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Regulation of Stroke Volume

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Intracranial Pressure Monitoring In Nontraumatic Intraventricular Hemorrhage Rodent Model

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Intracranial pressure elevation post-stroke: Mechanisms and consequences.

Rebecca J Hood^1,2, Daniel J Beard^1,2,3, Damian D McLeod^1,4

¹College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.

Frontiers in Stroke

|January 16, 2026

Summary

Intracranial pressure (ICP) elevation after stroke, even small ones, is increasingly recognized. New evidence suggests cerebrospinal fluid (CSF) volume changes, not just edema, may drive this critical ICP rise.

Keywords:

cerebral blood volume (CBV)cerebral edema cerebrospinal fluid (CSF)collateral blood flow early infarct expansion experimental stroke intracranial pressure (ICP)

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Area of Science:

Neurology
Stroke Medicine
Cerebrovascular Diseases

Background:

Intracranial pressure (ICP) elevation is a known complication of large, malignant strokes.
Traditionally, ICP rise was linked to cerebral edema and considered a pre-terminal event.
Emerging evidence indicates ICP also elevates after smaller strokes, often within 24 hours.

Purpose of the Study:

To explore the mechanisms behind intracranial pressure (ICP) elevation post-stroke.
To discuss the role of cerebrospinal fluid (CSF) volume changes in mild-to-moderate infarction.
To review the consequences of ICP elevation on stroke outcomes.

Main Methods:

Review of recent mechanistic studies on ICP elevation post-stroke.
Analysis of the timing and potential causes of ICP rise in small infarcts.
Discussion of the role of CSF dynamics versus cerebral edema.

Main Results:

ICP elevation occurs after small strokes, suggesting a role in early infarct expansion and collateral failure.
Cerebral edema alone may not explain ICP rise in mild-to-moderate strokes.
Changes in cerebrospinal fluid (CSF) volume are implicated as a key mechanism.

Conclusions:

ICP elevation is a significant factor in stroke outcomes, even after small infarcts.
Understanding the mechanisms, particularly CSF volume changes, is crucial for managing post-stroke ICP.
Further research is needed to elucidate the full impact and management strategies for ICP elevation post-stroke.