Raised ICP Flashcards
What are some of the causes of raised ICP
Space occupying lesion (e.g. tumour)
Brain swelling (e.g. infection)
Raised CSF pressure (hydrocephalus, intracranial hypertension)
What features suggest a high pressure headache
Progressive headache with associated symptoms and signs
what are the symptoms of high pressure headache (7)
Headache wakens patient up
Cough or other valsalva headache
Visual obscurations (blacking of vision on movement)
Pulsatile tinnitus (whooshing in ear)
Progressive focal symptoms
Cognitive change/drowsiness
Headache associated with loss of consciousness
What are the clinical signs of high pressure headache (2)
Papilloedema (swelling of optic disk)
New abnormal neurological examination
What is intracranial hypertension (and clinical presentation (4))
Elevated CSF opening pressure
Clinical presentation:
Progressive episodic or persistent headache
Visual obscurations
Pulsatile tinnitus
Papilloedema (often with enlarged blind spot)
What causes intracranial hypotension (2)
Spontaneous
Post lumbar puncture
Due to “brain sink”
What is the presentation of intracranial hypotension
Postural headache (develops or worsens soon after assuming upright position - lessens after lying down)
What is the investigation of intracranial hypotension
MRI brain and spine to show characteristic features
What is the treatment of intracranial hypotension (5)
Bed rest
Fluids
Analgesia
Caffeine (possibly IV)
Epidural blood patch
What is giant cell arteritis
Inflammation (arteritis) of large arteries
What are features of giant cell arteritis (6)
Non-specific headache
Scalp and jaw tenderness
Jaw claudication
Visual disturbance
Prominent, beaded or enlarged temporal arteries may be present
Systemically unwell
What is the treatment for giant cell arteritis
High dose predinsolone (steroid which reduces inflammation)
