The spectrum of progressive multifocal leukoencephalopathy: a practical approach.

John Cunningham virus (JCV) infection of the central nervous system causes progressive multifocal leukoencephalopathy (PML) in patients with systemic immunosuppression. With the increased application of modern immunotherapy and biologics in various immune-mediated disorders, the PML risk spectrum has changed. Thus, new tools and strategies for risk assessment and stratification in drug-associated PML such as the JCV antibody indices have been introduced. Imaging studies have highlighted atypical presentations of cerebral JCV disease such as granule cell neuronopathy. Imaging markers have been developed to differentiate PML from new multiple sclerosis lesions and to facilitate the early identification of pre-clinical manifestations of PML and its immune reconstitution inflammatory syndrome. PML can be diagnosed either by brain biopsy or by clinical, radiographic and virological criteria. Experimental treatment options including immunization and modulation of interleukin-mediated immune response are emerging. PML should be considered in any patient with compromised systemic or central nervous system immune surveillance presenting with progressive neurological symptoms.

Classical Branch Structure from Spatial Redundancy in a Many-Body Wave Function.

When the wave function of a large quantum system unitarily evolves away from a low-entropy initial state, there is strong circumstantial evidence it develops "branches": a decomposition into orthogonal components that is indistinguishable from the corresponding incoherent mixture with feasible observations. Is this decomposition unique? Must the number of branches increase with time? These questions are hard to answer because there is no formal definition of branches, and most intuition is based on toy models with arbitrarily preferred degrees of freedom. Here, assuming only the tensor structure associated with spatial locality, I show that branch decompositions are highly constrained just by the requirement that they exhibit redundant local records. The set of all redundantly recorded observables induces a preferred decomposition into simultaneous eigenstates unless their records are highly extended and delicately overlapping, as exemplified by the Shor error-correcting code. A maximum length scale for records is enough to guarantee uniqueness. Speculatively, objective branch decompositions may speed up numerical simulations of nonstationary many-body states, illuminate the thermalization of closed systems, and demote measurement from fundamental primitive in the quantum formalism.

[Psychosocial situation of families with chronically ill children: a survey of parent initiatives]. / Psychosoziale Lage von Familien mit chronisch kranken Kindern: Eine Befragung betroffener Eltern in Selbsthilfegruppen.

Children with chronic illness or disabilities and their families require more support than healthy families. The working group "custodial and psychosocial supply" defined 4 theses to figure out deficits and targets of family support: 1) my child is different; 2) my child is not devisable; 3) my child needs strong helpers; and 4) my child needs safety.Based on these theses, a questionnaire for parents was designed of which 20 were sent to 34 parent initiatives in Germany each, for distribution to a random sample of member families.499/680 questionnaires were returned of which 419 could be included in the analysis. Less than 50% of the parents felt adequately and timely informed about their child's condition, and support for coping with the child's diagnosis was rarely given. Less than half of the parents reported to have been informed about the options for support within the German social system, and less than 15% were aware of instructions for clearing houses on care and support. About a third of the parents reported needs for managing family, siblings or household, but only a third of these had been offered organised and structured family support. More than 50% of the families reported restraints in participating in social life: such restraints were associated with problems in partnership and loss of friends. Half of the parents felt restraints of the family income because of their child's condition.There is need for improvement of the psychosocial condition of families with chronically ill or disabled children by better, more and timely information about the child's clinical condition, access to the social support system and availability of support services.

Amplification, redundancy, and quantum Chernoff information.

Amplification was regarded, since the early days of quantum theory, as a mysterious ingredient that endows quantum microstates with macroscopic consequences, key to the "collapse of the wave packet," and a way to avoid embarrassing problems exemplified by Schrödinger's cat. Such a bridge between the quantum microworld and the classical world of our experience was postulated ad hoc in the Copenhagen interpretation. Quantum Darwinism views amplification as replication, in many copies, of the information about quantum states. We show that such amplification is a natural consequence of a broad class of models of decoherence, including the photon environment we use to obtain most of our information. This leads to objective reality via the presence of robust and widely accessible records of selected quantum states. The resulting redundancy (the number of copies deposited in the environment) follows from the quantum Chernoff information that quantifies the information transmitted by a typical elementary subsystem of the environment.

