clinical features of raised intracranial pressure

Last reviewed 06/2023

The characteristic features of raised intracranial pressure are:

  • headache - typical of raised intracranial pressure
  • vomiting
  • visual disturbances:
    • blurring
    • obscurations - transient blindness
    • papilloedema in some patients
    • retinal haemorrhages if the rise in ICP has been rapid
  • brain shifts - often, with depression of conscious level
  • Cushing's peptic ulceration
  • in infants, slowly increasing intracranial pressure may present as a slowly increasing head size

A classic history is one of brief depression of conscious level after an insult, followed by improvement then progressive drowsiness. The situation is an acute medical emergency.

Gradual dilatation of one pupil and a decreasing responsiveness to light is an important sign as it often indicates the expansion of a clot over the ipsilateral hemisphere.