Intracranial Hypertension
Conditions
Keywords
Intracranial Hypertension, venous drainage, MRI, blood flow, cerebrospinal fluid flow
Brief summary
Intracranial hypertension (IIH) is a disorder producing a syndrome of increased intracranial pressure secondary to a compressive intracranial lesion or said to be idiopathic. The most common symptoms are headaches, blindness, pulsatile tinnitus or papillary edema. There are many options for the treatment of IIH, especially neurosurgery (derivation of cerebrospinal fluid or stent placement). Currently, idiopathic IIH has no clear etiology but the hypothesis of sino-venous insufficiency is more and more recognized. The assumption of venous insufficiency has not been demonstrated so far. Therefore the investigators propose to demonstrate that cerebral venous drainage pathways are altered in adult patients with idiopathic intracranial hypertension in comparison to healthy individuals having normal circulation. Assessment will be performed using Magnetic Resonance Imaging which is part of the patient care.
Detailed description
The investigator working hypothesis is an impairment of the cerebral venous drainage in IIH compared to the circulation observed in healthy volunteers considered as the reference. The research will focus on adult patients referred to the imaging department for intracranial hypertension assessment. MRI support is common for this type of request The reference will be established in a population of healthy volunteers for whom MRI blood flow measurements will be performed. In addition to the primary objective, the investigators assess the impact of IIH on CSF dynamics The study does not present any risk for the subject, any contraindication to MRI examination being respected. The subjects will undergo MRI examination including morphological and flow sequences without contrast injection. The flow sequences, in planes located at the C2-C3 and aqueductal levels, will be used to measure vascular flows (venous and arterial) and CSF oscillatory volumes. Image post-processing will be performed on a semi-automatic software allowing to extract fluid dynamics parameters.
Interventions
DIAGNOSTIC_TESTMRI examination
Subjects will be placed in supine position. The systematic use of a headset will reduce the noise inherent to the machine. Standard MRI examination using a 32-channel head coil consists of angiographic, morphological and phase-contrast 2D flow sequences. The flow planes are set perpendicularly to the structure axis (blood or CSF regions). The velocity measured in the pixels inside the region of interest allow the calculation of a mean flow rate as well as the volume displaced during a cardiac cycle.
DIAGNOSTIC_TESTECG
A cardiac synchronization system using peripheral ECG allows the synchronization with the subject's heart rate.
Sponsors
Centre Hospitalier Universitaire, Amiens
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age : \>18 years old * adult patients referred to the imaging department for intracranial hypertension assessment * adult control subjects without history of cerebral or vascular pathology
Exclusion criteria
* history of cerebral or vascular pathology for the control subjects * pregnant woman * claustrophobia * major obesity * any contraindication to MRI exam
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ratio between jugular vein flow and total arterial brain flow. | day 0 = day of inclusion | Venous jugular flow is the sum right and left internal jugular vein flows. Total arterial flow is the sum of right and left internal carotid and vertebral arteries flows. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| CSF (cerebrospinal fluid) Stroke volumes | day 0 = day of inclusion | CSF oscillatory volumes measured at the Sylvius' aqueduct and sub-arachnoidian space levels |
Countries
France
Outcome results
None listed