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The Role of Arachnoid Granulations and the Glymphatic System in the Pathophysiology of Idiopathic Intracranial Hypertension

  • Neuro-Ophthalmology (R. Mallery, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Idiopathic intracranial hypertension (IIH) is a disorder characterized by long-standing elevated intracranial pressure (ICP). As the name applies, no uniform cause has been identified. IIH is typically characterized by headaches, pulsatile tinnitus, and visual deterioration.

Recent Findings

Anomalies in cerebrospinal fluid (CSF) absorption are implicated in the pathophysiology of IIH. Non-invasive imaging of the brain parenchyma and the cerebral venous sinus has improved, and research has gained a better understanding of the role of cerebral venous sinus stenosis. Both have led to a better delineation of the role of arachnoid granulations (AG) and the glymphatic system in the development of IIH.

Summary

IIH may occur as a result of restrictions of CSF absorption from the venous system, and or the congestion and overflow of the glymphatic system. Elucidating these mechanisms will lead to greater understanding of its underlying pathophysiologic mechanisms.

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Fig. 1

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Abbreviations

IIH:

Idiopathic intracranial hypertension

ICP:

Intracranial pressure

CSF:

Cerebrospinal fluid

AG:

Arachnoid granulations

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Authors and Affiliations

  1. Interventional Neuroradiology, Department of Neurological Surgery, Weill Cornell Medicine, New York, NY, USA

    Victoria Mondejar & Athos Patsalides

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  1. Victoria Mondejar
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  2. Athos Patsalides
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Correspondence to Victoria Mondejar.

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Mondejar, V., Patsalides, A. The Role of Arachnoid Granulations and the Glymphatic System in the Pathophysiology of Idiopathic Intracranial Hypertension. Curr Neurol Neurosci Rep 20, 20 (2020). https://doi.org/10.1007/s11910-020-01044-4

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