Description
Book SynopsisThis book provides a valuable guide to understanding idiopathic intracranial hypertension (IIH), which is a very complex and painful disease. It is a chronic, often disabling condition resulting in headaches, visual loss, and ringing in the ears. This condition was thought to be rare but is becoming much more common, especially as the population becomes more overweight. Patients with this condition often suffer from intractable headaches with poor quality of life. Very few physicians specialize in this condition, and as a result, there is almost no information or resources available to those trying to understand this condition. The text is designed to take very complex neurosurgical anatomy, principles, and treatments and reduce them down into simple principles. The book contains 12 chapters, each organized into distinct sections. All chapters also contain key points from those paragraphs to summarize useful take home messages.
Written by an expert specializing in this debilitating condition,
Idiopathic Intracranial Hypertension Explained serves as a valuable guide towards understanding and treating IIH. The ultimate goal is to empower patients and families with knowledge about the disease.
Table of ContentsTable of Contents
Chapter 1. Introduction Chapter 2. Basic Brain Anatomy and PhysiologyThe Brain and Its FluidThe Flow of Brain FluidThe Reabsorption of Brain Fluid is Into VeinsBrain VeinsBlood Pressure – Arteries vs. VeinsCerebrospinal Fluid Reabsorption is Dependent on Venous Sinus PressuresWhat are Normal Venous Sinus Pressures?Venous Sinus Pressures Are Not Uniform Throughout the BrainIIH is Due to High Venous Sinus PressuresHydrocephalus is NOT the Same as IIHIntracranial Pressure and CSF PressureNormal Intracranial Pressures (ICP)
Chapter 3. Idiopathic Intracranial Hypertension (IIH)DiagnosisPresentationCommon SymptomsHeadacheVisual SymptomsPapilledema and Visual LossLight SensitivityPulsatile Tinnitus‘Brain Fog’Cerebrospinal Fluid Leak (Rhinorrhea or Otorrhea)Other symptomsSymptoms Are Worsened By Weather ChangesSymptoms Are Often Related to Intracranial PressureDistinguishing ICP That is Too High (Hyper) vs Too Low (Hypo)Ehlers-Danlos Syndrome
Chapter 4. The Fundamental Reasons Patients get IIHIIH is Actually Not IdiopathicVenous Pressures In the Body and the BrainNormal Venous Pressures in the Body and BrainVenous Pressures in the Body and Brain when CVP is HighVenous Narrowing (“Stenosis”)Why Does Venous Sinus Stenosis Occur?What Triggers the Positive Feedback Loop to Start?Vein Narrowing May Occur at More Than One SiteThe Pressure GradientVenous Congestion and CollateralsVenous Sinus ThrombosisConfusion Between Thrombosis and AplasiaOther Causes of High Venous PressuresNot All IIH Patients are the SameIIH Links to Medications or SurgeriesGeneral Treatment StrategiesIIH is a Chronic Condition
Chapter 5. Understanding Your Brain ImagingImaging in IIHCT ScanMRI ScanMRV and CTVBrain Imaging Findings You May See in Your Report“Empty Sella”“Venous Sinus Stenosis”“Venous Sinus Thrombosis”“Chiari Malformation”“Collapsed ventricle”“Pneumocephalus”“Cerebral Edema”“Bone Dehiscence”“Metal Artifact”
Chapter 6. Measuring Intracranial PressureObtaining Intracranial Pressure MeasurementsLumbar Puncture (Spinal Tap)Lumbar Drain PlacementIntracranial Pressure Monitor (Bolt) Placement
Chapter 7. Lifestyle Modification and Weight LossThe Link Between IIH and Being OverweightHow We Measure Normal Weight Versus OverweightIs Being Overweight Dangerous?The Relationship Between Body Mass Index and Central Venous PressureWeight Loss is an Effective Treatment for IIH in Most PatientsLifestyle ModificationTips for Being Successful with Lifestyle ModificationWeight Loss SurgeriesThe Importance of Weight Loss After Surgical Treatment of IIH
Chapter 8. Medical Therapies for IIHAn Overview of Medications for IIHAcetazolamide (trade name: DiamoxMethazolamide (trade name: Neptazane)Topiramate (trade name: Topamax)Furosemide (trade name: Lasix)Opiate medicationsOver the counter medications
Chapter 9. Catheter AngiographyOverviewTiming of the Procedure is ImportantAnesthesia Affects Pressure MeasurementsAngiograms in Patients Who Have ShuntsContrast Dye, Allergies and Kidney ProblemsCerebral Angiogram Procedure
Chapter 10. Venous Sinus StentingReasons to Have a Surgical Procedure Performed for IIHVenous Sinus Stenting OverviewStents Reduce Intracranial Venous and CSF Pressures and Relieve the Pressure GradientCandidacy for StentingUsually The Larger Transverse Sinus is TreatedTiming of the Procedure is Less Important Than the AngiogramVenous Sinus Stenting Symptom Improvement RatesDefining Success With StentingSudden Visual LossVenous Sinus Stenting in Children or Mentally Handicapped IndividualsBlood ThinnersVenous Stenting ProcedureStent PainStopping IIH Medications After StentingEvaluation of Patients with Persistent Symptoms After StentingReasons For Stent FailuresNew Vein Narrowing Can Develop After StentingUsing Spinal Tap Opening Pressure After StentingRepeat Cerebral Angiography After StentingRepeat Stenting Re-Equilibration PhenomenonSome Final Comments About Stents
Chapter 11. Cerebrospinal Fluid ShuntingOverviewShunting For Impaired Quality of LifeLife Expectancy of ShuntsAny of the 3 Parts Can Stop Working and Cause the Shunt to FailVentriculo-peritoneal (VP) ShuntsVentriculo-atrial (VA) ShuntsLumbo-peritoneal (LP) Shunts Other ShuntsShunt Valves Blood ThinnersShunt Surgical ProcedurePain, Swelling and Numbness at Shunt SiteCerebrospinal Fluid Leak From IncisionEvaluating Patients With IIH Symptoms After ShuntingShunt SeriesCT BrainNuclear Medicine ShuntogramVentricular CollapseShunt TapShunt Re-programmingVP Shunt Peritoneal Catheter, Catheter Migration and Pelvic Pain Shunt InfectionRe-equilibration Phenomenon After ShuntingShunt Revision SurgerySome Final Comments About Shunts
Chapter 12. Other Surgical TreatmentsInternal Jugular Vein TreatmentsOptic Nerve Sheath FenestrationCranio-cervical (Occipito-cervical Fusion)Cerebrospinal Fluid Leak RepairsChiari Decompression
