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Hyperemic hydrocephalus: a new form of childhood hydrocephalus analogous to hyperemic intracranial hypertension in adults.
[hydrocephalus with stenosis of the aqueduct of sylvius]
In
the
majority
of
adults
with
idiopathic
intracranial
hypertension
(
IIH
)
,
there
is
an
elevation
in
venous
pressure
associated
with
a
venous
outflow
stenosis
.
In
about
15
%
of
IIH
patients
the
elevated
venous
pressure
is
associated
with
an
elevation
in
blood
flow
but
little
or
no
evidence
of
a
stenosis
.
Venostenotic
IIH
and
idiopathic
hydrocephalus
in
children
with
a
normal
blood
inflow
have
been
shown
to
be
equivalent
.
The
aim
of
this
study
was
to
test
whether
children
with
hydrocephalus
and
an
elevated
arterial
inflow
have
a
vascular
pathophysiology
that
is
analogous
to
the
hyperemic
form
of
IIH
in
adults
.
Nine
children
with
idiopathic
hydrocephalus
underwent
MR
imaging
with
flow
quantification
and
were
found
to
have
arterial
inflows
2
SDs
above
the
mean
for
normal
controls
.
Measurements
of
the
head
circumference
,
ventricular
enlargement
,
total
blood
inflow
,
superior
sagittal
sinus
(
SSS
)
/
straight
sinus
(
SS
)
outflow
,
and
the
degree
of
collateral
venous
flow
were
performed
.
The
results
were
compared
with
findings
in
14
age-matched
controls
.
In
hyperemic
hydrocephalus
the
cerebral
blood
inflow
was
elevated
but
the
SSS
and
SS
outflows
were
in
the
normal
range
.
The
sinus
outflow
as
a
percentage
of
the
inflow
was
reduced
by
8
percentage
points
in
the
SSS
territory
and
5
percentage
points
in
the
SS
territory
compared
with
findings
in
the
controls
(
p
=
0
.
04
,
p
=
0
.
003
,
respectively
)
,
suggesting
blood
was
returning
via
collateral
channels
.
Similar
to
patients
with
hyperemic
IIH
,
children
with
hyperemic
hydrocephalus
show
a
significant
elevation
in
collateral
venous
flow
,
indicating
that
the
same
venous
pathophysiology
may
be
operating
in
both
conditions
.
Diseases
Validation
Diseases presenting
"intracranial hypertension"
symptom
achondroplasia
cushing syndrome
hydrocephalus with stenosis of the aqueduct of sylvius
von hippel-lindau disease
This symptom has already been validated