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Intracranial Hypertension (intracranial + hypertension)

Distribution by Scientific Domains
Medical Sciences100%
Distribution within Medical Sciences
Neurology53%
Anesthesia & Pain Management19%
5 Other Subdomains28%

Kinds of Intracranial Hypertension

  • idiopathic intracranial hypertension
    		•

    Selected Abstracts

    Cerebellar Tonsillar Herniation After Weight Loss in a Patient With Idiopathic Intracranial Hypertension

    HEADACHE, Issue 1 2010
    Jerome J. Graber MD
    (Headache 2010;50:146-148) Acquired cerebellar tonsillar herniation is a known complication of lumboperitoneal shunt (LPS) for any indication, including idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri.1 While the underlying pathophysiology of IIH remains unknown, increasing body mass index is a clear risk factor for the development of IIH. We describe an obese patient with IIH unresponsive to LPS who developed symptoms of intracranial hypotension and cerebellar tonsillar herniation after bariatric surgery and a 50-kg weight loss. [source]

    Topiramate-Responsive Headache Due to Idiopathic Intracranial Hypertension in Behçet Syndrome

    HEADACHE, Issue 5 2004
    Enrique Palacio MD
    A 14-year-old adolescent was seen with an 8-month history of almost daily incapacitating headaches due to idiopathic intracranial hypertension in Behçet syndrome. All his clinical signs and symptoms, including headache, resolved 2 to 4 weeks after topiramate was initiated. An effect on carbonic anhydrase isoenzymes II and IV, reducing cerebrospinal fluid production, could potentially explain the beneficial effect of topiramate in intracranial hypertension. Further studies are necessary, however, to confirm the significance of topiramate in this indication. [source]

    Idiopathic Intracranial Hypertension and PostlumbarPuncture Headache

    HEADACHE, Issue 2 2004
    Yince Loh MD
    Idiopathic intracranial hypertension and low cerebrospinal pressure are 2 conditions that are thought to be on opposite ends of the cerebrospinal pressure spectrum. Headache is the prominent component of both conditions. We describe a patient whose evaluation for idiopathic intracranial hypertension resulted in a postlumbar puncture headache. Although not entirely intuitive, we suggest that the 2 conditions can be present in the same patient. [source]

    Benign intracranial hypertension associated with arteriovenous malformation

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2002
    E B A Vorstman MRCPCH
    This is a report of a 9-year-old female with a clinical presentation of benign intracranial hypertension (BIH) who was found to have an unruptured pial arteriovenous malformation (AVM) with a significant fistula. The AVM was completely embolized using a recently developed liquid embolic system, Onyx, after which gradual clinical improvement followed. A few cases of BIH associated with AVM have been described in adults and adolescents. Possible causal relation is discussed. [source]

    Gliomatosis cerebri in a 10,year-old girl masquerading as diffuse encephalomyelitis and spinal cord tumour

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2001
    Sandeep Jayawant
    Gliomatosis cerebri is the unifying term used when diffuse glial infiltration occurs throughout the cerebral hemispheres. The very few cases reported in children have presented with intractable epilepsy, corticospinal tract deficits, unilateral tremor, headaches, and developmental delay. Antemortem diagnosis is difficult because of the vagueness of the physical, radiological and pathological findings. Adult cases may simulate an acute diffuse encephalomyelitis and show postmortem evidence of a marked swelling of the spinal cord. Apparently benign intracranial hypertension with papilloedema has also been recorded. We report a 10,year-old girl who presented with a history and physical signs suggestive of benign intracranial hypertension. A diffuse encephalomyelopathy occurred, which was complicated by spinal cord swelling, followed by deterioration and death. Gliomatosis cerebri affecting the brain and spinal cord was found at postmortem examination. [source]

    Obstruction of cerebral venous sinus secondary to idiopathic intracranial hypertension

    EUROPEAN JOURNAL OF NEUROLOGY, Issue 12 2008
    A. Stienen
    Background:, Whether cerebral venous sinus obstruction is a cause or consequence of idiopathic intracranial hypertension (IIH) is uncertain. Methods and results:, Among the nine children with IIH, five showed stenosis (n = 5) and occlusion (n = 1) of cerebral venous sinus on cranial magnetic resonance imaging (n = 4) or conventional angiography (n = 1), respectively. Follow-up magnetic resonance imaging performed in four children showed complete regression of the venous pathology in one and partial regression in two of them. Conclusions:, Our data demonstrate that cerebral venous sinus obstruction is frequent and frequently transient in pediatric IIH and suggest that stenoses may result from elevated intracranial pressure. [source]

