Tag: Intracranial pressure

Elevated intracranial pressure (ICP) in traumatic brain injury is a life-threatening emergency. In cases of subdural hematoma (SDH), a condition where blood collects between the brain's covering and its surface, the question often arises: can we give mannitol in SDH? Yes, mannitol is a potent osmotic diuretic used as a standard temporizing measure to reduce ICP, but its application is specifically reserved for patients showing clinical or radiographic signs of increased pressure, and it is not used prophylactically.

Acetazolamide, a carbonic anhydrase inhibitor, can decrease the production of cerebrospinal fluid (CSF) when the enzyme is significantly inhibited. So, what does acetazolamide do to the brain? It impacts pressure, blood flow, and neuronal excitability.

In a documented case involving a head-injured patient, the intravenous administration of metoclopramide was linked to a significant, acute increase in intracranial pressure (ICP). This rare but serious complication prompts a closer look at whether and how metoclopramide can increase intracranial pressure and its broader spectrum of neurological side effects.

While corticosteroids are often used to treat inflammation, a well-documented but rare side effect is the development of benign intracranial hypertension, a condition where **steroids can cause increased intracranial pressure**. This elevated pressure, also known as pseudotumor cerebri, frequently manifests during dose reduction or withdrawal of the medication, not during treatment.

While uncommon at therapeutic doses, lamotrigine toxicity, typically from an overdose, has been shown to cause severe intracranial hypertension in case studies. This serious risk is distinct from the medication's common, mild side effects and requires immediate medical attention.

First-line pharmacological treatment for idiopathic intracranial hypertension often includes acetazolamide, a medication widely used for its ability to reduce intracranial pressure. But **can acetazolamide decrease intracranial pressure** and how effective is it? The answer is a resounding yes, primarily by inhibiting the enzyme carbonic anhydrase in the brain's choroid plexus to reduce cerebrospinal fluid production.

Over 50% of glaucoma patients may not tolerate the long-term side effects of oral carbonic anhydrase inhibitors like acetazolamide [1.4.5]. This medication, a potent carbonic anhydrase inhibitor, is prescribed to address several conditions by asking: **what does acetazolamide reduce?**

According to the landmark Idiopathic Intracranial Hypertension Treatment Trial (IIHTT), a combination of acetazolamide and a low-sodium weight-reduction diet resulted in modestly significant visual field improvements for patients with mild visual loss. This makes acetazolamide a cornerstone of medical therapy for IIH.

Dexamethasone is the most commonly used corticosteroid for managing increased intracranial pressure (ICP) associated with brain tumors. This is because it potently reduces vasogenic edema and significantly lowers ICP. The question, however, is not simply, "**Does dexamethasone increase ICP?**" but rather, under which specific circumstances might its use be counterproductive or cause complications related to ICP?

According to a Cochrane review of mannitol for acute traumatic brain injury, excessive or prolonged administration may cause mannitol to pass into the brain, where it might contribute to increased intracranial pressure. This finding offers a complex answer to the question: does mannitol increase intracranial pressure under specific, medically significant circumstances?