Headache Centre, Department of Neurological Sciences, University of Naples Federico II, via Pansini 5, 80131 Naples, Italy.
Neurol Sci. 2012 May;33 Suppl 1:S21-5. doi: 10.1007/s10072-012-1037-6.
The recently advanced hypothesis that idiopathic intracranial hypertension without papilledema (IIHWOP) is a powerful risk factor for the progression of pain in individuals prone to episodic primary headache implies that IIHWOP is much more prevalent than it is believed to be in the general population and that it can run almost asymptomatic in most of the affected individuals. In this review, we discuss the evidence available supporting that: (a) sinus venous stenosis-associated IIHWOP is much more prevalent than believed in the general population and can run without symptoms or signs of raised intracranial pressure in most of individuals affected, (b) sinus venous stenosis is a very sensitive and specific predictor of intermittent or continuous idiopathic intracranial hypertension with or without papilledema, even in asymptomatic individuals, (c) in primary headache prone individuals, a comorbidity with a hidden stenosis-associated IIHWOP represents a very common, although largely underestimated, modifiable risk factor for the progression and refractoriness of headache.
最近提出的假说认为，无脑压增高性颅内静脉高压（IIHWOP）是易发性原发性头痛患者疼痛进展的一个强有力的危险因素，这意味着 IIHWOP 的发病率远高于人们普遍认为的水平，并且在大多数受影响的个体中，它可能几乎无症状。在这篇综述中，我们讨论了支持以下观点的现有证据：（a）与静脉窦狭窄相关的 IIHWOP 的发病率远高于一般人群，并且在大多数受影响的个体中可能无症状或无颅内压升高的迹象，（b）静脉窦狭窄是间歇性或持续性无脑压增高伴或不伴视乳头水肿的非常敏感和特异的预测因子，甚至在无症状个体中也是如此，（c）在原发性头痛易发性个体中，与隐匿性狭窄相关的 IIHWOP 共存是头痛进展和难治性的一个非常常见但很大程度上被低估的可改变危险因素。
