Why is increased intracranial pressure fatal?
Aug 21, 2025
Source: Cainiu Health
Dr. Tian Hongbo
Introduction
Under normal circumstances, the main causes of death due to increased intracranial pressure include brainstem compression, reduced cerebral blood flow, cerebral herniation, brain tissue ischemia and hypoxia, and central respiratory and circulatory failure. If discomfort symptoms occur, it is recommended to seek timely medical treatment at a qualified hospital. In daily life, one should take care to avoid head injuries and actively treat primary conditions such as intracranial infections and cerebral hemorrhage.
Generally, the main causes of death due to increased intracranial pressure include brainstem compression, reduced cerebral blood flow, brain herniation, cerebral ischemia and hypoxia, and central respiratory and circulatory failure. If symptoms occur, it is recommended to seek timely medical treatment at a formal hospital. Detailed analysis is as follows:
1. Brainstem Compression
Elevated intracranial pressure causes brain tissue to shift toward areas of lower pressure, compressing the brainstem. The brainstem serves as the center for vital functions such as respiration and heartbeat, and its compression leads to functional failure. Intracranial pressure must be promptly reduced, and medications such as mannitol injection, glycerol fructose injection, and furosemide injection should be administered under medical guidance to rapidly reduce edema and relieve pressure.
2. Reduced Cerebral Blood Flow
When intracranial pressure exceeds cerebral perfusion pressure, cerebral blood flow is impeded, leading to cerebral ischemia and hypoxia, and ultimately brain tissue necrosis. The patient should be positioned with the head elevated and feet lower to promote cerebral venous return. Concurrently, nimodipine tablets can be used to dilate cerebral blood vessels and improve cerebral circulation.
3. Brain Herniation
Persistently elevated intracranial pressure forces brain tissue to shift through anatomical gaps within the skull, resulting in brain herniation, such as transtentorial or foramen magnum herniation. This causes severe compression of nerves and blood vessels, endangering life. Emergency decompressive craniectomy is required to relieve intracranial pressure and buy time for further treatment.
4. Cerebral Tissue Ischemia and Hypoxia
Elevated intracranial pressure leads to insufficient cerebral perfusion, while cerebral edema exacerbates hypoxia, causing widespread brain cell necrosis and permanent neurological damage. Oxygen therapy can improve oxygen supply, and dexamethasone sodium phosphate injection can be administered to reduce cerebral edema and protect brain tissue.
5. Central Respiratory and Circulatory Failure
Elevated intracranial pressure affects the brainstem centers responsible for respiration and circulation, leading to irregular breathing patterns and cardiac arrest. This is the most direct life-threatening consequence of increased intracranial pressure. Immediate endotracheal intubation for respiratory support and administration of epinephrine injection to maintain circulation are necessary, along with active measures to reduce intracranial pressure.
In daily life, head trauma should be avoided, and primary conditions such as intracranial infection and cerebral hemorrhage should be actively treated. Immediate medical attention is required if symptoms such as severe headache, vomiting, or altered consciousness occur. Regular monitoring of intracranial pressure-related indicators allows for early detection and intervention.
