Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (869 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Hypertension, Intracranial; Elevated ICP (Intracranial Pressure); ICP, Elevated (Intracranial Pressure); Elevated Intracranial Pressure; Intracranial Pressure, Elevated; Pressure, Elevated Intracranial; ICP (Intracranial Pressure) Elevation; ICP (Intracranial Pressure) Increase.
Where it fits in the MeSH classification
- Broader topics
- Brain Diseases
- Narrower topics
- Hypertensive Encephalopathy; Pseudotumor Cerebri
- See also
- Brain Edema; Hydrocephalus
Related concepts
- Hydrocephalus
- Brain Edema
- Hypertension
- Pseudotumor Cerebri
Research landscape
PubMed indexes 13,233 records tagged with the MeSH heading “Intracranial Hypertension” (counts retrieved 2026-10-29). 3,119 of them (23.6%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 4,573 records.
Reviews account for 2,163 records (16.3%) and meta-analyses for 129. Randomized controlled trials number 175 (1.3%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 2,667 |
| 2000-2009 | 2,874 |
| 2010-2019 | 4,573 |
| 2020 onward | 3,119 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 2,163 | 16.3% |
| Meta-analyses | 129 | 1.0% |
| Randomized controlled trials | 175 | 1.3% |
Method: PubMed query "Intracranial Hypertension"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in neuroscience
Neuroscience draws on tools with different strengths: cellular and animal work can manipulate circuits directly, while human imaging and electrophysiology observe the living brain at lower resolution. Small imaging studies are prone to false positives, and findings in animals do not always carry over to people. Clinical neurology and psychiatry rely on trials and cohort studies whose outcomes are often symptom scales. Check the species, the sample size, how the outcome was measured and whether results were replicated.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
Treatment with GLP-1 receptor agonists is associated with significant weight loss and favorable headache outcomes in idiopathic intracranial hypertension [1]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundIn idiopathic intracranial hypertension (IIH), sustained weight loss is the main pillar in modifying disease course, whereby glucagon-like peptide-1 receptor agonists (GLP-1-RAs) could present an attractive treatment option.
- Closing excerpt
- 7]; p ConclusionsThis open-label, single-center pilot study suggests that GLP-1-RAs are an effective and safe treatment option for achieving significant weight loss with a favorable effect on headache, leading to reduced acetazolamide dosage in pwIIH.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (212 words)
BackgroundIn idiopathic intracranial hypertension (IIH), sustained weight loss is the main pillar in modifying disease course, whereby glucagon-like peptide-1 receptor agonists (GLP-1-RAs) could present an attractive treatment option.MethodsIn this open-label, single-center, case-control pilot study, patients with IIH (pwIIH) and a body mass index (BMI) of ≥ 30 kg/m2 were offered to receive a GLP-1-RA (semaglutide, liraglutide) in addition to the usual care weight management (UCWM). Patients electing for UCWM only served as a control group matched for age-, sex- and BMI (1:2 ratio). The primary endpoint was the percentage weight loss at six months (M6) compared to baseline. Secondary endpoints included the rate of patients with a weight loss of ≥ 10%, monthly headache days (MHD), the rate of patients with a ≥ 30% and ≥ 50% reduction in MHD, visual outcome parameters, and adverse events (AEs).ResultsWe included 39 pwIIH (mean age 33.6 years [SD 8.0], 92.3% female, median BMI 36.3 kg/m2 [IQR 31.4-38.3]), with 13 patients being treated with GLP-1-RAs. At M6, mean weight loss was significantly higher in the GLP-1-RA group (-12.0% [3.3] vs. -2.8% [4.7]; p ConclusionsThis open-label, single-center pilot study suggests that GLP-1-RAs are an effective and safe treatment option for achieving significant weight loss with a favorable effect on headache, leading to reduced acetazolamide dosage in pwIIH.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37460968 · DOI · PMC10353241
Intracranial Pressure Monitoring and Management in Aneurysmal Subarachnoid Hemorrhage [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Aneurysmal subarachnoid hemorrhage is a medical condition that can lead to intracranial hypertension, negatively impacting patients' outcomes.
