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Low Pressure Headache

Temel Fatih Yılmaz, Ayse Aralasmak, Huseyin Toprak, Gulsen Kocaman, Alpay Alkan
Craniospinal hypotension is the syndrome of orthostatic headache associated with low cerebrospinal fluid pressure. Imaging findings are usually explained by Monro-Kellie hypothesis stating that the craniospinal compartment is incompressible and any increase in volume of one of the craniospinal constituents (blood, cerebrospinal fluid, and parenchyma) must be compensated by a decrease in volume of another constituent or vice versa. We report a case of craniospinal hypotension in whom drainage of subdural hematoma upon clinical impairments resulted in pontine hemorrhage, supporting Monro-Kellie hypothesis...
February 2018: Radiology Case Reports
Ebru Apaydın Doğan, Selen Doğan, Ethem Taner Göksu, Sibel Özkaynak, Çile Aktan, İnanç Mendilcioğlu
Idiopathic intracranial hypertension (IIH) is a relatively uncommon disorder characterised by raised intracranial pressure without an established pathogenesis. Diagnosis of IIH requires the demonstration of symptoms and signs referable only to elevated intracranial pressure; cerebrospinal fluid (CSF) opening pressure >25cm H2 O measured in the lateral decubitus position; normal CSF composition; and no evidence for an underlying structural cause demonstrated by using MRI or contrast-enhanced CT scan for typical patients and MRI and MR venography for atypical patients such as man, children and those with low body mass index...
February 6, 2018: Neurologia i Neurochirurgia Polska
Oluwaseun O Akinduro
INTRODUCTION: Prolactinomas may rarely present with meningitis and cerebrospinal fluid (CSF) rhinorrhea secondary to erosion of the wall of the sella turcica. It is even more un-common for this abnormal communication to be caused by an ectopic prolactinoma arising from the sphenoid sinus and eroding into the sella. This atypical growth pattern makes diagnosis very difficult, as there may be no displacement of the normal pituitary gland. The authors present the first reported case of a patient with an ectopic prolactinoma presenting primarily with meningitis, and discuss the management strategy as well as surgical and non-surgical treatment options for these patients...
January 26, 2018: World Neurosurgery
René F Castien, Johannes C van der Wouden, Willem De Hertogh
Sensitivity of tissues can be measured by algometry. Decreased pressure pain thresholds over the cranio-cervical area are supposed to reflect signs of sensitization of the trigemino-cervical nucleus caudalis. A systematic review was conducted to assess the current scientific literature describing pressure pain threshold (PPT) values over the cranio-cervical region in patients with migraine, tension-type headache (TTH), and cervicogenic headache (CeH). A literature search was executed in three databases. The search strategy included the following keywords: migraine, TTH, CeH, PPT and algometry...
January 26, 2018: Journal of Headache and Pain
Hideaki Nagashima, Tomoru Miwa, Takashi Horiguchi, Ryosuke Tomio, Yu Nakagawa, Kazunari Yoshida
BACKGROUND: Cerebral vasospasm is an uncontrollable and sometimes fatal complication occurring after subarachnoid hemorrhage. However, cerebral hyperperfusion syndrome is a rare complication after subarachnoid hemorrhage. Although plain computed tomography of cerebral hyperperfusion syndrome looks similar to cerebral infarction induced by cerebral vasospasm, they should be distinguished from each other because they require completely different treatments. CASE DESCRIPTION: A 65-year-old man complained of severe headache and vomiting...
January 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
S Ashina, R B Lipton, L Bendtsen, N Hajiyeva, D C Buse, A C Lyngberg, R Jensen
BACKGROUND: Low back pain is common in the general population and in individuals with primary headaches. We assessed the relative frequency of self-reported back pain in persons with and without primary headaches and examined pain sensitivity. METHOD: A population of 796 individuals completed a headache interview based on ICHD criteria and provided data of interest in a self-administered questionnaire. Headache cases were classified into chronic (≥15) (CH) or episodic (<15 headache days/month) (EH)...
January 19, 2018: European Journal of Pain: EJP
Kaveh Vahdani, Katherine McVeigh, Rhys Harrison, Mandy Williams, Helen Garrott
Intracranial hypotension (ICH) is characterized by low cerebrospinal fluid pressure, postural headaches, and diffuse pachymeningeal enhancement on magnetic resonance imaging (MRI). A variety of ophthalmoparetic manifestations have been reported in the context of the ICH. The authors describe an unusual case of a 64-year-old woman who presented with rapid onset of headaches, bilateral upper-lid ptosis, and blurring of vision within 4 days after sustaining a trivial head injury. She was noted to have bilateral symmetrical ophthalmoplegia and ptosis-simulating chronic progressive external ophthalmoplegia...
