【Learning Points】
- Normal intracranial pressure should be less than 10-15mmHg or 135-200mmH2O. If the pressure continues to be higher than 15mmHg or 200mmH2O, it is called intracranial hypertension.
- The causes of increased intracranial pressure include increased brain tissue, increased cerebrospinal fluid, and increased intracranial blood volume.
- Avoid forced defecation, blowing your nose, coughing and other activities that may require holding your breath and exerting force to reduce the chance of increasing intracranial pressure.
I. What is increased intracranial pressure (IICP) ?
Skull basically is a very hard structure. The contents in the skull, such as brain tissue, blood and cerebrospinal fluid, maintain a steady inside pressure (so-called intracranial pressure, ICP). The intracranial pressure will elevate once the contents of skull increase. The pressure varies in response to change of blood pressure, pressure inside chest wall or abdomen, body position, and body temperature. Normal intracranial pressure should be less than 10-15mmHg or 135-200mmH2O. When the pressure is constantly higher than 15mmHg or 200mmH2O, it is called increased intracranial pressure (IICP) and it endangers the lives of patients.
II. The factors of causing increased intracranial pressure (IICP)
- Increased brain tissue: such as brain tumor or brain tissue swollen by trauma.
- Increased cerebrospinal fluid (CSF): obstruction of CSF circulating pathway; excessive secretion or slow absorption of CSF causing fluid overloaded .
- Increased blood volume within the skull: blood clot formation due to rupture of brain vessels caused by trauma or stroke.
III. The symptoms of increased intracranial pressure
- Persistent headache , dizziness, nausea and vomiting.
- High blood pressure, slow heart rate, irregular breathing.
- Conscious change, such as sleepy, drowsy, unclear speech, weird behavior, etc.
- Weakness of muscle strengths of limbs; loss of balance for walking or standing .
- Convulsion.
- Blurred vision.
IV. Nursing for increased intracranial pressure
- When lying on bed, raise up the top of bed, keep the head and neck in a straight line. Do not turn the head around that may interrupt the venous blood return and cause IICP.i.
- Avoid defecating with exertion, blowing the nose, coughing strongly by which the intracranial pressure will elevate.
- Eat more high-fiber food and take some stool softeners by doctor’s prescription to avoid constipation.
- Possibly avoid or reduce noise and keep the environment quiet. When pain occurs, patients can take painkillers prescribed by doctor. Avoid unpleasant or painful stimuli that may cause intracranial pressure to increase.
- When IICP symptoms get worse or consciousness changes, please call for medical assistance immediately.