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Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri
OBJECTIVE: Pseudotumour cerebri syndrome (PTCS including idiopathic intracranial hypertension) is characterised by the symptoms and signs of raised cerebrospinal fluid pressure (CSFp) in the absence of ventricular dilatation or an intracranial mass lesion. Its aetiology is unknown in the majority of...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Vienna
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156361/ https://www.ncbi.nlm.nih.gov/pubmed/31832847 http://dx.doi.org/10.1007/s00701-019-04095-w |
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author | Lalou, Afroditi-Despina Czosnyka, Marek Czosnyka, Zofia H. Krishnakumar, Deepa Pickard, John D. Higgins, Nick J. |
author_facet | Lalou, Afroditi-Despina Czosnyka, Marek Czosnyka, Zofia H. Krishnakumar, Deepa Pickard, John D. Higgins, Nick J. |
author_sort | Lalou, Afroditi-Despina |
collection | PubMed |
description | OBJECTIVE: Pseudotumour cerebri syndrome (PTCS including idiopathic intracranial hypertension) is characterised by the symptoms and signs of raised cerebrospinal fluid pressure (CSFp) in the absence of ventricular dilatation or an intracranial mass lesion. Its aetiology is unknown in the majority of cases but there is much evidence for impaired CSF absorption. Traditionally, sagittal sinus pressure has been considered to be independent of CSF pressure in adults. However, the discovery of stenoses of intracranial venous sinuses and introduction of venous sinus stenting has highlighted the importance of the venous drainage in PTCS. In this study, we have explored the relationship between CSFp and SSp before and during a CSF infusion test and during CSF drainage. MATERIALS AND METHODS: Ten patients (9 females:1 male) with PTCS underwent infusion studies in parallel with direct retrograde cerebral venography. Both SSp and CSFp were recorded at a baseline and during CSFp elevation in a course of a CSF infusion test. The drainage of CSF after the CSF infusion was performed in 7 patients. In 5 cases, jugular venous pressure was also measured. RESULTS: CSFp and SSp including their amplitudes correlated significantly and strongly both at baseline (R = 0.96; p = 0.001) and during infusion (R = 0.92; p = 0.0026). During drainage, this correlation was maintained until SSp reached a stable value, whereas CSFp continued to decrease. CONCLUSIONS: In this series of ten patients with PTCS, CSFp and SSp were coupled, both at baseline and during infusion. The implications of such coupling for the calculation of CSF outflow resistance are discussed. |
format | Online Article Text |
id | pubmed-7156361 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Vienna |
record_format | MEDLINE/PubMed |
spelling | pubmed-71563612020-04-23 Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri Lalou, Afroditi-Despina Czosnyka, Marek Czosnyka, Zofia H. Krishnakumar, Deepa Pickard, John D. Higgins, Nick J. Acta Neurochir (Wien) Original Article - CSF Circulation OBJECTIVE: Pseudotumour cerebri syndrome (PTCS including idiopathic intracranial hypertension) is characterised by the symptoms and signs of raised cerebrospinal fluid pressure (CSFp) in the absence of ventricular dilatation or an intracranial mass lesion. Its aetiology is unknown in the majority of cases but there is much evidence for impaired CSF absorption. Traditionally, sagittal sinus pressure has been considered to be independent of CSF pressure in adults. However, the discovery of stenoses of intracranial venous sinuses and introduction of venous sinus stenting has highlighted the importance of the venous drainage in PTCS. In this study, we have explored the relationship between CSFp and SSp before and during a CSF infusion test and during CSF drainage. MATERIALS AND METHODS: Ten patients (9 females:1 male) with PTCS underwent infusion studies in parallel with direct retrograde cerebral venography. Both SSp and CSFp were recorded at a baseline and during CSFp elevation in a course of a CSF infusion test. The drainage of CSF after the CSF infusion was performed in 7 patients. In 5 cases, jugular venous pressure was also measured. RESULTS: CSFp and SSp including their amplitudes correlated significantly and strongly both at baseline (R = 0.96; p = 0.001) and during infusion (R = 0.92; p = 0.0026). During drainage, this correlation was maintained until SSp reached a stable value, whereas CSFp continued to decrease. CONCLUSIONS: In this series of ten patients with PTCS, CSFp and SSp were coupled, both at baseline and during infusion. The implications of such coupling for the calculation of CSF outflow resistance are discussed. Springer Vienna 2019-12-12 2020 /pmc/articles/PMC7156361/ /pubmed/31832847 http://dx.doi.org/10.1007/s00701-019-04095-w Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article - CSF Circulation Lalou, Afroditi-Despina Czosnyka, Marek Czosnyka, Zofia H. Krishnakumar, Deepa Pickard, John D. Higgins, Nick J. Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri |
title | Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri |
title_full | Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri |
title_fullStr | Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri |
title_full_unstemmed | Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri |
title_short | Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri |
title_sort | coupling of csf and sagittal sinus pressure in adult patients with pseudotumour cerebri |
topic | Original Article - CSF Circulation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156361/ https://www.ncbi.nlm.nih.gov/pubmed/31832847 http://dx.doi.org/10.1007/s00701-019-04095-w |
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