Intracranial pressure, raised headache

Raised intracranial pressure could be a cause of early morning headache. Early morning headache could also be triggered by sinusitis, tension or muscle spasm. 

Q10 An excessive amount of ADH may be produced by some brain tumours, certain drugs and some lung cancers. Since this causes a reduced water excretion, an excess of ADH leads to water retention and hyponatraemia. As hyponatraemia in the ECF causes passage of water into the body cells, there may be brain swelling, raised intracranial pressure and neurological symptoms, such as headache, muscle weakness, lethargy, nausea and vomiting, irritability, confusion and coma. 

Patients who are taking a retinoid, especially in combination with a tetracycline, should be carefully counseled to seek evaluation in the event of the development of blurred vision (static or transient), double vision, and/or headaches.These patients should have been counseled to avoid vitamin A. Discontinuation of treatment usually permits resolution of the raised intracranial pressure and disc edema, but other interventions may be undertaken if warranted. 

Headache of raised intracranial pressure (cerebral oedema) responds to dexamethasone (10 mg i.v. 4 mg 6-hourly, 2-10 d) which reduces the pressure and to nonopioid anedgesics (see also Palliative care). 

Acute poisoning with vitamin A produces symptoms such as drowsiness, sluggishness, irritability, an irresistible desire to sleep, severe headache, and papilledema. In some cases papilledema is the only symptom (SEDA-11, 333) (16,17). In young children, raised intracranial pressure with bulging of the fontanelle, papilledema, and diplopia have been observed (SED-8,799, 801) (SEDA-15, 411) (18). 

On more detailed examination one can find anaemia and punctate basophilia, heightened bone density (particularly at metaphyseal zones) and raised intracranial pressure. This last will give rise to the coma and convulsions seen more frequently in children. In children the brain appears more severely affected than in adults, where characteristic features of the encephalopathy are headache, lassitude, irritability. Although the immature brain is particularly susceptible to lead, encephalopathy presents in adults... 

---