High blood pressure and epilepsy in hydrocephalus due to stenosis of the aqueduct of sylvius

Abstract

With 5 FiguresEkbom et al. (1969) recently reported high blood pressure and epilepsy in conjunction with hydrocephalus due to ectasia of the basilar artery. The generalized alterations of the blood vessels as well as hypothalamie damage due to deformity of the third ventricle by the elongated basilar artery were considered aetiologieal factors in the development of the high blood pressure in these patients. If epilepsy and hypertension were due not to the vascular changes but to the dilatation of the ventricular system, these should occur also in other types of hydrocephalus. In order to analyse this question we have reviewed the clinical records and air studies--pneumoeneephalograms and ventriculograms--in a group of patients with aqueduct stenosis. Material and MethodsThe clinical records of 124 patients with a diagnosis of aqueduct stenosis were examined. Their ages varied from 1 month to 67 years, with an average of 19,7 (Fig. 1). The records were scrutinized with special emphasis on the occurrence of epilepsy and on the blood pressure records. In the Department of Neurosurgery blood pressure measurements have been made with the patients lying in bed, using conventional pressure-cuff sphygmomanometers. A resting blood pressure value preceding encephalography was obtained in 91 patients. Papilloedema was present in 35 eases. The CSFpressure was measured only in 3 eases.

Do systolic BP and pulse pressure relate to ventricular enlargement?

“…This is consistent with animal experiments that have related pulse pressure to ventricular enlargement . Several animal and cross‐sectional human studies have also shown associations between systemic hypertension and hydrocephalus .…”

“…Notably, the spontaneously hypertensive rat develops enlarged ventricles compared with the genetically similar but normotensive WKY rats . Cross‐sectional studies in humans report systemic hypertension to be associated with normal pressure hydrocephalus (NPH) and with hydrocephalus from aqueductal stenosis . Importantly, Greitz has proposed the ‘hydrodynamic hypothesis versus the bulk flow hypothesis’, with the essential feature being increased pulse pressure as a major cause of hydrocephalus .…”

Benign aqueduct stenosis in adults

“…Greitz et al (1971) recently reported a similar prevalence (18.5%). In both these series grand mal fits predominated but focal seizures also occurred.…”

Діагностика, Лікування Й Прогнозування Епілептичних Нападів У Дітей Із Гідроцефалією

“…Виявлено епілептичні напади у 18,5 % випадків. Напади переважно виникали за типом неусвідомлених [10].…”