What should you know about cranial hypertension?

Because the skull is a fixed space, extra fluid, swelling, bleeding, or a growth can raise pressure and interfere with normal brain function. The cause may be temporary or related to another illness, injury, medicine, or a condition affecting the flow or absorption of cerebrospinal fluid.

Headache is often worse in the morning, when lying down, or with coughing, straining, or bending. Nausea, vomiting, blurred or double vision, brief episodes of visual dimming, ringing in the ears that follows the heartbeat, drowsiness, confusion, or weakness can also occur. Symptoms vary, and a headache alone does not establish the diagnosis.

A clinician may examine your alertness, movement, reflexes, pupils, and vision. Further assessment can include an eye examination for swelling at the optic nerve and brain imaging. A lumbar puncture may be considered in selected situations, but it is not appropriate for everyone and should only be performed after a clinician has assessed safety.

Arrange prompt medical advice if you have a new, persistent, or progressively worsening headache, particularly with visual changes, vomiting, or unusual sleepiness. Tell the clinician about recent head injury, pregnancy or recent childbirth, infections, blood-clotting problems, and every medicine or supplement you take.

Treatment depends on the cause and may involve monitoring, medicines to reduce swelling or cerebrospinal fluid, treatment of an infection, or a procedure to relieve pressure. Do not stop prescribed medicines or start diuretics on your own. Avoid driving if your vision, alertness, or coordination is affected.

Seek emergency care immediately for a sudden severe headache, reduced consciousness, a seizure, repeated vomiting, new weakness or numbness, trouble speaking, unequal pupils, sudden vision loss, or confusion. These signs can indicate dangerous pressure or another neurological emergency and should not be watched at home.

After a head injury, worsening headache, increasing drowsiness, vomiting, or a change in behaviour needs urgent assessment even if the injury initially seemed minor. Do not drive yourself if you are confused, faint, very sleepy, or having visual symptoms.

Ask what may be causing the pressure, which symptoms should trigger emergency help, whether your eyesight or optic nerves need checking, and which tests are suitable for you. You can also ask how any recommended treatment will be monitored and whether a medicine you already take could be contributing.