Effects of suboptimal or excessive gestational weight gain on childhood overweight and abdominal adiposity: results from a retrospective cohort study.

BACKGROUND: Defining prenatal modifiable risk factors of childhood overweight and obesity has become critical as the need of primary preventive strategies increases. OBJECTIVE: To investigate the interrelationship between inadequate or excessive gestational weight gain (GWG), according to maternal prepregnancy body mass index (BMI)-specific Institute of Medicine (IOM) recommendations, and childhood overweight and abdominal adiposity. DESIGN: In a retrospective cohort study in Germany, data of 6837 mother-child dyads were obtained from medical records, a questionnaire and by anthropometric measurements of children at school entry. Main exposure was GWG as categorized by the 2009 IOM guidelines and as a continuous variable. Outcome measures were children's overweight and abdominal adiposity defined as ≥ 90 th age- and sex-specific percentiles for BMI and waist circumference, respectively. RESULTS: During pregnancy, more than half of mothers (53.6%) had gained weight excessively. Among the children (mean age: 5.8 years), 10.5% were overweight and 15.1% had abdominal adiposity. A nonlinear relationship between absolute GWG and the risk of offspring overweight and abdominal adiposity was observed. An increased risk of childhood overweight was related to excessive compared with recommended GWG, after adjustment for potential confounders (odds ratio (OR): 1.57, 95% confidence interval (CI): 1.30, 1.91), but not to inadequate GWG. Similar results were obtained for the risk of childhood abdominal adiposity by excessive GWG (OR: 1.39, 95% CI: 1.19, 1.63); there was no association with inadequate GWG. Analyses stratified by maternal prepregnancy BMI category did not suggest effect modification. CONCLUSION: Exceeding the recommended BMI-specific IOM GWG ranges has an adverse impact on the risk of childhood overweight and abdominal adiposity, whereas suboptimal GWG conveys no benefit or risk, reflecting a nonlinear relationship between absolute GWG and the risk of childhood overweight and adiposity. Strategies focussing on the awareness and prevention of excessive GWG and its consequences are justified.

Inhibitory effect of high-dosage zinc oxide dietary supplementation on Campylobacter coli excretion in weaned piglets.

AIMS: This study investigated the impact of zinc oxide (ZnO) on Campylobacter coli by in vivo and in vitro assays. METHODS AND RESULTS: By in vitro growth inhibition assays, a high susceptibility of Camp. coli against ZnO could be observed. At concentrations ≥ 2.6 mmol l(-1) ZnO, a decline in cell numbers occurred. Quantitative real-time PCR assays demonstrated an up-regulation of the main oxidative stress gene (katA) in response to ZnO treatment. The expression level of katA was increased by fivefold after ZnO treatment. An experiment was carried out in pigs to elucidate the impact of ZnO as feed supplement on Camp. coli faecal excretion. Feeding a high-dosage ZnO concentration (3100 mg kg(-1) ) to piglets significantly reduced the faecal excretion of Camp. coli by up to 1 log CFU g(-1) as compared to animals receiving a low (40 mg kg(-1) ) or medium (100 mg kg(-1) ) ZnO diet. CONCLUSION: In vitro assays showed a high susceptibility of Camp. coli against ZnO. Adding high levels of ZnO to the diet of weaned piglets reduced Camp. coli excretion significantly. There is evidence for the induction of an oxidative stress response by ZnO supplementation in Camp. coli. SIGNIFICANCE AND IMPACT OF THE STUDY: Supplementation of a high-dosage ZnO diet to piglets can reduce the Camp. coli load, potentially leading to a lower contamination risk of meat during slaughter.

