Case Report: Cerebrospinal Fluid Dynamics in the Optic Nerve Subarachnoid Space and the Brain Applying Diffusion Weighted MRI in Patients With Idiopathic Intracranial Hypertension—A Pilot Study
PurposeThe aim of this study was to examine the cerebrospinal fluid (CSF) flow rates in the subarachnoid space (SAS) of the optic nerve (ON) and the brain in patients with idiopathic intracranial hypertension (IIH) and papilledema (PE) compared to healthy controls by applying non-invasive diffusion-...
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.862808/full |
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| author | Jatta Berberat Jatta Berberat Achmed Pircher Philipp Gruber Karl-Olof Lovblad Luca Remonda Luca Remonda Hanspeter Esriel Killer |
| author_facet | Jatta Berberat Jatta Berberat Achmed Pircher Philipp Gruber Karl-Olof Lovblad Luca Remonda Luca Remonda Hanspeter Esriel Killer |
| author_sort | Jatta Berberat |
| collection | DOAJ |
| description | PurposeThe aim of this study was to examine the cerebrospinal fluid (CSF) flow rates in the subarachnoid space (SAS) of the optic nerve (ON) and the brain in patients with idiopathic intracranial hypertension (IIH) and papilledema (PE) compared to healthy controls by applying non-invasive diffusion-weighted MRI.MethodsA retrospective analysis of diffusion-weighted MR images of 5 patients with IIH (10 ONs), mean age: 31 ± 10 years (5 women), and 11 healthy controls (22 ONs, mean age: 60 ± 13 years, 5 women) was performed. The flow velocity flow-range ratio (FRR) between the intracranial cavity and the SAS of the ON was calculated in both groups and then compared.ResultsThe mean FRR was 0.55 ± 0.08 in patients with IIH and 0.63 ± 0.05 in healthy controls. The difference between patients with IIH and healthy controls was statistically significant (p < 0.05).ConclusionsThe CSF flow velocity was decreased in patients with IIH with PE compared to healthy controls. The reduced CSF flow dynamics might be involved in the pathophysiology of PE in IIH and diffusion-weighted MRI can be a useful non-invasive tool to study the CSF flow dynamics within the SAS ON.SummaryIdiopathic intracranial hypertension is a neurological disease, where vision loss is the most feared complication of this disorder. The pathophysiology of IIH is not fully understood but is strongly linked to a reduced uptake of CSF into the central dural sinus veins. In this study, we examined the CSF flow rates in the SAS ON and the brain in patients with IIH and PE compared to healthy controls by applying non-invasive diffusion-weighted MRI. Knowing about the flow ratio of CSF may be of clinical relevance for the treatment decisions of IIH. If medical treatment fails, surgical options for lowering the ICP pressure need to be taken into consideration. As the primary goal of treatment is to prevent the loss of vision and visual field, it is important to know whether the communication of CSF between the intracranial CSF and the CSF in the perioptic space is intact. We showed that the CSF flow velocity was decreased in IIH patients with PE compared to healthy controls. The reduced CSF flow might be involved in the pathophysiology of PE in IIH, and diffusion-weighted MRI can be a useful non-invasive tool to study the CSF flow dynamics within the SAS ON. |
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| last_indexed | 2024-12-12T19:39:23Z |
| publishDate | 2022-04-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-f6e33ccb2e05447097c5fb4b50992a3d2022-12-22T00:14:14ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-04-011310.3389/fneur.2022.862808862808Case Report: Cerebrospinal Fluid Dynamics in the Optic Nerve Subarachnoid Space and the Brain Applying Diffusion Weighted MRI in Patients With Idiopathic Intracranial Hypertension—A Pilot StudyJatta Berberat0Jatta Berberat1Achmed Pircher2Philipp Gruber3Karl-Olof Lovblad4Luca Remonda5Luca Remonda6Hanspeter Esriel Killer7Institute of Neuroradiology, Kantonsspital Aarau, Aarau, SwitzerlandDepartment of Psychiatry, University of Geneva, Geneva, SwitzerlandDepartment of Neuroscience/Ophthalmology, Uppsala University, Uppsala, SwedenInstitute of Neuroradiology, Kantonsspital Aarau, Aarau, SwitzerlandDivision of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals and Faculty of Medicine of Geneva, Geneva, SwitzerlandInstitute of Neuroradiology, Kantonsspital Aarau, Aarau, SwitzerlandFaculty of Medicine, University of Bern, Bern, SwitzerlandDepartment of Biomedicine, University