    Cerebellar Tonsillar Herniation After Weight Loss in a Patient With Idiopathic Intracranial Hypertension

    HEADACHE, Issue 1 2010
    Jerome J. Graber MD
    (Headache 2010;50:146-148) Acquired cerebellar tonsillar herniation is a known complication of lumboperitoneal shunt (LPS) for any indication, including idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri.1 While the underlying pathophysiology of IIH remains unknown, increasing body mass index is a clear risk factor for the development of IIH. We describe an obese patient with IIH unresponsive to LPS who developed symptoms of intracranial hypotension and cerebellar tonsillar herniation after bariatric surgery and a 50-kg weight loss. [source]

    Topiramate-Responsive Headache Due to Idiopathic Intracranial Hypertension in Behçet Syndrome

    HEADACHE, Issue 5 2004
    Enrique Palacio MD
    A 14-year-old adolescent was seen with an 8-month history of almost daily incapacitating headaches due to idiopathic intracranial hypertension in Behçet syndrome. All his clinical signs and symptoms, including headache, resolved 2 to 4 weeks after topiramate was initiated. An effect on carbonic anhydrase isoenzymes II and IV, reducing cerebrospinal fluid production, could potentially explain the beneficial effect of topiramate in intracranial hypertension. Further studies are necessary, however, to confirm the significance of topiramate in this indication. [source]

    Idiopathic Intracranial Hypertension and PostlumbarPuncture Headache

    HEADACHE, Issue 2 2004
    Yince Loh MD
    Idiopathic intracranial hypertension and low cerebrospinal pressure are 2 conditions that are thought to be on opposite ends of the cerebrospinal pressure spectrum. Headache is the prominent component of both conditions. We describe a patient whose evaluation for idiopathic intracranial hypertension resulted in a postlumbar puncture headache. Although not entirely intuitive, we suggest that the 2 conditions can be present in the same patient. [source]

    Cutaneous acanthamebiasis infection in immunocompetent and immunocompromised patients

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2009
    Carlos Galarza MD
    Background, Cutaneous acanthamebiasis is a rare infection and few patients have been reported worldwide. Methods, Observational and descriptive study carried out from March 1996 to February 2006 in patients with diagnosis of cutaneous free-living amebic infection caused by Acanthamoeba spp. The patients were diagnosed at the Dos de Mayo National Hospital (Lima-Peru) where skin biopsies, histopathologic studies and cultures were performed. The clinical and epidemiologic characteristics, diagnosis, treatment and evolution were recorded in a survey. Results, Five patients with cutaneous free-living amebic infection caused by Acanthamoeba spp. were identified. Skin lesions were ulceronecrotic (four patients), an infiltrative bluish plaque (one patient), and a periorbital tumor (one patient). Three patients were positive for human immunodeficiency virus (HIV), had only cutaneous involvement, and died of opportunistic infections. The two immunocompetent patients developed Acanthamoeba granulomatous encephalitis and meningoencephalitis that progressed to intracranial hypertension and death. Conclusion, The clinical manifestations of cutaneous free-living amebic infection caused by Acanthamoeba spp. appear to vary according to the underlying immunologic status. [source]

    Transverse sinus septum: A new aetiology of idiopathic intracranial hypertension?

    JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 2 2004
    Rathan M Subramaniam
    Summary A venographic cryptic stenosis at the junction of middle and lateral third of the transverse sinus has been observed in patients suffering from idiopathic intracranial hypertension. After reviewing the anatomical and embryological literature of the transverse sinus, 20 transverse sinuses were explored (in a pilot study of 10 human cadavers) in order to determine the anatomical basis of this stenosis. The presence of septa of varying sizes was observed. We conclude that the presence of a large septum is one of the causes of venographic cryptic stenosis observed in these patients and might be one of the aetiological factors involved in idiopathic intracranial hypertension. [source]

    Application of intensive care medicine principles in the management of the acute liver failure patient

