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Mechanism of Pseudotumor in Guillain-Barré Syndrome

Mechanism of Pseudotumor in Guillain-Barré Syndrome Abstract • A patient with pseudotumor cerebri and Guillain-Barré syndrome was studied with serial measurements of pressure-volume index, CSF outflow resistance (Ro), and CSF production rate. The results were comparable to findings in previous cases of idiopathic pseudotumor. Although Ro was elevated and progressively diminished as the pseudotumor syndrome improved, the extent of elevation in Ro was inadequate to account for raised CSF pressure. These results suggest an alternative explanation for pseudotumor based on raised effective venous pressures at points of CSF outflow that are passively reflected in raised CSF pressure. A parallel rise in vascular and CSF pressure may also explain why patients with pseudotumor tolerate such high intracranial pressures. References 1. Mann JD, Johnson RN, Butler AB, et al: Impairment of cerebrospinal fluid circulatory dynamics in pseudotumor cerebri and response to steroid treatment, abstracted . Neurology 1979; 29:550.Crossref 2. Calabrese VP, Selhorst JB, Harbison JW: Cerebrospinal fluid infusion test in pseudotumor cerebri, abstracted . Ann Neurol 1978;4:173. 3. Raichle MC, Grubb RL Jr, Phelps ME, et al: Cerebral hemodynamics and metabolism in pseudotumor cerebri . Ann Neurol 1978;4:104-111.Crossref 4. Mathews NT, Meyer JS, Ott EO: Increased cerebral blood volume in benign intracranial hypertension . Neurology 1975;25:646-649.Crossref 5. Joynt RJ: Mechanism of production of papilledema in the Guillain-Barré syndrome . Neurology 1958;8:8-12.Crossref 6. Fishman RA: Pathophysiology of pseudotumor . Ann Neurol 1979;5:496.Crossref 7. Denny-Brown DE: The changing pattern of neurologic medicine . N Engl J Med 1952; 246:839-846.Crossref 8. Marmarou A, Shulman K, LaMorgese J: Compartmental analysis of compliance and outflow resistance of the cerebrospinal fluid system . J Neurosurg 1975;43:523-534.Crossref 9. Shapiro K, Marmarou A, Shulman K: Characterization of clinical CSF dynamics and neural axis compliance using the pressure-volume index . Ann Neurol 1980;7:508-514.Crossref 10. Sklar FH: Non-steady state measurements of CSF dynamics , in Wood J (ed): Neurobiology of Cerebrospinal Fluid . New York, Plenum Press, 1980, chap 28, pp 365-379. 11. Hussey F, Schanzer B, Katzman R: A simple constant-infusion test for measurement of CSF absorption: II. Clinical studies . Neurology 1970;20:665-680.Crossref 12. Janny P, Chazal J, Colnet G, et al: Benign intracranial hypertension and disorders of CSF absorption . Surg Neurol 1981;15:168-173.Crossref 13. Sullivan H, Miller JD, Griffith R, et al: Bolus versus steady state infusion for determination of CSF outflow resistance . Ann Neurol 1979;5:228-238.Crossref 14. Dacey RG, Welsh JE, Scheid WM, et al: Alterations of cerebrospinal outflow resistance in experimental bacterial meningitis, abstracted . Ann Neurol 1978;4:173. 15. Johnson RN, Maffeo CJ, Dacy RW, et al: Mechanisms for intracranial hypertension during experimental subarachnoid hemorrhage: Acute malfunction of arachnoid villi by components of plasma, abstracted . Ann Neurol 1978; 4:173. 16. Johnston I: Reduced CSF absorption syndrome reappraisal of benign intracranial hypertension and related conditions . Lancet 1973; 2:418-421.Crossref 17. Sullivan R, Reeves A: Normal cerebrospinal fluid protein, increased intracranial pressure and the Gullain-Barré syndrome . Ann Neurol 1977;1:108-109.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Mechanism of Pseudotumor in Guillain-Barré Syndrome

