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- When performing a lumbar puncture, an opening intracranial pressure (ICP) greater than 20 to 25 mm of H2O is elevated.
- If it is thought that a patient's headache is due to elevated pressure, cerebrospinal fluid (CSF) can be therapeutically removed. It is typically recommended that the pressure not be lowered by more than 50% of the amount above which it is normal.
- The source of elevated ICP should be determined and addressed. Common causes of increased intracranial pressure include:
--- Venous drainage obstruction (i.e. cerebral venous sinus thrombosis).
--- Endocrine (i.e. obesity, hypothyroidism, Cushing's disease, Addison's disease).
--- Medications (i.e. vitamin A, cyclosporine, lithium, lupron, oral contraceptives,
amiodorone, and antiobiotics such as tetracyclines and sulfonamides).
--- Other conditions (i.e. pregnancy, steroid withdrawal, acromegaly, polycystic ovary
syndrome, systemic lupus erythematosus, sleep apnea, HIV).