Intracranial Pressure (ICP) is defined as the pressure within the skull/cranium, normally 10-15 mm Hg in adults and 3-7 mm Hg in children. ICP is determined by the contents of the skull, namely brain, blood, and cerebrospinal fluid (CSF). There are a variety of causes of elevated ICP, including the following: subarachnoid hemorrhage, intracranial hemorrhage, subdural hematomas, brain tumors, and hydrocephalus.

Patients with elevated ICP, for whatever reason, need prompt neurosurgical evaluation because increased intracranial pressure can lead to herniation, or displacement of brain tissue into abnormal positions or spaces, causing worsening neurological status, respiratory failure, or death. There are a variety of treatment strategies for measuring and lowering ICP. Patients may need an ICP monitor, which is a small fiberoptic device placed into the brain tissue to continuously measure ICP and to direct therapy for lowering ICP. Other patients may require a ventricular drain, a catheter placed into the ventricular system of the brain, which can be used to both monitor ICP and to treat elevated ICP by draining cerebrospinal fluid (CSF) from the catheter. Some patients may require surgery to lower ICP, including removal of a brain tumor or evacuation of a blood clot, for example.

It is important to keep in mind that the cause of elevated ICP differs from patient to patient, and the treatment strategy to normalize the ICP varies accordingly.