RT Journal Article
SR Electronic
T1 Idiopathic intracranial hypertension
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 515
OP 522
DO 10.1212/WNL.0000000000006166
VO 91
IS 11
A1 Lenck, Stéphanie
A1 Radovanovic, Ivan
A1 Nicholson, Patrick
A1 Hodaie, Mojgan
A1 Krings, Timo
A1 Mendes-Pereira, Vitor
YR 2018
UL http://n.neurology.org/content/91/11/515.abstract
AB The recent discoveries of the glymphatic and lymphatic systems of the brain have helped advance our understanding of CSF physiology and may allow new insights in the understanding of idiopathic intracranial hypertension (IIH). The clinical and radiologic presentations of IIH appear to be related to congestion of the glymphatic system associated with an overflow of the lymphatic CSF outflow pathway. By revisiting the role of “vascular arachnoid granulations” in the brain, we hypothesize that an initial impairment of the transport of interstitial fluid from the glymphatic system to the venous blood of the dural sinuses may trigger the hydrodynamic cascade of IIH. Furthermore, we speculate that, similar to other water-exchange systems in the brain, a specific subtype of aquaporin is involved in this transport. This theory may eventually help to provide an underlying explanation for IIH and its associated conditions, since in most of them, the expression of several aquaporins is altered.AG=arachnoid granulation; AQP=aquaporin; CVP=cerebral venous pressure; ICP=intracranial pressure; IIH=idiopathic intracranial hypertension; ISF=interstitial fluid; TS=transverse sinus