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. 1997 Mar;62(3):229–233. doi: 10.1136/jnnp.62.3.229

Potentially prothrombotic abnormalities of coagulation in benign intracranial hypertension.

J Sussman 1, M Leach 1, M Greaves 1, R Malia 1, G A Davies-Jones 1
PMCID: PMC1064150  PMID: 9069476

Abstract

OBJECTIVE: Benign intracranial hypertension (BIH) may be caused by intracranial venous sinus thrombosis. Cerebral angiograms may, however, be normal in patients with BIH that are associated with conditions with an increased risk of venous thrombosis. This raises the possibility that unrecognised non-occlusive venous thrombus might impede CSF drainage. This study therefore examined the strength of the association between risk factors for thrombosis and BIH. METHODS: The incidence of prothrombotic abnormalities among a mixed prospectively and retrospectively investigated cohort of 38 patients with BIH, was compared with healthy obese subjects, and patients with other neurological diseases. Prothrombotic abnormalities investigated included anticardiolipin antibodies, lupus anticoagulant, antithrombin III, proteins C and S, plasma fibrinogen, kaolin cephalin clotting time, prothrombin time, and full blood counts. RESULTS: Evidence for the presence of an antiphospholipid antibody was found in 32% of cases. Cases of familial deficiency of antithrombin III, thrombocytosis, and polycythaemia were also noted. Additionally, an increased concentration of plasma fibrinogen was found in 26%. A coagulation abnormality was more often detectable in those subjects with normal or low body mass index and in those tested within six months of onset. CONCLUSION: There is a thrombotic pathogenesis in some cases of BIH.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Balleisen L., Bailey J., Epping P. H., Schulte H., van de Loo J. Epidemiological study on factor VII, factor VIII and fibrinogen in an industrial population: I. Baseline data on the relation to age, gender, body-weight, smoking, alcohol, pill-using, and menopause. Thromb Haemost. 1985 Aug 30;54(2):475–479. [PubMed] [Google Scholar]
  2. Boddie H. G., Banna M., Bradley W. G. "Benign" intracranial hypertension. A survey of the clinical and radiological features, and long-term prognosis. Brain. 1974 Jun;97(2):313–326. doi: 10.1093/brain/97.1.313. [DOI] [PubMed] [Google Scholar]
  3. CLAUSS A. Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens. Acta Haematol. 1957 Apr;17(4):237–246. doi: 10.1159/000205234. [DOI] [PubMed] [Google Scholar]
  4. Corbett J. J., Mehta M. P. Cerebrospinal fluid pressure in normal obese subjects and patients with pseudotumor cerebri. Neurology. 1983 Oct;33(10):1386–1388. doi: 10.1212/wnl.33.10.1386. [DOI] [PubMed] [Google Scholar]
  5. Dandy W. E. INTRACRANIAL PRESSURE WITHOUT BRAIN TUMOR: DIAGNOSIS AND TREATMENT. Ann Surg. 1937 Oct;106(4):492–513. doi: 10.1097/00000658-193710000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Detection of lupus like anticoagulant: current laboratory practice in the United Kingdom. The Lupus Anticoagulant Working Party. J Clin Pathol. 1990 Jan;43(1):73–75. doi: 10.1136/jcp.43.1.73. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Digre K. B., Corbett J. J. Pseudotumor cerebri in men. Arch Neurol. 1988 Aug;45(8):866–872. doi: 10.1001/archneur.1988.00520320056015. [DOI] [PubMed] [Google Scholar]
  8. Esack A., Thompson G., Burmester H. Benign intracranial hypertension and essential thrombocythaemia. J Neurol Neurosurg Psychiatry. 1989 Jul;52(7):914–914. doi: 10.1136/jnnp.52.7.914. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. FOLEY J. Benign forms of intracranial hypertension; toxic and otitic hydrocephalus. Brain. 1955;78(1):1–41. doi: 10.1093/brain/78.1.1. [DOI] [PubMed] [Google Scholar]
  10. GREER M. Benign intracranial hypertension. II. Following corticosteroid therapy. Neurology. 1963 May;13:439–441. doi: 10.1212/wnl.13.5.439. [DOI] [PubMed] [Google Scholar]
  11. Griffin J. P. A review of the literature on benign intracranial hypertension associated with medication. Adverse Drug React Toxicol Rev. 1992 Spring;11(1):41–57. [PubMed] [Google Scholar]
