Bruns syndrome occurs in patients with an obstructing intraventricular mass and consists of abrupt paroxysms of:
- severe headache
The symptoms are characteristically exacerbated with sudden movements of the head.
There are two main theories as to the pathogenesis of Bruns syndrome:
- intraventricular mass episodically adopts a position, due to the sudden head movements, such that there is intermittent obstructive hydrocephalus and a rapid rise in intracranial pressure due to a ball-valve effect 2.
- irritation of the vestibular nuclei in the lower pons: this would help to explain why some individuals experience these unpleasant attacks despite the inability of the intracranial lesion to move
Historically, the primary cause of this presentation was an intraventricular tumor, which could be benign or malignant. Since the 1950s the typical patient has had intraventricular neurocysticercosis.
History and etymology
This entity was first described in 1902 by the German neurologist, Ludwig Bruns (1858-1916), who worked in Hanover 2. It was another German neurologist, Hermann Oppenheim (1858-1919), who coined the term Bruns syndrome 3.
- 1. Yvonne Chan, John C. Goddard. KJ Lee's Essential Otolaryngology, 12th edition. (2019) ISBN: 9781260122237
- 2. Krasnianski M, Müller T, Stock K, Zierz S. Bruns syndrome caused by intraventricular tumor. (2008) European journal of medical research. 13 (4): 179-81. Pubmed
- 3. Pearce JM. Hermann Oppenheim (1858-1919). (2003) Journal of neurology, neurosurgery, and psychiatry. 74 (5): 569. doi:10.1136/jnnp.74.5.569 - Pubmed