95. Low pressure headache not low CSF pressure appears to predict immediate resolution of idiopathic intracranial hypertension (IIH)

2010 ◽  
Vol 17 (12) ◽  
pp. 1638
Author(s):  
Peter Gates ◽  
Jakob Christiansen ◽  
Gillian Skardoon ◽  
Kate Bryan
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Low Pressure ◽  
Csf Pressure ◽  
Low Pressure Headache ◽  
Pressure Headache

Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review

Cephalalgia ◽  
2011 ◽  
Vol 31 (16) ◽  
pp. 1627-1633 ◽  
Author(s):  
Alexandra J Sinclair ◽  
Sarin Kuruvath ◽  
Diptasri Sen ◽  
Peter G Nightingale ◽  
Michael A Burdon ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Visual Acuity ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Low Pressure ◽  
Shunt Revision ◽  
Common Symptom ◽  
Csf Diversion ◽  
Low Pressure Headache ◽  
Pressure Headache

Background: The role of cerebrospinal fluid (CSF) diversion in treating idiopathic intracranial hypertension (IIH) is disputed. Method: We conducted a 10-year, retrospective case note review to evaluate the effects of CSF diversion in IIH. Symptoms, signs and details of shunt type, complications and revisions were documented at baseline, 6, 12 and 24 months post-operatively. Results: Fifty-three IIH patients were shunted [predominantly lumboperitoneal (92%)]. The most common symptom pre-surgery was headache (96%). Post-operatively, significantly fewer patients experienced declining vision and visual acuity improved at 6 ( p = 0.001) and 12 months ( p = 0.016). Headache continued in 68% at 6 months, 77% at 12 months and 79% at 2 years post-operatively. Additionally, post-operative low-pressure headache occurred in 28%. Shunt revision occurred in 51% of patients, with 30% requiring multiple revisions. Conclusion: We conclude that CSF diversion reduces visual decline and improves visual acuity. Unfortunately, headache remained in the majority of patients and low-pressure headache frequently complicated surgery. Over half of the patients required shunt revision with the majority of these requiring multiple revisions. We suggest that CSF shunting should be conducted as a last resort in those with otherwise untreatable, rapidly declining vision. Alternative treatments, such as weight reduction, may be more effective with less associated morbidity.

1338 Bariatric Surgery as a Viable Treatment for Idiopathic Intracranial Hypertension: A Case Series

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
V Mahendran ◽  
P Ricart ◽  
M Wadley ◽  
A Perry ◽  
S Robinson
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Case Series ◽  
Radicular Pain ◽  
Csf Pressure ◽  
Disease Modifying Therapy ◽  
Effective Treatment Modality ◽  
Preventable Blindness

Abstract Introduction Idiopathic Intracranial Hypertension (IIH) is a significant cause of preventable blindness. Patients also suffer from debilitating headaches, pulsatile tinnitus, nausea, vomiting, photophobia, and radicular pain. If IIH continues to rise as predicted, treatment cost will increase to 462.7 million GBP annually by 2030. Weight loss is the only proven disease-modifying therapy for reversal of IIH. Bariatric surgery is an attractive treatment option due to superlative weight loss and reversal of related comorbidities. The case series aims to raise awareness of bariatric surgery as a safe and effective treatment modality for IIH. Method The case series consists of a retrospective analysis of four patients with a pre-operative diagnosis of IIH. They were referred to our department for bariatric surgery between January to December 2018. They were followed up for a total of two years. Results In our case series, all four patients were females with a mean age of 34 years. Mean BMI reduced from 47.3 kg/m2 before surgery to 30 kg/m2 with an EWL of 76.4% at the end of two years after surgery. They all showed significant improvement or resolution in their symptoms related to IIH, and none of them required further CSF pressure reducing procedures afterwards. Conclusions Bariatric surgery is a safe and effective method of treating IIH. It is superior compared to medical management and CSF pressure reducing procedures which have high rates of recurrence.

