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Stages of Intra Cranial Hypertension

Discuss the stages of intra cranial hypertension and make a list of symptoms that are associated with each stage. Discuss how to identify hypertension from these clinical manifestations

Intra Cranial Hypertension Stages

Intra-cranial hypertension is high pressure around the brain. It’s a disorder which is characterized by headache. It affects men, slim individuals, children and obese women who are at the childbearing stage (Friedman and Jacobson, 2004). Intra cranial hypertension is classified under four stages; the first stage is Falx Herniation, the second stage is Unilateral Transtentorial Herniation, the third stage is Bilateral Transtentorial Herniation and the fourth stage is Cerebellar Herniation (Bennett et al., 2019).

Notably, Falx Herniation occurs when brain tissues are displaced along the skull. It’s a sickle-shaped matter that spreads along cerebral hemispheres to the longitudinal fissure. It’s mainly caused by primary injury. Symptoms present at this stage include; traumatic brain injury, Hemorrhage, Ischemia, Tumor, Osmotic Edema, Hyperosmolality, hyperammonemia, change in cerebrospinal fluid pressure and change in cerebral blood volume (Kostecki et al., 2022).

Intra Cranial Hypertension

The unilateral Transtentorial Herniation stage occurs when cerebral tissue shifts from a local place to an adjacent place and this includes upward Herniation, uncal and central. This can be reversed through surgical intervention. The key compartments are the posterior fossa and supratentorial compartments. Transtentorial Herniation is of three kinds; upward Herniation, uncal Herniation and central Herniation. Symptoms of this stage include; vomiting, headache, nausea, dilated pupil, contralateral hemipares, impaired motility (Decker and Pearson-Shaver, 2022).

Bilateral Transtentorial is the third stage of intracranial hypertension. It is characterized by the movement of tissues within the brain. It is caused by excessive severe trauma and supratentorial hydrocephalus. Symptoms of this stage include; brainstem ischemia, Duret hemorrhage, and reduced cerebrospinal fluid.

The last stage is Cerebellar Herniation which causes a deficit in balance control and a deficit in motor due to low oxygen supply. In addition, it causes bleeding which damages tissues worsening deficits. Symptoms for this stage are; headache, vertigo, Horner’s syndrome, anesthesia and dysmetria (Ioannides et al., 2022). Hypertension can be identified from intra cranial hypertension through spinal tap brain scan, test to check muscle balance and eye test.

References

Bennett, J., Dolin, R., and Blaser, M. (2019). Principles and Practice of Infectious Diseases. Elsevier. ISBN: 9780323482554

Decker, R. and Pearson-Shaver, A. (2022). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537108/

Friedman, D. and M. Jacobson, D. (2004). Idiopathic intracranial hypertension. J Neuroophthalmol. 24(2):138-45. doi: 10.1097/00041327-200406000-00009. PMID: 15179068.

Ioannides, K., Tadi, P. and Naqvi, I. (2022). Cerebellar Infarct. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470416/

Kostecki, K., De Jesus O. and Pearson-Shaver, A. (2022). Subfalcine Herniation. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 30725631.

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