[Off-label use and G-BA. Legal framework for off-label use]. / Off-label-Use und G-BA. Rechtliche Rahmenbedingungen für Off-label-Use.

Off-label use of medicinal products, i.e. beyond their submitted, tested and approved indications, lies between 30 and 90%--depending on the indication. In dermatology, off-label use is of special importance, for even guideline-endorsed standard therapeutic approaches for common dermatological diseases like atopic eczema, psoriasis, or malignant melanoma are to some extent not licensed for these indications. In addition, many of the approximately 5000 dermatological diseases have a low prevalence. For many such orphan diseases, there are no approved drugs, and it is not feasible that licensing studies will be performed for these indications within a foreseeable time. A reliable legal framework for the reimbursement of medicinal products that are used off-label is essential both for patients and to allow physicians to choose the most adequate therapy. Therefore, off-label use expert groups have been convened by the Federal Ministry of Health (BMG) in order to improve patient care. So far this new and innovative approach has not provided any reasonable improvement for many patients with dermatological diseases whose treatment can only be off-label since a comprehensive evaluation of all off-label indications is not possible. The following statement of the former Federal Minister of Health, U. Schmidt, is particularly true for dermatological therapy: "Good oncologic care also requires a good drug treatment--especially in the outpatient setting. The use of drugs which are not or not yet approved for this indication is often required here". Federal Minister of Health, Ulla Schmidt, 25th German Cancer Congress, 10 March 2002, Berlin.

Multicenter study of the safety and effectiveness of intracranial aneurysm treatment with the p64MW-HPC flow modulation device.

BACKGROUND AND PURPOSE: The new p64 flow diverter with hydrophilic polymer coating (HPC) was designed to reduce thrombogenicity. To date, it is unclear how antithrombogenic surface modifications affect neoendothelialization and thrombus formation in patients with unruptured intracranial aneurysms. The purpose of this study was to evaluate the safety and effectiveness of the p64MW-HPC in the treatment of unruptured aneurysms of small to giant size and of both the anterior and posterior circulation. MATERIALS AND METHODS: Between March 2020 and October 2022 all patients with unruptured intracranial aneurysms treated with the p64MW-HPC were included at five neurovascular centers. Demographic data, aneurysm characteristics, antiplatelet therapy, procedural complications, and clinical and angiographic outcomes were recorded. RESULTS: A total of 100 patients with 100 unruptured intracranial aneurysms met the inclusion criteria. Eighty-three aneurysms were classified as saccular, 12 aneurysms were fusiform, 4 aneurysms dissecting, and 1 aneurysm was blister-like. Dual antiplatelet therapy with Clopidogrel and Aspirin was given in 68 cases, and with Ticagrelor and Aspirin in 24 cases. Technical issues with deployment were encountered in 14 cases (torsion (n = 3), foreshortening (n = 8), and incomplete opening (n = 3)). Ischemic stroke occurred in a total of seven cases. In one patient a wire perforation and subsequent severe ICH occurred. Complete aneurysm occlusion at angiographic follow-up (mean time = 7 months) was seen in 73% and adequate occlusion in 93%. CONCLUSION: This study is the largest multicenter study to date documenting the safety and effectiveness of the new antithrombogenic p64MW-HPC in the treatment of unruptured intracranial aneurysms of the anterior and posterior circulation.

Cranial nerve injuries in patients with moderate to severe head trauma - Analysis of 91,196 patients from the TraumaRegister DGU® between 2008 and 2017.