January 4, 2018: Orbit
Mina Alvandipour, Shahram Ala, Mehdi Khalvati, Jamshid Yazdanicharati, Neda Koulaeinejad
BACKGROUND: Anal fissure is a common anorectal problem causing severe pain and discomfort to the patients. Chemical sphincterotomy has emerged as a noninvasive alternative to the surgical methods of fissure treatment. The objective of this study was evaluation of the efficacy and the adverse effects of topically applied minoxidil in chemical sphincterotomy of chronic anal fissure in comparison with topical diltiazem. METHODS: A total of 88 patients with chronic anal fissure aged between 15 and 65 years were included in this double-blind, randomized clinical trial and were randomly assigned to either 0...
December 31, 2017: World Journal of Surgery
Tian Shen, Guoqiang Xing, Jingfen Zhu, Shuxian Zhang, Yong Cai, Donghua Li, Gang Xu, Evan Xing, Jianyu Rao, Rong Shi
BACKGROUNDS: To study the effects of supplementation of a marine omega-3 poly-unsaturated fatty acids (n3-PUFA) formulation (Omega3Q10) in older adults with hypertension and/or hypercholesterolemia. METHODS: A total of 97 people were enrolled to receive 12-week supplementation of either Omega3Q10 (n = 48) or soybean oil (n = 49). Total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and hypertension-related symptoms were determined before and after the supplementation...
December 27, 2017: Lipids in Health and Disease
Thomas Beez, Sven Burgula, Marcel Kamp, Marion Rapp, Hans-Jakob Steiger, Michael Sabel
INTRODUCTION: High grade glioma (HGG) treatment has seen a paradigm shift with intensified regimes, but hospitalisation burden is partially attributed to side effects of therapy. Symptomatic communicating hydrocephalus (HC) is a potential complication. Aim of this study was to investigate its incidence, risk factors and treatment in a contemporary cohort. METHODS: We performed a retrospective review of HGG patients. Patients with symptomatic communicating HC were identified and demographic, tumour and treatment variables extracted from hospital notes...
November 21, 2017: British Journal of Neurosurgery
Claudia L Craven, Irene Baudracco, Simon D Thompson, Lewis Thorne, Laurence D Watkins, Ahmed K Toma
BACKGROUND: Complex hydrocephalus affecting lateral and fourth ventricles separately is occasionally managed with cerebrospinal fluid diversion via supratentorial and infratentorial ventricular catheters. The optimal configuration to reduce complications is currently unknown in adults. We describe a consistently similar clinical presentation of patients with complex hydrocephalus and a fourth ventricle separately drained by infratentorial shunt insertion. METHODS: This was a retrospective single-center case series...
February 2018: World Neurosurgery
Shoichi Deguchi, Koichi Mitsuya, Yoko Nakasu, Nakamasa Hayashi, Hirohisa Katagiri, Hideki Murata, Junji Wasa, Mitsuru Takahashi, Masahiro Endo
Posterior reversible encephalopathy syndrome (PRES) is a clinical entity characterized by acute neurological symptoms such as severe headache, seizures, and visual disturbance, and by typical reversible lesion on brain magnetic resonance (MR) images. Since PRES is thought to be caused by vascular endothelial injury due to cytotoxic agents or acute systemic hypertension, the number of reports on PRES associated with angiogenesis inhibitors has been increasing. Although five cases that developed PRES due to pazopanib for renal cell carcinoma have already been reported, none of PRES due to pazopanib for soft-tissue sarcoma has been reported thus far...
October 25, 2017: Investigational New Drugs
Enrico Ferrante, Fabio Rubino, Federica Beretta, Caroline Regna-Gladin, M Mirko Ferrante
Spontaneous intracranial hypotension (SIH) is characterized by orthostatic headache, low CSF pressure and diffuse pachymeningeal enhancement on brain MRI. SIH results from spontaneous CSF leakage leading to brain sag. Sometimes, tearing of bridging veins may produce subdural hematomas (SDHs). Patients with SDH were identified retrospectively from 212 consecutive SIH patients. Data were collected on demographics, clinical courses, neuroimaging findings, treatment and outcome of SDH. Thirty-five patients (16%), (6 women, 29 men; aged 33-68; mean, 50 years) with SDH were recruited...
October 20, 2017: Acta Neurologica Belgica
Jessica Gill, Ann Cashion, Nicole Osier, Lindsay Arcurio, Vida Motamedi, Kristine C Dell, Walter Carr, Hyung-Suk Kim, Sijung Yun, Peter Walker, Stephen Ahlers, Matthew LoPresti, Angela Yarnell
OBJECTIVE: To explore gene expression after moderate blast exposure (vs baseline) and proteomic changes after moderate- (vs low-) blast exposure. METHODS: Military personnel (N = 69) donated blood for quantification of protein level, and peak pressure exposures were detected by helmet sensors before and during a blast training program (10 days total). On day 7, some participants (n = 29) sustained a moderate blast (mean peak pressure = 7.9 psi) and were matched to participants with no/low-blast exposure during the training (n = 40)...
October 2017: Neurology. Genetics
Alieh Zamani Kiasari, Anahita Babaei, Abbas Alipour, Shima Motevalli, Afshin Gholipour Baradari
BACKGROUND: Unilateral spinal anesthesia is used to limit the spread of block. The aim of the present study was to compare hemodynamic changes and complications in unilateral spinal anesthesia and epidural anesthesia below the T10 sensory level in unilateral surgeries. MATERIALS AND METHODS: In this double-blind randomized clinical trial in total 120 patients were randomly divided into a unilateral spinal anesthesia group (Group S) and an epidural anesthesia group (Group E)...
August 2017: Medical Archives
Kimberly B Hoang, Kristopher G Hooten, Carrie R Muh
Idiopathic intracranial hypertension (IIH), formerly known as pseudotumor cerebri, is a disease of elevated intracranial pressure that is thought to develop due to impaired CSF absorption related to elevated venous sinus pressure in the setting of increased intraabdominal and thoracic pressures. Symptoms can be disabling and, if left untreated, can lead to permanent visual loss. Previous treatments directed toward vision preservation include CSF diversion through shunting and optic nerve sheath fenestration...
December 2017: Journal of Neurosurgery. Pediatrics
Nese Keser, Erhan Celikoglu, Merih İs, Zeynep Demet İlgezdi, Bendigar Sunar, Yusuf Sinan Aydin, Ahmet Ugur Kevenk, Bora Gurer, Ali Fatih Ramazanoglu, Nurgul Keser
INTRODUCTION: Atherosclerosis might diminish the nutrient supply to intervertebral discs (IVD), leading to disc herniation. Therefore, there is interest in determining the possible association between the blood lipid profile and lumbar disc herniation (LDH). We aimed to evaluate the association between blood lipids and LDH in a homogeneous group of patients, controlling for age- and sex-specific effects. MATERIAL AND METHODS: This is a case-control study which consisted of 100 individuals (mean age: 41...
2017: Archives of medical sciences. Atherosclerotic diseases
J Chu, S McNally, F Bruyninckx, D Neuhauser
INTRODUCTION: Autonomous twitch elicitation at myofascial trigger points from spondylotic radiculopathies-induced denervation supersensitivity can provide favourable pain relief using electrical twitch-obtaining intramuscular stimulation (ETOIMS). AIM: To provide objective evidence that ETOIMS is safe and efficacious in migraine and persistent pain management due to decades-old injuries to head and spine from paediatric American football. METHODS AND MATERIALS: An 83-year-old mildly hypertensive patient with 25-year history of refractory migraine and persistent pain self-selected to regularly receive fee-for-service ETOIMS 2/week over 20 months...
April 2017: BMJ Innovations
Edward J Ruane, Catharine B Garland, Liliana Camison, Regina A Fenton, Ken K Nischal, Ian F Pollack, Mandeep S Tamber, Lorelei J Grunwaldt, Joseph E Losee, Jesse A Goldstein
BACKGROUND: Sagittal craniosynostosis typically presents shortly after birth, with a scaphocephalic head shape, and is addressed surgically for functional and aesthetic concerns. This study highlights the authors' experience with a challenging patient population: those with phenotypically mild, missed, and late-developing sagittal craniosynostosis. METHODS: A prospective cohort study was conducted for all cases of sagittal craniosynostosis presenting to the authors' institution between July of 2013 and December of 2015...
September 2017: Plastic and Reconstructive Surgery
Henry A Nasrallah, Willie Earley, Andrew J Cutler, Yao Wang, Kaifeng Lu, István Laszlovszky, György Németh, Suresh Durgam
BACKGROUND: Schizophrenia is a chronic and debilitating neuropsychiatric disorder that often requires long-term pharmacotherapy to manage symptoms and prevent relapse. Cariprazine is a potent dopamine D3 and D2 receptor partial agonist that is FDA-approved in the US for the treatment of schizophrenia and manic or mixed episodes associated with bipolar I disorder in adults; the recommended dose range is 1.5-6 mg/d. METHODS: To further characterize the long-term safety of cariprazine, data from two 48-week open-label, flexible-dose extension studies were pooled for post hoc analyses...
August 24, 2017: BMC Psychiatry
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