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Low Pressure Headache

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https://www.readbyqxmd.com/read/28545408/importance-of-correctly-interpreting-magnetic-resonance-imaging-to-diagnose-posterior-reversible-encephalopathy-syndrome-associated-with-hellp-syndrome-a-case-report
#1
Syuichi Tetsuka, Hiroaki Nonaka
BACKGROUND: Severe haemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome in pregnancy are possible underlying trigger factors for posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging (MRI) shows diffuse signal abnormalities involving the subcortical white matter in the parieto-occipital lobes. Although the diagnosis of RPES was clearly established by the distinctive reversibility of clinical and radiological abnormalities, it is difficult to distinguish from differential diagnosis...
May 25, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28510323/a-systematic-review-and-pooled-analysis-of-select-safety-parameters-among-normal-healthy-volunteers-taking-placebo-in-phase-1-clinical-trials
#2
Tina C Young, Subasree Srinivasan, Marion L Vetter, Venkat Sethuraman, Zubin Bhagwagar, Ricardo Zwirtes, Premkumar Narasimhan, Tilda Chuang, Brendan J Smyth
A systematic review of the Bristol-Myers Squibb normal healthy volunteers (NHVs) database identified phase 1 trials that included NHVs administered placebo with the aim of characterizing normal inter- and intraindividual safety parameter variability. Twenty-five single and multiple ascending dose studies, median duration 28 (2 to 63) days, were included in the pooled analysis (355 NHVs). Laboratory evaluations, vital signs, electrocardiograms, and adverse events were assessed. The most commonly occurring adverse event was headache (28 [7...
May 16, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28506404/-dural-sinus-thrombosis-following-epidural-analgesia-for-delivery-a-clinical-case
#3
Marco Aurelio Dornelles, Luis M Pereira
BACKGROUND AND OBJECTIVES: Neurological complications of spinal anesthesia are rare conditions. Headache caused by low pressure of the cerebrospinal fluid is one of the most frequent, which occurs after post-dural puncture. A comprehensive history and physical exam must be carried out before making the diagnosis of Post-Dural Puncture Headache (PDPH) and additional tests are necessary to exclude the possibility of developing serious neurological complications such as Dural Sinus Thrombosis (DST)...
May 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28504775/efficacy-of-epidural-blood-patches-for-spontaneous-low-pressure-headaches-a-case-series
#4
S Ansel, A Rae, A Tyagi
Patients with a spontaneous cerebrospinal fluid leak, normally at a spinal level, typically present with low-pressure headache. In refractory cases, an epidural blood patch may be attempted. We aimed to assess the efficacy of lumbar epidural blood patching in spontaneous, low-pressure headaches. Methods We retrospectively analysed notes of patients who had an epidural blood patch performed for spontaneous low-pressure headaches in a single centre. Information regarding demographics, radiology and clinic follow-up was extracted from an electronic patient record system...
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28459892/severe-headache-neck-pain-intermittent-cough-%C3%A2-dx
#5
Claudia Lyon, Swapna Sayeneni, Jeanne Carey
A 32-year-old Chinese woman sought care from our family medicine clinic because she had a headache, neck pain, and an intermittent cough that had produced white sputum for 7 days. She described the headache as severe and pressure-like, and said that it had progressively worsened over the previous 3 weeks, coinciding with her first trip outside of China to the United States. The patient indicated that she also had occasional vomiting, dizziness, a low-grade fever, chills, night sweats, and increasing fatigue...
May 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28429459/nitric-oxide-donors-nitrates-l-arginine-or-nitric-oxide-synthase-inhibitors-for-acute-stroke
#6
REVIEW
Philip Mw Bath, Kailash Krishnan, Jason P Appleton
BACKGROUND: Nitric oxide (NO) has multiple effects that may be beneficial in acute stroke, including lowering blood pressure, and promoting reperfusion and cytoprotection. Some forms of nitric oxide synthase inhibition (NOS-I) may also be beneficial. However, high concentrations of NO are likely to be toxic to brain tissue. This is an update of a Cochrane review first published in 1998, and last updated in 2002. OBJECTIVES: To assess the safety and efficacy of NO donors, L-arginine, and NOS-I in people with acute stroke...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28379619/blood-pressure-lowering-efficacy-of-renin-inhibitors-for-primary-hypertension
#7
REVIEW
Vijaya M Musini, Kendra Ak Lawrence, Patricia M Fortin, Ken Bassett, James M Wright
BACKGROUND: Hypertension is a chronic condition associated with an increased risk of mortality and morbidity. Renin is the enzyme responsible for converting angiotensinogen to angiotensin I, which is then converted to angiotensin II. Renin inhibitors are a new class of drugs that decrease blood pressure (BP) by preventing the formation of both angiotensin I and angiotensin II. OBJECTIVES: To quantify the dose-related BP lowering efficacy of renin inhibitors compared to placebo in the treatment of primary hypertension...
