Raised intracranial pressure from a brain tumour

Key points about raised intracranial pressure from a brain tumour

  • Raised intracranial pressure is increased pressure in your skull. It's a life-threatening condition as the increase in pressure in your skull could damage your brain and spinal cord. 
  • See your doctor immediately if you experience symptoms such as headache, drowsiness, vomiting, blurred vision, fits, altered sensation or weakness of your arms and legs.
  • A brain scan such as a CT scan or an MRI scan is usually used to diagnose raised intracranial pressure. Occasionally, a lumbar puncture may be required. 
  • Treatment of raised intracranial pressure aims to reduce swelling and pressure around your brain.
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Symptoms of raised intracranial pressure often develop gradually and include:

  • headache
  • drowsiness
  • blurred vision
  • confusion or personality change
  • poor memory or restlessness
  • seizures or fits
  • nausea or vomiting
  • altered sensation in parts of your body such as tingling, 'pins and needles' or numbness
  • weakness of your legs or arms.

If you notice any of the symptoms above, contact your doctor immediately. This is a medical emergency.  

Your nervous system comprises your skull, brain, spinal cord and nerves to other parts of your body. Your skull is the outer layer of bones on your head that protect your brain. Underneath your skull, there are two components: your brain and the cerebrospinal fluid (a colourless liquid surrounding your brain).

Because your skull acts as a protective layer, it is very hard and rigid. If there is a tumour or cancer growth in your brain, it presses against your skull, increasing pressure in your brain, which causes raised intracranial pressure. This is a dangerous condition. It is a medical emergency, so if you have the symptoms below seek immediate medical attention as it can cause permanent damage to your brain or spinal cord. 

Raised intracranial pressure can be caused by:

  • tumours or cancers originating from your brain
  • tumours or cancers that are spread from other parts of your body, such as your breast, bowel or lungs
  • inflammation of the protective membranes (meninges) covering your brain or build up of cerebrospinal fluid (CSF) within your brain following brain surgery
  • bleeding into tumours or cancers in your brain.

Your doctor will take a history and do a physical examination and request some tests based on your symptoms. This involves urgent brain scanning such as a CT scan or an MRI scan to find out the cause of raised intracranial pressure. Your doctor may also do a lumbar puncture, where a needle is inserted into the lower part of your spine to measure the pressure of cerebrospinal fluid.

If you have raised intracranial pressure, your doctor will discuss with you the best treatment options. Treatment usually depends on the type of cancer you have and your general health. Before treatment is started, your doctor may ask you about your wishes or whether you have any advance care plan. You may also be admitted to a hospital to receive treatment and be referred to a palliative care specialist.

Treatment aims to reduce swelling and pressure around your brain. Your doctor may give you medicines to reduce your symptoms and make you feel better. These include:

  • steroids such as dexamethasone or prednisone
  • sedating medications such as benzodiazepines or opioids
  • anticonvulsants such as sodium valproate or carbamazepine if there is risk of seizures.

Sometimes, radiotherapy or surgery may be offered depending on the outlook of your condition.

It can be scary to have raised intracranial pressure as the condition can cause a severe headache and affect your vision. Talk through your feelings with your family/whānau members or health professionals taking care of you. Read more about how to talk about your feelings.(external link) 

Below are some support services and information for people affected by cancer and their family/whānau:

Emotions and cancer(external link) Cancer Society of NZ
How we can help(external link) Cancer Society of NZ
NZ cancer services – find a hospital/service near you(external link) Healthpoint, NZ
More cancer support groups

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Jarna Standen, Registered Nurse, Mercy Hospice, Auckland

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