Skip to main content
SpringerLink
Log in

Cerebrospinal Fluid and Cerebral Blood Flows in Idiopathic Intracranial Hypertension

  • Conference paper
  • First Online:
Intracranial Pressure & Neuromonitoring XVI

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 126))

Abstract

Objectives: Cerebrospinal fluid (CSF) and blood flows have a strong relationship during a cardiac cycle. Idiopathic intracranial hypertension (IIH) is a pathology that seems to present hemodynamic and hydrodynamic disturbance. The aim of this study was to establish CSF and blood interaction in IIH.

Material and methods: We retrospectively studied cerebral hydrodynamic and hemodynamic flows by phase-contrast MRI (PCMRI) in 13 IIH subjects (according Dandy’s criteria) and 16 controls. We analyzed arterial peak flow, pulsatility index, and resistive index in arterial and venous compartments (PFart, PIart, RIart, PFvein, PIvein, RIvein) and measured arteriovenous and CSF peak flow and stroke volume (PFav, SVVASC, PFCSF, SVCSF).

Results: We found no significant difference between IIH and control groups in arterial and venous parameters. Arteriovenous flow analysis showed higher PFav and SVVASC in the IIH group than in the control group (respectively 369 ± 27 mL/min and 286 ± 47 mL/min, p = 0.02; and 1085 ± 265 μL/cardiac cycle and 801 ± 226 μL/cardiac cycle, p = 0.007). PFCSF and SVCSF were higher in the IIH group than in the control group (respectively 206 ± 50 mL/min and 126.6 ± 24.8 mL/min, p = 0.04; and 570 ± 190 μL/cardiac cycle and 430 ± 100 μL/cardiac cycle, p = 0.0007).

Conclusion: Although no significant change was found in arterial and venous flows, we showed that a small phase shift of venous outflow might cause an increase in the arteriovenous pulsatility and an increasing brain expansion during the cardiac cycle. This arteriovenous flow increase would result in an increase of CSF flushing through the foramen magnum and an increased ICP.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Gross CE, Tranmer BI, Adey G, Kohut J. Increased cerebral blood flow in idiopathic pseudotumour cerebri. Neurol Res. 1990;12(4):226–30.

    Article  CAS  PubMed  Google Scholar 

  2. Wall M. Idiopathic intracranial hypertension. Semin Ophthalmol. 1995;10(3):251–9.

    Article  CAS  PubMed  Google Scholar 

  3. Alperin N, Ranganathan S, Bagci AM, Adams DJ, Ertl-Wagner B, Saraf-Lavi E, Sklar EM, Lam BL. MRI evidence of impaired CSF homeostasis in obesity-associated idiopathic intracranial hypertension. AJNR Am J Neuroradiol. 2013;34(1):29–34.

    Article  CAS  PubMed  Google Scholar 

  4. Bateman GA. Vascular hydraulics associated with idiopathic and secondary intracranial hypertension. AJNR Am J Neuroradiol. 2002;23(7):1180–6.

    PubMed  Google Scholar 

  5. Pickard JD, Czosnyka Z, Czosnyka M, Owler B, Higgins JN. Coupling of sagittal sinus pressure and cerebrospinal fluid pressure in idiopathic intracranial hypertension – a preliminary report. Acta Neurochir Suppl. 2008;102:283–5.

    Article  CAS  PubMed  Google Scholar 

  6. Leker RR, Steiner I. Features of dural sinus thrombosis simulating pseudotumor cerebri. Eur J Neurol. 1999;6(5):601–4.

    Article  CAS  PubMed  Google Scholar 

  7. Biousse V, Ameri A, Bousser MG. Isolated intracranial hypertension as the only sign of cerebral venous thrombosis. Neurology. 1999;53(7):1537–42.

    Article  CAS  PubMed  Google Scholar 

  8. Farb RI, Vanek I, Scott JN, Mikulis DJ, Willinsky RA, Tomlinson G, terBrugge KG. Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology. 2003;60(9):1418–24.

    Article  CAS  PubMed  Google Scholar 

  9. Rohr A, Dörner L, Stingele R, Buhl R, Alfke K, Jansen O. Reversibility of venous sinus obstruction in idiopathic intracranial hypertension. AJNR Am J Neuroradiol. 2007;28(4):656–9.

    CAS  PubMed  Google Scholar 

  10. Bateman GA, Stevens SA, Stimpson J. A mathematical model of idiopathic intracranial hypertension incorporating increased arterial inflow and variable venous outflow collapsibility. J Neurosurg. 2009;110(3):446–56.

    Article  PubMed  Google Scholar 

  11. Balédent O, Henry-Feugeas MC, Idy-Peretti I. Cerebrospinal fluid dynamics and relation with blood flow: a magnetic resonance study with semiautomated cerebrospinal fluid segmentation. Invest Radiol. 2001;36(7):368–77.

    Google Scholar 

  12. Wang Y, Duan Y-Y, Zhou H-Y, Yuan L-J, Zhang L, Wang W, Li L-H, Li L. Middle cerebral arterial flow changes on transcranial color and spectral Doppler sonography in patients with increased intracranial pressure. J Ultrasound Med. 2014;33(12):2131–60.

    Article  PubMed  Google Scholar 

  13. Greitz D, Wirestam R, Franck A, Nordell B, Thomsen C, Ståhlberg F. Pulsatile brain movement and associated hydrodynamics studied by magnetic resonance phase imaging. The Monro-Kellie doctrine revisited. Neuroradiology. 1992;34(5):370–80.

    Article  CAS  PubMed  Google Scholar 

  14. Bateman GA. Vascular compliance in normal pressure hydrocephalus. AJNR Am J Neuroradiol. 2000;21(9):1574–85.

    CAS  PubMed  Google Scholar 

Download references

Conflicts of interest statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Neurosurgery Department, Hospital University Center of Amiens-Picardie, Amiens, France

    Cyrille Capel M.D.

  2. BioFLOW Image Research Group, Hospital University Center of Amiens-Picardie, Amiens, France

    Cyrille Capel M.D., Roger Bouzerar Ph.D. & Olivier Balédent Ph.D.

  3. Neurosurgery Department, CHU Amiens—Picardie, Salouel, Amiens, France

    Cyrille Capel M.D.

  4. Neurosurgery Department, Hospital University Center of Lille, Lille, France

    Marc Baroncini M.D., Ph.D.

  5. Radiology Department, Hospital University Center of Amiens-Picardie, Amiens, France

    Catherine Gondry-Jouet M.D.

  6. Neurosciences Department, University of Cambridge, Cambridge, UK

    Marek Czosnyka Ph.D. & Zofia Czosnyka Ph.D.

Authors
  1. Cyrille Capel M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc Baroncini M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Catherine Gondry-Jouet M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roger Bouzerar Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marek Czosnyka Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zofia Czosnyka Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Olivier Balédent Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cyrille Capel M.D. .

Editor information

Editors and Affiliations

  1. Institute for Medical Engineering & Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA

    Thomas Heldt

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Capel, C. et al. (2018). Cerebrospinal Fluid and Cerebral Blood Flows in Idiopathic Intracranial Hypertension. In: Heldt, T. (eds) Intracranial Pressure & Neuromonitoring XVI. Acta Neurochirurgica Supplement, vol 126. Springer, Cham. https://doi.org/10.1007/978-3-319-65798-1_48

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-65798-1_48

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65797-4

  • Online ISBN: 978-3-319-65798-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation