A Modeling Study Of Idiopathic Intracranial
Hypertension
Author(s)
S. A. Stevens, W. D. Lakin, N. J. Thakore, P. L. Penar
& B. I. Tranmer2
Abstract
Idiopathic intracranial hypertension (IIH) is a syndrome of unknown cause characterized
by elevated intracranial pressure (ICP). A stenosis of the transverse sinus
is observed in many patients suffering from IIH. The role that this feature plays
in the etiology of IIH remains unresolved. It may be the primary cause of IIH,
an exacerbating factor, or merely a secondary event. A lumped-parameter model
of intracranial pressure dynamics has been modified to accommodate transverse
sinus stenosis via a Starling-like resistor. In the absence of this type of resistor
the system has a unique asymptotically-stable steady-state with normal pressures.
With this type of resistor present, a second, asymptotically-stable steady-state may
exist. This state is characterized by elevated ICP concurrent with a compressed
transverse sinus. It is hypothesized that IIH is a physiological manifestation of this
elevated steady state.We conclude that the primary cause of IIH is a compressible,
as opposed to rigid, transverse sinus, and that the observed stenosis is a necessary
characteristic of the elevated steady state. Simulations suggest possible diagnostic
techniques and comparisons are made to clinical data.
1 Introduction
Idiopathic intracranial hypertension (IIH), also called pseudotumor cerebri and
benign intracranial hypertension, is a syndrome of unknown cause characterized
by elevated intracranial pressure (ICP) without evidence of ventricular dilatation,
mass lesion, cerebrospinal fluid (CSF) abnormality, or dural sinus thrombosis. It
Keywords
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