Curriculum · Neurology
Raised intracranial pressure in a child
What it is
Raised intracranial pressure is a rise of the pressure within the skull. One form of it has no cause that can be found: idiopathic intracranial hypertension, also named pseudotumor cerebri or benign intracranial hypertension, a condition of unknown etiology that manifests with chronically elevated intracranial pressure. Raised intracranial pressure is also one of the neurological causes of secondary hypertension.
Causes and risk
Idiopathic intracranial hypertension predominantly affects obese women aged 15-44 years. Female sex, tetracyclines, obesity, excessive intake of vitamin A and danazol are the major risk factors for pseudotumor cerebri.
Pressure also rises from a mass or a bleed within the skull. Papilledema, taken as a red flag in a headache, points to disorders with increased intracranial pressure, that is an intracranial mass or bleed.
How it presents
The most common symptoms are diffuse headaches, although various visual symptoms and pulsatile tinnitus are also common. The clinical features are:
- Diffuse headaches.
- Transient vision loss, photopsia and retrobulbar pain.
- Pulsatile tinnitus, heard as a swishing sound.
- Cranial nerve disorders, especially CN VI, which gives diplopia.
Increased intracranial pressure is also one of the causes of an altered mental status, and the vital sign abnormalities that carry it are hypertension and bradypnea.