Intracranial venous hypertension

Intracranial venous hypertension (IVH) refers to elevated pressure in the veins of the brain, usually caused by impaired venous outflow. This condition can result from various factors, including:

1. Venous Sinus Thrombosis (VST): Clot formation in the major venous sinuses of the brain can block normal blood flow, leading to increased pressure. 2. Cerebral Venous Malformations: Abnormal formations of blood vessels can affect venous drainage and lead to increased intracranial pressure. 3. Tumors or Mass Effect: Brain tumors or other masses can compress venous structures, leading to impaired drainage and venous hypertension. For example, a meningioma extending into venous structures (such as the cavernous sinus) could cause this. 4. Idiopathic Intracranial Hypertension (IIH): Also known as pseudotumor cerebri, this condition occurs without an obvious cause but is associated with increased intracranial pressure and venous outflow resistance. 5. Obstructive Hydrocephalus: Accumulation of cerebrospinal fluid (CSF) can lead to increased pressure that impacts venous return.

### Symptoms of Intracranial Venous Hypertension: - Headache: Often worse in the morning or after straining. - Visual Disturbances: Due to increased pressure on the optic nerve (papilledema). - Nausea and Vomiting: Caused by raised intracranial pressure. - Seizures: As venous hypertension can lead to cerebral edema or ischemia. - Cognitive or Behavioral Changes: Due to chronic increased pressure.

### Diagnosis: - MRI/MRV: Imaging of the brain to assess venous structures, rule out venous sinus thrombosis, or detect other causes. - Lumbar Puncture: To measure CSF pressure and assess if it’s elevated. - Angiography: Sometimes used to visualize venous outflow.

### Treatment: - Addressing the Cause: For example, anticoagulation for venous sinus thrombosis, or surgery to remove a compressing tumor like a meningioma. - CSF Shunting: If hydrocephalus is contributing to pressure. - Medications: Dexamethasone to reduce inflammation or acetazolamide to decrease CSF production in cases of IIH.

For your case, where a meningioma affects venous structures like the cavernous sinus, monitoring for signs of intracranial venous hypertension and timely intervention is essential to prevent complications.