EVALUATION OF INTRACRANIAL HYPERTENSION ON DATA OF ULTRA-HIGH-FIELD MRI

Abstract

The goal is to evaluate the contribution of age and individual features of the cerebral cranium, foci in the CNS structures, pathomorphological changes in the liquor-containing spaces and angio-cerebral structures visualized on ultra high field magnetic resonance imaging (uhfMRI) in the formation of the syndrome of intracranial hypertension (ICH). Intracranial pressure (ICP) is the fundamental biophysical parameter of the brain, the result of perfusion and diffusion at the level of hemato-tissue, hemato-liquor, liquor-tissue contacts forming the hematoencephalic barrier (BBB), and the liquor-lymphatic contacts that form the liquor-lymphatic barrier (LLB). Violations of venous cerebral hemodynamics and liquorodynamics reduce the possibility of draining the subarachnoid space of the brain and spinal cord, and the «excess» of cerebrospinal fluid (CSF) in the static volume of the cerebral cranium causes the ICH. This is manifested in the form of violation of perfusion and diffusion processes, in the form of micro-foci in the structures of the nervous tissue of the brain and spinal cord, in changes in cerebral vessels, liquor-containing spaces and liquor-lymphatic contacts. Clinically, on the background of ICH, a symptom-complex of headache is formed, and the functional abilities of the central nervous system decrease. Direct measurement of ICP is an invasive procedure with a violation of the integrity of the dura mater. Therefore, for individual diagnosis of the mechanism of increasing ICP in 249 patients with clinical manifestations of ICH, biomarkers (pathomorphological findings with uhfMRI) were analyzed: biomarkers of hydrocephalus-hypertension-edematous syndrome, biomarkers of residual cerebral changes, biomarkers of unfavorable anatomical variants of the structure of the brain skull and brain tissue, biomarkers of the consequences of the development of hydrocephalus-hypertension-edematous syndrome, biomarkers of unfavorable variants of cerebral vascular network structure and hemodynamics. Each patient develops an individual pathogenetic scheme of development of ICH, which during life changes at least 3 times.

Key words

ultrahigh-field MRI, intracranial pressure, blood-brain barrier, cerebrospinal fluid-lymph barrier, cerebrospinal fluid, intracranial hypertension syndrome

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About Authors (Correspondence):

Letyagin A.Yu. – doctor of medical sciences, professor, director, e-mail: letyagin-andrey@yandex.ru

Full Text

snmzh_4-2018_letyagtn_49-64_i_dr.pdf

Received: 30/08/2018

Accepted: 30/08/2018