Document Detail

Increased intra-abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri.
MedLine Citation:
PMID:  9270586     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine whether intra-abdominal pressure (as estimated from urinary bladder pressure) is elevated in patients with central obesity (as measured by sagittal abdominal diameter) and pseudotumor cerebri and whether this increased intra-abdominal pressure is associated with increased pleural pressure and cardiac filling pressure, implying a resistance to venous return from the brain. DESIGN: Nonrandomized, prospective. SETTING: University hospital, operating room. MAIN OUTCOME MEASUREMENTS: Intracranial pressure, urinary bladder pressure, sagittal abdominal diameter, transesophageal pleural pressure, central venous pressure, pulmonary artery pressure, and pulmonary artery occlusion pressure. SUBJECTS: Six women with pseudotumor cerebri (one with CSF leak, one with lumboperitoneal shunt). RESULTS: Urinary bladder pressure (22 +/- 3 cm H2O) and sagittal abdominal diameter (29 +/- 3 cm) were significantly elevated in these patients with elevated intracranial pressure (293 +/- 80 mm H2O) compared with a previously reported group of nonobese control patients. The transesophageal pleural pressure (15 +/- 10 mm Hg), central venous pressure (20 +/- 6 mm Hg), mean pulmonary artery pressure (31 +/- 6 mm Hg), and pulmonary artery occlusion pressure (21 +/- 7 mm Hg) were all markedly elevated compared with published normal values and with previous data from obese patients without pseudotumor cerebri. CONCLUSIONS: These data support the hypothesis that central obesity raises intra-abdominal pressure, which increases pleural pressure and cardiac filling pressure, which impede venous return from the brain, leading to increased intracranial venous pressure and increased intracranial pressure associated with pseudotumor cerebri.
H J Sugerman; E J DeMaria; W L Felton; M Nakatsuka; A Sismanis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurology     Volume:  49     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  1997 Aug 
Date Detail:
Created Date:  1997-09-17     Completed Date:  1997-09-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  507-11     Citation Subset:  AIM; IM    
Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA.
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MeSH Terms
Abdomen / physiopathology*
Coronary Circulation*
Gastric Bypass
Headache / etiology
Heart / physiopathology*
Obesity / complications*,  surgery
Prospective Studies
Pseudotumor Cerebri / etiology*,  physiopathology*
Tinnitus / etiology

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