Table 2 - uploaded by Sumayya Almarzouqi
Content may be subject to copyright.
Causes of increased intracranial pressure 

Causes of increased intracranial pressure 

Source publication
Article
Full-text available
Papilledema is optic disc swelling due to high intracranial pressure. Possible conditions causing high intracranial pressure and papilledema include intracerebral mass lesions, cerebral hemorrhage, head trauma, meningitis, hydrocephalus, spinal cord lesions, impairment of cerebral sinus drainage, anomalies of the cranium, and idiopathic intracrania...

Context in source publication

Context 1
... potential mechanism of high ICP in IIH is high intra- abdominal pressure, which may increase pleural pressure and cardiac filling pressure, leading to increased intracranial venous pressure and high ICP. 8 Table 2 lists a number of causes for high ICP. ...

Similar publications

Article
Full-text available
A 10‑year‑old boy was admitted with chest wall infection around the implanted ventriculoperitoneal shunt (VPS) catheter of 5 days. He had received a right‑sided, medium pressure, whole‑length VPS for hydrocephalus, following tubercular meningitis at the age of 3 years. Seven years, 9 months following VPS implantation, he was admitted with shunt tra...
Article
Full-text available
We report a case of a ventriculoperitoneal shunt incidentally found within the stomach while the patient was undergoing a percutaneous endoscopic gastrostomy (PEG) tube placement. Among the complications of ventriculoperitoneal shunt placement, bowel perforation is rare a complication found in 0.01%-0.07% of cases, and typically occurs in premature...
Article
Full-text available
In the management of hydrocephalus, the ventriculo-gallbladder shunt is justified in situations where the ventriculo-peritoneal shunt is not useful due to peritoneal involvement and/or when the ventriculo-auricular and ventriculo-pleural shunts are contraindicated.

Citations

... Papilledema is defined as swelling of the optic disc due to elevation in intracranial pressure (ICP) [1]. Papilledema, in essence, is always associated with high ICP, however high ICP can exist in the absence of papilledema [2]. The etiology of high ICP can include known causes such as space-occupying lesions like tumor, abscesses, or hemorrhage; increase in CSF pressure as in meningitis or hydrocephalus; increase in the venous pressure as in cerebral venous thrombosis or it can be idiopathic. ...
Article
Papilledema is the swelling of the optic disc due to the transmission of intracranial pressure through the optic nerve. It can occur as a symptom of various intracranial pathologies that elevate the intracranial pressure. Even though anemia has been described as an association with raised intracranial pressure, the exact causal relationship between the two has not been well established in the literature. We present one such unusual case wherein a 21-year-old female patient, who complained of headaches, was found to have papilledema and severe anemia. After an unyielding workup for secondary causes, the rare association between papilledema and anemia was considered and prompt hemoglobin correction was ensued. Subsequently, resolution of papilledema and improvement in the visual acuity of the patient was observed. Although the causal relationship between anemia and papilledema has not been thoroughly explained, appropriate workup and correction of anemia play an integral role in the management of patients with papilledema and the prevention of long-term ocular complications.
... Papilledema refers to optic disc swelling caused by increased intracranial pressure (ICP) and is a vision threatening condition. Increased ICP and papilledema is related to several neurological disorders, e.g., brain hemorrhages, brain ischemia, traumatic brain injury, brain tumors, hydrocephalus and idiopathic intracranial hypertension (IIH) [1]. The complexity of these conditions complicates optimal treatment and prognosis. ...
