Intracranial Hypertension

Increased pressure within the cranial vault. This may result from several conditions, including HYDROCEPHALUS; BRAIN EDEMA; intracranial masses; severe systemic HYPERTENSION; PSEUDOTUMOR CEREBRI; and other disorders.

Also Known As:

Elevated ICP (Intracranial Pressure); Elevated Intracranial Pressure; ICP (Intracranial Pressure) Elevation; ICP (Intracranial Pressure) Increase; Intracranial Pressure Increase; Hypertension, Intracranial; ICP, Elevated (Intracranial Pressure); Intracranial Pressure, Elevated; Pressure Increase, Intracranial; Pressure, Elevated Intracranial

Networked: 2425 relevant articles (133 outcomes, 205 trials/studies)

Relationship Network

Disease Context: Research Results

Nervous System Diseases: 14178
- Central Nervous System Diseases: 4213
  - Brain Diseases: 15694
    - Intracranial Hypertension: 2425
      - Pseudotumor Cerebri: 1064
      - Hypertensive Encephalopathy: 187

Related Diseases

1.	Traumatic Brain Injuries (Traumatic Brain Injury)
2.	Brain Edema (Cerebral Edema)
3.	Neoplasms (Cancer)
4.	Coma (Comas)
5.	Wounds and Injuries (Trauma)

Experts

1.	Czosnyka, Marek: 18 articles (01/2022 - 01/2008)
2.	Jalan, Rajiv: 13 articles (06/2013 - 10/2002)
3.	Hutchinson, Peter J: 12 articles (01/2022 - 07/2013)
4.	Kochanek, Patrick M: 12 articles (01/2019 - 07/2003)
5.	Citerio, Giuseppe: 11 articles (12/2022 - 11/2002)
6.	Robba, Chiara: 11 articles (12/2022 - 02/2017)
7.	Menon, David K: 11 articles (01/2022 - 04/2008)
8.	Kolias, Angelos G: 10 articles (01/2022 - 07/2013)
9.	Oddo, Mauro: 10 articles (01/2022 - 11/2008)
10.	Smielewski, Peter: 10 articles (01/2021 - 05/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Intracranial Hypertension:

