Imaging and interventions in idiopathic intracranial hypertension: A pictorial essay

Sivasankar, Rajeev; Pant, Rochan; Indrajit, IK; Negi, R. S.; Sahu, Samresh; Hashim, PI; D’Souza, John

doi:10.4103/0971-3026.169464

Cited by 11 publications

(8 citation statements)

References 25 publications

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“…Several radiological findings exist which suggest toward BIH as etiology. These are-empty sella, increased perioptic CSF spaces, optic nerve tortuosity, and bilateral transverse sinus stenosis without evidence of current or remote thrombosis 6,7 (►Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Management of Spontaneous CSF Rhinorrhea: An Institutional Experience

et al. 2018

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Introduction Cerebrospinal fluid (CSF) rhinorrhea is the leakage of CSF through nasal cavity, due to abnormal communication between the arachnoid membrane and nasal mucosa. Middle-age (fourth to fifth decade) group, female gender, and obesity (body mass index > 40) are the most commonly reported risk-factors for this rare entity. In this study, we present our single center experience of spontaneous CSF rhinorrhea discussing important clinicoradiological aspects in preoperative evaluation and nuances in the endoscopic repair technique. Material and Methods A retrospective study conducted for 43 spontaneous CSF rhinorrhea patients admitted between Jan 2011 to Jan 2018 at our tertiary care center. All patients underwent endoscopic repair of the defect depending upon their site of leak. Results Mean age in our study was 36.7 ± 12.3 years (range: 9–62 years). Average BMI in males was found lower (28.7) as compared with females (32).Most common site of CSF leak was cribriform plate (n = 32, 74.4%) and Planum was found to be the least common site (n = 1, 2.3%) of CSF leak.Intraoperatively, 23 (53.5%) patients showed high-flow leak. Intrathecal injection of fluorescein dye was used to identify the site of CSF leakage in 15 cases (34.8%). The overall success rate of primary endoscopic repair in our study was 95.3%. Conclusion Spontaneous CSF rhinorrhea occurs secondary to elevated intracranial pressure, with a predilection for obese females in fourth to fifth decade. Individualized tailored surgical approach depending upon the site, size, and flow-variety of the defect forms the cornerstone of management.

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Section: Introductionmentioning

confidence: 99%

Management of Spontaneous CSF Rhinorrhea: An Institutional Experience

et al. 2018

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“…1 a-c). Additional investigation, including computed tomography cerebral venography and cerebrospinal fluid (CSF) study, was performed to exclude secondary cause of intracranial hypertension [6] . CSF profiles were in normal ranges, and there was no malignant cell in the cytological study Therefore, the diagnosis of IIH or CIM was suspected in which endoscopic third ventriculostomy was attempted by RN.…”

Section: Case Presentationmentioning

confidence: 99%

Rapidly progressive medulloblastoma initially mimicking idiopathic intracranial hypertension and Chiari I malformation: A case report

Noiphithak

Mektripop

Thamwongskul

2021

International Journal of Surgery Case Reports

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Introduction Medulloblastoma (MDB) often causes signs and symptoms of elevated intracranial pressure (ICP) with imaging findings of mass lesion. Here, we report a case of MDB who initially presented with clinical features imitating idiopathic intracranial hypertension (IIH) and Chiari I malformation (CIM). Case presentation A 19-year-old man had clinical symptoms of elevated ICP without mass lesion on imaging. He was initially diagnosed with IIH and CIM, which underwent shunt surgery and posterior fossa decompression. Later on, he had recurrent symptoms, and the new imaging revealed the development of MDB in the right cerebellar hemisphere. After tumor resection, the patient rapidly deteriorated with spinal metastases. Discussion and conclusion Management of the coexistence between IIH and CIM in patients with rising ICP is complicated. MDB is one of the aggressive malignant brain tumors showing a wide range of imaging features, including non-enhancing mass. Therefore, recognizing the possibility of brain tumors mimicking IIH or CIM is crucial.

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“…In this pathology, the cerebellar tonsils elongate due to pressure, leading the cerebellum to be pushed through the foramen magnum of the cranium resulting in additional increased intracranial pressure as well as tonsillar herniation [52]. This condition is life threatening, as cranial pressure is heavily diverted onto the medulla oblongata, a vital sector of the brain that controls cardiac and respiratory functions [53,55].…”

Section: Cerebellar Tonsilmentioning

confidence: 99%

Management of Intracranial Pressure in Traumatic Brain Injury

Ordookhanian¹,

Nagappan²,

Elias³

et al. 2018

Traumatic Brain Injury - Pathobiology, Advanced Diagnostics and Acute Management

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Traumatic brain injury (TBI) is the result of an external force acting upon the head, causing damage to the brain. The severity of injury, mechanism by which the injury occurs, and the frequency of the high-force impact all play a role in the determination of a TBI. TBI describes a wide range of traumatic pathologies which is comprised of damage done to a multitude of cranial central nervous system components. TBI patients typically present with a series of symptoms are correlated with the presence of an intracranial injury, such as physical/cognitive difficulties. A major concern associated with intracranial injuries is the management of intracranial pressure (ICP), a resulting factor of a TBI which facilitates into intracranial hematoma and/or cerebral edema. These conditions have adverse effects on one's brain, and the immediate management and relief of intracranial pressure are crucial in avoiding hydrocephalus and brain herniation, conditions which lead to sensory loss and even death. In this chapter, we will begin by thoroughly understanding what a TBI is, its clinical presentation, and the first-tier examination to determine severity. Then, we will progress into the anatomy of the brain, followed by a thorough investigation into intracranial pressure management strategies and prognosis.

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Imaging and interventions in idiopathic intracranial hypertension: A pictorial essay

Cited by 11 publications

References 25 publications

Management of Spontaneous CSF Rhinorrhea: An Institutional Experience

Management of Spontaneous CSF Rhinorrhea: An Institutional Experience

Rapidly progressive medulloblastoma initially mimicking idiopathic intracranial hypertension and Chiari I malformation: A case report

Management of Intracranial Pressure in Traumatic Brain Injury

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