Extensive radiculopathy: a manifestation of intracranial hypertension

Abstract

We report two patients with severe radiculopathy due to elevated intracranial pressure (ICP) resulting from idiopathic intracranial hypertension (IHH) in one, and cerebral venous sinus thrombosis (CVT) in the other. Our aim is to document this unique association, which escaped diagnosis in both patients.

Pseudotumor cerebral: análisis de nuestra casuística y revisión de la literatura

“…El acúfeno que aparece en estas pacientes es pulsátil y de tono grave, y parece explicar la hipoacusia [23,24] de tonos graves que presentan algunas de estas pacientes probablemente debido al efecto enmascarador del acúfeno. Se ha descrito también deterioro cognitivo [25], parálisis facial uni o bilateral [26][27][28][29], acorchamiento y parestesias en manos y pies [22], artralgias [22] -rodillas, muñecas y hombros-, dolor en la región lumbar [22,30] -con posible irradiación por una o ambas extremidades inferiores, pared abdominal y tórax-, plexopatía braquial [31] e inestabilidad en la marcha [22]. La marcha atáxica se atribuye a un componente de hipotensión ortostática asociado; una irritación en la vaina de las diferentes raíces medulares explicaría el dolor lumbar, las parestesias en manos y pies, la braquialgia y la rigidez de cuello.…”

Chameleons, red herrings, and false localizing signs in neurocritical care

“…71 Though rare, radiculopathy has been reported as a FLS in intracranial hypertension, particularly in IIH, central venous sinus thrombosis (CVT), and intracranial sinus venous thrombosis (ISVT). 8,72 One pathophysiology of this type of radiculopathy is similar to that of cranial nerve neuropathies in intracranial hypertension: elevated ICP in the subarachnoid space causing compression of nerve roots. 7,72 Motor roots may be more susceptible to damage as patients tend to have normal sensorium.…”

“…8,72 One pathophysiology of this type of radiculopathy is similar to that of cranial nerve neuropathies in intracranial hypertension: elevated ICP in the subarachnoid space causing compression of nerve roots. 7,72 Motor roots may be more susceptible to damage as patients tend to have normal sensorium. 8,72 Patients can present with headache, papilledema, progressive visual loss, complete ophthalmoplegia, flaccid areflexic quadriparesis, as well as motor weakness and leg pain presenting primarily in herniated lumbar disc patients.…”

“…7,72 Motor roots may be more susceptible to damage as patients tend to have normal sensorium. 8,72 Patients can present with headache, papilledema, progressive visual loss, complete ophthalmoplegia, flaccid areflexic quadriparesis, as well as motor weakness and leg pain presenting primarily in herniated lumbar disc patients. 8,72 Radiculopathy can be confirmed by electrophysical findings and normal MRI of brain and spinal cord, as well as normal angiography, can exclude other possibilities such as midbrain infarction secondary to deep cerebral venous thrombosis and cavernous sinus thrombosis.…”

Electromyography and A Review of the Literature Provide Insights into the Role of Sacral Perineural Cysts in Unexplained Chronic Pelvic, Perineal and Leg Pain Syndromes

“…Additionally, several other authors have reported radiculopathy in patients with IICH [35][36][37][38]. Obeid et al observed radiculopathy during a needle EMG of the paraspinal muscles in a patient with IICH [39].…”