Manometry combined with cervical puncture in idiopathic intracranial hypertension

Objective: To determine by cerebral venography and manometry in patients with idiopathic intracranial hypertension the cause of the previously demonstrated venous hypertension in the superior sagittal and proximal transverse sinuses. Methods: Cerebral venous sinus pressure was measured before and immediately after C1-2 puncture with removal of 20 to 25 mL of CSF. Results: Lowering the intracranial pressure by lateral C1-2 puncture during manometry has shown that the venous hypertension resolves immediately. Conclusion: These studies indicate that the venous hypertension is due to compression of the transverse sinuses by raised intracranial pressure and not due to a primary obstructive process in the cerebral venous sinuses.

[1]  J. Pickard,et al.  Venous sinus stenting for refractory benign intracranial hypertension , 2002, The Lancet.

[2]  K. Digre,et al.  Idiopathic intracranial hypertension , 2002, Neurology.

[3]  M Czosnyka,et al.  Cerebral Venous Blood Outflow: A Theoretical Model Based on Laboratory Simulation , 2001, Neurosurgery.

[4]  F. Fera,et al.  Cerebral venous thrombosis and isolated intracranial hypertension without papilledema in CDH , 2001, Neurology.

[5]  R. Walker Idiopathic intracranial hypertension: any light on the mechanism of the raised pressure? , 2001, Journal of neurology, neurosurgery, and psychiatry.

[6]  V. Biousse,et al.  Brief antiepileptic drug withdrawal prolongs interval to next seizure , 1999, Neurology.

[7]  A. Quattrone,et al.  A hypofibrinolytic state in overweight patients with cerebral venous thrombosis and isolated intracranial hypertension , 1999, Journal of Neurology.

[8]  F. Rowe,et al.  The relationship between obesity and idiopathic intracranial hypertension , 1999, International Journal of Obesity.

[9]  J. Chiras,et al.  Dural arteriovenous fistulas as a cause of intracranial hypertension due to impairment of cranial venous outflow , 1998, Journal of neurology, neurosurgery, and psychiatry.

[10]  K. Digre,et al.  Minocycline treatment and pseudotumor cerebri syndrome. , 1998, American journal of ophthalmology.

[11]  H. Sugerman,et al.  Increased intra-abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri , 1997, Neurology.

[12]  B. Jones,et al.  Normal appearance of arachnoid granulations on contrast-enhanced CT and MR of the brain: differentiation from dural sinus disease. , 1996, AJNR. American journal of neuroradiology.

[13]  H. Rekate,et al.  Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies , 1996, Neurology.

[14]  B. Tress,et al.  Cerebral venography and manometry in idiopathic intracranial hypertension , 1995, Neurology.

[15]  H. Sugerman,et al.  Effects of surgically induced weight loss on idiopathic intracranial hypertension in morbid obesity , 1995, Neurology.

[16]  M. Suzuki,et al.  Dural sinus pressure as related to neurosurgical positions. , 1983, Neurosurgery.

[17]  J Ekstedt,et al.  CSF hydrodynamic studies in man. 2 . Normal hydrodynamic variables related to CSF pressure and flow. , 1978, Journal of neurology, neurosurgery, and psychiatry.

[18]  K. Foley,et al.  Does pseudotumor cerebri cause the empty sella syndrome? , 1975, Neurology.

[19]  A. Martins,et al.  Pressure in the sagittal sinus during intracranial hypertension in man. , 1974, Journal of neurosurgery.