Elevated  intracranial pressure  (ICP), is a build-up of pressure in the skull. Whether it's caused by swelling, bleeding, a tumor , or some other problem, ICP can lead to compression of brain tissue and cause permanent damage. That's why it's considered a neurological emergency that needs to be addressed as soon as possible.

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    How will you know if someone has ICP? The key symptoms are blurry vision, headache , and changes in thinking that generally are worse when she's lying down. To tell if a person who's unconscious is experiencing ICP, a doctor or other medical professional usually will rely on fundoscopy, which involves lifting up an eyelid and using a bright light to illuminate the back of the eye and look for changes in the optic nerve.  

    To measure the increase in pressure, a monitor can be placed beneath the skull. This has the added benefit of being able to measure ICP constantly rather than just getting a single measurement, so changes in ICP can be captured. This is especially useful when it's likely ICP will get worse, such as after brain trauma that causes swelling.

    Treating ICP With Medication

    One way to manage ICP is to reduce the volume of  cerebrospinal fluid (CSF)  in the intracranial space under the skull. This can be done by slowing down production of it within the ventricles of the brain. A medication such as Diamox (acetazolamide), which primarily is used to treat glaucoma by reducing pressure in the eye, can slow CSF production and lower ICP as a result, but usually isn't the best choice: It's only mildly effective and also can change the acidity of the blood, which is not a desirable side effect.   

    Blood volume in the brain can be reduced by positioning the head to encourage the quick return of blood to the heart. If a patient is intubated  (has a breathing tube in), the breathing rate can be increased to change the acidity of the patient’s blood, which will cause the arteries in the brain to narrow, reduce blood flow, and clear more room for the brain—a temporary solution at best.

    Sometimes ICP is a result of edema, a leakage of fluid from blood vessels and into brain tissue. A substance such as mannitol (a naturally-occurring substance that draws fluid out of tissue) or saline can encourage fluid to return from the brain into the blood vessels.   A steroid such as dexamethasone can also help reduce brain swelling.

    When Surgery Is Necessary

    If the brain is being squeezed by something in the skull that doesn’t belong there, like an abscess  or tumor, removing it can be the answer. Another tactic is to insert a shunt in the brain through which excess CSF can drain. If there's already an ICP monitor in place, the fluid may be drained through the monitor to keep the pressure at a certain goal.

    Not surprisingly, shunting has potential side effects, including an increased chance of infection and bleeding. There’s also a risk that too much CSF will be removed from the wrong places, leading to pressure shifts that lead to herniation—the movement of part of the brain to where it doesn't belong.

    Another approach is to make the brain space bigger. This is done in a procedure called a  craniectomy , in which a portion of the skull is removed temporarily so the brain has room to swell. It sounds scary, and it is a very risky thing to do, but when swelling is so severe that a craniectomy is necessary there really are no other options.   During the period of time when the skull is removed, the tissue surrounding the brain is kept intact and clean as possible to prevent infection. 

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    Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

    How do you relieve pressure from the brain?
    What are the treatment options for increased ICP?
    1. placing a shunt through a small hole in the skull or in the spinal cord to drain excess cerebrospinal fluid.
    2. using medications like mannitol and hypertonic saline to lower pressure.
    3. sedation to reduce anxiety and neurological responses.
    How do doctors relieve pressure on the brain?
    A craniectomy is a type of brain surgery in which doctors remove a section of a person's skull. Doctors do this surgery to ease pressure on the brain that happens because of swelling or bleeding. They leave the skull open until the pressure goes down, at which point they close the opening in the skull. more
    What causes brain shrinkage?
    Diseases that cause cerebral atrophy include: stroke and traumatic brain injury. Alzheimer's disease, Pick's disease, and fronto-temporal dementia. cerebral palsy, in which lesions (damaged areas) may impair motor coordination. more
    Is it better to be right brain or left-brain?
    Left-handed people have right brain dominance for body control, which may also result in the more artistic personality for which such people are known. However, as can be seen by the fact that there are numerous right-handed artists as well as left-handed rational thinkers, brain lateralization only goes so far. more
    Is brain surgery a traumatic brain injury?
    Surgical brain injury (SBI) comprises a form of injury that inadvertently results from damaged brain tissue at the perisurgical site due to neurosurgical maneuvers such as incision, retraction, and electrocauterization, all of which are essential surgical techniques. more
    Can a brain scan show brain damage?
    These newer, specialized types of MRI scans can now look and assess damage to the brains structure, or measure brain function to detect changes in the brains structure and function due to TBI and concussions. more
    Do dogs have right brain or left brain?
    Individuals—canine or human—who favor the left paw or hand more often use the right hemisphere of their brain, while right-pawed and right-handed individuals have a more active left-brain hemisphere. Studies have shown differences between right-pawed and left-pawed dogs. more
    Does the brain sleep?
    Sleep is important to a number of brain functions, including how nerve cells (neurons) communicate with each other. In fact, your brain and body stay remarkably active while you sleep. Recent findings suggest that sleep plays a housekeeping role that removes toxins in your brain that build up while you are awake. more
    How do they relieve pressure on the brain?
    A craniectomy is a type of brain surgery in which doctors remove a section of a person's skull. Doctors do this surgery to ease pressure on the brain that happens because of swelling or bleeding. They leave the skull open until the pressure goes down, at which point they close the opening in the skull. more
    How is an ADHD brain different from a normal brain?
    ADHD brains have low levels of a neurotransmitter called norepinephrine. Norepinephrine is linked arm-in-arm with dopamine. Dopamine is the thing that helps control the brain's reward and pleasure center. The ADHD brain has impaired activity in four functional regions of the brain. more
    What is the difference between a traumatic brain injury and an acquired brain injury?
    An acquired brain injury is the umbrella term for all brain injuries. There are two types of acquired brain injury: traumatic and non-traumatic. A traumatic brain injury (TBI) is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force. more

    Source: www.verywellhealth.com

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