Higgins, Nicholas, Pickard, John, Lever, Andrew · Journal of neurological surgery reports · 2015 · DOI
This case study describes one woman with severe chronic fatigue syndrome (ME/CFS) who was found to have slightly elevated pressure inside her skull. Doctors discovered that blood vessels in her brain were narrowed, similar to a condition called idiopathic intracranial hypertension. When doctors placed stents (small tubes) to open these narrowed vessels, her fatigue symptoms dramatically improved and stayed better for at least 2 years.
This study raises an intriguing hypothesis that a subset of ME/CFS patients may have undetected elevated intracranial pressure amenable to vascular intervention. It suggests a potential biological mechanism and therapeutic pathway for a condition often dismissed as psychosomatic, which could redirect clinical investigation and treatment approaches for severely affected patients.
This single case report cannot establish that elevated intracranial pressure causes ME/CFS or that it applies to all or even most ME/CFS patients. The dramatic response in one patient does not prove causation, and the improvement could reflect placebo effect, natural variation, or other unmeasured factors. Larger controlled studies are needed before recommending invasive procedures for ME/CFS populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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