  12. Hayes K. C., McCombs H. L., Faherty T. P. The fine structure of vitamin A deficiency. II. Arachnoid granulations and CSF pressure. Brain. 1971;94(2):213–224. doi: 10.1093/brain/94.2.213. [DOI] [PubMed] [Google Scholar]
  13. Hill M. B., Phipps J. L., Malia R. G., Greaves M., Hughes P. Characterization and specificity of anti-endothelial cell membrane antibodies and their relationship to thrombosis in primary antiphospholipid syndrome (APS). Clin Exp Immunol. 1995 Nov;102(2):368–372. doi: 10.1111/j.1365-2249.1995.tb03791.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hoffman H. J. How is pseudotumor cerebri diagnosed? Arch Neurol. 1986 Feb;43(2):167–168. doi: 10.1001/archneur.1986.00520020055020. [DOI] [PubMed] [Google Scholar]
  15. Janny P., Chazal J., Colnet G., Irthum B., Georget A. M. Benign intracranial hypertension and disorders of CSF absorption. Surg Neurol. 1981 Mar;15(3):168–174. doi: 10.1016/0090-3019(81)90131-2. [DOI] [PubMed] [Google Scholar]
  16. Johnston I. Reduced C.S.F. absorption syndrome. Reappraisal of benign intracranial hypertension and related conditions. Lancet. 1973 Aug 25;2(7826):418–421. doi: 10.1016/s0140-6736(73)92277-0. [DOI] [PubMed] [Google Scholar]
  17. Koster T., Rosendaal F. R., Reitsma P. H., van der Velden P. A., Briët E., Vandenbroucke J. P. Factor VII and fibrinogen levels as risk factors for venous thrombosis. A case-control study of plasma levels and DNA polymorphisms--the Leiden Thrombophilia Study (LETS). Thromb Haemost. 1994 Jun;71(6):719–722. [PubMed] [Google Scholar]
  18. Levine S. R., Welch K. M. The spectrum of neurologic disease associated with antiphospholipid antibodies. Lupus anticoagulants and anticardiolipin antibodies. Arch Neurol. 1987 Aug;44(8):876–883. doi: 10.1001/archneur.1987.00520200078024. [DOI] [PubMed] [Google Scholar]
  19. Massons J., Arboix A., Oliveres M., Besses C., Muñoz C., Titus F. Trombosis venosa cerebral y déficit hereditario de proteína C. Neurologia. 1992 Jan;7(1):34–38. [PubMed] [Google Scholar]
  20. Meade T. W., Chakrabarti R., Haines A. P., North W. R., Stirling Y. Characteristics affecting fibrinolytic activity and plasma fibrinogen concentrations. Br Med J. 1979 Jan 20;1(6157):153–156. doi: 10.1136/bmj.1.6157.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Melamed E., Rachmilewitz E. A., Reches A., Lavy S. Aseptic cavernous sinus thrombosis after internal carotid arterial occlusion in polycythaemia vera. J Neurol Neurosurg Psychiatry. 1976 Apr;39(4):320–324. doi: 10.1136/jnnp.39.4.320. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Neville B. G., Wilson J. Benign intracranial hypertension following corticosteroid withdrawal in childhood. Br Med J. 1970 Sep 5;3(5722):554–556. doi: 10.1136/bmj.3.5722.554. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. OGSTON D., MCANDREW G. M. FIBRINOLYSIS IN OBESITY. Lancet. 1964 Dec 5;2(7371):1205–1207. doi: 10.1016/s0140-6736(64)91042-6. [DOI] [PubMed] [Google Scholar]
  24. Pierro L., Brancato R., Zaganelli E., Guarisco L., Lanzetta P. Ocular involvement in acute lymphoblastic leukemia: an echographic study. Int Ophthalmol. 1992 May;16(3):159–162. doi: 10.1007/BF00916435. [DOI] [PubMed] [Google Scholar]
  25. Prockop L. D., Fishman R. A. Experimental pneumococcal meningitis. Permeability changes influencing the concentration of sugars and macromolecules in cerebrospinal fluid. Arch Neurol. 1968 Nov;19(5):449–463. doi: 10.1001/archneur.1968.00480050019001. [DOI] [PubMed] [Google Scholar]
  26. Ridsdale L., Moseley I. Thoracolumbar intraspinal tumours presenting features of raised intracranial pressure. J Neurol Neurosurg Psychiatry. 1978 Aug;41(8):737–745. doi: 10.1136/jnnp.41.8.737. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Vyas C. K., Talwar K. K., Bhatnagar V., Sharma B. K. Steroid-induced benign intracranial hypertension. Postgrad Med J. 1981 Mar;57(665):181–182. doi: 10.1136/pgmj.57.665.181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Wall M. Idiopathic intracranial hypertension. Neurol Clin. 1991 Feb;9(1):73–95. [PubMed] [Google Scholar]
  29. Wasan H., Mansi J. L., Benjamin S., Powles R., Cunningham D. Myeloma and benign intracranial hypertension. BMJ. 1992 Mar 14;304(6828):685–685. doi: 10.1136/bmj.304.6828.685. [DOI] [PMC free article] [PubMed] [Google Scholar]

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