Abnormal Intracranial Pulse Pressure Amplitude Despite Normalized Static Intracranial Pressure in Idiopathic Intracranial Hypertension Refractory to Conservative Medical Therapy.
Abnormal Intracranial Pulse Pressure Amplitude Despite Normalized Static Intracranial Pressure in Idiopathic Intracranial Hypertension Refractory to Conservative Medical Therapy.
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DOI：
10.3390/life11060537
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发表时间：
2021-06-09
期刊：
影响因子：
--
通讯作者：
Eide PK
中科院分区：
文献类型：
--
作者：
Eide PK
特发性颅内高压（IIH）包括颅内压（ICP）升高的症状和体征，并通过腰椎脑脊液压力升高进行诊断。然而，我们对ICP异常特征的了解，例如，脉动与静态ICP的变化仍然很少。本研究探讨了保守治疗难治性IIH患者的夜间脉动ICP（平均ICP波幅，MWA）与静态ICP（平均ICP）之间的关系。该材料包括80名连续的IIH患者，他们在分流前接受ICP监测，作为保守药物治疗失败后检查的一部分。在该组中，52/80例患者的夜间平均ICP正常化，但45/52例患者的夜间MWA异常。尽管在组水平和个体ICP记录中MWA和平均ICP之间存在正相关性，但尽管平均ICP标准化，但高比例患者的MWA水平异常。总而言之，目前的结果显示，尽管保守药物治疗无效的IIH患者的静态ICP正常化，但持续异常脉动性ICP，这可能反映了潜在的病理生理学。初步认为IIH中异常搏动性ICP可能反映了胶质-神经血管界面的改变，导致星形胶质细胞搏动吸收机制受损。
Idiopathic intracranial hypertension (IIH) incorporates symptoms and signs of increased intracranial pressure (ICP) and is diagnosed by increased lumbar cerebrospinal fluid pressure. However, our knowledge about the characteristics of ICP abnormality, e.g., changes in pulsatile versus static ICP, remains scarce. This study questioned how overnight pulsatile ICP (mean ICP wave amplitude, MWA) associates with static ICP (mean ICP) in IIH patients who were refractory to conservative medical treatment. The material included 80 consecutive IIH patients undergoing ICP monitoring prior to shunt, as part of work-up for failed conservative medical therapy. In this group, the overnight mean ICP was normalized in 52/80 patients, but with abnormal overnight MWA in 45 of the 52 patients. Even though there was a positive correlation between MWA and mean ICP at group level and within individual ICP recordings, the levels of MWA were abnormal in a high proportion of patients despite normalized mean ICP. Taken together, the present results disclosed lasting abnormal pulsatile ICP despite normalized static ICP in IIH patients refractory to conservative medical therapy, which may reflect the underlying pathophysiology. It is tentatively suggested that abnormal pulsatile ICP in IIH may reflect alterations at the glia–neurovascular interface, resulting in impaired astrocytic pulsation absorber mechanisms.
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DOI：
10.1111/bpa.12152
发表时间：
2014-07
期刊：
Brain pathology (Zurich, Switzerland)
影响因子：
--
作者：
Winkler EA;Sagare AP;Zlokovic BV
通讯作者：
Zlokovic BV
影响因子：
1.9
作者：
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Kerty, Emilia
影响因子：
2.9
作者：
Eidsvaag, Vigdis Andersen;Hansson, Hans-Arne;Eide, Per Kristian
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Eide, Per Kristian
影响因子：
17.1
作者：
Iliff JJ;Wang M;Liao Y;Plogg BA;Peng W;Gundersen GA;Benveniste H;Vates GE;Deane R;Goldman SA;Nagelhus EA;Nedergaard M
通讯作者：
Nedergaard M
DOI：
10.1136/jnnp-2015-311302
发表时间：
2016-09
期刊：
Journal of neurology, neurosurgery, and psychiatry
影响因子：
--
作者：
Mollan SP;Ali F;Hassan-Smith G;Botfield H;Friedman DI;Sinclair AJ
通讯作者：
Sinclair AJ