Per Kristian Eide1, Geir Ringstad2. 1. Dept. of Neurosurgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: p.k.eide@medisin.uio.no. 2. Dept. of Radiology and Nuclear Medicine, Oslo University Hospital- Rikshospitalet, Oslo, Norway.
Abstract
BACKGROUND: In symptomatic individuals with non-hydrocephalic pineal cysts (PCs), it remains controversial what causes the symptoms. Based on magnetic resonance imaging (MRI) biomarkers, we proposed that PC-associated crowding of the pineal recess may cause central venous hypertension. The aim of this study was to compare pulsatile and static ICP in patients with PCs and chronic daily headache (CDH), and compare ICP data in PC patients with the previously identified MRI biomarkers. METHODS: All patients assessed with over-night ICP monitoring for PCs or CDH who had been ruled out for idiopathic intracranial hypertension without papilledema (IIHWOP) were retrieved from the database. The symptoms as well as the pulsatile and static ICP scores were compared between the PC and CDH patients, and ICP scores were compared with the MRI biomarkers indicative of central venous hypertension. RESULTS: The pulsatile ICP was significantly increased in the symptomatic patients with non-hydrocephalic PCs as compared to the CDH patients. Pulsatile ICP was significantly increased in the individuals with PC-grades 3-4, who had MRI biomarkers indicative of central venous hypertension. The tectum-splenium-cyst ratio correlated positively with pulsatile ICP and an index of thalamic edema. CONCLUSIONS: Pulsatile ICP is increased in symptomatic patients with PCs and imaging evidence of central venous hypertension, supporting the hypothesis that PC-induced crowding of the pineal recess and venous obstruction may cause a central venous hypertension syndrome.
BACKGROUND: In symptomatic individuals with non-hydrocephalic pineal cysts (PCs), it remains controversial what causes the symptoms. Based on magnetic resonance imaging (MRI) biomarkers, we proposed that PC-associated crowding of the pineal recess may cause central venous hypertension. The aim of this study was to compare pulsatile and static ICP in patients with PCs and chronic daily headache (CDH), and compare ICP data in PCpatients with the previously identified MRI biomarkers. METHODS: All patients assessed with over-night ICP monitoring for PCs or CDH who had been ruled out for idiopathic intracranial hypertension without papilledema (IIHWOP) were retrieved from the database. The symptoms as well as the pulsatile and static ICP scores were compared between the PC and CDHpatients, and ICP scores were compared with the MRI biomarkers indicative of central venous hypertension. RESULTS: The pulsatile ICP was significantly increased in the symptomatic patients with non-hydrocephalic PCs as compared to the CDHpatients. Pulsatile ICP was significantly increased in the individuals with PC-grades 3-4, who had MRI biomarkers indicative of central venous hypertension. The tectum-splenium-cyst ratio correlated positively with pulsatile ICP and an index of thalamic edema. CONCLUSIONS: Pulsatile ICP is increased in symptomatic patients with PCs and imaging evidence of central venous hypertension, supporting the hypothesis that PC-induced crowding of the pineal recess and venous obstruction may cause a central venous hypertension syndrome.
Authors: Riccardo Masina; Ali Ansaripour; Vladimír Beneš; Moncef Berhouma; Joham Choque-Velasquez; Per Kristian Eide; Stepan Fedorko; Steffen Fleck; Juha Hernesniemi; Andrzej Koziarski; Martin Májovský; Andrzej Podgorski; Henry Schroeder; Charles Teo; Andreas W Unterberg; Jacky T Yeung; Angelos Kolias; Thomas Santarius Journal: Acta Neurochir (Wien) Date: 2021-12-02 Impact factor: 2.216
Authors: Steffen Fleck; Ahmed El Damaty; Ina Lange; Marc Matthes; Ehab El Rafaee; Sascha Marx; Jörg Baldauf; Henry W S Schroeder Journal: Neurosurg Rev Date: 2022-07-12 Impact factor: 2.800
Authors: Per K Eide; Espen Mariussen; Hilde Uggerud; Are H Pripp; Aslan Lashkarivand; Bjørnar Hassel; Hege Christensen; Markus Herberg Hovd; Geir Ringstad Journal: JCI Insight Date: 2021-05-10
Authors: Joham Choque-Velasquez; Julio C Resendiz-Nieves; Behnam Rezai Jahromi; Roberto Colasanti; Rahul Raj; Kenneth Lopez-Gutierrez; Olli Tynninen; Mika Niemelä; Juha Hernesniemi Journal: Surg Neurol Int Date: 2019-06-19