Verhoogde intracraniële druk II: Pathofysiologie

Increased intracranial pressure often originates from pathological processes, such as cerebral edema, a mass effect from hemorrhage or tumor, or obstructed cerebrospinal fluid flow.

As cerebral edema worsens, the brain’s ability to autoregulate its blood supply becomes compromised.

Normally, cerebral vessels constrict or dilate to maintain constant blood flow, or perfusion, despite changes in systemic blood pressure.

Once this autoregulation fails, cerebral blood flow becomes pressure-dependent, making the brain more susceptible to hyperperfusion and further edema.

Since the skull and dura mater are rigid structures, they cannot accommodate this increased volume.

A severe rise in ICP pushes brain tissue from high to low-pressure regions, resulting in herniation syndromes such as transtentorial or tonsillar herniation.

These shifts can compress the brainstem, impairing vital functions like respiration, circulation, and consciousness.

Simultaneously, decreased cerebral perfusion causes severe ischemia. Without timely intervention, these processes culminate in widespread neuronal degeneration, permanent brain damage, or death.