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Table of Contents
Intro
Preface
Acknowledgments
Contents
Chapter 1: Introduction
Chapter 2: Basic Brain Anatomy and Physiology
The Brain and its Fluid
The Flow of Brain Fluid
The Reabsorption of Brain Fluid Is into Veins
Brain Veins
Blood Pressure: Arteries Vs. Veins
Cerebrospinal Fluid Reabsorption Is Dependent on Venous Sinus Pressures
What Are Normal Venous Sinus Pressures?
Venous Sinus Pressures Are Not Uniform throughout the Brain
IIH Is Due to High Venous Sinus Pressures
Hydrocephalus Is Not the Same as IIH
Intracranial Pressure and CSF Pressure
Normal Intracranial Pressures (ICP)
References
Chapter 3: Idiopathic Intracranial Hypertension (IIH)
Diagnosis
Presentation
Common Symptoms
Headache
Visual Symptoms
Papilledema and Visual Loss
Light Sensitivity
Pulsatile Tinnitus
"Brain Fog"
Cerebrospinal Fluid Leak (Rhinorrhea or Otorrhea)
Other Symptoms
Symptoms Are Worsened by Weather Changes
Symptoms Are Often Related to Intracranial Pressure
Distinguishing ICP That Is Too High (Hyper) vs. Too Low (Hypo)
Ehlers-Danlos Syndrome
Chapter 4: The Fundamental Reasons Patients Get IIH
IIH Is Actually Not Idiopathic
Venous Pressures in the Body and the Brain
Normal Venous Pressures in the Body and Brain
Venous Pressures in the Body and Brain When CVP Is High
Venous Narrowing ("Stenosis")
Why Does Venous Sinus Stenosis Occur?
What Triggers the Positive Feedback Loop to Start?
Vein Narrowing May Occur at More Than One Site
The Pressure Gradient
Venous Congestion and Collaterals
Venous Sinus Thrombosis
Confusion Between Thrombosis and Aplasia
Other Causes of High Venous Pressures
Not All IIH Patients Are the Same
IIH Links to Medications or Surgeries
General Treatment Strategies
IIH Is a Chronic Condition
References
Chapter 5: Understanding Your Brain Imaging
Imaging in IIH
CT Scan
MRI Scan
MRV and CTV
Brain Imaging Findings You May See in Your Report
Empty Sella
Optic Hydrops or Distention of Optic Nerve Sheath
Venous Sinus Stenosis
Venous Sinus Thrombosis
Chiari Malformation
Collapsed Ventricle
Pneumocephalus
Cerebral Edema
Bone Dehiscence
Metal Artifact
Chapter 6: Measuring Intracranial Pressure
Obtaining Intracranial Pressure Measurements
Lumbar Puncture (Spinal Tap)
The Basic Principles
Who Performs this Procedure?
Procedural Location
What to Expect: Pre-procedure
What to Expect: During the Procedure
What to Expect: Post-procedure
Complications
Lumbar Drain Placement
The Basic Principles
Who Performs this Procedure?
Procedural Location
What to Expect: Before the Procedure
What to Expect: During the Procedure
What to Expect: After the Procedure
Complications
Intracranial Pressure Monitor (Bolt) Placement
The Basic Principles
Who Performs this Procedure?
Procedural Location
Preface
Acknowledgments
Contents
Chapter 1: Introduction
Chapter 2: Basic Brain Anatomy and Physiology
The Brain and its Fluid
The Flow of Brain Fluid
The Reabsorption of Brain Fluid Is into Veins
Brain Veins
Blood Pressure: Arteries Vs. Veins
Cerebrospinal Fluid Reabsorption Is Dependent on Venous Sinus Pressures
What Are Normal Venous Sinus Pressures?
Venous Sinus Pressures Are Not Uniform throughout the Brain
IIH Is Due to High Venous Sinus Pressures
Hydrocephalus Is Not the Same as IIH
Intracranial Pressure and CSF Pressure
Normal Intracranial Pressures (ICP)
References
Chapter 3: Idiopathic Intracranial Hypertension (IIH)
Diagnosis
Presentation
Common Symptoms
Headache
Visual Symptoms
Papilledema and Visual Loss
Light Sensitivity
Pulsatile Tinnitus
"Brain Fog"
Cerebrospinal Fluid Leak (Rhinorrhea or Otorrhea)
Other Symptoms
Symptoms Are Worsened by Weather Changes
Symptoms Are Often Related to Intracranial Pressure
Distinguishing ICP That Is Too High (Hyper) vs. Too Low (Hypo)
Ehlers-Danlos Syndrome
Chapter 4: The Fundamental Reasons Patients Get IIH
IIH Is Actually Not Idiopathic
Venous Pressures in the Body and the Brain
Normal Venous Pressures in the Body and Brain
Venous Pressures in the Body and Brain When CVP Is High
Venous Narrowing ("Stenosis")
Why Does Venous Sinus Stenosis Occur?
What Triggers the Positive Feedback Loop to Start?
Vein Narrowing May Occur at More Than One Site
The Pressure Gradient
Venous Congestion and Collaterals
Venous Sinus Thrombosis
Confusion Between Thrombosis and Aplasia
Other Causes of High Venous Pressures
Not All IIH Patients Are the Same
IIH Links to Medications or Surgeries
General Treatment Strategies
IIH Is a Chronic Condition
References
Chapter 5: Understanding Your Brain Imaging
Imaging in IIH
CT Scan
MRI Scan
MRV and CTV
Brain Imaging Findings You May See in Your Report
Empty Sella
Optic Hydrops or Distention of Optic Nerve Sheath
Venous Sinus Stenosis
Venous Sinus Thrombosis
Chiari Malformation
Collapsed Ventricle
Pneumocephalus
Cerebral Edema
Bone Dehiscence
Metal Artifact
Chapter 6: Measuring Intracranial Pressure
Obtaining Intracranial Pressure Measurements
Lumbar Puncture (Spinal Tap)
The Basic Principles
Who Performs this Procedure?
Procedural Location
What to Expect: Pre-procedure
What to Expect: During the Procedure
What to Expect: Post-procedure
Complications
Lumbar Drain Placement
The Basic Principles
Who Performs this Procedure?
Procedural Location
What to Expect: Before the Procedure
What to Expect: During the Procedure
What to Expect: After the Procedure
Complications
Intracranial Pressure Monitor (Bolt) Placement
The Basic Principles
Who Performs this Procedure?
Procedural Location