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Cranial Venous Outflow Obstruction and Pseudotumor Cerebri Syndrome

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Advances and Technical Standards in Neurosurgery

Part of the book series: Advances and Technical Standards in Neurosurgery ((NEUROSURGERY,volume 30))

Abstract

The pathophysiology of PTS including idiopathic intracranial hypertension or ‘BIH’, remains controversial. The older literature frequently referred to pathology in the cerebral venous drainage but more modern imaging techniques (CT and early MR) failed to reveal gross venous pathology. The role of impaired cranial venous outflow has recently been re-examined in the light of new methods of investigation (advanced MR venography and direct microcatheter venography with manometry) and of treatment (venous sinus stenting).

Venous sinus obstruction in PTS is a more common factor in the pathogenesis of the condition than previously recognised. Venous obstruction may be primary, that is, it is the underlying aetiological factor in PTS. Venous sinus obstruction may also be secondary to raised CSF pressure which may exacerbate problems with intracranial compliance and raised CSF pressure. Early experience with venous stenting suggests that it may be a helpful treatment for patients with PTS but more experience and longer follow-up is required to define the subgroups of patients for whom it is most appropriate.

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Authors and Affiliations

  1. T. Y. Nelson Departments of Neurosurgery and Neurology, Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia

    B. K. Owler, G. M. Halmagyi, I. H. Johnston & M. Besser

  2. Department of Surgery, University of Sydney, Sydney, Australia

    B. K. Owler & M. Besser

  3. Department of Radiology, Royal Prince Alfred Hospital, Sydney, Australia

    G. Parker

  4. Department of Neurosurgery, Academic Neurosurgical Unit, University of Cambridge, Addenbrookes Hospital, Cambridge, UK

    J. D. Pickard

  5. Department of Neuroradiology, Addenbrookes Hospital, Cambridge, UK

    J. N. Higgins

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Owler, B.K. et al. (2005). Cranial Venous Outflow Obstruction and Pseudotumor Cerebri Syndrome. In: Pickard, J.D., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 30. Springer, Vienna. https://doi.org/10.1007/3-211-27208-9_4

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