Author Topic: IHS - Intracranial Hypotension Syndrome  (Read 1003 times)

Emmerson Elliot

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IHS - Intracranial Hypotension Syndrome
« on: February 14, 2017, 02:49:35 AM »
This neat concise article explains IHS (Intracranial Hypotension Syndrome) really well and has some good imaging pics too

Explains why IHS gives you POTS-like symptoms - photophobia, hyperacusis, dizziness, headache etc.


Pathophysiology and management of Spontaneous Intracranial Hypotension  A Review

Journal of  Pakistan Medical Association
January 2012

Nadir Ali Syed ( Department of Neurology, South City Hospital, Aga Khan University Hospital, Karachi, Pakistan. )
Farhan Arshad Mirza ( Medical Student, Aga Khan University Hospital, Karachi, Pakistan. )
Aqueel Hussain Pabaney ( Department of Neurology, Aga Khan University Hospital, Karachi, Pakistan. )
Rameez-ul-Hassan ( Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan. )


Abstract

Spontaneous Intracranial Hypotension is a syndrome involving reduced intracranial pressure secondary to a dural tear which occurs mostly due to connective tissue disorders such as Marfans Syndrome, and Ehler Danlos Syndrome. Patients with dural ectasias leading to CSF leakage into the subdural or epidural space classically present with orthostatic headaches and cranial nerve deficits mostly seen in cranial nerves V-VIII. Diagnosis of SIH is confirmed with the aid of neuroimaging modalities of which Cranial MR imaging is most widely used. SIH can be treated conservatively or with epidural blood patches which are now widely being used to repair dural tears, and their effectiveness is being recognized. Recently epidural injection of fibrin glue has also been used which has been found to be effective in certain patients.


Keywords: Intracranial hypotension, Marfans syndrome, Dural tears, Orthostatic headache, Cranial MR imaging.


Link to full, free article:

http://www.jpma.org.pk/full_article_text.php?article_id=3228


EE
« Last Edit: February 16, 2017, 03:30:02 AM by Emmerson Elliot »

Emmerson Elliot

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Re: IHS - Intracranial Hypotension Syndrome
« Reply #1 on: May 05, 2017, 09:46:52 AM »
UCLA Neurosurgery
Intracranial Hypotension overview /  causes and diagnosing


http://neurosurgery.ucla.edu/intracranial-hypotension


EE

Emmerson Elliot

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Re: IHS - Intracranial Hypotension Syndrome
« Reply #2 on: May 18, 2017, 11:01:44 PM »
 Research papers on meningeal enhancement on MRI can be found at this link   



https://scholar.google.com/scholar?hl=en&q=meningeal+enhancement&as_sdt=1%2C5&as_sdtp=&oq=meningeal+enhance


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Emmerson Elliot

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Re: IHS - Intracranial Hypotension Syndrome
« Reply #3 on: July 12, 2017, 06:58:47 AM »


For anyone interested in learning more about the anatomy of the brain and CSF flow I have found a few useful you tube clips

There are plenty more clips out there but I found this a good introductory sequence.

Just take is slowly and don't try to remember it all at once - this takes doctors years to learn -  so watch one a day or a few occasionally and you will start to pick it up  - very interesting of course.




1 Tad Wanveer clip on normal  CSF  flow in a diagram
short 6 mins - good animated diagrams - good intro

https://www.youtube.com/watch?v=sqLb-lzbbWA


2 More in depth and thorough

types of brain  scans, brain anatomy  and CSF

shows what axial coronial and sagital images mean  - pause it at this point to see it clearly.

https://www.youtube.com/watch?v=k5JpjHo6Gxo



3 Neuroanatomy brain dissection

see anatomy on real human brain - very, very helpful but also a bit squishy of course.

WARNING   - shows a REAL human brain - some kind person donated their brain so that we can learn from this - my mother did the same when she died.)
It is more about general brain anatomy than csf but very intereting and useful to persist to see the venticles as they are in real life.
 
https://www.youtube.com/watch?v=_aCCsRCw78g


4 Even more squishy but totes fascinating  - shows how SOFT the brain is in real life and therefore whey CSF is SO important  - hello brain fog???
But seriously be WARNED that this shows a REAL HUMAN BRAIN removed from a recently-deceased human.
(Some kind person donated their brain so that we can learn from this - my mother who was very ill due to EDS did the same when she died.)

Excellent clear view of the cerebellum at the 3/4 mark.
https://www.youtube.com/watch?v=8zsSxrlIR_c