Pseudotumor Cerebri Support Group

Pseudotumor cerebri (PTC) is a neurological disorder that is characterized by increased intracranial pressure, in the absence of a tumor or other diseases affecting the brain or its lining. Diagnosis requires brain scans and lumbar puncture. Characteristic symptoms are headache, transient visual obscurations or transient visual loss in one or both eyes usually lasting...

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antiquerose 08/21/2014

Since so many symptoms of migraines and IIH are, by some, seemingly indistinguishable, this article is especially interesting:

Intracranial pressure in unresponsive chronic migraine

Excerpt from the conclusion section -
".we suggest that intracranial hypertension without papilledema should be considered in all patients suffering from an almost daily migrainous pain with evidence of unresponsiveness to medical treatments and cerebral venous outflow abnormalities at MRV."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4097326/pdf/415_2014_Article_7355.pdf

Sophiasmom06 08/22/2014

thanks, this is a great find!
of course it wasn't US docs who figured this out.

PressureCooker 08/26/2014

One of the paper's authors is Roberto De Simone -- the guy who challenged Friedman's report on the updated diagnostic criteria for IIH specifying OPs must be greater than 25 cm. De Simone's point being that patients with lower OPs (20-ish) can't be discounted especially if they're IIWOP patients.

We talked about it a while ago; here's our thread: http://www.dailystrength.org/c/Psuedotumor-Cerebri/forum/18973993-peer-review-op

PressureCooker 08/26/2014

Also, it would seem that De Simone concludes that refractory migraine amongst IIWOP patients rather is a demonstration of venous sinus stenosis, or "outflow abnormalities". I think they're enough of us on this board to demonstrate otherwise -- those of us with elevated ICP, without pap, and without stenosis or DVMs.

There's great info here, tho, that supports his earlier argument for including the lower ICP ranges in the mix.

I just have a problem with the now-standardized diagnostic modality of "lower ICP + no stenosis = no IIH".

Sophiasmom06 08/26/2014

I agree. are they even looking at the jugular veins?

PressureCooker 08/27/2014

Re Jugular: It would seem NO! And, when I had my cerebral angiogram, I showed elevated venous pressure in jugular and arterial pressure in carotid. I asked, "why?". Was told since there was no pressure gradient & no large stenosis that the elevated pressures had no meaning. WTH?!?!?!

Has anyone else had angiography with elevated numbers yet no stenosis? And, did you get any explanation?

Taleema 09/04/2014

Great article!

deleted_user 09/05/2014

I feel really lucky to have a great doctor. Sometimes my scans shows venous stenosis and outflow abnormalities and sometimes they don't. My doctor says its irresponsible to rely on these scans alone since what's going on in our heads is constantly changing due to the level of pressure, the amount of stress that day, possible transient thrombosis too small for the scans to detect. And both my jugulars always show up severely narrowed but not always the arteries in my brain, sometimes they look perfect, and sometimes the look mildly to severely narrowed. Of course my dr thinks just about every other dr is a complete twit :)

deleted_user 09/05/2014

Reduced drainage due to narrowing in the jugulars in a significant cause of IIH, Triedmon.
Have a look at the second half of his paper https://drive.google.com/?usp=docs_home&authuser=0#my-drive
and that was only on one side, if your scans shoul consistant narrowing on both sides you could be looking at answer to your situation?

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