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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Pulsality Index Shows promise for
Assessing Intracranial Pressure |
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BY DON SCHRADER
Contributing Writer |
CHICAGO
(EGMN)— Measurement of pulsatility index with
transcranial Doppler may offer an effective, noninvasive means
to monitor intracranial pressure in patients with idiopathic
intracranial hypertension, Canadian neurologists reported on
April 15 at the annual meeting of American Academy of Neurology.
Pulsatility index values were significantly higher in patients
with idiopathic intracranial hypertension versus a control
group, said Drs. Gary Hunter and Christopher Voll of the
University of Saskatchewan. In a subgroup of patients treated by
lumbar puncture and withdrawal of cerebrospinal fluid (CSF), the
pulsatility index declined along with CSF pressure.
“This technique may provide an effective means of following
patients with known idiopathic intracranial hypertension,
offering less invasive means of documenting trends in
intracranial pressure over time and response to treatment,” the
investigators concluded.
However, they added that for new patients presenting with
headache, papilledema, and visual symptoms, lumbar puncture
offers therapeutic advantages and remains the standard of care.
Idiopathic intracranial hypertension poses a diagnostic
challenge that can lead to poor visual outcomes. Currently,
lumbar puncture and direct manometry offer the only effective
means of diagnosis and follow-up for the condition, leaving a
need for an accurate noninvasive means for monitoring patients.
Previous studies have shown that transcranial Doppler
measurements of pulsatility accurately predict elevated
intracranial pressure of various etiologies. Dr. Hunter and Dr.
Voll retrospectively identified 14 patients with idiopathic
intracranial hypertension and compared pulsatility index values
in those patients and in 14 matched controls without
intracranial hypertension.
The patients had a significantly higher average pulsatility
index of 0.82 compared with 0.75 in the control group (P=0.04).
In the four patients who had therapeutic withdrawal of CSF, the
pulsatility index decreased by an absolute value of 12% (0.72 to
0.60), which corresponded with a decline in CSF pressure of 19
cm H2O as measured by direct manometry.
The researchers concluded that the results suggest that
pulsatility index values determined by transcranial Doppler vary
according to intracranial pressure in patients with idiopathic
intracranial hypertension. They advised that the results warrant
additional study to evaluate the accuracy of the pulsatility
index and its potential clinical value in assessing patients
with idiopathic intracranial hypertension. |
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