The Impact of Valsalva Manoeuvres and Exercise on Intracranial Pressure and Cerebrovascular Dynamics in Idiopathic Intracranial Hypertension

• DOI: 10.1080/01658107.2023.2281433
• Publication Date: 2023-11-22T17:12:45Z
• Authors: Andreas Yiangou; Samuel R. C. Weaver; Mark Thaller; James L. Mitchell; Hannah S. Lyons; Georgios Tsermoulas; Susan P. Mollan; Samuel J. E. Lucas; Alexandra J. Sinc...
• Keywords: Valsalva maneuver; Pseudotumor cerebri

Idiopathic intracranial hypertension (IIH) is a disease characterised by elevated pressure (ICP). The impact of straining and exercise on ICP regulation poorly understood yet clinically relevant to IIH patient care. We sought investigate the Valsalva manoeuvres (VMs) cerebrovascular haemodynamics in IIH. People with were prospectively enrolled had an intraparenchymal telemetric sensor inserted. Three participants (age [mean ± standard deviation]: 40.3 13.9 years) underwent continuous real-time monitoring coupled haemodynamic assessments during VMs moderate exercise. Participants supine measuring 15.3 8.7 mmHg (20.8 11.8 cm cerebrospinal fluid (CSF)) sitting −4.2 7.9 (−5.7 10.7 cmCSF). During phase I VM increased 29.4 13.5 (40.0 18.4 cmCSF) but returned baseline within 16 seconds from onset. pattern changes phases was associated that blood pressure, middle cerebral artery velocity prefrontal cortex haemodynamics. Exercise led minimal effects ICP. In conclusion, VM-induced showed no sustained did not lead prolonged elevation Those experiencing (for example, labour) may be reassured at brief nature changes. Future research must look corroborate findings larger cohort.