Article
Full-text available
Background: The kaolin induced obstructive hydrocephalus (OHC) model is well known for its ability to increase intracranial pressure (ICP) in experimental animals. Papilledema (PE) which is a predominant hallmark of elevated ICP in the clinic has not yet been studied in this model using high-resolution digital fundus microscopy. Further, the long-term effect on ICP and optic nerve head changes have not been fully demonstrated. In this study we aimed to monitor epidural ICP after induction of OHC and to examine changes in the optic disc. In addition, we validated epidural ICP to intraventricular ICP in this disease model. Method: Thirteen male Sprague-Dawley rats received an injection into the cisterna magna containing either kaolin-Ringer's lactate suspension (n = 8) or an equal amount of Ringer's lactate solution (n = 5). Epidural ICP was recorded post-operatively, and then continuously overnight and followed up after 1 week. The final epidural ICP value after 1 week was confirmed with simultaneous ventricular ICP measurement. Optic disc photos (ODP) were obtained preoperatively at baseline and after one week and were assessed for papilledema. Results: All animals injected with kaolin developed OHC and had significant higher epidural ICP (15.49 ± 2.47 mmHg) compared to control animals (5.81 ± 1.33 mmHg) on day 1 (p < 0.0001). After 1 week, the epidural ICP values were subsided to normal range in hydrocephalus animals and there was no significant difference in epidural ICP between the groups. Epidural ICP after 1 week correlated with the ventricular ICP with a Pearson's r = 0.89 (p < 0.0001). ODPs from both groups showed no signs of acute papilledema, but 5 out of 8 (62.5%) of the hydrocephalus animals were identified with peripapillary changes. Conclusions: We demonstrated that the raised ICP at day 1 in the hydrocephalus animals was completely normalized within 1 week and that epidural ICP measurements are valid method in this model. No acute papilledema was identified in the hydrocephalus animals, but the peripapillary changes indicate a potential gliosis formation or an early state of a growing papilledema in the context of lateral ventricle dilation and increased ICP.
... obesity. The estimated incidence within different demographics in USA is listed in Table 1 [1,10]. ...
... The information used in this table was obtained from the following sources: [1,10] Table 2 is a summary of the incidence of IIH among various countries. We provide the incidence of IIH among both the general population as well as in women. ...
... Since papilledema presents in the setting of elevated ICP, regardless of the underlying etiology, typical complaints include headache, nausea, vomiting, and an array of visual symptoms [1,4,26,27]. When a secondary source of elevated ICP is the cause, patients typically have identifiable image findings and/or focal neurological deficit(s) that localize to the offending anatomical region of interest [6]. ...
Article
Papilledema is a swelling of the optic disc secondary to elevated intracranial pressure (ICP). We analyzed 79 peer-review journal articles and provided a concise summary of the etiology, epidemiology, pathophysiology, clinical presentation, evaluation, natural history, differential diagnosis, treatment, and prognosis of papilledema. Only studies written in English with the full text available were included. Although many etiologies of papilledema exist, idiopathic intracranial hypertension is the most common and, thus, a large focus of this review.
... Papilledema is defined as an optic disc swelling secondary to raised intracranial pressure which usually presents bilaterally and may develop within hours to weeks. Papilledema from various causes of IH may develop at any age, in either sex, and in any racial or ethnic group [7]. Several larger neurosurgical series found papilledema in up to 60-80% of patients with cerebral tumors [8]. ...
... Classical symptoms include headache, usually worse when awakening, vomiting and blurring of vision. Possible conditions causing high intracranial pressure and papilledema include intracerebral mass lesions, cerebral hemorrhage, head trauma, meningitis, hydrocephalus, spinal cord lesions, impairment of cerebral sinus drainage, anomalies of the cranium, and idiopathic intracranial hypertension (IIH) [7]. Fundus examination shows hyperemia and swelling of the optic disc, blurring of the disc margin, blurring of the peripapillary retinal fiber layer and absence of spontaneous venous pulsations [9]. ...