    LIVER TRANSPLANTATION, Issue S2 2008
    David J. Kramer
    Key Points 1Acute liver failure is a paradigm for multiple system organ failure that develops as a consequence of sepsis. 2In the United States, systemic inflammatory response, sepsis, and septic shock are common reasons for intensive care unit admission. Intensive care management of these patients serves as a template for the management of patients with acute liver failure. 3Acute liver failure is attended by high mortality. Although intensive care results in improved survival, the key treatment is liver transplantation. Intensive care unit intervention may open a "window of opportunity" and enable successful liver transplantation in patients who are too ill at presentation. 4Intracranial hypertension complicates the course for many patients with acute liver failure. Initially, intracranial hypertension results from hyperemia, which is cerebral edema that reduces cerebral blood flow and eventuates in herniation. The precepts of neurocritical care,monitoring cerebral perfusion pressure, cerebral blood flow, and cortical activity,with rapid response to hemodynamic abnormalities, maintenance of normoxia, euglycemia, control of seizures, therapeutic hypothermia, osmotic therapy, and judicious hyperventilation are key to reducing mortality attributable to neurologic failure. Liver Transpl 14:S85,S89, 2008. © 2008 AASLD. [source]

    Prevention and management of brain edema in patients with acute liver failure

    LIVER TRANSPLANTATION, Issue S2 2008
    Fin Stolze Larsen
    Key Points 1Intracranial pressure is the pressure exerted by the cranial contents on the dural envelope and consists of the partial pressures of the brain, blood, and cerebrospinal fluid. 2Severe cases of acute liver failure are frequently complicated by brain edema (due to cytotoxic edema) and an increase in cerebral blood flow while the cerebrospinal fluid volume remains constant. 3The development of intracranial hypertension in patients with acute liver failure may be controlled by manipulation of the position, body temperature, plasma tonicity, arterial carbon dioxide tension, and arterial pressure. 4If intracranial hypertension evolves despite these first-tier interventions, increased sedation, induction of hypothermia (body temperature of 33°C to 34°C), and the use of anti-inflammatory drugs may help secure brain viability. Liver Transpl 14:S90,S96, 2008. © 2008 AASLD. [source]

    Management of critically ill children with traumatic brain injury

    PEDIATRIC ANESTHESIA, Issue 6 2008
    GILLES A. ORLIAGUET MD PhD
    Summary The management of critically ill children with traumatic brain injury (TBI) requires a precise assessment of the brain lesions but also of potentially associated extra-cranial injuries. Children with severe TBI should be treated in a pediatric trauma center, if possible. Initial assessment relies mainly upon clinical examination, trans-cranial Doppler ultrasonography and body CT scan. Neurosurgical operations are rarely necessary in these patients, except in the case of a compressive subdural or epidural hematoma. On the other hand, one of the major goals of resuscitation in these children is aimed at protecting against secondary brain insults (SBI). SBI are mainly because of systemic hypotension, hypoxia, hypercarbia, anemia and hyperglycemia. Cerebral perfusion pressure (CPP = mean arterial blood pressure , intracranial pressure: ICP) should be monitored and optimized as soon as possible, taking into account age-related differences in optimal CPP goals. Different general maneuvers must be applied in these patients early during their treatment (control of fever, avoidance of jugular venous outflow obstruction, maintenance of adequate arterial oxygenation, normocarbia, sedation,analgesia and normovolemia). In the case of increased ICP and/or decreased CPP, first-tier ICP-specific treatments may be implemented, including cerebrospinal fluid drainage, if possible, osmotic therapy and moderate hyperventilation. In the case of refractory intracranial hypertension, second-tier therapy (profound hyperventilation with PaCO2 < 35 mmHg, high-dose barbiturates, moderate hypothermia, decompressive craniectomy) may be introduced, after a new cerebral CT scan. [source]

    Post dural puncture headache in a pediatric patient with idiopathic intracranial hypertension

    PEDIATRIC ANESTHESIA, Issue 9 2005
    OLUBUKOLA O. NAFIU MD FRCA
    Summary We describe the occurrence of postdural puncture headache (PPDH) in an adolescent with idiopathic intracranial hypertension (IIH) and its successful management with an epidural blood patch. PPDH is a very rare occurrence in patients with intracranial hypertension and is described as a paradoxical situation in the literature. There are only two previous case reports (in adults) of the possible association. A 15-year-old obese patient with a diagnosis of IIH had an uneventful diagnostic spinal tap using a 22G Quincke needle in the pediatric emergency department but returned 24 h later with PPDH. After a failed trial of conservative management, she had an uneventful but curative epidural blood patch with 15 ml of autologous venous blood and was able to return to school the day after the blood patch. Follow-up review by her neuro-ophthalmologist shows resolution of her headaches, considerable improvement in her visual field defect and resolution of papilledema. This is the first report of PPDH and its successful management with an epidural blood patch in a pediatric patient with IIH. [source]

    Endoscopic Endonasal Management of Pseudotumor Cerebri: Is it Effective?

