Intracranial elastance is increased in idiopathic intracranial hypertension

Jt, Chisholm; Sudhakar, Padmaja; An, Alhajeri; Jh, Smith

doi:10.1111/ene.13410

Cited by 14 publications

(27 citation statements)

References 20 publications

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“…The PVI is inversely related to craniospinal elastance (E). PVI has reflected an increased elastance in patients with idiopathic intracranial hypertension . Conversely, an association has been previously reported between spontaneous intracranial hypotension and connective tissue disorders, where dysfunctional tissue elasticity is present …”

Section: Introductionmentioning

confidence: 92%

“…In addition to the routinely reported lumbar puncture indices, it has been hypothesized that the change in CSF pressure relative to the volume withdrawn may be more reflective of PDPH susceptibility . In 1925, Alpers observed, “the outstanding feature in the cases in which there was a headache, however, was the marked fall in the spinal fluid pressure after the withdrawal of fluid.” The relationship between OP, closing pressure (CP) and volume removed (V) is captured by the pressure‐volume index (PVI) . The PVI is inversely related to craniospinal elastance (E).…”

Section: Introductionmentioning

confidence: 99%

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CSF Pressure, Volume, and Post‐Dural Puncture Headache: A Case‐Control Study and Systematic Review

et al. 2019

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Objectives (1) To perform a systematic literature review to evaluate associations between post‐dural puncture headache (PDPH) and opening pressure (OP), closing pressure (CP), and volume of cerebrospinal fluid (V) removed. (2) To perform a case‐control study to evaluate pressure‐volume index (PVI) as a novel risk factor for PDPH. Background According to the International Classification of Headache Diagnoses, 3rd Edition (ICHD‐3), the diagnosis of PDPH requires documentation of intracranial hypotension. However, this remains an unproven concept. Methods A systematic literature review was conducted, searching Cochrane Database of Systematic Reviews, Ovid EMBASE, OVID MEDLINE, Scopus, and Web of Science. Study inclusion required a comparison of headache incidence following a LP as a function of OP, CP, and/or V. A retrospective, case‐control study with 1:1 matching was conducted utilizing ICHD‐3 criteria. Patients with factors that could influence CSF pressure were excluded. Results In our case‐control study, we did not identify a paired difference in either median (95% CI) elastance (0.05 [−0.09, 0.11], P = .503) or PVI (4.53 [−7.98, 19.97], P = .678). We identified 22 references, evaluating V (n = 14), OP (n = 11), and/or CP (n = 4). There was no convincing evidence for an association of PDPH with either OP or CP. A minority of studies documenting an association with V included patients with high‐volume CSF removal, and/or stratified patients by the timing of the headache onset. Conclusions The overall risk of PDPH does not appear to be influenced by OP, CP, V or PVI. PDPH may be related to V in instances of high‐volume removal, and depend on the timing of outcome assessment. Future revision of criteria should consider the existence of immediate and delayed PDPH subtypes, and not presume intracranial hypotension as a mandatory feature.

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Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

CSF Pressure, Volume, and Post‐Dural Puncture Headache: A Case‐Control Study and Systematic Review

et al. 2019

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“…In addition, I think that the authors should mention whether the association between intracranial elastance and opening pressure was analyzed, which probably constitutes a more crucial point for interpretation of the study results. The authors state that the pressure-volume index is a variable that has been shown to be independent of ICP [1,2]. Therefore, I think that it was redundant to analyze the correlation between the pressure-volume index and cerebrospinal fluid removal opening pressure, which was negative as expected.…”

mentioning

confidence: 96%

“…I read with great interest the article by Chisholm et al [1] in which they found increased intracranial elastance in their patient group of idiopathic intracranial hypertension (IIH) and discussed some crucial hypotheses in this setting. I think that the starting point used for the study, which is a hypothesis opposite to the previous explanation that discusses the influence of compliant dura in patients with spontaneous intracranial hypotension, is cleverly figured and original.…”

mentioning

confidence: 99%

Intracranial elastance and idiopathic intracranial hypertension?

Önder

2017

Euro J of Neurology

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“…New strategies to improve service provision with accelerated diagnosis and treatment are being employed, e.g., through telemedicine , a model that appears successful. Neurological involvement in medicine remains active across a large spectrum of presentations . Novel mutations in adult‐onset leukoencephalopathy and the spinocerebellar ataxias and the search for biomarkers in neurological disease are some examples of the involvement of neurology research across this spectrum.…”

mentioning

confidence: 99%