Watane Gaurav Vishwasrao, Patel Bhumi, Brown Derek, Taheri M Reza
J Comput Assist Tomogr. 2018 Mar/Apr;42(2):282-285. doi: 10.1097/RCT.0000000000000668.
The aim of this article was to study the significance of arachnoid granulations (AGs) in patients with idiopathic intracranial hypertension (IIH).
In an institutional review board-approved retrospective chart review study, 79 patients with clinical diagnosis of idiopathic increased intracranial pressure were compared with 63 patients with a diagnosis of multiple sclerosis. Inclusion criteria also included available magnetic resonance imaging (MRI) of the brain, older than 18 years, and female sex. Patients with elevated intracranial pressure due to other causes were excluded. The electronic medical records were mined for presence of the following: body mass index, age, headache, vision changes, tinnitus, and vertigo. The MRI of the brain was reviewed for the presence of the following features: empty sella, prominent cerebrospinal fluid space in the optic sheaths, tortuosity of the optic nerves and enlarged Meckel cave. In addition, the number, size, and location of AGs associated with major venous drainage sinuses were documented in all patients. Using statistical analysis, association between various imaging and clinical signs were evaluated.
The association between AG and various imaging and clinical signs were evaluated. The percentage of patients with AG were significantly higher in patients with IIH. Patients with IIH tended to have 0 to 3 AG. The most common imaging findings observed in MRI of the brain of patients with IIH were empty sella and prominent cerebrospinal fluid space in the optic sheaths. The prevalence of these MRI findings in patients with IIH was inversely proportional to the number of AG. A similar inverse trend was also noted with the opening pressure of patients with IIH and number of AG.
The study establishes that there is a relationship between presence of AG and IIH. Arachnoid granulation seems to act in a compensatory mechanism in patients with IIH.
本文旨在研究蛛网膜颗粒（AGs）在特发性颅内高压（IIH）患者中的意义。
在一项经机构审查委员会批准的回顾性病历审查研究中，将79例临床诊断为特发性颅内压升高的患者与63例诊断为多发性硬化症的患者进行比较。纳入标准还包括可获得的脑部磁共振成像（MRI）、年龄大于18岁以及女性。排除其他原因导致颅内压升高的患者。从电子病历中提取以下信息：体重指数、年龄、头痛、视力变化、耳鸣和眩晕。对脑部MRI进行审查，以确定是否存在以下特征：空蝶鞍、视神经鞘内脑脊液间隙增宽、视神经迂曲和Meckel腔扩大。此外，记录所有患者与主要静脉引流窦相关的AG的数量、大小和位置。采用统计分析方法评估各种影像学表现与临床体征之间的关联。
评估了AG与各种影像学表现和临床体征之间的关联。IIH患者中AG的比例显著更高。IIH患者往往有0至3个AG。IIH患者脑部MRI最常见的影像学表现是空蝶鞍和视神经鞘内脑脊液间隙增宽。这些MRI表现在IIH患者中的患病率与AG的数量成反比。在IIH患者的开放压与AG数量之间也观察到类似的反比趋势。
该研究证实AG的存在与IIH之间存在关联。蛛网膜颗粒似乎在IIH患者中发挥代偿机制作用。
