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Idiopathic Intracranial Hypertension is Associated with a Higher Burden of Visible Cerebral Perivascular Spaces: The

O Jones1, J Cutsforth-Gregory2, J Chen2,3

  • 1From the Departments of Radiology (O.J., J.H., W.B.).

AJNR. American Journal of Neuroradiology
|November 26, 2021
PubMed

Insights

Patients with idiopathic intracranial hypertension show more dilated perivascular spaces, suggesting a link to glymphatic system dysfunction. This finding may serve as a biomarker for idiopathic intracranial hypertension.

Area of Science:

  • Neurology
  • Radiology
  • Neuroscience

Background:

  • Idiopathic intracranial hypertension (IIH) is a condition of increased intracranial pressure.
  • Research suggests a potential link between IIH and the cerebral glymphatic system.
  • Visible dilated perivascular spaces are hypothesized to represent functional glymphatic pathways.

Purpose of the Study:

  • To investigate the prevalence of visible dilated perivascular spaces in patients with IIH compared to healthy controls.
  • To explore whether these spaces could serve as a biomarker for IIH.
  • To provide further evidence for the glymphatic system's role in the pathogenesis of IIH.

Main Methods:

  • A case-control study involving 36 adult patients with IIH and 19 age-matched controls.
  • Standardized MR imaging protocol including high-resolution T2- and T1-weighted sequences.
  • Qualitative rating scale to assess the number of visible perivascular spaces in different brain regions (centrum semiovale, basal ganglia, midbrain).

Main Results:

  • Patients with IIH exhibited a significantly greater number of visible perivascular spaces overall compared to controls (P = .004).
  • This increased prevalence was significant in the centrum semiovale (P = .003) and basal ganglia (P = .009) but not in the midbrain (P = .47).

Conclusions:

  • Idiopathic intracranial hypertension is associated with an increased number of visible intracranial perivascular spaces.
  • This finding supports a potential relationship between IIH and glymphatic dysfunction.
  • Visible perivascular spaces may represent a novel imaging biomarker for IIH.
Abstract

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