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Blood-Brain Barrier Dysfunction in Idiopathic Intracranial Hypertension
Md Mahdi Hasan-Olive1,2, Hans-Arne Hansson3, Rune Enger4,5
1Department of Neurosurgery, Oslo University Hospital - Rikshospitalet.
Journal of Neuropathology and Experimental Neurology
|August 9, 2019
Summary
Idiopathic intracranial hypertension (IIH) is not benign. This study found blood-brain barrier leakage in IIH patients, indicating a more serious neurodegenerative condition than previously understood.
Area of Science:
- Neuroscience
- Pathology
- Ophthalmology
Background:
- Idiopathic intracranial hypertension (IIH) is typically viewed as a benign condition.
- IIH symptoms include headache and vision impairment due to increased intracranial pressure.
- Previous research noted astrogliosis, increased aquaporin-4 (AQP4), and degenerating pericytes in IIH brains.
Purpose of the Study:
- To investigate blood-brain barrier (BBB) dysfunction in idiopathic intracranial hypertension (IIH).
- To assess blood protein leakage and its correlation with astrogliosis and AQP4 expression in IIH patients.
Main Methods:
- Light microscopic immunohistochemistry to detect extravasated fibrinogen/fibrin.
- Immunogold transmission electron microscopy to evaluate perivascular AQP4 expression.
- Comparison between 14 IIH patients and 14 reference subjects.
Main Results:
- Significantly more pronounced BBB dysfunction (fibrinogen/fibrin leakage) in IIH patients compared to controls.
- Extravasated fibrinogen positively correlated with astrogliosis and vascular AQP4 immunoreactivity.
- No significant changes in AQP4 expression at astrocytic vascular endfeet between IIH and control groups.
Conclusions:
- Idiopathic intracranial hypertension (IIH) demonstrates evidence of blood-brain barrier leakage.
- These findings suggest IIH is a more serious neurodegenerative disease than previously considered.
- BBB dysfunction may be a key pathological mechanism in IIH progression.
Keywords:
AQP4Benign intracranial hypertensionFibrinogen/fibrin extravasationImmunogold electron microscopyNeurodegenerationNeurovascular unitPseudotumor cerebriMore Related Videos
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