Archives of Neurology , Volume 41 (3) – Mar 1, 1984

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1984.04050150037012
Publisher site
See Article on Publisher Site

Abstract

Abstract • A patient with pseudotumor cerebri and Guillain-Barré syndrome was studied with serial measurements of pressure-volume index, CSF outflow resistance (Ro), and CSF production rate. The results were comparable to findings in previous cases of idiopathic pseudotumor. Although Ro was elevated and progressively diminished as the pseudotumor syndrome improved, the extent of elevation in Ro was inadequate to account for raised CSF pressure. These results suggest an alternative explanation for pseudotumor based on raised effective venous pressures at points of CSF outflow that are passively reflected in raised CSF pressure. A parallel rise in vascular and CSF pressure may also explain why patients with pseudotumor tolerate such high intracranial pressures. References 1. Mann JD, Johnson RN, Butler AB, et al: Impairment of cerebrospinal fluid circulatory dynamics in pseudotumor cerebri and response to steroid treatment, abstracted . Neurology 1979; 29:550.Crossref 2. Calabrese VP, Selhorst JB, Harbison JW: Cerebrospinal fluid infusion test in pseudotumor cerebri, abstracted . Ann Neurol 1978;4:173. 3. Raichle MC, Grubb RL Jr, Phelps ME, et al: Cerebral hemodynamics and metabolism in pseudotumor cerebri . Ann Neurol 1978;4:104-111.Crossref 4. Mathews NT, Meyer JS, Ott EO: Increased cerebral blood volume in benign intracranial hypertension . Neurology 1975;25:646-649.Crossref 5. Joynt RJ: Mechanism of production of papilledema in the Guillain-Barré syndrome . Neurology 1958;8:8-12.Crossref 6. Fishman RA: Pathophysiology of pseudotumor . Ann Neurol 1979;5:496.Crossref 7. Denny-Brown DE: The changing pattern of neurologic medicine . N Engl J Med 1952; 246:839-846.Crossref 8. Marmarou A, Shulman K, LaMorgese J: Compartmental analysis of compliance and outflow resistance of the cerebrospinal fluid system . J Neurosurg 1975;43:523-534.Crossref 9. Shapiro K, Marmarou A, Shulman K: Characterization of clinical CSF dynamics and neural axis compliance using the pressure-volume index . Ann Neurol 1980;7:508-514.Crossref 10. Sklar FH: Non-steady state measurements of CSF dynamics , in Wood J (ed): Neurobiology of Cerebrospinal Fluid . New York, Plenum Press, 1980, chap 28, pp 365-379. 11. Hussey F, Schanzer B, Katzman R: A simple constant-infusion test for measurement of CSF absorption: II. Clinical studies . Neurology 1970;20:665-680.Crossref 12. Janny P, Chazal J, Colnet G, et al: Benign intracranial hypertension and disorders of CSF absorption . Surg Neurol 1981;15:168-173.Crossref 13. Sullivan H, Miller JD, Griffith R, et al: Bolus versus steady state infusion for determination of CSF outflow resistance . Ann Neurol 1979;5:228-238.Crossref 14. Dacey RG, Welsh JE, Scheid WM, et al: Alterations of cerebrospinal outflow resistance in experimental bacterial meningitis, abstracted . Ann Neurol 1978;4:173. 15. Johnson RN, Maffeo CJ, Dacy RW, et al: Mechanisms for intracranial hypertension during experimental subarachnoid hemorrhage: Acute malfunction of arachnoid villi by components of plasma, abstracted . Ann Neurol 1978; 4:173. 16. Johnston I: Reduced CSF absorption syndrome reappraisal of benign intracranial hypertension and related conditions . Lancet 1973; 2:418-421.Crossref 17. Sullivan R, Reeves A: Normal cerebrospinal fluid protein, increased intracranial pressure and the Gullain-Barré syndrome . Ann Neurol 1977;1:108-109.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Mar 1, 1984

References