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Borderline Intracranial Hypertension Manifesting as CFS

Discussion in 'Other Health News and Research' started by MeSci, Nov 14, 2015.

  1. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    I've seen some threads on Intracranial Hypertension but couldn't find this one:
    Full text here.
     
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  2. Never Give Up

    Never Give Up Collecting improvements, until there's a cure.

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    So interesting.

    They looked at patients with "chronic fatigue" and headaches and found:

    "Most of the patients we have investigated in this way have had intracranial pressures that fail to make the cut-off for IIH, but a number have been borderline and in some the intracranial hypertension has been unequivocal.[10] Regardless of the absolute value of the CSF pressure, however, we have found that most respond clinically to CSF withdrawal,[11] [12] an observation suggesting that a disturbance of intracranial pressure is a critical component of their clinical condition."

    So far it seems like they have stented one patient.

    "it is notable that the relief of symptoms after stenting was profound, yet there was only a minimal reduction in CSF pressure at follow-up."

    "The unequivocally favorable outcome suggests that this is an area ripe for further study."

    Go for it!
     
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  3. L'engle

    L'engle moogle

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    September of this year, out of Addenbrooks in Cambridge. I thought they were distancing themselves from CFS? (from another thread)
     
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  4. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Interesting .
    I found when my sinusitis would get bad my bp would go up eg 160/110 as well as intense frontal headaches and once on abx for a few days this would return back to normal .

    Beginning of this year after shingles on side of my head my bp was 190 / 120 . I was then place on anti hypertensive meds . Recently read that one month after shingles there is an increased risk of strokes , which can correlate with high bp.

    I wonder if high bp and intercranial pressure is somehow related to infections and possible scare tissue to structures in the brain like blood vessels etc???????

    I think something also related is those who have hypertensive orthostatic intolerance ?
     
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  5. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Is intracranial hypertension reflected in hypertension in the body? There are numerous types of hypertension, and some appear to be limited to particular parts of the body (or head/brain in this case).
     
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  6. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Intercranial pressure is more specific to the brain i guess . Many things that can cause hypertension but with intercranial pressure, blood pressure can increase and can be a sign.

    I know in acute head injuries blood pressure increase is one sign of raised intercranial pressure.
     
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  7. Snow Leopard

    Snow Leopard Hibernating

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    What causes intercranial hypertension?
     
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  8. L'engle

    L'engle moogle

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    Does anyone know of any other ME patients who have felt dramatically better after a lumbar puncture? Many people have had them to rule out MS etc.
     
  9. Forbin

    Forbin Senior Member

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    I doubt you would notice much if any improvement from a typical spinal tap, even if inter-cranial pressure were an issue.

    The turnover of spinal fluid is actually pretty rapid. The average person has about 150 ml of CSF at any one time, but the body produced about 20-30 ml an hour. That's more than is usually taken in a spinal tap, so the shortfall would be replaced in less than an hour.

    If there were improvement from a spinal tap it seems likely that it would be pretty brief. Continuously regulating pressure via a stent would be another matter.

    I had a spinal tap about 2 months after onset and noticed no effect on my symptoms afterward.

    [When my doctor did the spinal tap, he told me that, in the past, doctors used to drain all the spinal fluid. He chuckled and called that "barbaric."]
     
    Last edited: Nov 16, 2015
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  10. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Anything affecting blood vessels or fluid increase in brain can increase ICP. Inflammation from infections like shingles is a possibility
     
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  11. L'engle

    L'engle moogle

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    @Forbin In the article the patient in question was said to have a remission lasting 4 days after the lumbar puncture. That's all I'm going on. thanks for your info!
     
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  12. Forbin

    Forbin Senior Member

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    Thanks @L'engle. I should have read the article more carefully.

    In several places, I've seen it said that the CSF should be replaced in about an hour. On the other hand, I've found others that recommend drinking additional fluids for 24 hours to help replace what was lost.

    I guess it's possible that this patient just took longer to return to her previous pressure - perhaps because it was slightly high (20 cm of H20 versus 18 cm [the high end of normal]). Or maybe the effects of the elevated pressure are somehow delayed.

    As I mentioned, I personally had no benefit from lumbar puncture, but, unlike this patient, I did not have bad headaches at the time (although I would develop them a few months later).
     
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  13. DeGenesis

    DeGenesis Senior Member

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    I wonder if some cases of low blood volume seen in PWME are an attempt by the body to prevent a further rise in intracranial pressure.
     
  14. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    I think the tachycardia some get is a compensation for low blood pressure.
    Cfsme seems to be a mixed bag with orthostatic issue being hyper or hypotensive ?
     
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  15. Rlman

    Rlman Senior Member

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    how did you find this article @MeSci ?
     
  16. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    I can't remember!
     
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  17. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    I've remembered. It was a Yahoo email group. Most things posted there are also here, but that seems to have been a rare one that wasn't.
     
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  18. Dolphin

    Dolphin Senior Member

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  19. heapsreal

    heapsreal iherb 10% discount code OPA989,

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  20. pattismith

    pattismith Senior Member

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    two interesting papers about intracranial hypertension:

    -association with thyroid dysfunction:

    Idiopathic intracranial hypertension (IIH) is a central nervous system disorder characterized by raised intracranial pressure with normal cerebrospinal fluid composition and absence of any structural anomaly on neuroimaging. Among all endocrine disorders associated with the development of IIH, the association of hyperthyroidism and IIH is very rare with few cases reported till date. Thyroid disturbances have a unique association with IIH. Hypo- and hyper-thyroidism have been reported in association with this disorder. We present a rare case of a 25-year-old man with Graves' disease with intractable headache that was later investigated and attributed to development of IIH.

    -association with mandibular compression on jugular vein:

    Idiopathic intracranial hypertension eliminated by counterclockwise maxillomandibular advancement: a case report

    2016 Abstract
    Introduction: Obstructive sleep apnea (OSA) is a secondary cause of intracranial hypertension (IH). Decreased jugular venous drainage has been seen in patients with idiopathic IH.

    Clinical Presentation: A complex case of a 48-year-old female whose idiopathic IH was put into remission after counterclockwise maxillomandibular advancement (CC-MMA), despite persistence of her OSA.

    Conclusion: This case highlights the relationship between OSA and IH and points to the significant morbidity that can result from mild OSA and from what are considered borderline intracranial pressures. This indicates the need for a high index of suspicion for actual underlying pathology that can be surgically corrected when patients manifest symptoms of a somatic syndrome. This is the first report in the medical literature of clinical elimination of IH by CC-MMA. The authors propose that this positive outcome was effected via mandibular advancement producing a decrease in jugular venous resistance, allowing improved absorption of cerebrospinal fluid.
     

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