OBJECTIVE: Traumatic brain injury (TBI) constitutes a major cause of trauma-related disability and mortality. The epidemiology and implications of associated cranial nerve injuries　(CNI)　in moderate to severe TBI are largely unknown. We aimed to determine the incidence of CNI in a large European cohort of TBI patients as well as clinical differences between TBI cases with and without concomitant CNI (CNI vs. control group) by means of a multinational trauma registry. METHODS: The TraumaRegister DGU® was evaluated for trauma patients with head injuries ≥ 2 Abbreviated Injury Scale, who had to be treated on intensive care units after emergency admission to European hospitals between 2008 and 2017. CNI and control cases were compared with respect to demographic, clinical, and outcome variables. RESULTS: 1.0% (946 of 91,196) of TBI patients presented with additional CNI. On average, CNI patients were younger than control cases (44.3 ± 20.6 vs. 51.8 ± 23.0 years) but did not differ regarding sex distribution (CNI 69.4% males vs. control 69.1%). Traffic accidents were encountered more frequently in CNI cases (52.3% vs. 46.7%; p < 0.001; chi-squared test) and falls more commonly in the control group (45.2% vs. 37.1%; p < 0.001). CNI patients suffered more frequently from concomitant face injuries (28.2% vs. 17.5%; p < 0.001) and skull base fractures (51.0% vs. 23.5%; p < 0.001). Despite similar mean Injury Severity Score (CNI 21.8 ± 11.3; control 21.1 ± 11.7) and Glasgow Coma Scale score (CNI 10.9 ± 4.2, control 11.1 ± 4.4), there was a considerably higher proportion of anisocoria in CNI patients (20.1% vs. 11.2%; p < 0.001). Following primary treatment, 50.8% of CNI and 35.5% of control cases showed moderate to severe disability (Glasgow Outcome Scale score 3-4; p < 0.001). CONCLUSION: CNI rarely occur in the context of TBI. When present, they indicate a higher likelihood of functional impairment following primary care and complicating skull base fractures should be suspected.

From animal studies into clinical trials: the relevance of animal models to develop vaccines and therapies to reduce disease severity and prevent hRSV infection.

INTRODUCTION: Human respiratory syncytial virus (hRSV) is an important cause of lower respiratory tract infections in the pediatric and the geriatric population worldwide. There is a substantial economic burden resulting from hRSV disease during winter. Although no vaccines have been approved for human use, prophylactic therapies are available for high-risk populations. Choosing the proper animal models to evaluate different vaccine prototypes or pharmacological treatments is essential for developing efficient therapies against hRSV. AREAS COVERED: This article describes the relevance of using different animal models to evaluate the effect of antiviral drugs, pharmacological molecules, vaccine prototypes, and antibodies in the protection against hRSV. The animal models covered are rodents, mustelids, bovines, and nonhuman primates. Animals included were chosen based on the available literature and their role in the development of the drugs discussed in this manuscript. EXPERT OPINION: Choosing the correct animal model is critical for exploring and testing treatments that could decrease the impact of hRSV in high-risk populations. Mice will continue to be the most used preclinical model to evaluate this. However, researchers must also explore the use of other models such as nonhuman primates, as they are more similar to humans, prior to escalating into clinical trials.

Contrast inversion in electrostatic force microscopy imaging of trapped charges: tip-sample distance and dielectric constant dependence.

We present a numerical and analytical study of the behavior of both electrostatic force and force gradient created by a charge trapped below the surface of a dielectric on an atomic force microscope tip as a function of the dielectric constant and tip-sample distance. As expected, the force decreases monotonously when the dielectric constant increases. However, a maximum in the dielectric constant dependence of the force gradient is found. This maximum occurs in the typical experimental parameters' range and depends on the tip-sample distance and the sample thickness. The analytical study permits us to understand the physical origin of this phenomenon and is in good agreement with the numerical simulation for small tip-sample distances. We also report a study exemplifying a possible contrast inversion in electrostatic force microscopy (EFM) signals while scanning, at different heights, two charges trapped in a sample having heterogeneous dielectric domains. In addition to this particular contrast inversion effect, this study can be considered as a way to gain insight into the mechanisms of EFM image formation as a function of the dielectric constant and tip-sample.

Numerical study of the lateral resolution in electrostatic force microscopy for dielectric samples.