1.	Mannitol (Osmitrol)FDA LinkGeneric 03/01/2011 - "We found that hypertonic saline is more effective than mannitol for the treatment of elevated intracranial pressure. " 06/01/2000 - "Mannitol is effective in reducing ICP, and its use is recommended as a guideline in the management of traumatic intracranial hypertension. " 07/01/1995 - "In this study, the fluid regimen was compared with hypertonic mannitol to investigate their therapeutic efficacy in intracranial hypertension. " 01/01/2020 - "Mannitol is effective in reducing pathological ICP, proportionally to the degree of intracranial hypertension. " 11/01/2018 - "Osmotherapy seems to be effective in intracranial hypertension management; however, there is no clear evidence regarding the superiority of hypertonic saline over mannitol. "
2.	barbituric acid (barbiturate)IBA 01/01/1983 - "Barbiturate administration has been beneficial in some cases of sustained, uncontrolled intracranial hypertension. " 10/01/1999 - "The purpose of this study was to examine the changes in cerebral hemodynamics of head-injured patients undergoing barbiturate treatment of refractory intracranial hypertension. " 11/01/2008 - "Barbiturate infusion for intractable intracranial hypertension and its effect on brain oxygenation." 09/01/1981 - "Barbiturate effects on acute experimental intracranial hypertension." 06/01/1994 - "The purpose of this study was to evaluate the role of barbiturate therapy as an adjunctive treatment for control of intracranial hypertension when conventional methods failed. "
3.	Hypertonic Saline SolutionIBA 10/25/2016 - "The aim of this study was to evaluate the maintained efficacy of a 3% hypertonic saline solution in an experimental model of intracranial hypertension. " 09/01/2002 - "Hypertonic saline solution (HSS) has been investigated in the treatment of intracranial hypertension (ICH) in a limited number of studies, usually after failure of conventional treatment. " 01/01/2021 - "The 20% hypertonic saline solution was administered for 48 hours or longer if patients remained at risk of intracranial hypertension. " 10/25/2016 - "CONCLUSIONS Bolus infusion of 3% hypertonic saline solution with the aid of a pump does not significantly reduce intracranial pressure in an animal model of intracranial hypertension." 10/25/2016 - "Evaluation of the Maintained Effect of 3% Hypertonic Saline Solution in an Animal Model of Intracranial Hypertension."
4.	BarbituratesIBA 04/01/1983 - "Our experience suggests that barbiturates can be effective in lowering intracranial pressure in patients with otherwise unresponsive intracranial hypertension, and, by doing so, may decrease the mortality in a group of patients considered untreatable by the usual therapeutic modalities." 01/01/2021 - "We have also illustrated the application of these methods, in which they were used to estimate the efficacy of barbiturates prescribed during the first 24 h of an episode of intracranial hypertension. " 01/01/1989 - "Efficacy of barbiturates in the treatment of resistant intracranial hypertension in severely head-injured children." 01/01/1989 - "Efficacy of barbiturates in the treatment of resistant intracranial hypertension in severely head-injured children." 01/01/2016 - "An update on the RESCUEicp study, a randomised trial of DC versus advanced medical management (including barbiturates) for severe and refractory post-traumatic intracranial hypertension is provided. "
5.	6-chloro-2-(1-piperazinyl)pyrazine (CPP)IBA 03/01/2018 - "Early DC for CT evidence of intracranial hypertension decreased abnormal ICP and CPP time and improved ICP and CPP thresholds, but had no obvious effect on the outcome." 06/01/2011 - "Invasive intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring were considered as the gold standard to measure intracranial hypertension (ICH). " 07/01/2009 - "The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. " 01/01/2000 - "Some authors have suggested that CPP is more important in influencing outcome than is intracranial hypertension, a hypothesis that this study was designed to investigate. " 01/01/2023 - "For this aim, we (1) compared end-hour ICP and CPP values manually recorded (MR) with values recorded continuously by computerized high-resolution (HR) systems and (2) analyzed whether MR ICP and MR CPP are reliable indicators of the burden of intracranial hypertension and low CPP. "
6.	Acetazolamide (Diamox)FDA LinkGeneric 10/01/2021 - "Case 3 was a 5-year-old girl with acute intracranial hypertension that improved after going through lumbar puncture and using acetazolamide. " 01/01/2019 - "Acetazolamide treatment normalized intracranial pressure, but several trials of medication tapering led to recurrence of intracranial hypertension symptoms. " 08/01/2011 - "Ongoing studies, especially an ongoing National Institutes of Health-funded clinical trial of acetazolamide, should provide more insight into this important, yet poorly understood, syndrome of isolated intracranial hypertension." 01/01/2023 - "She was diagnosed with intracranial hypertension and began treatment with acetazolamide. " 01/30/2021 - "Acetazolamide at the time of treatment may potentially be used as prophylaxis for rebound intracranial hypertension. "
7.	Ketamine FDA LinkGeneric 01/01/2023 - "Of the 143 patients, 23 had pre-intubation and post-intubation intracranial pressure values recorded; 11 received ketamine, and 3 of these patients had intracranial hypertension that resolved or improved, whereas the remaining 8 children had intracranial pressure within the normal range that was not exacerbated by ketamine. " 01/01/2023 - "If these findings are reproduced in a larger study, ketamine may warrant consideration as a treatment for intracranial hypertension in children with severe TBI." 01/01/2023 - "The objective of this study was to evaluate and compare the effects of ketamine versus other medications as the primary induction agent on peri-intubation neurologic, hemodynamic and respiratory associated events in pediatric patients with neurologic conditions at risk for intracranial hypertension. " 01/01/2016 - "Animal studies have shown that ketamine has neuroprotective properties, and there is no evidence of elevated intracranial pressure after ketamine dosing in humans. " 03/01/1997 - "Studies in spontaneously ventilating pigs with and without intracranial hypertension have shown that racemic ketamine (0.5-5.0 mg/kg) produces increases in PaCO2 and ICP. "
8.	Starch (Cornstarch)IBA 10/01/2004 - "7.2% saline in 6% hydroxyethyl starch is an effective and safe therapy for intracranial hypertension after SAH. " 01/01/1997 - "The purpose of the present study was to test the efficacy of administration of HS (7.5%) combined with 6% hydroxyethyl starch (molecular weight 200.000/0.60-0.66; HHES) for the treatment of therapy-resistant intracranial hypertension in patients with severe TBI. " 01/01/1997 - "The purpose of the present study was to test the efficacy of administration of HS (7.5%) combined with 6% hydroxyethyl starch (molecular weight 200,000/0.60-0.66; HHES) for the treatment of intracranial hypertension refractory to standard therapy in patients with severe TBI. " 10/01/2004 - "Predictable reduction of intracranial hypertension with hypertonic saline hydroxyethyl starch: a prospective clinical trial in critically ill patients with subarachnoid haemorrhage." 03/01/2008 - "To observe the effect of hypertonic sodium chloride hydroxyethyl starch 40 injection (HSH) in treatment of acute intracranial hypertension complicated by hemorrhagic shock in dogs, and explore the mechanism of the effects of HSH. "
9.	Adrenal Cortex Hormones (Corticosteroids)IBA 05/01/1991 - "Episodic exacerbations were accompanied by intracranial hypertension and were relieved by the administration of corticosteroids. " 09/01/2018 - "In 4 patients, corticosteroid had been prescribed before surgery due to intracranial hypertension. " 01/01/2017 - "However, long-term corticosteroid use may have adverse effects, including intracranial hypertension (IH). " 11/01/2004 - "The elevated intracranial pressure returned to normal following a corticosteroid taper. " 04/13/1996 - "Corticosteroids were used to treat intracranial hypertension in 19 units. "
10.	Glycerol (Glycerine)FDA LinkGeneric 03/01/1982 - "Glycerol was found to be effective and safe when employed in this protocol and proved to be a valuable adjunct to the standard methods available for control of intracranial hypertension." 11/12/2022 - "Glycerol is clinically used as a treatment for elevated intracranial pressure and induces the expression of glpT in Escherichia coli. " 03/12/2021 - "Intrahospital transport and horizontal positioning during CT scans induce immediate intracranial hypertension and an increase in cerebral glycerol, suggesting neuronal injury. " 07/01/2015 - "Because of the beneficial effects of lumbar puncture, we decided to manage his symptoms of intracranial hypertension conservatively with repeated lumbar puncture and administration of glycerol. " 03/01/1982 - "Oral glycerol for the treatment of traumatic intracranial hypertension."

