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뇌및의공학 발표
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Saúde e medicina
in Brain and Cognitive Science Progress Report
Heechan BakSeguir
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뇌및의공학 발표
- 1 /14 IIH: Idiopathic Intracranial Hypertension Team Gonoe’(고뇌) Kim Jooyoon Bak Heechan Cha Eunhyang Kim Gyurang Lee Joonsoo Kim Dooyoung Ricardo Leader Sub Leader
- 2 /14 Contents 1. Introduction 2. Raise of ICP 3. Mechanism 4. Similar Disease 5. Our goal 6. Reference
- 3 /14 1. Introduction What is IIH? ※ Original image is from Fastfission Idiopathic Intracranial Hypertension (IIH), Beni gn Intracranial Hypertension (BIH) Pseudotum or Cerebri (PTC) Increase of ICP Absence of tumor or other disease Headache, vomiting, and visual disorders like a vi sual loss.
- 4 /14 2. Raise of ICP 1) Expanding mass 2) Increase of brain water 3) Increase of blood in brain 4) CSF circulation disorder Expanding Mass Intracellular fluid Extracellular Fluid CSF Blood 5) …Studying IIH
- 5 /14 3. Mechanism Idiopathic Poorly understood Theories of IIH Mechanism 1) increased production of cerebrospinal fluid 2) increased blood flow to the brain or increase of brain tissue itself 3) restricted venous drainage
- 6 /14 3. Mechanism Brain Pressure ↑ Brain edema Closing of cerebrospinal fluid Brain Damage ※ Reference : Neurology and Neurosurgery Illustrated 5th Brain blood volume↑ CVP↑ Cerebrovascular expansion Extracellular ph ↓ Brain Shifting Expanding tumor CBF↓ Blood Pressure↓ CO2↑ O2↓↓ CPP ↓ ↓ ↓ Damaged Self-control function Brain tissue hypoxia BBB Damage CPP ↓
- 7 /14 4. Similar Disease Hydrocephalus – 'water on the brain' Cause Blocking of CSF drainage, Infection, Head injuries, and others. Step of the hydrocephalus 1) Blockage of CSF flow or absorption problem 2) CSF accumulation 3) Ventricular dilatation 4) ICP increase
- 8 /14 4. Similar Disease Hydrocephalus (1) (2) ※ Original image is from University of Rochester.(1) ※ Original image is from Lucien Monfis.(2)
- 9 /14 4. Similar Disease Achondroplasia – ‘dwarfism’ ※ Original image is from HBO Cause Genetic disorder of FGFR3 gene. Problem in ossification Neurological symptom - Hydrocephalus - Spinal Stenosis - Megalencephaly
- 10/14 4. Similar Disease Comparison Disease ICP Ventriculomegaly Treatment IIH Increase No Shunt Hydrocephalus Increase Yes Shunt Achondroplasia Not Increase Yes Shunt
- 11/14 5. Our goal The cause of IIH is not known. Research similar disease and mechanism. Make our own conclusion.
- 12/14 6. Reference Kim Dongjoo, et al. (2010) Cerebrospinal compensation of pulsating cerebral blood volume in hydrocephalus. Maney & Son Ltd. Stefan Mircea, et al. (2009) Laboratory and Clinical Research Developments : Intracranial Hypertension. USA: Nova Science Publishers. s James F. Acheson. (2006) Idiopathic intracranial hypertension and visual function. British Medical Bulletin. R. W. H. WALKER. (2001) Idiopathic intracranial hypertension: any light on the mechanism of the raised pressure?. J Neurol Neurosurg Psychiatry. Lippincott Williams & Wilkins, Arielle Spitze, et al. (2014) Surgical and endovascular interventions in idiopathic intracranial hypertension. Neurology. M Skau. (2005) What is new about idiopathic intracranial hypertension?. Blackwell Publishing Ltd Cephalalgia Kenneth. W. Lindsay, et al. (2011) Neurology and Neurosurgery Illustrated 5th. Churchill Livingstone Elsevier.
- 13/14 Any Question?