Article
Full-text available
Background and Objectives: Ventriculoperitoneal Shunt (VPS) and Endoscopic Third Ventriculostomy (ETV) are both gold standard procedures to reduce intracranial pressure (ICP) in patients with obstructive hydrocephalus, which often results in papilledema. This comparative study was carried out at the Department of Neurosurgery of Dhaka Medical College and Hospital to compare the efficacy of VPS and ETV in the resolution of papilledema in 18 patients with obstructive hydrocephalus. Materials and Methods: The success of CSF diversion was evaluated by a decrease in retinal nerve fiber layer (RNFL) thickness by optical coherence tomography (OCT) and modified Frisen grading of papilledema at the same time. The statistical analyses were carried out by using paired sample t test and the Spearman’s correlation coefficient test. The level of significance (p value) was set at <0.05. Results: After 7 days, both VPS and ETV were able to reduce RNFL thickness of both eyes with a p value = 0.016 (right eye) and 0.003 (left eye) in group A (VPS) and with a p value <0.001 (both eyes) in group B (ETV). Change of Frisen grading after CSF diversion was not satisfying for both the procedures with p value > 0.05. Further, the inter-group comparison between VPS and ETV showed no difference in decreasing RNFL thickness and modified Frisen grading (p value = 0.56). Conclusion: VPS and ETV procedures both appear very efficient in treating obstructive hydrocephalus, which in turn reduces papilledema in these patients. This paper is preliminary and requires further work.
... 4 This observation supports the hypothesis that chronic headward venous congestion may also contribute to the optic disc edema that was first identified in crew members returning from long-duration spaceflight 5,6 and was subsequently found to progress with mission duration. 7 Because escalating levels of optic disc edema may produce permanent visual loss due to intraneuronal ischemia, 8 methods to reproduce diurnal variation of venous blood volume and flow distributions during spaceflight are being actively evaluated. ...
Article
Background: Optic disc edema develops in most astronauts during long-duration spaceflight. It is hypothesized to result from weightlessness-induced venous congestion of the head and neck and is an unresolved health risk of space travel. Purpose: Determine if short-term application of lower body negative pressure (LBNP) could reduce internal jugular vein (IJV) expansion associated with the supine posture without negatively impacting cerebral perfusion or causing IJV flow stasis. Study type: Prospective. Subjects: Nine healthy volunteers (six women). Field strength/sequence: 3T/cine two-dimensional phase-contrast gradient echo; pseudo-continuous arterial spin labeling single-shot gradient echo echo-planar. Assessment: The study was performed with two sequential conditions in randomized order: supine posture and supine posture with 25 mmHg LBNP (LBNP25 ). LBNP was achieved by enclosing the lower extremities in a semi-airtight acrylic chamber connected to a vacuum. Heart rate, bulk cerebrovasculature flow, IJV cross-sectional area, fractional IJV outflow relative to arterial inflow, and cerebral perfusion were assessed in each condition. Statistical tests: Paired t-tests were used to compare measurement means across conditions. Significance was defined as P < 0.05. Results: LBNP25 significantly increased heart rate from 64 ± 9 to 71 ± 8 beats per minute and significantly decreased IJV cross-sectional area, IJV outflow fraction, cerebral arterial flow rate, and cerebral arterial stroke volume from 1.28 ± 0.64 to 0.56 ± 0.31 cm2 , 0.75 ± 0.20 to 0.66 ± 0.28, 780 ± 154 to 708 ± 137 mL/min and 12.2 ± 2.8 to 9.7 ± 1.7 mL/cycle, respectively. During LBNP25 , there was no significant change in gray or white matter cerebral perfusion (P = 0.26 and P = 0.24 respectively) and IJV absolute mean peak flow velocity remained ≥4 cm/sec in all subjects. Data conclusion: Short-term application of LBNP25 reduced IJV expansion without decreasing cerebral perfusion or inducing IJV flow stasis. Level of evidence: 1 TECHNICAL EFFICACY STAGE: 1.
... The mechanism of papilledema is due to axoplasmic flow stasis. High intracranial pressure produces raise in cerebrospinal fluid pressure surrounding the optic nerve, which disturbs the normal gradient between intraocular pressure retro lamellar pressure leading to high pressure within the nerves and this leads to papilledema [54]. ...
