intracranial hypertension (IIH or PTC)

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

intracranial hypertension (IIH or PTC)

Postby zap » Mon Jun 29, 2009 2:36 pm

I've been looking at other diseases in which venous pressure is a problem, and finding a lot of stuff to chew on ... did a search for "intracranial hypertension" and didn't find any threads with the phrase, thought it might be something worth looking into ... apologies if I missed or forgot about a huge discussion on the subject.

Anyway, here are a few of the links I found interesting for various reasons - if they are of interest to anyone, please discuss- if not, feel free to let this thread sink into oblivion ...

http://emedicine.medscape.com/article/1214410-overview

http://www.neurology.org/cgi/content/abstract/46/1/198

http://jnnp.bmj.com/cgi/content/abstract/74/12/1662

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Postby peekaboo » Mon Jun 29, 2009 5:38 pm

Hey Zap - thanks

Lots to read got thru it w/time...I sent the URLs to my H.S. buddy that has ms too and she has vision problems...these papers suggest quite often vision impairment issues. (as well as venous) She lives in PA and she is going for the Buffalo deal w/kids and also going to MD where there is a clinical trial for MRV's Her computer sucks so I forward much info to her...Email she can handle....

P.S. I forgot to say that she has vision problems most likey due to ms..(maybe ccsvi instead or both?)
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Postby mrhodes40 » Tue Jun 30, 2009 8:51 am

Hi Zap!
I'm glad you posted these I had fun reading them and following some other links in them.

The biggest difference here is that they are talking about hydrocephalus or water on the brain and what causes this. In some cases there had been a problem with some venous obstruction that was preventing the fluid in the ventricles--the CSF--- from circulating like it should and it built up. This is similar to the problem seen in DAVF--veins so fat and big they actually stop something else from funcitonin correctly, thouhg in the case of DAVF itis not the ventricles and CSF drainage it s spinal cord funciton.

But hydrocephalus people are profoundly ill and they need a shunt to make it so the excess fluid in their brain can drain away . It sometimes goes to the peritoneum (stomach) and sometimes to the jugular where the fluid can retunr to circulation safely without pressing on the brain any more.

It is also hard for the researchers to be sure any thing they see in regards to the venous system is not a holdover finding from the hydrocephalus, in other words is the seeming high pressure coming from the venous system or is it coming from the hydrocephalus? Apparently some researchers a decade ago thought it was always initated by an increase in venous pressure but they retracted that finding after all becasue it turns out they were not testing the venous ressure but the fluid pressure instead.

the brain volume is the total of blood in the veins and ateries, the parenchyma (brain tissue) and the fluid in the ventricles. This has to remain constant in relation to each other because your skull is a limited size and you cant' tolerate extra stuff in there or the brain gets squished and you get developmental delays, which is what happens in hydrocephalus, the brain gets so squished it ends up with retardation.

Here's a cool abstract I found on one of these links
HERE IS PAPER about inflammation and how it both helps and hurts the brain when an injury results in inflammation after the fact.

ANd another one just on the venous system in the head all around and it is a complete paper
http://www.ajnr.org/cgi/content/full/23/9/1500

cool huh?
thanks for the links they were interesting material
I'm not offering medical advice, I am just a patient too! Talk to your doctor about what is best for you...
http://www.thisisms.com/ftopic-7318-0.html This is my regimen thread
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Postby peekaboo » Tue Jun 30, 2009 9:24 am

REALLY COOL Great images too...checkem out thanks marie
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Postby zap » Wed Aug 19, 2009 10:46 am

Came across this today, thought it was interesting:

http://www.springerlink.com/content/r28484t2127691qx/

In six of the IIH patients, either complete or partial functional obstruction of the internal jugular veins (IJVs) coupled with increased venous outflow through secondary venous channels was documented.
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Postby mrhodes40 » Wed Aug 19, 2009 12:48 pm

That is interesting.

The documented problems with the externally occluded jugs (ie perhaps the sonographer pushed on the jugs to occlude them and thus to force blood elsewhere) showing that the blood was redirected to the epidural or vertebral areas is similar to the Russian paper...they were documenting myelopathy (dysfunction similar to MS) and found that was the venous pattern associated.
I'm not offering medical advice, I am just a patient too! Talk to your doctor about what is best for you...
http://www.thisisms.com/ftopic-7318-0.html This is my regimen thread
http://www.ccsvibook.com Read my book published by McFarland Health topics
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finding parallels

Postby lobra » Wed Aug 19, 2009 10:19 pm

Reading your posts I remembered things I`ve learnt about "normotensive hydrocephalus". That means, that there is more liquor in the ventricles, but tension is normal. It is a disease, that produces symptoms such as problems with urine continence, walking disorders and light cognitive impairment. Does that sound familiar?
The therapeutic answer is lumbar puncture, withdrawl of liquor, and then the symptoms will be much better for a certain time. Only in cases, when this is needed too often, a shunt will be implanted.
So high pressure is not necessary to produce neurologic symptoms.
Sorry, my english is not at the top.

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Re: intracranial hypertension (IIH or PTC)

Postby Cece » Fri Nov 18, 2011 5:10 pm

A really old thread!!
I wanted to add some info on IIH.
J Neurol. 2009 Jun;256(6):964-9. Epub 2009 Mar 1.

Venous obstruction and jugular valve insufficiency in idiopathic intracranial hypertension.

Nedelmann M, Kaps M, Mueller-Forell W.


Source

Department of Neurology, Justus Liebig University Giessen, Am Steg 14, 35385, Giessen, Germany. max.nedelmann@neuro.med.uni-giessen.de


Abstract

The pathophysiology of elevated intracranial pressure in idiopathic intracranial hypertension (IIH) is unclear. Cerebral venous outflow obstruction and elevated intracranial venous pressure may play an etiological role. We examined jugular valve insufficiency as a potential factor contributing to intracranial hypertension. Jugular venous valve function was assessed bilaterally by duplex sonography in 20 consecutive patients with diagnosis of IIH and in 20 healthy controls matched for age, gender and body mass index. Diagnosis of valvular insufficiency was based on reflux duration during a controlled Valsalva maneuver. Intracranial venous outflow was evaluated in 11 patients (MR venography in 10, digital subtraction angiography (DSA) in two cases). As a principle result, valvular insufficiency was significantly more frequent in patients with IIH (70 vs. 30%; p < 0.05). This finding was associated with irregular leaflet structures on B-mode imaging (p < 0.01). Bilateral insufficiency was more frequent in the patient group which, however, was not significant (p = 0.08). In addition, sinovenous outflow obstruction was found in five of six patients that had undergone contrast-enhanced MR venography and DSA. The detection rate was inferior in phase-contrast MR imaging (one of five patients). In conclusion, this study gives evidence that valvular insufficiency may play a causal role in IIH. Obesity is a major risk factor for the disease and weight reduction leads to improvement of symptoms. Possibly, increased intra-abdominal pressure is transmitted into the intracranial venous system, causing intracranial hypertension. Jugular valve insufficiency may facilitate pressure transmission. As transverse sinus stenosis was a concomitant finding, these factors may be complementary.

Whaddya think they mean by "irregular leaflet structures"? I had fixed irregular valve leaflets. If anyone has a copy of this, can you check for images included in the paper? I think I could recognise a CCSVI valve leaflet if that's what they happen to have found.
http://www.ncbi.nlm.nih.gov/pubmed/19252781
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