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Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Increased Intracranial Pressure l: Introduction01:14

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Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Cranial and Spinal Meninges01:19

Cranial and Spinal Meninges

The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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Update on hemicrania continua.

Elisabetta Cittadini1, Peter J Goadsby

  • 1Functional Magnetic Resonance Imaging of the Brain Centre, Pain Group, Oxford University, Oxford, UK. cittadin@fmrib.ox.ac.uk

Current Pain and Headache Reports
|November 17, 2010
PubMed
Summary
This summary is machine-generated.

Hemicrania continua (HC) is a rare headache syndrome with unilateral pain, uniquely responding to indometacin. Research highlights its distinct subcortical brain involvement, supporting its classification as a separate entity.

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Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Hemicrania continua (HC) is a rare primary headache disorder.
  • First described in 1984, over 100 cases are documented globally.
  • Recent case series reveal complex clinical presentations of HC.

Purpose of the Study:

  • To characterize the unique clinical presentation and neurobiological underpinnings of Hemicrania continua.
  • To support the classification of HC as a distinct headache entity.

Main Methods:

  • Review of clinical case series.
  • Analysis of functional imaging studies investigating subcortical brain activity.

Main Results:

  • HC presents with unilateral pain and a complete response to indometacin.
  • Functional imaging reveals specific subcortical involvement: contralateral posterior hypothalamus, ipsilateral dorsal pons, and ipsilateral ventral midbrain.
  • These findings, combined with indometacin's efficacy, suggest HC is a unique neurological entity.

Conclusions:

  • Hemicrania continua is a distinct primary headache syndrome.
  • Its unique clinical features and neurobiological profile, particularly hypothalamic and brainstem involvement, differentiate it from other headaches.
  • Increased clinical awareness is crucial for accurate diagnosis and management of HC.