Idiopathic intracranial hypertension without intracranial hypertension

2020 ◽  
pp. 10.1212/CPJ.0000000000001022
Author(s):  
Mattia Sansone ◽  
Michelangelo De Angelis ◽  
Leonilda Bilo ◽  
Vincenzo Bonavita ◽  
Roberto De Simone
Keyword(s):  
Physical Activity ◽  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Valsalva Manoeuvre ◽  
Dural Sinus ◽  
Daily Fluctuation ◽  
Csf Pressure ◽  
Postural Changes

The intracranial pressure (ICP) show large daily fluctuation, mainly due to postural changes and physical activity (e.g. it goes up to 470 mmH2O under Valsalva manoeuvre1). Consequently, the dural sinus must be sufficiently rigid in order to avoid its collapse during cerebrospinal fluid (CSF) pressure peaks. Hereby, we describe a patient with collapsible dural sinus associated with an intracranial hypertension syndrome without a detectable raised ICP, suggesting that a number of crucial assumptions on idiopathic intracranial hypertension with (IIH) or without papilledema (IIHWOP) might be discussed.

CSF pressure, papilledema grade, and response to acetazolamide in the Idiopathic Intracranial Hypertension Treatment Trial

2015 ◽  
Vol 262 (10) ◽  
pp. 2271-2274 ◽  
Author(s):  
Jorge C. Kattah ◽  
John H. Pula ◽  
Luis J. Mejico ◽  
Michael P. McDermott ◽  
Mark J. Kupersmith ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Hypertension Treatment ◽  
Treatment Trial ◽  
Csf Pressure

scholarly journals Pediatric Idiopathic Intracranial Hypertension Post-measles Vaccine: A Case Report

2021 ◽  
Author(s):  
Ahmed Arafa Helaly ◽  
Ahmed Ezzat ◽  
Mohammed Gamal Abdellatif
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Signs And Symptoms ◽  
Normal Brain ◽  
Measles Vaccine ◽  
Increased Intracranial Pressure ◽  
Csf Pressure ◽  
General Signs ◽  
Sixth Nerve

Idiopathic intracranial hypertension is characterized by an increase in intracranial pressure with no significant structural cause. The diagnostic criteria include general signs and symptoms of generalized increased intracranial pressure or papilledema, increased Cerebrospinal Fluid (CSF) pressure (>250 mm H2 O), and normal brain imaging. It usually occurs in adults but rarely can be seen in children. We report a 7-year-old child with a manifestation of increased intracranial tension after the measles vaccine, associated with bilateral sixth nerve palsy and bilateral facial palsy with lower motor neuron features. Normal magnetic resonance imaging and CSF results were normal, except for an increase in CSF pressure. The symptoms began to be resolved after lumbar puncture with the complete resolution of symptoms after one and half months. We add also acetazolamide at the proper dose to reduce intracranial pressure from the first day of diagnosis.

Ringing in the Ears and Pain in the Head

2017 ◽  
Author(s):  
M. Angela O’Neal
Keyword(s):  
Headache Disorder ◽  
Clinical History ◽  
Low Pressure ◽  
Patient Specific ◽  
Prior History ◽  
Operator Experience ◽  
Blood Patch ◽  
History Of ◽  
Low Pressure Headache ◽  
Pressure Headache

The case illustrates the classic clinical features of a low-pressure headache. The pathophysiology results from the loss of cerebrospinal fluid (CSF). This causes sagging of the brain, stretching of the bridging veins, and venodilatation. The clinical history is of a headache that is worse in the upright position and remits when the patient is supine. Due to the connection of the perilymphatic fluid and CSF, postural tinnitus is a frequent symptom. Risk factors for low-pressure headache include those that are patient-specific: female sex, low body mass index, prior history of a low-pressure headache, and an underlying headache disorder. Operator-specific factors that decrease the risk of a postdural puncture headache (PDPH) include greater operator experience and the use of a smaller-gauge, non-cutting lumbar puncture needle. The best treatment for low-pressure headache is a blood patch with resolution in over 90% of low-pressure headaches.

A Lady with a Headache in the Second Trimester

2017 ◽  
Author(s):  
M. Angela O’Neal
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Weight Control ◽  
Visual Loss ◽  
International Headache Society ◽  
Major Complication ◽  
High Volume ◽  
Second Trimester ◽  
Normal Range ◽  
Csf Pressure

This case illustrates a typical presentation of idiopathic intracranial hypertension (IIH) during pregnancy. The diagnostic criteria, complications, and treatment of the condition during pregnancy are explored. The major complication of IIH is visual loss. The International Headache Society 2013 criteria for idiopathic intracranial hypertension are: that the headache should remit after the CSF pressure is in the normal range, CSF pressure is greater than 250 mm, and the majority of patients have papilledema and other symptoms, which may include visual obscurations, pulsatile tinnitus, double vision, and neck or back pain. IIH treatment includes weight control, high-volume lumbar punctures, and medications.

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