We present a study of the lateral resolution in electrostatic force microscopy for dielectric samples in both force and gradient modes. Whereas previous studies have reported expressions for metallic surfaces having potential heterogeneities (Kelvin probe force microscopy), in this work we take into account the presence of a dielectric medium. We introduce a definition of the lateral resolution based on the force due to a test particle being either a point charge or a polarizable particle on the dielectric surface. The behaviour has been studied over a wide range of typical experimental parameters: tip-sample distance (1-20) nm, sample thickness (0-5) µm and dielectric constant (1-20), using the numerical simulation of the equivalent charge method. For potential heterogeneities on metallic surfaces expressions are in agreement with the bibliography. The lateral resolution of samples having a dielectric constant of more than 10 tends to metallic behaviour. We found a characteristic thickness of 100 nm, above which the lateral resolution measured on the dielectric surface is close to that of an infinite medium. As previously reported, the lateral resolution is better in the gradient mode than in the force mode. Finally, we showed that for the same experimental conditions, the lateral resolution is better for a polarizable particle than for a charge, i.e. dielectric heterogeneities should always look 'sharper' (better resolved) than inhomogeneous charge distributions. This fact should be taken into account when interpreting images of heterogeneous samples.

Three dimensional rotational angiography in surgical planning of aneurysm clipping.

BACKGROUND: Three-dimensional (3D) angiography is increasingly used in the diagnostics of brain aneurysms. Aim of the present study was to evaluate the accuracy of 3D angiograms with respect to its value for preoperative planning of aneurysm clipping. PATIENTS AND METHODS: The 3D angiograms of 42 patients with subarachnoid bleeding caused by aneurysm rupture of the anterior circle of Willis and the intradural carotid have been compared to intraoperative photographs of the aneurysms. RESULTS: Neighbouring vessels, aneurysm anatomy, arteries originating from the aneurysm wall were accurately shown decreasing the surgical risk of aneurysm clipping. CONCLUSIONS: The 3D images enabled a perfect preoperative planning through the operation by illuminating the aneurysm anatomy, neck localisation and shape and relation of the aneurysm to neighbouring vessels. Operative approach, use of an accurate clip and avoidance of clipping arteries close to the aneurysm have become predictable and safer by the use of 3D angiography.

Aneurysm Treatment in Acute SAH with Hydrophilic-Coated Flow Diverters under Single-Antiplatelet Therapy: A 3-Center Experience.

BACKGROUND AND PURPOSE: In certain clinical circumstances, dual-antiplatelet therapy can be problematic in patients with acute SAH. In some aneurysms, however, flow-diverting stents are the ideal therapeutic option. We report our experience with ruptured intracranial aneurysms treated with flow diverters with hydrophilic coating (p48 MW HPC and p64 MW HPC) under single-antiplatelet therapy. MATERIALS AND METHODS: Patients were treated with either flow-diverter placement alone or a flow diverter and additional coiling. Due to the severity of the hemorrhage, the potential for periprocedural rehemorrhage, and the potential for additional surgical interventions, a single-antiplatelet regimen was used in all patients. RESULTS: Thirteen aneurysms were treated in 10 patients. The median age was 62 years; 5 patients were male. All had acute SAH due to aneurysm rupture. Four blood-blister, 2 dissecting, and 7 berrylike aneurysms were treated. Seven aneurysms were adjunctively coiled. Eight of the 10 patients received a single-antiplatelet protocol of aspirin, 1 patient was treated with prasugrel only, and 1 patient was treated with tirofiban first and then switched to the aspirin single-antiplatelet protocol. One device-related complication occurred, a thrombosis of an overstented branch. All stents, however, remained open at DSA, CTA, or MRA follow-up. CONCLUSIONS: The implantation of flow diverters with reduced thrombogenicity due to hydrophilic surface coating under single-antiplatelet therapy seems to be an option in carefully selected cases of SAH due to aneurysm rupture.

