In an MRI, by size lateral ventricles and areas around might have taken more attention. My question above gives a notice to all smaller spaces CSF passes around. This way of consideration of CSF journey can give clues to the mysteries of CSF. The regional and conclusive thinking above, might help in understanding IH pathophysiology and symptoms better as well as to find more mehods to monitor it and to find solutions to refine its treatment.
My best regards,
Signs and symptoms usually include headache, nausea, vomiting, dizziness and may be associated with signs such as cranial nerve function deficits and even seizures (3rd nerve, 4th nerve, 6th nerve). This clinical condition may arise as part of the manifestations of hydrocephalus, which basically defines the obstruction of the cerebrospinal fluid flow leading to intracranial hypertension and may have several causes. In these cases there is usually no clear distinction of signs and symptoms linked to the 3rd or 4th ventricle.
On the other hand, conditions such as tumors of the 3rd ventricle, for example: colloid cysts, in addition to coursing with hydrocephalus, can evolve with characteristic signs and symptoms such as gelastic seizures.
Thank you too much Dr Oliveira for your expert answer, I appreciate.
Regarding cranial nerves you mentioned 3rd, 4th and 6th nerves. What about others: 5th,7th and the others?
The above are in the 4th ventricles added to effects on vomiting centre cardiorespiratory and vestibular centres.
3rd ventricle may be having separate effects due to pressure on other structures like hypothalamus, fornix and pituitary.
What you mentioned are very relevant, and my aim is to refine more the descriptions to avoid losing IH patients in different medical clinics instead of neurosurgical. Many colleagues might not think of brain imaging if no papilledema.
Best regards,
As an example I suggest we study together the cross section mentioned down:
https://www.ncbi.nlm.nih.gov/books/NBK544265/figure/article-17032.image.f2/
Dr Oliveira,
May be you are not willing to discuss other cranial nerves symptoms or you did not notice any.
In this case let us try to discuss cranial nerves you mentioned above; the 3rd, 4th and 6th nerves:
Do you have case reports or personal observations of symptoms of the above nerves in IH patients?
What are the symptoms reported or noticed?
Was it ocular paralysis and squint? Or something else.
How the pathology in IH differs from the pathology of diabetic neuropathy as an example of the same nerves? Or how compression of a tumor differs from the effects of increased intracranial CSF pressure.
Documented cases revisions or clinical observations can answer the above question and similar others.
I hope such kind of closer looks can help to better understanding of IH symptoms.
Other than understanding symptoms, above anatomy could be relevant in comps,ring VP shunt with LP shunt. Which is more effective in IH and which is safer.
I meant LP is considered by some neurosurgeons more effective in IH.
Most neurosurgeons prefer VP shunt as safer.
LP drains first 4th and third ventricles (major IH symptoms).
This is more effective but also potenially more serious (close contact with vital centres)
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