April 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28339438/the-role-of-autonomic-function-in-exercise-induced-endogenous-analgesia-a-case-control-study-in-myalgic-encephalomyelitis-chronic-fatigue-syndrome-and-healthy-people
#8
Jessica Van Oosterwijck, Uros Marusic, Inge De Wandele, Lorna Paul, Mira Meeus, Greta Moorkens, Luc Lambrecht, Lieven Danneels, Jo Nijs
BACKGROUND: Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) are unable to activate brain-orchestrated endogenous analgesia (or descending inhibition) in response to exercise. This physiological impairment is currently regarded as one factor explaining post-exertional malaise in these patients. Autonomic dysfunction is also a feature of ME/CFS. OBJECTIVES: This study aims to examine the role of the autonomic nervous system in exercise-induced analgesia in healthy people and those with ME/CFS, by studying the recovery of autonomic parameters following aerobic exercise and the relation to changes in self-reported pain intensity...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28331772/an-automated-gravity-driven-csf-drainage-system-decreases-complications-and-lowers-costs
#9
Robert E Lieberson, Jan Eckermann, William Meyer, Tung Trang
BACKGROUND: FlowSafe(TM) (BeckerSmith Medical, Irvine, CA, USA) is a novel, robotic, external lumbar drainage (ELD) system, which was designed to control cerebrospinal fluid (CSF) drainage, reduce complications, and decrease treatment costs. METHODS:  Forty-seven consecutive neurosurgical patients requiring ELD were treated using the FlowSafe system. RESULTS: In 39 of 40 patients with traumatic and surgical dural openings, potential CSF leaks were avoided...
February 3, 2017: Curēus
https://www.readbyqxmd.com/read/28278066/characterization-of-exposure-to-byproducts-from-firing-lead-free-frangible-ammunition-in-an-enclosed-ventilated-firing-range
#10
Christin M Grabinski, Mark M Methner, Jerimiah M Jackson, Alexander L Moore, Laura E Flory, Trevor Tilly, Saber M Hussain, Darrin K Ott
U.S. Air Force small arms firing ranges began using copper-based, lead-free frangible ammunition in the early 2000s due to environmental and health concerns related to the use of lead-based ammunition. Exposure assessments at these firing ranges have routinely detected chemicals and metals in amounts much lower than their mass-based occupational exposure limits, yet, instructors report work-related health concerns including respiratory distress, nausea, and headache. The objective of this study at one firing range was to characterize the aerosol emissions produced by weapons during firing events and evaluate the ventilation system's effectiveness in controlling instructor exposure to these emissions...
February 26, 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/28165764/gravity-assisted-valve-gav-systems-to-prevent-low-pressure-headaches-in-patients-with-lumboperitoneal-shunts
#11
Mohammed Akbar Hussain, Roger David Strachan
OBJECTIVES: Low-pressure symptoms after lumboperitoneal (LP) shunting for idiopathic intracranial hypertension (IIH) remain a significant problem. Gravity-assisted valves (GAV) operate at a higher pressure in a vertical position and therefore aim to reduce postural over-drainage. We audited patients with GAV valves inserted in their shunt system to assess their efficacy in reducing low-pressure symptoms and ascertain whether the additional cost of such device can be justified. METHOD: Using a standard proforma, we reviewed patient medical notes and recorded indications and post-operative outcomes in symptom control...
February 6, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28107890/affective-impairment-in-chronic-low-blood-pressure
#12
Stefan Duschek, Alexandra Hoffmann, Gustavo A Reyes Del Paso
OBJECTIVE: Physical complaints such as faintness, dizziness, cold limbs and headaches have been well-established in chronic low blood pressure (hypotension). This study investigated the occurrence of adverse emotional states and the symptoms of depression in this condition. As autonomic dysregulation, particularly diminished sympathetic tone, is believed to be involved in the etiology of hypotension, the impact of different facets of autonomic cardiovascular control on mood and depressive symptoms was also explored...
February 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27928421/asymmetrical-intraocular-pressures-and-asymmetrical-papilloedema-in-pseudotumor-cerebri-syndrome
#13
Mitchell Lawlor, Michael G Zhang, Jonathan Virgo, Gordon T Plant
This report is of two cases of asymmetrical papilloedema in patients with asymmetrical intraocular pressures (IOPs). The first patient presented with headaches, transient visual obscurations (TVOs), and elevated IOPs, and was found to have increased intracranial pressure caused by a torcula meningioma. He developed papilloedema after his IOPs were pharmacologically lowered; the papilloedema resolved after the IOP became elevated again after stopping his glaucoma drops, and then again returned as the IOP reduced when the drops were restarted...
December 2016: Neuro-ophthalmology
https://www.readbyqxmd.com/read/27928418/a-possible-role-for-temporary-lumbar-drainage-in-the-management-of-idiopathic-intracranial-hypertension
#14
Peter Gates, Peter McNeill
This paper reports 14 patients with idiopathic intracranial hypertension (IIH) who experienced immediate and sustained resolution of their IIH; 13 in the setting of a low-pressure headache and 1 who underwent lumbar drainage for 4 days draining the cerebrospinal fluid (CSF) at a rate of 5-15 mL/h. These observations, if confirmed, suggest that draining CSF using a temporary lumbar drain draining CSF at a rate greater than it is produced may potentially have a pivotal role in the management of IIH.