of Basel, Basel, SwitzerlandPurposeThe aim of this study was to examine the cerebrospinal fluid (CSF) flow rates in the subarachnoid space (SAS) of the optic nerve (ON) and the brain in patients with idiopathic intracranial hypertension (IIH) and papilledema (PE) compared to healthy controls by applying non-invasive diffusion-weighted MRI.MethodsA retrospective analysis of diffusion-weighted MR images of 5 patients with IIH (10 ONs), mean age: 31 ± 10 years (5 women), and 11 healthy controls (22 ONs, mean age: 60 ± 13 years, 5 women) was performed. The flow velocity flow-range ratio (FRR) between the intracranial cavity and the SAS of the ON was calculated in both groups and then compared.ResultsThe mean FRR was 0.55 ± 0.08 in patients with IIH and 0.63 ± 0.05 in healthy controls. The difference between patients with IIH and healthy controls was statistically significant (p < 0.05).ConclusionsThe CSF flow velocity was decreased in patients with IIH with PE compared to healthy controls. The reduced CSF flow dynamics might be involved in the pathophysiology of PE in IIH and diffusion-weighted MRI can be a useful non-invasive tool to study the CSF flow dynamics within the SAS ON.SummaryIdiopathic intracranial hypertension is a neurological disease, where vision loss is the most feared complication of this disorder. The pathophysiology of IIH is not fully understood but is strongly linked to a reduced uptake of CSF into the central dural sinus veins. In this study, we examined the CSF flow rates in the SAS ON and the brain in patients with IIH and PE compared to healthy controls by applying non-invasive diffusion-weighted MRI. Knowing about the flow ratio of CSF may be of clinical relevance for the treatment decisions of IIH. If medical treatment fails, surgical options for lowering the ICP pressure need to be taken into consideration. As the primary goal of treatment is to prevent the loss of vision and visual field, it is important to know whether the communication of CSF between the intracranial CSF and the CSF in the perioptic space is intact. We showed that the CSF flow velocity was decreased in IIH patients with PE compared to healthy controls. The reduced CSF flow might be involved in the pathophysiology of PE in IIH, and diffusion-weighted MRI can be a useful non-invasive tool to study the CSF flow dynamics within the SAS ON.https://www.frontiersin.org/articles/10.3389/fneur.2022.862808/fullCSFoptic nerve (ON)MRIdiffusion imagingidiopathic intracranial hypertension (IIH)papilledema |
| spellingShingle | Jatta Berberat Jatta Berberat Achmed Pircher Philipp Gruber Karl-Olof Lovblad Luca Remonda Luca Remonda Hanspeter Esriel Killer Case Report: Cerebrospinal Fluid Dynamics in the Optic Nerve Subarachnoid Space and the Brain Applying Diffusion Weighted MRI in Patients With Idiopathic Intracranial Hypertension—A Pilot Study Frontiers in Neurology CSF optic nerve (ON) MRI diffusion imaging idiopathic intracranial hypertension (IIH) papilledema |
| title | Case Report: Cerebrospinal Fluid Dynamics in the Optic Nerve Subarachnoid Space and the Brain Applying Diffusion Weighted MRI in Patients With Idiopathic Intracranial Hypertension—A Pilot Study |
| title_full | Case Report: Cerebrospinal Fluid Dynamics in the Optic Nerve Subarachnoid Space and the Brain Applying Diffusion Weighted MRI in Patients With Idiopathic Intracranial Hypertension—A Pilot Study |
| title_fullStr | Case Report: Cerebrospinal Fluid Dynamics in the Optic Nerve Subarachnoid Space and the Brain Applying Diffusion Weighted MRI in Patients With Idiopathic Intracranial Hypertension—A Pilot Study |
| title_full_unstemmed | Case Report: Cerebrospinal Fluid Dynamics in the Optic Nerve Subarachnoid Space and the Brain Applying Diffusion Weighted MRI in Patients With Idiopathic Intracranial Hypertension—A Pilot Study |
| title_short | Case Report: Cerebrospinal Fluid Dynamics in the Optic Nerve Subarachnoid Space and the Brain Applying Diffusion Weighted MRI in Patients With Idiopathic Intracranial Hypertension—A Pilot Study |
| title_sort | case report cerebrospinal fluid dynamics in the optic nerve subarachnoid space and the brain applying diffusion weighted mri in patients with idiopathic intracranial hypertension a pilot study |
| topic | CSF optic nerve (ON) MRI diffusion imaging idiopathic intracranial hypertension (IIH) papilledema |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.862808/full |
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