Abstract
BackgroundIdiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure without a clear cause and can have serious visual effects. Previous research work suggests that transcranial Doppler measurements of pulsatility index correlate accurately with elevated intracranial pressure.ObjectiveTo assess the cerebrovascular hemodynamic changes in patients with IIH using transcranial Doppler before and after lumbar puncture and CSF withdrawal.MethodsAn interventional study conducted on 40 patients (31 females and 9 males) fulfilling the modified Dandy criteria for diagnosis of idiopathic intracranial hypertension, MRI brain, and MRV was done to the patients. Lumbar puncture was done for all included patients to measure intracranial pressure and CSF withdrawal. Transcranial Doppler was performed for all included before and after lumbar puncture and CSF withdrawal and the following parameters were measured: peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI).ResultsSignificant relation was found between grades of papilledema and PSV, RI, and PI (p value 0.012, 0.025, 0.016) but no significant relation was found between grades of papilledema and EDV (0.102). Significant changes occurred in parameters of TCD pre- and post-CSF withdrawal including PSV, EDV, and PI (p value 0.001, 0.015, 0.019) denoting a significant change in cerebral hemodynamics after CSF withdrawal which denotes a decrease in intracranial pressure.ConclusionIncreased intracranial pressure significantly affects cerebral blood flow. A normalization of transcranial Doppler parameters occurs following lowering of intracranial pressure through lumbar puncture and CSF withdrawal.
Highlights
Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by increased intracranial pressure in the absence of a space occupying lesion or other diseases
A normalization of transcranial Doppler parameters occurs following lowering of intracranial pressure through lumbar puncture and cerebrospinal fluid (CSF) withdrawal
We studied effects of papilledema grades on transcranial Doppler (TCD) parameters; a significant relation was found between grades of papilledema and peak systolic velocity (PSV), resistivity index (RI), and pulsatility index (PI) but no significant relation was found between grades of papilledema and end diastolic velocity (EDV) which means that with higher grades of papilledema, PSV, RI, and PI show significant changes in cerebral blood flow more than EDV (Table 2)
Summary
Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by increased intracranial pressure in the absence of a space occupying lesion or other diseases. The most common manifestations are headache, blurring of vision, pulsatile tinnitus, nausea, and vomiting. Lumbar puncture is performed in patients with IIH to measure the opening cerebrospinal fluid (CSF) pressure and to exclude alternative diagnoses. CSF may be withdrawn for transient relief of symptoms if the opening pressure was too high [2]. Previous studies demonstrated that transcranial Doppler measurements of pulsatility index correlate accurately with the degree of elevation in intracranial pressure (ICP) [4]. Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure without a clear cause and can have serious visual effects. Previous research work suggests that transcranial Doppler measurements of pulsatility index correlate accurately with elevated intracranial pressure
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