December 2016: Neuro-ophthalmology
https://www.readbyqxmd.com/read/27918377/utility-of-emergency-department-observation-units-for-neurologically-intact-children-with-head-ct-abnormalities-secondary-to-acute-closed-head-injury
#15
Roxanna Lefort, Jill V Hunter, Andrea T Cruz, A Chantal Caviness, Thomas G Luerssen, Aderonke Adekunle-Ojo
OBJECTIVE: The aim of the study was to evaluate the utility of the emergency department observation unit (EDOU) for neurologically intact children with closed head injuries (CHIs) and computed tomography (CT) abnormalities. METHODS: A retrospective cohort study of children aged 0 to 18 years with acute CHI, abnormal head CT, and a Glasgow Coma Scales score of 14 or higher admitted to the EDOU of a tertiary care children's hospital from 2007 to 2010. Children with multisystem trauma, nonaccidental trauma, and previous neurosurgical or coagulopathic conditions were excluded...
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27830325/efficacy-complications-and-cost-of-surgical-interventions-for-idiopathic-intracranial-hypertension-a-systematic-review-of-the-literature
#16
REVIEW
Aristotelis V Kalyvas, Mark Hughes, Christos Koutsarnakis, Demetrios Moris, Faidon Liakos, Damianos E Sakas, George Stranjalis, Ioannis Fouyas
BACKGROUND: To define the efficacy, complication profile and cost of surgical options for treating idiopathic intracranial hypertension (IIH) with respect to the following endpoints: vision and headache improvement, normal CSF pressure restoration, papilloedema resolution, relapse rate, operative complications, cost of intervention and quality of life. METHODS: A systematic review of the surgical treatment of IIH was carried out. Cochrane Library, MEDLINE and EMBASE databases were systematically searched from 1985 to 2014 to identify all relevant manuscripts written in English...
January 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27716387/extreme-hypernatremia-as-a-probable-cause-of-fatal-arrhythmia-a-case-report
#17
Maulee Hiromi Arambewela, Noel P Somasundaram, Chaminda Garusinghe
BACKGROUND: Hypernatremia is a frequent occurrence among hospitalized patients. Severe hypernatremia is associated with mortality rates of over 60 %. Extreme hypernatremia, defined as sodium levels >190 mmol/l, is a rare occurrence. The literature on electrocardiographic changes occurring with this degree of hypernatremia is extremely scarce. We report the case of an 11-year-old Sri Lankan girl who presented with sodium levels of 226 mmol/l following infusion with 3 % hypertonic saline who developed diffuse QT prolongation leading to fatal ventricular tachycardia...
October 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27694537/microangiopathic-antiphospholipid-antibody-associated-syndrome-in-a-pregnant-lady
#18
G S Kew, J Cho, A Lateef
We describe a gravid 37-year-old Chinese lady with known triple positive primary antiphospholipid syndrome with previous recurrent deep vein thrombosis and early spontaneous miscarriages. She was managed with low-molecular weight heparin, aspirin, hydroxychloroquine, prednisolone and monthly intravenous immunoglobulin.She presented with recurrent per-vaginal bleeding at 22 weeks of gestation and was found to have abruptio placentae. Anti-coagulation was held off. She subsequently delivered a stillborn at 24 weeks and anti-coagulation was restarted...
October 1, 2016: Lupus
https://www.readbyqxmd.com/read/27690252/octreotide-the-iih-therapy-beyond-weight-loss-carbonic-anhydrase-inhibitors-lumbar-punctures-and-surgical-interventional-treatments
#19
Patrick M House, Stefan R G Stodieck
OBJECTIVE: Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without a space-occupying cerebral lesion, venous sinus thrombosis or hydrocephalus and with normally composited cerebrospinal fluid (CSF). Main symptoms are headache, sight disturbances and potential visual impairment. Weight loss, carbonic anhydrase inhibitors, lumbar punctures with CSF drain, CSF shunting, optic nerve sheath fenestration, and venous sinus stenting are common IIH therapies...
November 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27638077/meni%C3%A3-re-s-disease
#20
REVIEW
J M Espinosa-Sanchez, J A Lopez-Escamez
Menière's disease (MD) is a chronic multifactorial disorder of the inner ear characterized by episodic vestibular symptoms associated with sensorineural hearing loss, tinnitus, and aural pressure. Epidemiologic and genomic evidence supports a genetic susceptibility with multiple biochemical pathways involved, including the endocrine system, innate immune response, and autonomic nervous system. Allergens, infectious agents, vascular events, or genetic factors could modify inner-ear homeostasis and trigger MD...
2016: Handbook of Clinical Neurology
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