    THE LARYNGOSCOPE, Issue 7 2007
    Ashok K. Gupta MD
    Abstract Purpose: To study the efficacy and safety of endoscopic endonasal optic nerve fenestration for the management of idiopathic intracranial hypertension (IIH). Design: A prospective study at a tertiary care center. Patients and Methods: All patients with a final diagnosis of IIH from July 2001 to March 2005 were included and subjected to detailed neuro-ophthalmologic examination and endoscopic endonasal optic nerve fenestration. Postoperative visual acuity and the perimetry was compared with the preoperative status, and the results were analyzed using the ,2 test. Results: Of the 18 patients included in the study, 17 had improvement in vision postoperatively. Fifteen patients had visual deterioration in the other eye as well, and of these, 12 had improvement, obviating the need for surgery on the other side. Complications were minimal and in the form of synechiae in two of the cases. Discussion: A number of procedures have been described for the management of this entity, and each is associated with a significant morbidity; therefore, there was a need for a minimally invasive procedure. The procedure adopted in the series is minimally invasive and is associated with a 94.5% success rate and minimal morbidity. Conclusions: Endoscopic endonasal optic nerve fenestration is a safe, minimally invasive, and extremely effective procedure for the management of IIH. [source]

    Hypertonic saline in critical care: a review of the literature and guidelines for use in hypotensive states and raised intracranial pressure,

    ANAESTHESIA, Issue 9 2009
    G. F. Strandvik
    Summary Hypertonic saline has been in clinical use for many decades. Its osmotic and volume-expanding properties make it theoretically useful for a number of indications in critical care. This literature review evaluates the use of hypertonic saline in critical care. The putative mechanism of action is presented, followed by a narrative review of its clinical usefulness in critical care. The review was conducted using the Scottish Intercollegiate Guidelines Network method for the review of cohort studies, randomised-controlled trials and meta-analyses. The review focuses specifically on blood pressure restoration and outcome benefit in both haemorrhagic and non-haemorrhagic shock, and the management of raised intracranial pressure. Issues of clinical improvement and outcome benefit are addressed. Hypertonic saline solutions are effective for blood pressure restoration in haemorrhagic, but not other, types of shock. There is no survival benefit with the use of hypertonic saline solutions in shock. Hypertonic saline solutions are effective at reducing intracranial pressure in conditions causing acute intracranial hypertension. There is no survival or outcome benefit with the use of hypertonic saline solutions for raised intracranial pressure. Recommendations for clinical use and future directions of clinical research are presented. [source]

    Persistent visual loss in malignant idiopathic intracranial hypertension

    ACTA OPHTHALMOLOGICA, Issue 8 2009
    Aurore Mensah
    No abstract is available for this article. [source]

    INTRAPERITONEAL GLYCEROL INDUCES OXIDATIVE STRESS IN RAT KIDNEY

    CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 8 2008
    Elenara Rieger
    SUMMARY 1Glycerol has been used for the treatment of intracranial hypertension, cerebral oedema and glaucoma. Experimentally, intramuscular administration of hypertonic glycerol solution is used to produce acute renal failure. In this model, glycerol causes rhabdomyolysis and myoglobinuria, resulting in the development of renal injury. The pathogenesis is thought to involve vascular congestion, the formation of casts and oxidative stress. However, the effect of glycerol itself independent of rhabdomyolysis has not been investigated. Therefore, the aim of the present study was to investigate the effects of i.p. glycerol on some biochemical and oxidative stress parameters in the kidney of young rats. 2Rats received 10 mL/kg, i.p., hypertonic glycerol solution (50% v/v) or saline (NaCl 0.85 g%) followed by 24 h water deprivation. Twenty-four hours after the administration of glycerol, rats were killed. Creatinine levels and the activity of creatine kinase (CK) and lactate dehydrogenase (LDH) were determined in the plasma. In addition, CK, pyruvate kinase and LDH activity and oxidative stress parameters (free radical formation, lipid peroxidation and protein carbonylation) were measured in renal tissue. 3Glycerol did not alter plasma CK activity and increased plasma creatinine levels, suggesting renal insufficiency and the absence of rhabdomyolysis. Renal CK and pyruvate kinase activity was decreased, suggesting diminution of energy homeostasis in the kidney. Plasma and renal LDH activity was decreased, whereas the formation of free radicals, lipid peroxidation and protein carbonylation were increased, suggesting oxidative stress. 4These results are similar to those described after the intramuscular administration of glycerol. Therefore, it is possible that glycerol may provoke renal lesions by mechanisms other than those induced by rhabdomyolysis. [source]