Pseudotumor cerebri causes: Difference between revisions
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Pseudotumor cerebri may be caused by: | Pseudotumor cerebri may be caused by: | ||
# Increased production of CSF and reduced resorption: Normal CSF flow involves production at the [[choroid plexus]]es and absorption at the cranial and [[spinal nerve]] root arachnoid villi and granulations. Impaired CSF absorption at the [[superior sagittal sinus]] or along the spinal nerve roots could therefore explain IIH and has been documented in 75-100% of IIH patients.<ref name="Skau_et_al_2006" /> Permeability along the blood-CSF barrier varies, producing an increasing [[oncotic pressure]] gradient between the CSF and venous system in a [[rostral]] to [[caudal]] progression.<ref name="Walker_2001">{{cite journal |author=Walker RW |title=Idiopathic intracranial hypertension: any light on the mechanism of the raised pressure? |journal=J. Neurol. Neurosurg. Psychiatr. |volume=71 |issue=1 |pages=1–5 |year=2001 |pmid=11413251 |url = http://jnnp.bmj.com/cgi/content/full/71/1/1}}</ref> It is speculated that variations in this oncotic pressure contribute to or impede CSF absorption.<ref name="Skau_et_al_2006" /> | # Increased production of CSF and reduced resorption: Normal CSF flow involves production at the [[choroid plexus]]es and absorption at the cranial and [[spinal nerve]] root arachnoid villi and granulations. Impaired CSF absorption at the [[superior sagittal sinus]] or along the spinal nerve roots could therefore explain IIH and has been documented in 75-100% of IIH patients.<ref name="Skau_et_al_2006" /> Permeability along the blood-CSF barrier varies, producing an increasing [[oncotic pressure]] gradient between the CSF and venous system in a [[rostral]] to [[caudal]] progression.<ref name="Walker_2001">{{cite journal |author=Walker RW |title=Idiopathic intracranial hypertension: any light on the mechanism of the raised pressure? |journal=J. Neurol. Neurosurg. Psychiatr. |volume=71 |issue=1 |pages=1–5 |year=2001 |pmid=11413251 |url = http://jnnp.bmj.com/cgi/content/full/71/1/1}}</ref> It is speculated that variations in this oncotic pressure contribute to or impede CSF absorption.<ref name="Skau_et_al_2006" /> | ||
# obesity: Some evidences suggest that onesity can increase intra abdominal and intra cranial pressure and have a role in pathogenesis of IHH. | # obesity: Some evidences suggest that onesity can increase intra abdominal and intra cranial pressure and have a role in pathogenesis of IHH.<ref name="pmid9270586">{{cite journal |vauthors=Sugerman HJ, DeMaria EJ, Felton WL, Nakatsuka M, Sismanis A |title=Increased intra-abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri |journal=Neurology |volume=49 |issue=2 |pages=507–11 |date=August 1997 |pmid=9270586 |doi= |url=}}</ref> In a study on 7 obese women with IHH it was seen that weith loss improved their symptoms.<ref name="pmid11319651">{{cite journal |vauthors=Sugerman HJ, Felton III WL, Sismanis A, Saggi BH, Doty JM, Blocher C, Marmarou A, Makhoul RG |title=Continuous negative abdominal pressure device to treat pseudotumor cerebri |journal=Int. J. Obes. Relat. Metab. Disord. |volume=25 |issue=4 |pages=486–90 |date=April 2001 |pmid=11319651 |doi= |url=}}</ref> In the other hand higher level of leptin (a protein released from adipose tissue) was found in IHH patiets.<ref name="pmid11971053">{{cite journal |vauthors=Lampl Y, Eshel Y, Kessler A, Fux A, Gilad R, Boaz M, Matas Z, Sadeh M |title=Serum leptin level in women with idiopathic intracranial hypertension |journal=J. Neurol. Neurosurg. Psychiatry |volume=72 |issue=5 |pages=642–3 |date=May 2002 |pmid=11971053 |pmc=1737898 |doi= |url=}}</ref> | ||
# Vitamin A intoxication: There are some evidences of higher serum and CSF level of vitamin A, retinol and retinol binding protein can be related to IHH pathogenesis. | # Vitamin A intoxication: There are some evidences of higher serum and CSF level of vitamin A, retinol and retinol binding protein can be related to IHH pathogenesis.<ref name="pmid10496276">{{cite journal |vauthors=Jacobson DM, Berg R, Wall M, Digre KB, Corbett JJ, Ellefson RD |title=Serum vitamin A concentration is elevated in idiopathic intracranial hypertension |journal=Neurology |volume=53 |issue=5 |pages=1114–8 |date=September 1999 |pmid=10496276 |doi= |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Causes
Pseudotumor cerebri may be caused by:
- Increased production of CSF and reduced resorption: Normal CSF flow involves production at the choroid plexuses and absorption at the cranial and spinal nerve root arachnoid villi and granulations. Impaired CSF absorption at the superior sagittal sinus or along the spinal nerve roots could therefore explain IIH and has been documented in 75-100% of IIH patients.[1] Permeability along the blood-CSF barrier varies, producing an increasing oncotic pressure gradient between the CSF and venous system in a rostral to caudal progression.[2] It is speculated that variations in this oncotic pressure contribute to or impede CSF absorption.[1]
- obesity: Some evidences suggest that onesity can increase intra abdominal and intra cranial pressure and have a role in pathogenesis of IHH.[3] In a study on 7 obese women with IHH it was seen that weith loss improved their symptoms.[4] In the other hand higher level of leptin (a protein released from adipose tissue) was found in IHH patiets.[5]
- Vitamin A intoxication: There are some evidences of higher serum and CSF level of vitamin A, retinol and retinol binding protein can be related to IHH pathogenesis.[6]
References
- ↑ 1.0 1.1
- ↑ Walker RW (2001). "Idiopathic intracranial hypertension: any light on the mechanism of the raised pressure?". J. Neurol. Neurosurg. Psychiatr. 71 (1): 1–5. PMID 11413251.
- ↑ Sugerman HJ, DeMaria EJ, Felton WL, Nakatsuka M, Sismanis A (August 1997). "Increased intra-abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri". Neurology. 49 (2): 507–11. PMID 9270586.
- ↑ Sugerman HJ, Felton III WL, Sismanis A, Saggi BH, Doty JM, Blocher C, Marmarou A, Makhoul RG (April 2001). "Continuous negative abdominal pressure device to treat pseudotumor cerebri". Int. J. Obes. Relat. Metab. Disord. 25 (4): 486–90. PMID 11319651.
- ↑ Lampl Y, Eshel Y, Kessler A, Fux A, Gilad R, Boaz M, Matas Z, Sadeh M (May 2002). "Serum leptin level in women with idiopathic intracranial hypertension". J. Neurol. Neurosurg. Psychiatry. 72 (5): 642–3. PMC 1737898. PMID 11971053.
- ↑ Jacobson DM, Berg R, Wall M, Digre KB, Corbett JJ, Ellefson RD (September 1999). "Serum vitamin A concentration is elevated in idiopathic intracranial hypertension". Neurology. 53 (5): 1114–8. PMID 10496276.