Tuță Sorin
Department of Neurology, "Carol Davila" University of Medicine and Pharmacy, 050471 Bucharest, Romania.
Department of Neurology, National Institute of Neurology and Neurovascular Diseases, 041914 Bucharest, Romania.
Life (Basel). 2022 Jun 8;12(6):854. doi: 10.3390/life12060854.
In this review, we provide an update on the pathogenesis, diagnosis, and management of adults with idiopathic intracranial hypertension (IIH) and implications of the cerebral venous system, highlighting the progress made during the past decade with regard to mechanisms of the venous outflow pathway and its connection with the cerebral glymphatic and lymphatic network in genesis of IIH. Early diagnosis and treatment are crucial for favorable visual outcomes and to avoid vision loss, but there is also a risk of overdiagnosis and misdiagnosis in many patients with IIH. We also present details about treatment of intracranial hypertension, which is possible in most cases with a combination of weight loss and drug treatments, but also in selected cases with surgical interventions such as optic nerve sheath fenestration, cerebral spinal fluid (CSF) diversion, or dural venous sinus stenting for some patients with cerebral venous sinus stenosis, after careful analysis of mechanisms of intracranial hypertension, patient clinical profile, and method risks.
在本综述中，我们提供了关于成人特发性颅内高压（IIH）的发病机制、诊断和管理以及脑静脉系统影响的最新信息，强调了过去十年在静脉流出途径机制及其在IIH发生中与脑类淋巴系统和淋巴网络的联系方面取得的进展。早期诊断和治疗对于获得良好的视力结果和避免视力丧失至关重要，但在许多IIH患者中也存在过度诊断和误诊的风险。我们还详细介绍了颅内高压的治疗方法，在大多数情况下，通过减肥和药物治疗相结合是可行的，但在仔细分析颅内高压机制、患者临床情况和方法风险后，对于一些患有脑静脉窦狭窄的患者，在某些选定的情况下，也可采用手术干预，如视神经鞘开窗术、脑脊液（CSF）分流术或硬脑膜静脉窦支架置入术。
