Vascular etiology of intracranial hypertension

Abstract

Intracranial hypertension is an important problem i n neurology and neurosurgery. Some authors consider that there are differences between idiopathic intracranial hypertension and intracranial hypertension caused by sinus thrombosis or stenosis, but others consider that intracranial venous sinus thrombosis and steno sis are the main etiological factors for idiopathic intracranial hypertension. The aim of th is study was to present the characteristics that differentiate between idiopathic intracranial hypertension and intracranial hypertension caused by intracranial vascular damage. This prospective study included twenty-one patients, 14 women and 7 men of 18 ‐ 61 years old. The main symptoms and the imaging findings diagnosed intracranial hypertension in the absence of an expansive intracranial process, hydrocephalus and intracranial infection. Cerebral angiography with venous phases showed whether there was cerebral vascular disease (cerebral venous thrombosis, venous sinus thrombosis or stenosis). The pressure of the cerebro-spinal fluid was determined by repeated lumbar puncture with manometry after the exclusion of endocranial lesions by cerebral explorations. The analysis of the symptomatology correlated with the values of intracranial pressure, and the imaging findings revea led significant differences between these two types of intracranial hypertension. Vascular in tracranial hypertension has a known etiology, such as cerebral vascular illness, and a rel atively rapid increase in intracranial pressure of approximately 21 cm H2O. Intracranial hypertension caused by intracranial vascular damage is named vascular intracranial hypertension. The treatment of vascular intracranial hypertension is etiologic, pathogenic and sy mptomatic, but that of idiopathic intracranial hypertension is only symptomatic.