Chapter
Full-text available
Brain tumor is an abnormal growth of mass of cells in (or) around the brain. Brain tumors can be malignant (cancerous) or being non-cancerous. It is the most common malignant primary intracranial tumors of central nervous system. Brain tumor can affect brain function if they grow large enough to press on surrounding nerves, blood vessels and tissues. Only one third of tumors formed in the brain are formed as cancerous cells. Brain tumors release molecular information to the circulation. Liquid biopsies collect and analyse tumor component in the body fluid and there is an increasing interest in investigation of liquid biopsies as substitute from tumor markers. Tumor-derived biomarkers include nucleic acids, proteins and tumor-derived extracellular vesicles that accumulate in blood (or) cerebrospinal fluid. Circulating biomarkers like O-6-methylguanine DNA methyl transferase, epidermal growth factor, isocitrate dehydrogenase, circulating tumor cells, circulating cell free micro RNAs, circulating extracellular vesicles plays and important role in causing a cancer. Brain tumor can be treated by surgery, radiation therapy (or) targeted therapy. Radiation therapy is often given afterwards. As a consequence, the most recent review reviewed the present state of research with the hopes of discovering a new brain tumor inhibitor that may be used to treat advanced malignancies.
... The visual findings are thought to be secondary to transient ischemia of the optic nerve head from progressive disc edema (Markey et al., 2016). These patients typically have papilledema, usually bilateral and symmetric, although asymmetric or unilateral papilledema has been reported in up to 10% of patients (Rigi et al., 2015). Patients can also experience binocular horizontal diplopia due to a unilateral or bilateral abducens nerve palsy e a false localizing sign for elevated ICPs e all which can resolve with reducing ICP (Mollan et al., 2018). ...
Chapter
The optic nerve and retinal abnormalities seen in Spaceflight Associated Neuro-Ocular Syndrome (SANS) are likely to involve imbalances of intraocular pressure (IOP) and intracranial pressure (ICP). In this chapter, we briefly summarize the changes in IOP and ICP, which occur during spaceflight. Next, we describe IOP–ICP relationships at the optic nerve head in health and disease, highlighting the importance of the translaminar pressure difference (TLPD), which is defined as the difference between IOP and ICP (IOP − ICP). Finally, we review the theoretical and experimental basis for SANS countermeasures that are based on the manipulation of IOP or ICP to correct an abnormal TLPD. In this last section, we discuss recent literature in both animals and humans to address the validity of this approach, as well as potential pitfalls.
... High ICP can occur in the absence of papilledema and appearing time of the papilledema is different depending on the reason. Papilledema that develops in patients after head trauma may develop immediately, occur several days after the injury, or up to 2 weeks later [8]. In patients with increased ICP, the diameter of the optic nerve sheath increases before the development of the papillary edema [9]. ...
Article
Full-text available
Background The increased intracranial pressure (ICP) syndrome may emerge depending on many different neurological factors and the early diagnosis and treatment are important for the prevention of neurologic damage and related mortality. In recent years, the follow-up of increased ICP with non-invasive methods has been rising. In this study, our objective was to determine the significance and any possible correlation between Optic Nerve Sheath Diameter (ONSD) and Near Infrared Spectroscopy (NIRS) in children with increased ICP. Methods Patients who were hospitalized in our pediatric ICU at Çukurova University Medical Faculty between June 2018 and June 2019 due to the suspicion of increased ICP were included in this study. The demographic characteristics of patients, diagnosis at admission, results of the cranial CT and MRI examinations, and results of the simultaneous ONSD and NIRS measurements were recorded. Results A total of 36 patients were included in our study. With respect to the diagnosis, non-traumatic causes were at the forefront in 30 patients (83.3%), and the most common causes were meningoencephalitis ( n = 9; 25%) and non-traumatic bleeding ( n = 7; 19.4%). Six of the patients were under the age of one year (16.7%), and the mean values of ONSD and NIRS were 4.8 ± 0.7 mm and 71.1 ± 12.4% respectively in this group. Fourteen patients were in the one to ten year age group and the mean values of ONSD and NIRS were 6.1 ± 0.6 mm and 72.7 ± 9.3% respectively. Sixteen patients were over ten years of age (44.4%), and the mean values of ONSD and NIRS were 5.6 ± 0.7 mm and 74.2 ± 16% respectively. There was no correlation between the ONSD and NIRS values (r:0.307; p = 0.068). Conclusion Our study showed that ONSD measurements were helpful in children with increased ICP and reflected the increase in ICP. However, our study also demonstrated that ONSD was not in correlation with the NIRS monitoring. We believe that there is a need for further studies focused on the use of ONSD and NIRS in the monitoring of increased ICP.
