Department of Neuroscience, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia.
J Neurol Neurosurg Psychiatry. 2024 Mar 13;95(4):375-383. doi: 10.1136/jnnp-2023-332222.
Idiopathic intracranial hypertension (IIH) is a condition of significant morbidity and rising prevalence. It typically affects young people living with obesity, mostly women of reproductive age, and can present with headaches, visual abnormalities, tinnitus and cognitive dysfunction. Raised intracranial pressure without a secondary identified cause remains a key diagnostic feature of this condition, however, the underlying pathophysiological mechanisms that drive this increase are poorly understood. Previous theories have focused on cerebrospinal fluid (CSF) hypersecretion or impaired reabsorption, however, the recent characterisation of the glymphatic system in many other neurological conditions necessitates a re-evaluation of these hypotheses. Further, the impact of metabolic dysfunction and hormonal dysregulation in this population group must also be considered. Given the emerging evidence, it is likely that IIH is triggered by the interaction of multiple aetiological factors that ultimately results in the disruption of CSF dynamics. This review aims to provide a comprehensive update on the current theories regarding the pathogenesis of IIH.
特发性颅内高压（IIH）是一种发病率高且呈上升趋势的疾病。它通常影响肥胖的年轻人，主要是育龄妇女，其症状包括头痛、视力异常、耳鸣和认知功能障碍。颅内压升高而无明确的继发原因仍然是这种疾病的一个关键诊断特征，然而，导致这种升高的潜在病理生理机制仍知之甚少。以前的理论集中在脑脊液（CSF）分泌过多或吸收受损上，然而，最近在许多其他神经疾病中对糖质系统的描述需要重新评估这些假设。此外，还必须考虑代谢功能障碍和激素失调对这一人群的影响。鉴于新出现的证据，IIH 很可能是由多种病因因素相互作用引发的，这些因素最终导致 CSF 动力学的破坏。这篇综述旨在提供关于 IIH 发病机制的现有理论的全面更新。
