Periventricular white matter changes in idiopathic intracranial hypertension

Abstract

Objective To evaluate whether increased cerebrospinal fluid ( CSF ) pressure causes alteration of periventricular white matter ( WM ) microstructure in patients with idiopathic intracranial hypertension ( IIH ). Methods In a prospective study, patients with refractory chronic headache with and without IIH performed a neuroimaging study including 3T MRI , 3D Phase Contrast MR venography, and diffusion tensor imaging ( DTI ) of the brain. Whole‐brain voxel‐wise comparisons of DTI abnormalities of WM were performed using tract‐based spatial statistics. A correlation analysis between DTI indices and CSF opening pressure, highest peak, and mean pressure was also performed in patients with IIH . Results We enrolled 62 consecutive patients with refractory chronic headaches. Thirty‐five patients with IIH , and 27 patients without increased intracranial pressure. DTI analysis revealed no fractional anisotropy changes, but decreased mean, axial, and radial diffusivity in body ( IIH MD = 0.80 ± 0.04, non‐ IIH MD = 0.84 ± 0.4, IIH AD = 1.67 ± 0.07, non‐ IIH AD = 1.74 ± 0.05, IIH RD = 0.38 ± 0.04, non‐ IIH RD = 0.42 ± 0.05 [mm 2 /sec × 10 −3 ]) of corpus callosum, and in right superior corona radiata ( IIH MD = 0.75 ± 0.04, non‐ IIH MD = 0.79 ± 0.05, IIH AD = 1.19 ± 0.07, non‐ IIH AD = 1.28 ± 0.09, IIH RD = 0.59 ± 0.03, non‐ IIH RD = 0.53 ± 0.03 [mm 2 /sec × 10 −3 ]) of 35 patients with IIH compared with 27 patients without increased intracranial pressure. DTI indices were negatively correlated with high CSF pressures ( P < 0.05). After medical treatment, eight patients showed incremented MD in anterior corona radiata left and right and superior corona radiata right. Conclusions There is significant DTI alteration in perivent...

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Noninvasive Detection of Intracranial Hypertension by Novel Ultrasound Time-Harmonic Elastography

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