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Related Concept Videos

Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

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...
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...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...

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Diffuse Calvarial Hyperostosis and Spontaneous Intracranial Hypotension: A Case-Control Study.

J C Babcock1, D R Johnson2, J C Benson2

  • 1From the Department of Radiology, Mayo Clinic, Rochester, Minnesota Babcock.Jeffrey@mayo.edu.

AJNR. American Journal of Neuroradiology
|June 30, 2022
PubMed
Summary
This summary is machine-generated.

Layered calvarial hyperostosis is significantly more common in patients with spontaneous intracranial hypotension. This finding can aid in diagnosing this condition and identifying underlying cerebrospinal fluid leaks.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Diagnosing spontaneous intracranial hypotension (SIH) and associated cerebrospinal fluid (CSF) leaks presents diagnostic challenges.
  • Additional supportive imaging findings are needed to guide further evaluation.

Purpose of the Study:

  • To investigate the prevalence of calvarial hyperostosis in patients with SIH.
  • To compare calvarial hyperostosis prevalence in SIH patients versus a matched control group.

Main Methods:

  • Retrospective analysis of cross-sectional imaging (CT head or brain MRI) from 166 SIH patients and 321 controls.
  • Neuroradiologists qualitatively assessed for diffuse or layered calvarial hyperostosis and quantitatively measured calvarial thickness.

Main Results:

  • Layered hyperostosis was significantly more frequent in SIH patients (31.9%) compared to controls (5.0%).
  • Overall hyperostosis (layered and diffuse) was also more prevalent in SIH patients (38.6%) versus controls (13.2%).
  • Calvarial thickness was significantly different between groups in both axial and coronal planes.

Conclusions:

  • Layered calvarial hyperostosis is a more prevalent finding in spontaneous intracranial hypotension.
  • This imaging finding can serve as an additional noninvasive marker for SIH and underlying spinal CSF leaks.