Changes in intracranial venous hemodynamics in a patient with idiopathic intracranial hypertension after lumbar puncture precedes therapeutic success

Juhász, J; Lindner, Thomas; Jansen, Olav; Margraf, Nils G.; Rohr, Axel

doi:10.1002/jmri.25660

Cited by 8 publications

(8 citation statements)

References 7 publications

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“…Figure 2 shows an example of a patient having distinct changes in PI and RI in the SSS after LP. 26 In this study, we only evaluated the short-term effects of reducing CSF pressure by a single LP. Follow-up studies regarding the long-term effects of a single LP (or multiple LPs), medical treatment, or dural sinus stent placement might also give added insight into pathophysiologic changes in these patients.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Phase-Contrast MR Angiography to Measure Hemodynamic Changes in Idiopathic Intracranial Hypertension

Juhász¹,

Lindner²,

Riedel³

et al. 2018

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Quantitative Phase-Contrast MR Angiography to Measure Hemodynamic Changes in Idiopathic Intracranial Hypertension

Juhász¹,

Lindner²,

Riedel³

et al. 2018

AJNR Am J Neuroradiol

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“…Stenosis can be intrinsic or extrinsic, dynamic or static. While still debatable, there is growing evidence that CSF removal during LP causes transient resolution of dural venous sinus stenosis, suggesting that these are more likely extrinsic (Buell et al, 2017;Juhász et al, 2017;Rohr et al, 2007). The increased resistance to venous outflow will further augment CSF pressure in the SAS by obstructing its absorption at the level of arachnoid granulations, thus leading to a vicious cycle.…”

Section: Introductionmentioning

confidence: 99%

Intracranial fluid dynamics changes in idiopathic intracranial hypertension: pre and post therapy

Agarwal¹,

Contarino

Limbucci

et al. 2018

Preprint

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Keywords:Idiopathic intracranial hypertension, Cerebrospinal fluid, Phase contrast-cine magnetic resonance imaging, dural venous stenosis, papilledema Running title: MR fluid analysis in IIH Abbreviations: AaCD=artero-aqueduct CSF delay; AcCD= artero-cervical CSF delay; aCSF=CSF through the AoS; AoS=aqueduct of Sylvius; AVD=arterovenous delay; CC= cardiac cycle; cCSF=CSF in the cervical subarachnoid space; CSF=cerebrospinal fluid; CVO=cerebral venous outflow; ICA=internal carotid artery; ICP = intracranial pressure; IIH = idiopathic intracranial hypertension; IJV=internal jugular vein; tA=total cerebral arterial inflow; tIJV=total outflow from internal jugular veins; LP=lumbar puncture; RFNL = retinal fiber nerve layer; PCC-MR=phase contrast cine magnetic resonance; SAS=subarachnoid space; TS=transverse sinus; VA= vertebral artery peer-reviewed) is the author/funder. All rights reserved. No reuse allowed without permission.The copyright holder for this preprint (which was not . http://dx.doi.org/10.1101/245894 doi: bioRxiv preprint first posted online Jan. 19, 2018; Analyses were run before lumbar puncture (LP) (A), after LP (B), after medical therapy (C) and after venous stent placements deployed at two separate times (D and E). AVD and tIJV/tA improved only after CSF removal and after stent placements. CSF velocity amplitude remained elevated. Arterial flow profile showed a dramatic reduction after LP with improvement in mean venous flow. This report is the first to demonstrate interactive changes in intracranial fluid dynamics that occur before and after different therapeutic interventions in IIH. We discuss how increased intracranial venous blood could be "tumoral" in IIH and facilitating its outflow could be therapeutic.peer-reviewed)

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“…Andere Autoren machten die Beobachtung, dass in den überwiegenden Fällen die Sinusstenosen nach Liquordruckentlastung persistieren [28,29]. Demnach können wohl in einigen Fällen die Sinusstenosen nicht als Folge, sondern als Ursache des erhöhten Liquordrucks angesehen werden.…”

Section: Venöse Sinusunclassified

“…Das Ausmaß der Stenosen reicht von leichter Einengung bis zur Fluss- unterbrechung. In einigen Fällen zeigt sich dann eine Reversibilität der Stenosen nach erfolgreicher Drucksenkung via Lumbalpunktion [24,44], in anderen Fällen ist jedoch eine Persistenz der Stenosen zu beobachten, womit sie als fixierte Stenosen imponieren [28,29].…”

Section: Mrt-befundeunclassified

MRI-findings in idiopathic intracranial hypertension (Pseudotumor cerebri)

Juhász

Hensler

Jansen

2021

Rofo

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Background Pseudotumor cerebri, also known as idiopathic intracranial hypertension, is a disorder of increased intracranial pressure of unknown etiology. Main symptom is headache which has a characteristic similar to other headache diseases, therefore the idiopathic intracranial hypertension often remains undetected. The incidence is 1/100 000 with the number of unreported cases being much higher. This article highlights the essential role of MRI in the differential diagnosis. Methods A literature search was carried out on idiopathic intracranial hypertension and Pseudotumor cerebri in English and German. Original and Review articles as well as case reports were taken into account. Since the main focus of the article is MRI diagnostics, some images were selected to illustrate the characteristic MRI morphological features. Results and Conclusion The diagnosis of idiopathic intracranial hypertension is based on an exclusion procedure. Most common syndromes are headache, transient visual obscurations, pulsatile tinnitus and nausea. In the presence of an underlying cause for the increased intracranial pressure one speaks of a secondary intracranial hypertension. The diagnostics include a detailed medical history, neurological and ophthalmic examination, lumbar puncture, and neuroradiological imaging procedures. MRI, in particular, has become increasingly important in recent years, since signs for changes in cerebrospinal fluid pressure are now detectable and well-defined. The therapeutic approaches are symptom-oriented and aim to lower the pressure. With a precise diagnosis and timely start of therapy, idiopathic intracranial hypertension has a good prognosis, especially with regard to the preservation of eyesight. Key Points: Citation Format

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Changes in intracranial venous hemodynamics in a patient with idiopathic intracranial hypertension after lumbar puncture precedes therapeutic success

Cited by 8 publications

References 7 publications

Quantitative Phase-Contrast MR Angiography to Measure Hemodynamic Changes in Idiopathic Intracranial Hypertension

Quantitative Phase-Contrast MR Angiography to Measure Hemodynamic Changes in Idiopathic Intracranial Hypertension

Intracranial fluid dynamics changes in idiopathic intracranial hypertension: pre and post therapy

MRI-findings in idiopathic intracranial hypertension (Pseudotumor cerebri)

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