Pseudotumour cerebri Idiopathic intracranial hypertension and vascular intracranial hypertension

Abstract

Abstract:From the first to use of "pseudotumor cerebri" by Nonne in 1904, the historic evolution of the knowledge on pseudotumor cerebri has been marked by several periods (the otologic stage, the neurosurgical stage, the neuro-ophthalmologic stage); today there are clear diagnosis criteria for the idiopathic intracranial hypertension, there is a clear differentiation between idiopathic intracranial hypertension and vascular intracranial hypertension, also the comprehension of the illness pathogeny is based on the dynamics of the intracranial fluids, which allows the auto-regulation of the cerebral circulation within quasi-normal limits, despite the very high intracranial pressure.

Fluidic Considerations of Measuring Intracranial Pressure Using an Open External Ventricular Drain

“…While the two measurements did not differ by T-test, in some cases the EVD transducer underestimated ICP in clinically significant way. Clinical intracranial hypertension is often defined as >20 mmHg [19], and the authors report that the EVD transducer failed to detect this in several instances. The conclusion of this study was that pressure measurement via EVD with concurrent flow can be useful but requires close surveillance for artifacts.…”

“…EVD-relevant ICP range Up to 30 mmHg [13] Hypertension threshold 20 mmHg [19] 20-30 mmHg [20] 22 mmHg [3] CSF production rate 18-24 mL/hr [21] 22 mL/hr [22] 18-36 mL/hr [23] 12-30 mL/hr [13]…”

Vascular etiology of intracranial hypertension

“…Vascular intracranial hypertension has a known etiology — any cerebral vascular illness that causes intracranial hypertension: cerebral venous thrombophlebitis, cerebral venous sinus thrombosis, cerebral ischemias with secondary ischemic brain edema, as in the ischemic stroke caused by the occlusion or stenosis of the big cerebral vessels, and possible extra‐cerebral illnesses, such as hypertensive encephalopathy with congestive brain edematization [4].…”