intracranial pressure in a child.

Treatment

Self-treatment of increased intracranial pressure in infants is not worthwhile.

Only a doctor can be trusted to determine treatment methods and tactics. The main goal is to normalize intracranial pressure.

The consequences of a difficult birth and complicated pregnancy can be eliminated with the help of prolonged breastfeeding, adherence to a sleep schedule and long walks in the fresh air, but this is far from the only way to normalize intracranial pressure in a baby, since in some cases drug therapy is necessary.

The course of treatment includes:

In especially severe cases, surgical intervention is performed. A special tube is installed to pump out excess fluid from the cranial cavity.