Association of Intracranial Hypertension with Calvarial and Skull Base Thinning

Cyrus Rabbani, Janaki M. Patel, Amit Nag, Elizabeth Schueth, Mohamad Z. Saltagi, Richard Kao, Rick F. Nelson

Research output: Contribution to journalArticle

Abstract

Objective: Determine if patients with increased opening pressure (OP) on lumbar puncture (LP) have thinner calvaria and skull bases. Study Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: Patients (≥18 yr of age) who had a recorded OP on LP and high-resolution computed tomography imaging of the head. Patient age, sex, body mass index were calculated. Intracranial hypertension (IH) was defined with an OP≥25 cm-H2O and low intracranial pressure with an OP<15 cm-H2O. Intervention: Measurement of calvarial, zygoma, and skull base thickness when blinded to OP with three-dimensional slicer and radiologic calipers. Main Outcome Measures: Association of calvarial, skull base, and zygoma thickness with OP and age. Results: Fifty-eight patients were included with a mean (SD) age of 53.1 (16.2) years and average (SD) body mass index of 30.1 (9.1) kg/m2. Patients with IH had thinner mean (SD) calvaria (3.01 [0.81] versus 2.70 [0.58] mm; p = 0.036) and skull bases (5.17 [1.22] versus 4.60 [1.42] mm; p = 0.043) when compared with patients without IH. The mean (SD) extracranial zygoma thickness was similar between the two groups (5.09 [0.76] versus 5.00 [0.73] mm; p = 0.56). General linear model regression demonstrated advancing age was associated with increasing calvarial thickness in patients without IH and calvarial thinning in patients with IH (p = 0.038). Conclusion: IH is independently associated with intracranial bone (calvaria and skull base) thinning and not extracranial (zygoma) thinning. Skull thinning occurs with IH and advancing age. These findings support a possible role of increased ICP in the pathophysiologic development of spontaneous cerebrospinal fluid leaks.

Original languageEnglish (US)
Pages (from-to)E619-E626
JournalOtology and Neurotology
Volume40
Issue number6
DOIs
StatePublished - Jul 1 2019
Externally publishedYes

Fingerprint

Intracranial Hypertension
Skull Base
Zygoma
Skull
Pressure
Spinal Puncture
Linear Models
Body Mass Index
Intracranial Pressure
Tertiary Care Centers
Cohort Studies
Retrospective Studies
Head
Tomography
Outcome Assessment (Health Care)
Bone and Bones

Keywords

  • Intracranial hypertension
  • Lumbar puncture
  • Opening pressure
  • Skull thickness
  • Spontaneous CSF leak
  • Tegmen
  • Thinning

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Rabbani, C., Patel, J. M., Nag, A., Schueth, E., Saltagi, M. Z., Kao, R., & Nelson, R. F. (2019). Association of Intracranial Hypertension with Calvarial and Skull Base Thinning. Otology and Neurotology, 40(6), E619-E626. https://doi.org/10.1097/MAO.0000000000002249

Association of Intracranial Hypertension with Calvarial and Skull Base Thinning. / Rabbani, Cyrus; Patel, Janaki M.; Nag, Amit; Schueth, Elizabeth; Saltagi, Mohamad Z.; Kao, Richard; Nelson, Rick F.

In: Otology and Neurotology, Vol. 40, No. 6, 01.07.2019, p. E619-E626.

Research output: Contribution to journalArticle

Rabbani, C, Patel, JM, Nag, A, Schueth, E, Saltagi, MZ, Kao, R & Nelson, RF 2019, 'Association of Intracranial Hypertension with Calvarial and Skull Base Thinning', Otology and Neurotology, vol. 40, no. 6, pp. E619-E626. https://doi.org/10.1097/MAO.0000000000002249
Rabbani, Cyrus ; Patel, Janaki M. ; Nag, Amit ; Schueth, Elizabeth ; Saltagi, Mohamad Z. ; Kao, Richard ; Nelson, Rick F. / Association of Intracranial Hypertension with Calvarial and Skull Base Thinning. In: Otology and Neurotology. 2019 ; Vol. 40, No. 6. pp. E619-E626.
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