Quantum Darwinism in an everyday environment: huge redundancy in scattered photons.

We study quantum Darwinism--the redundant recording of information about the preferred states of a decohering system by its environment--for an object illuminated by a blackbody. In the cases of point-source and isotropic illumination, we calculate the quantum mutual information between the object and its photon environment. We demonstrate that this realistic model exhibits fast and extensive proliferation of information about the object into the environment and results in redundancies orders of magnitude larger than the exactly soluble models considered to date.

Involvement of T helper type 17 and regulatory T cell activity in Citrobacter rodentium invasion and inflammatory damage.

Citrobacter rodentium is a murine pathogen that transiently colonizes the lumen of the large intestine. C. rodentium induces colitis, but the relative importance and temporal induction of the T helper type 17 (Th17) and regulatory T cell (T(reg)) pathways in protection from the infection and inflammation have not been assessed. Our aim was to investigate the key immunological signalling events associated with successful clearance of C. rodentium. Mice were challenged with luminescent-tagged C. rodentium and killed at days 3 (early infection), 10 (peak infection) and 21 (late infection) post-infection. Bioluminescent imaging and bacterial culture determined levels of C. rodentium. Distal colon mRNA expression of interleukin (IL)-17, IL-6, IL-1beta, tumour necrosis factor (TNF)-alpha, forkhead box P3 (FoxP3) and ghrelin were assessed using real-time polymerase chain reaction. Results were compared with age-matched non-infected mice. Low levels of C. rodentium were found at day 3, high levels at day 10, with clearance from the majority of the mice by day 21. In the distal colon, there was up-regulation of TNF-alpha and FoxP3 throughout the study and increases in IL-6 and IL-17 during the peak and late stages of infection. Ghrelin expression was increased at the peak and late stages of infection. This study has characterized changes to the T helper cell pathways, following the course of C. rodentium infection in mice. There were significant immunological changes, with up-regulation of the Th17 and T(reg) pathways in the distal colon and an increase in ghrelin expression compared with non-infected control mice. These changes may play a role in the pathology and clearance of C. rodentium.

Journey of the iodide transporter NIS: from its molecular identification to its clinical role in cancer.

The Na+/I- symporter (NIS) is an intrinsic plasma membrane protein that mediates the active transport of I- in the thyroid, lactating mammary gland, stomach and salivary glands. The presence of NIS in the thyroid is exploited in diagnostic scintigraphic imaging and radioiodide therapy in thyroid cancer. The continued rapid progress in NIS research (aimed at the elucidation of the Na+-dependent I- transport mechanism, the analysis of NIS structure-function relations and the study of the tissue-specific regulation of NIS at all levels), holds potentially far-reaching medical applications beyond thyroid disease, in breast cancer and malignancies in other tissues.

Maternal hypothyroxinemia impairs spatial learning and synaptic nature and function in the offspring.

Neurological deficits in the offspring caused by human maternal hypothyroxinemia are thought to be irreversible. To understand the mechanism responsible for these neurological alterations, we induced maternal hypothyroxinemia in pregnant rats. Behavior and synapse function were evaluated in the offspring of thyroid hormone-deficient rats. Our data indicate that, when compared with controls, hypothyroxinemic mothers bear litters that, in adulthood, show prolonged latencies during the learning process in the water maze test. Impaired learning capacity caused by hypothyroxinemia was consistent with cellular and molecular alterations, including: 1) lack of increase of phosphorylated c-fos on the second day of the water maze test; 2) impaired induction of long-term potentiation in response to theta-burst stimulation to the Schaffer collateral pathway in the area 1 of the hippocampus Ammon's horn stratum radiatum, despite normal responses for input/output experiments; 3) increase of postsynaptic density protein 95 (PSD-95), N-methyl-D-aspartic acid receptor subunit 1, and tyrosine receptor kinase B levels in brain extracts; and 4) significant increase of PSD-95 at the PSDs and failure of this molecule to colocalize with N-methyl-D-aspartic acid receptor subunit 1, as it was shown by control rats. Our findings suggest that maternal hypothyroxinemia is a harmful condition for the offspring that can affect key molecular components for synaptic function and spatial learning.