- Closing excerpt
- The review also discusses various therapeutic strategies for managing increased ICP and identifies potential areas for future research.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (127 words)
Aneurysmal subarachnoid hemorrhage is a medical condition that can lead to intracranial hypertension, negatively impacting patients' outcomes. This review article explores the underlying pathophysiology that causes increased intracranial pressure (ICP) during hospitalization. Hydrocephalus, brain swelling, and intracranial hematoma could produce an ICP rise. Although cerebrospinal fluid withdrawal via an external ventricular drain is commonly used, ICP monitoring is not always consistently practiced. Indications for ICP monitoring include neurological deterioration, hydrocephalus, brain swelling, intracranial masses, and the need for cerebrospinal fluid drainage. This review emphasizes the importance of ICP monitoring and presents findings from the Synapse-ICU study, which supports a correlation between ICP monitoring and treatment with better patient outcomes. The review also discusses various therapeutic strategies for managing increased ICP and identifies potential areas for future research.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37280411 · DOI · PMC10499755
Regulation of brain fluid volumes and pressures: basic principles, intracranial hypertension, ventriculomegaly and hydrocephalus [3]
Abstract reading summary — source excerpts
- Opening excerpt
- The principles of cerebrospinal fluid (CSF) production, circulation and outflow and regulation of fluid volumes and pressures in the normal brain are summarised.
- Closing excerpt
- Further studies that are needed to explain the development of hydrocephalus are outlined.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (346 words)
The principles of cerebrospinal fluid (CSF) production, circulation and outflow and regulation of fluid volumes and pressures in the normal brain are summarised. Abnormalities in these aspects in intracranial hypertension, ventriculomegaly and hydrocephalus are discussed. The brain parenchyma has a cellular framework with interstitial fluid (ISF) in the intervening spaces. Framework stress and interstitial fluid pressure (ISFP) combined provide the total stress which, after allowing for gravity, normally equals intracerebral pressure (ICP) with gradients of total stress too small to measure. Fluid pressure may differ from ICP in the parenchyma and collapsed subarachnoid spaces when the parenchyma presses against the meninges. Fluid pressure gradients determine fluid movements. In adults, restricting CSF outflow from subarachnoid spaces produces intracranial hypertension which, when CSF volumes change very little, is called idiopathic intracranial hypertension (iIH). Raised ICP in iIH is accompanied by increased venous sinus pressure, though which is cause and which effect is unclear. In infants with growing skulls, restriction in outflow leads to increased head and CSF volumes. In adults, ventriculomegaly can arise due to cerebral atrophy or, in hydrocephalus, to obstructions to intracranial CSF flow. In non-communicating hydrocephalus, flow through or out of the ventricles is somehow obstructed, whereas in communicating hydrocephalus, the obstruction is somewhere between the cisterna magna and cranial sites of outflow. When normal outflow routes are obstructed, continued CSF production in the ventricles may be partially balanced by outflow through the parenchyma via an oedematous periventricular layer and perivascular spaces. In adults, secondary hydrocephalus with raised ICP results from obvious obstructions to flow. By contrast, with the more subtly obstructed flow seen in normal pressure hydrocephalus (NPH), fluid pressure must be reduced elsewhere, e.g. in some subarachnoid spaces. In idiopathic NPH, where ventriculomegaly is accompanied by gait disturbance, dementia and/or urinary incontinence, the functional deficits can sometimes be reversed by shunting or third ventriculostomy. Parenchymal shrinkage is irreversible in late stage hydrocephalus with cellular framework loss but may not occur in early stages, whether by exclusion of fluid or otherwise. Further studies that are needed to explain the development of hydrocephalus are outlined.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39020364 · DOI · PMC11253534
Four Distinct Dynamic Intracranial Pressure Trajectories and Their Prognostic Implications in Acute Brain Injury: A Multicenter Cohort Study [4]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundAcute brain injury (ABI) often elevates intracranial pressure (ICP), yet static measurements miss dynamic risk.