... Papilledema refers to optic disc swelling caused only by elevated intracranial pressure (ICP) [1]. Acute elevated ICP with bilateral, symmetric papilledema is often linked to, e.g., intracranial space-occupying lesions, meningitis/encephalitis, cerebral venous sinus thrombosis, or idiopathic intracranial hypertension (IIH) [2]. Meningoencephalitis causes diffuse cerebral edema with increased production of cerebrospinal fluid (CSF) and/or decreased CSF absorption by the arachnoid granulations. ...
Article
Objective: We report that lumbar puncture (LP) with removal of cerebrospinal fluid (CSF) induced rebound intracranial hypertension with increased papilledema as monitored by optical coherence tomography (OCT). Background: Severe papilledema causes visual field loss and central vision damage if untreated. Fundoscopy is a key to diagnose papilledema, but is not sensitive enough to monitor therapeutic effects. Methods: OCT was applied to follow a 24-year-old woman with headache, visual dysfunction, severe bilateral papilledema, and elevated CSF opening pressure. She was first treated with serial LP, which led to symptom deterioration, increased CSF pressure, and increased the retinal nerve fiber layer (RNFL) thickness. She was then successfully treated with acetazolamide and furosemide. Results: OCT showed reduction of RNFL thickness directly after LP with CSF removal, accompanied with reduced CSF pressure. Increased RNFL thickness accompanied with worsened headache, visual dysfunction, and increased CSF pressure was observed on the next day after LP. Less than 24 h after start of medication, the symptoms had reversed and RNFL thickness was reduced. The patient was symptom-free 2 weeks after starting on medical treatment. Papilledema had vanished on fundoscopy 6 weeks after the therapy, and RNFL thickness was normalized at 3 months of follow-up. Conclusion: This case provides evidence that OCT is an objective and sensitive tool to monitor papilledema and its response to therapy, and thereby important to help in correct clinical decision-making.
... Based on the modified Dandy criteria, papilledema is one criterion of diagnosing idiopathic intracranial hypertension [42]. Because papilledema is optic disc edema resulted from elevated ICP transmitted through optic nerve sheath [43], increase of ONSD should takes precedence prior to the development of papilledema. Because of under powering of the number of included studies, these speculation warrants further research (Fig. 5). ...
Article
Full-text available
Objectives Timely diagnosis and treatment of increased intracranial pressure can decrease morbidity and prevent mortality. The present meta-analysis aims to determine the mean value of the ONSD measured in patients with various elevated ICP etiologies under different clinical settings, as well as comparing the value of ONSD between patients with and without elevated ICP. Methods This meta-analysis complied with the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement8. PubMed, Embase, and Cochrane Library were searched to identify ONSD measured by US for patients with increased ICP from establishment to October 2020. Results A total of 779 patients with elevated ICP among 22 studies were included in the present meta-analysis. Studies were published between 2003 and 2020. Eighteen were comparative (18/22, 81.8%), and four were single-armed study (4/22, 18.2%). Twenty were prospective studies (20/22, 90.9%). There was moderate-to-high heterogeneity based on the prediction ellipse area and variance logit of sensitivity and specificity. Conclusions The mean value of the ONSD among patients diagnosed with increased ICP was 5.82 mm (95% CI 5.58–6.06 mm). Variations were observed based on etiology of intracranial hypertension, clinical settings where ONSD was measured, and standards for diagnosing intracranial hypertension. The US-ONSD among patient with elevated ICP was significantly higher than the normal control. Although a cut-off value is not clearly determined, these mean values can be implemented to evaluate the sensitivity and specificity of US-ONSD in diagnosing intracranial hypertension in future studies.