Therapies and Procedures

1.	Therapeutics 01/01/2023 - "Uncertainties remain about the safety and efficacy of therapies for managing intracranial hypertension in acute brain injured (ABI) patients. " 01/01/2018 - "The efficacy of treatment was based on a timely urgent neurosurgical intervention and adequate intensive therapy in the form of extended neuromonitoring with continuous measurement of intracranial pressure, which enabled using the whole complex of measures for timely management of intracranial hypertension. " 04/01/2016 - "The extrapolation of therapies from general neurocritical care to the treatment of ALF-induced intracranial hypertension has resulted in improved neurologic outcomes. " 11/01/2012 - "Intracranial pressure control with intubation, sedation, and hyperosmolar therapy improved episodes of decreased brain tissue oxygenation associated with intracranial hypertension. " 09/01/2010 - "Future therapies targeting anti-inflammatory response in plasma may help to reduce the inflammatory cascade responsible for development of intracranial hypertension."
2.	Decompressive Craniectomy 01/01/2022 - "Decompressive craniectomy (DC) is highly effective in relieving intracranial hypertension; however, patient selection, intracranial pressure threshold, timing, and long-term functional outcomes are all subject to controversy. " 06/01/2018 - "Decompressive craniectomy, effective in some cases of pharmaco-resistant intracranial hypertension (ICH) resulting from other causes, may be suggested in severe HSE, with several good results reported in the literature. " 01/01/2022 - "Decompressive craniectomy (DC) is an effective treatment of intracranial hypertension. " 12/30/2017 - "By performing a prophylactic decompressive craniectomy (DC) in a rat model of SAH we aimed to study brain perfusion after the component of intracranial hypertension has been eliminated. " 11/01/2015 - "Decompressive craniectomy (DC) with duroplasty is the gold standard for refractory intracranial hypertension despite paucity of randomized controlled trials. "
3.	Craniotomy 08/01/2015 - "Surgery was effective in relieving or preventing intracranial hypertension in all patients, irrespective of craniectomy size. " 05/01/1996 - "Craniectomy alone induced a decrease in ICP of 45% (40 torr) in case 1 and 30% (35 torr) in case 2. Although this method remains controversial, given the lack of controlled trials, it can offer a salvage procedure in children with rapidly worsening intracranial hypertension, allowing survival without disabling neurological sequelae." 01/01/2023 - "Craniectomy may prevent intracranial hypertension, but whether it is associated with better outcomes is unclear. " 01/01/2023 - "Hinge craniotomy as an alternative technique for patients with refractory intracranial hypertension." 03/01/2022 - "Monitoring optic nerve sheath by ultrasound can be considered a reliable method for identifying severe intracranial hypertension in patients with large vessel occlusion, as well as for monitoring patients undergoing craniectomy. "
4.	Decompression 02/01/2004 - "External decompression can be an effective treatment for acute intracranial hypertension, but the cranial defect must be repaired. " 03/01/1984 - "External decompression is an effective treatment for acute intracranial hypertension, but the repair of cranial defect by cranioplasty is necessary sooner or later. " 12/01/2019 - "In all patients, the visual function and intracranial hypertension improved after decompression. " 01/01/2022 - "The benefits of controlled decompression (CDC) for patients with acute intracranial hypertension especially in terms of alleviating the complications caused by rapid decompression (RDC) have been confirmed by clinical studies. " 01/01/2020 - " opinion: Given the results of the trials, there needs to be a change in the clinical decision-making paradigm such that decompression is reserved for patients who develop intractable intracranial hypertension and who are thought unlikely to survive without surgical intervention. "
5.	Ventriculoperitoneal Shunt 08/01/1995 - "A ventriculo-peritoneal shunt relieved the symptoms of intracranial hypertension. " 11/13/2023 - "Among them, 37 with syndromic CS, including 17 ventricular megaly patients, had an EI >0.3 (46.0%), and 4 of them had intracranial hypertension and needed ventriculoperitoneal shunt treatment before cranial vault remolding. " 04/01/2022 - "One patient developed intracranial hypertension after 3 months requiring ventriculoperitoneal shunt, which resolved PT as well. " 01/01/2020 - "An emergency lateral ventriculoperitoneal shunt was performed to relieve the clinical symptoms of intracranial hypertension. " 01/01/2019 - "Two patients (mean BMI = 52) with persistent postoperative CSF leaks and elevated intracranial pressure were successfully managed with ventriculoperitoneal shunt placement. "