title: Static and pulsatile intracranial pressure in idiopathic intracranial hypertension.
abstract: OBJECTIVE
  The aim of this observational study was to characterize the static and pulsatile intracranial pressure (ICP) in conservatively (medically) treated idiopathic intracranial hypertension (IIH) patients in need of shunt surgery, and also in patients with chronic daily headache (CDH) without visual disturbances.
  
  
  METHODS
  The material includes 14 IIH patients and 7 CDH patients in whom ICP was monitored continuously over-night. Static ICP was characterized by mean ICP, pulsatile ICP was characterized by the wave amplitude, rise time, and rise time coefficient.
  
  
  RESULTS
  In the IIH group all 14 had headache and visual disturbances. Mean ICP was high (> 15 mmHg) in only 7 patients (50%), while mean ICP wave amplitude was high (≥ 4 mmHg) in all 14 (100%). All IIH patients were shunted and improved clinically thereafter (i.e., relief from visual disturbances and/or headache). None in the CDH group had high mean ICP or mean ICP wave amplitude, and none were shunted.
  
  
  CONCLUSIONS
  In this cohort of 14 conservatively treated IIH patients with lasting and shunt-responsive headache and visual disturbances, the mean ICP wave amplitude was elevated (≥ 4 mmHg) in all patients despite normal mean ICP (< 15 mmHg) in 7 patients (all but one on medication). Therefore, the pulsatile ICP may be more relevant than the static ICP in the diagnostic setting for patients with IIH. Further prospective standardized approaches are warranted.
authors.affiliation: Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway; University of Oslo, Oslo, Norway. per.kristian.eide@oslo-universitetssykehus.no
authors.forename: Per Kristian
authors.initials: PK
authors.lastname: Eide
authors.forename: Emilia
authors.initials: E
authors.lastname: Kerty
mesh_terms: D000293:Adolescent; D000328:Adult; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D020773:Headache Disorders / Q000209:etiology; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D017287:Ventriculoperitoneal Shunt; D055815:Young Adult