- 14/14 Thank You Main Presenter : Kim Jooyoon PT editor : Bak Heechan Research Contributor : Cha Eunhyang, Kim Gyurang
Notas do Editor
- Idiopathic intracranial hypertension (IIH), sometimes called by the older names benign intracranial hypertension (BIH) or pseudotumor cerebri (PTC), is a neurological disorder that is characterized by increased intracranial pressure (pressure around the brain) in the absence of a tumor or other diseases. The main symptoms are headache, nausea, and vomiting, as well as pulsatile tinnitus (sounds perceived in the ears, with the sound occurring in the same rhythm as the pulse), double vision and other visual symptoms. If untreated, it may lead to swelling of the optic disc in the eye, which can progress to vision loss. 1 Signs and symptoms -주요 증상_headache, nausea, and vomiting, pulsatile tinnitus (sounds perceived in the ears, with the sound occurring in the same rhythm as the pulse), double vision and other visual symptoms, swelling of the optic disc in the eye, vision loss. 2 Causes - IIH can only be diagnosed if there is no alternative explanation for the symptoms . Intracranial pressure may be increased due to medications such as high-dose vitamin A derivatives (e.g. isotretinoin for acne), long-term tetracycline antibiotics (for a variety of skin conditions) and hormonal contraceptives(피임약). +)우리의 뇌와 척수는 뇌척수액에 둘러 쌓여 있는데 뇌척수액은 충격과 같은 부상으로부터 조직을 보호해주는 완충역할을 하고 영양분을 공급하는 중요한 역할을 수행한 후 혈액속으로 재흡수 된다. 재흡수가 제대로 이루어지지 않게 되면 IIH발병 가능성이 높아짐. +)위험요소 -비만_이반인은 십만명당 1명 꼴로 나타나나 44세 이하의 비만 여성일 경우 위험률 20배 증가. -약물_리듐(Lithium),구강 피임약(Oral contraceptives), 테트라실린(Tetracyline), 스테로이드(steroids), 비타민 A의 과다복용(이거 관련 메커니즘이 있나? 왜 vit.A가 문제가 될까) -건강상 이유_뇌부상, 신장질환, 루퍼스(lupus), 단핵증(mononuclerosis), 부갑상선기능저하(underactive parathyroids glands)
- 1) expanding mass (tumor나 edema 등등) 2) increase of Brain water 3) Blood 4) CSF circulation
- (그림설명) ICP increase에 대한 상호관계가 매우 복잡함 IIH에 대해 현재까지 영향이 있을 것이라고 알려진 원인들 - venous outflow의 폐색 (thrombosis 등) -obesity -vitamin A deficiency or excess -endocrinal disorder(pregnancy or other disease) - anemia -drugs (경구피임약, 스테로이드 등) >> IIH의 메커니즘은 poorly understood 따라서 IIH와 비슷한 symptom을 보이는 병들을 주목 hydrocephalus , achondroplasia The cause of IIH is not known. The Monro-Kellie rule states that the intracranial pressure (literally: pressure inside the skull) is determined by the amount of brain tissue, cerebrospinal fluid (CSF) and blood inside the bony cranial vault. Three theories therefore exist as to why the pressure might be raised in IIH: an excess of CSF production, increased volume of blood or brain tissue, or obstruction of the veins that drain blood from the brain. The first theory, that of increased production of cerebrospinal fluid, was proposed in early descriptions of the disease. The second theory posits that either increased blood flow to the brain or increase in the brain tissue itself may result in the raised pressure. The third theory suggests that restricted venous drainage from the brain may be impaired resulting in congestion.
- (그림설명) ICP increase에 대한 상호관계가 매우 복잡함 IIH에 대해 현재까지 영향이 있을 것이라고 알려진 원인들 - venous outflow의 폐색 (thrombosis 등) -obesity -vitamin A deficiency or excess -endocrinal disorder(pregnancy or other disease) - anemia -drugs (경구피임약, 스테로이드 등) >> IIH의 메커니즘은 poorly understood 따라서 IIH와 비슷한 symptom을 보이는 병들을 주목 hydrocephalus , achondroplasia The cause of IIH is not known. The Monro-Kellie rule states that the intracranial pressure (literally: pressure inside the skull) is determined by the amount of brain tissue, cerebrospinal fluid (CSF) and blood inside the bony cranial vault. Three theories therefore exist as to why the pressure might be raised in IIH: an excess of CSF production, increased volume of blood or brain tissue, or obstruction of the veins that drain blood from the brain. The first theory, that of increased production of cerebrospinal fluid, was proposed in early descriptions of the disease. The second theory posits that either increased blood flow to the brain or increase in the brain tissue itself may result in the raised pressure. The third theory suggests that restricted venous drainage from the brain may be impaired resulting in congestion.
- The cause of IIH is not known. Research similar disease and mechanism. Make our own conclusion.
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