- Closing excerpt
- Incorporating trajectories-particularly the stabilized-elevated pattern in older adults-adds prognostic value beyond clinical variables and supports prospective validation.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (184 words)
BackgroundAcute brain injury (ABI) often elevates intracranial pressure (ICP), yet static measurements miss dynamic risk. We evaluated the prognostic value of early ICP trajectories.MethodsWe formed a multicenter ICU cohort from MIMIC-IV (2008-2022), eICU (2014-2015), and NSICU (2024-2025). Latent class growth modeling identified ICP trajectories over the first 120 h. Associations with in-hospital mortality were tested with Cox models, and incremental value beyond baseline clinical variables was quantified by AUC, integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Sensitivity analyses were performed across datasets and age groups.ResultsAmong 1700 patients with ABI, four trajectories emerged-Severe Progressive, Stabilized Elevated, Mildly Elevated Stable, and Normal. Versus Normal, mortality risk was highest for Severe Progressive (HR 13.54; 95% CI 9.35-19.59), followed by Stabilized Elevated (HR 2.53; 1.83-3.49) and Mildly Elevated Stable (HR 1.48; 1.16-1.91). In patients aged ≥ 55 years, risk with Stabilized Elevated was amplified (HR 2.87; 1.97-4.20). Adding trajectories improved risk stratification (IDI +0.065; NRI +0.201) with modest AUC gains.ConclusionsEarly ICP trajectories define reproducible phenotypes with distinct mortality risk. Incorporating trajectories-particularly the stabilized-elevated pattern in older adults-adds prognostic value beyond clinical variables and supports prospective validation.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41482820 · DOI · PMC12759305
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis [5]
- Research article Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: a meta-analysis of randomized clinical trials [6]
- Research article Venous sinus stenting for idiopathic intracranial hypertension: a systematic review and meta-analysis [7]
- Research article Sonography of the Optic Nerve Sheath Diameter for Detection of Raised Intracranial Pressure Compared to Computed Tomography: A Systematic Review and Meta-analysis [8]
- Research article Intracranial pressure: current perspectives on physiology and monitoring [9]
- Research article Diagnosis of elevated intracranial pressure in critically ill adults: systematic review and meta-analysis [10]
References
- Krajnc N, Itariu B, Macher S, Marik W, Harreiter J, Michl M, et al.. Treatment with GLP-1 receptor agonists is associated with significant weight loss and favorable headache outcomes in idiopathic intracranial hypertension. . 2023. PMID 37460968 · DOI · PMC10353241
- Addis A, Baggiani M, Citerio G. Intracranial Pressure Monitoring and Management in Aneurysmal Subarachnoid Hemorrhage. . 2023. PMID 37280411 · DOI · PMC10499755
- Hladky SB, Barrand MA. Regulation of brain fluid volumes and pressures: basic principles, intracranial hypertension, ventriculomegaly and hydrocephalus. . 2024. PMID 39020364 · DOI · PMC11253534
- Wang J, Li H, Xu M, Li WJ, Cheng L, Li S, et al.. Four Distinct Dynamic Intracranial Pressure Trajectories and Their Prognostic Implications in Acute Brain Injury: A Multicenter Cohort Study. . 2026. PMID 41482820 · DOI · PMC12759305
- Robba C, Santori G, Czosnyka M, Corradi F, Bragazzi N, Padayachy L, et al.. Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2018. PMID 30019201 · DOI
- Kamel H, Navi BB, Nakagawa K, Hemphill JC, Ko NU. Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: a meta-analysis of randomized clinical trials. Crit Care Med. 2011. PMID 21242790 · DOI
- Nicholson P, Brinjikji W, Radovanovic I, Hilditch CA, Tsang ACO, Krings T, et al.. Venous sinus stenting for idiopathic intracranial hypertension: a systematic review and meta-analysis. J Neurointerv Surg. 2019. PMID 30166333 · DOI
- Ohle R, McIsaac SM, Woo MY, Perry JJ. Sonography of the Optic Nerve Sheath Diameter for Detection of Raised Intracranial Pressure Compared to Computed Tomography: A Systematic Review and Meta-analysis. J Ultrasound Med. 2015. PMID 26112632 · DOI
- Hawryluk GWJ, Citerio G, Hutchinson P, Kolias A, Meyfroidt G, Robba C, et al.. Intracranial pressure: current perspectives on physiology and monitoring. Intensive Care Med. 2022. PMID 35816237 · DOI
- Fernando SM, Tran A, Cheng W, Rochwerg B, Taljaard M, Kyeremanteng K, et al.. Diagnosis of elevated intracranial pressure in critically ill adults: systematic review and meta-analysis. BMJ. 2019. PMID 31340932 · DOI · PMC6651068
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
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