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This article has been cited by other articles in PMC. Ocular fundoscopy available in 12 patients showed bilateral papilloedema in eight and optic disk atrophy in four. Clinical evolution was particularly noticeable in five patients because of chronic two patients or acute after lumbar shunting or puncture: three patients, one death tonsillar herniation. The remaining 11 had type II fistulas drainage into a sinus, with abnormal retrograde venous drainage into sinuses or cortical veins. Stenosis or thrombosis of the sinus es distal to the fistula was present in five patients.
The cerebral venous drainage was abnormal in all patients. Normal cerebral angiography should be added as a fifth criterion of benign intracranial hypertension. The cerebral venous drainage pattern must be carefully studied by contralateral carotid and vertebral artery injections to correctly evaluate the impairment of the cerebral venous outflow.
Lumbar CSF diversion puncture or shunting may induce acute tonsillar herniation and should be avoided absolutely. DAVF may induce intracranial hypertension, which has a poor long term prognosis and may lead to an important loss of visual acuity and chronic tonsillar herniation.
Consequently, patients with intracranial hypertension must be treated, even agressively, to obliterate the fistula or at least to reduce the arterial flow and to restore a normal cerebral venous drainage. Patients in whom the fistula is not obliterated after an endovascular therapeutic procedure, need continous clinical and angiographical follow up. Selected References These references are in PubMed. This may not be the complete list of references from this article.
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Comment diagnostiquer une hypertension intracrânienne bénigne ?
Hypertension intracrânienne pas si bénigne