[Pseudotumor cerebri: quantitative in-vivo measurements of markers of intracranial hypertension]. / Pseudotumor cerebri: Quantitative Normalwerte anatomischer Kennstrukturen im kraniellen MRT.

PURPOSE: Intracranial hypertension can change the morphology of anatomical structures that are critical in the evaluation of pseudotumor syndromes. The purpose of our study was to establish the normal range of such markers of intracranial hypertension and to consider a dependency on sex, age and body-mass index (BMI). MATERIALS AND METHODS: 123 persons without signs or symptoms of intracranial hypertension (63 females, 60 males, 18- 86-years-old, mean 49.5 SD17.8 years, mean BMI 25.3 SD42) were prospectively enrolled and MRI was performed at 3T. A STIR sequence in the coronal plane was used to measure the width of the optic nerve, the perioptic fluid rim and the total optic nerve sheath diameter in 4 different locations behind the eyeball. The height and width of the pituitary and Meckel's cave were also measured and the area was calculated. RESULTS: The mean width of the optic nerve sheath narrows significantly from anterior (mean 5.3 SD 0.6 mm) to posterior (mean 4.1 SD 0.4 mm), as does the perioptic fluid rim (mean 1.4 SD 0.3 mm vs. mean 1.0 SD 0.2 mm) and--to a lesser extent--the optic nerve itself (mean 2.4 SD 0.4 mm vs. mean 2 SD 0.3 mm, p=0.000 for all). There was no statistically relevant correlation of the width of the optic nerve sheath with age. The coronal area of Meckel's cave was independent of sex, age or BMI (mean 39 SD 9.3 mm2). The height of the pituitary differed little in women (mean 4.4 SD 0.9 mm) and men (mean 4.2 SD 0.8 mm), but we found a significant negative correlation with age in women only (r = -0.38, p = 0.01). CONCLUSION: The presented typical values and their deviations serve as a basis for the evaluation of pathologies in patients suspected of having pseudotumor syndrome.

Quantitative Phase-Contrast MR Angiography to Measure Hemodynamic Changes in Idiopathic Intracranial Hypertension.

BACKGROUND AND PURPOSE: Idiopathic intracranial hypertension is a syndrome of raised intracranial pressure of unknown etiology. Few MR imaging-based studies have investigated arterial and venous blood flow in these patients. Results are inconclusive, and to our knowledge, no comparison of the hemodynamic parameters before and after CSF pressure reduction has been published. The aim of this study was to assess the short-term effects of normalizing CSF pressure on intracranial flow to better understand the pathophysiology of idiopathic intracranial hypertension. MATERIALS AND METHODS: In this study, we performed quantitative MR imaging-derived flow measurements of brain-supplying arteries and draining veins/dural sinuses to visualize hemodynamic changes in patients with idiopathic intracranial hypertension before and after therapy by lumbar puncture in comparison with a healthy control group. RESULTS: We found differences in patients before and after lumbar puncture in the calculated resistance and pulsatility indices in the superior sagittal sinus. Venous pulsatility showed a negative correlation with CSF pressure in untreated patients. Additionally, there was a trend toward lower flow in the superior sagittal sinus in patients compared with healthy controls. Flow in the internal jugular veins was significantly reduced by lumbar puncture, and the resistance and pulsatility indices differed in patients and controls. The arterial flow was not influenced by pressure normalization. CONCLUSIONS: The results of the present study indicate that venous but not arterial blood flow differs in patients compared with controls and that calculating resistance and pulsatility indices may contribute to assessing short-term hemodynamic changes in patients with diagnosed idiopathic intracranial hypertension before and after CSF diversion.