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Spontaneous Intracranial Hypotension

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https://www.readbyqxmd.com/read/29665012/wavelet-pressure-reactivity-index-a-validation-study
#1
Xiuyun Liu, Marek Czosnyka, Joseph Donnelly, Danilo Cardim, Manuel Cabeleira, Peter J Hutchinson, Xiao Hu, Peter Smielewski, Ken Brady
KEY POINTS: The brain is vulnerable to damage from too little or too much blood flow. A physiological mechanism called cerebral autoregulation (CA) exists to maintain stable blood flow even if cerebral perfusion pressure (CPP) is changing. A robust method for assessing CA is not yet available. There are still some problems with the traditional measure, the pressure reactivity index (PRx). We introduced a new method, wavelet transform method (wPRx) to assess CA using data from two sets of controlled hypotension experiments in piglets: One set with artificially manipulated ABP oscillations; the other group were spontaneous ABP waves...
April 17, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29629045/iatrogenic-development-of-cerebrospinal-fluid-leakage-in-diagnosing-spontaneous-intracranial-hypotension
#2
Chang-Joon Lee, Sung-Min Shim, Sang-Hyeon Cho, Jae-Ho Park, Young Ki Kim
A 34-year-old woman came to the emergency room complaining of a severe orthostatic headache. Results of a cerebrospinal fluid tap and brain computed tomography were normal. Based on her history and symptoms, she was found to have spontaneous intracranial hypotension. She was hospitalized and her symptoms improved with conservative treatment. On the next day, her headache suddenly worsened. Cisternography was performed to confirm the diagnosis and determine the spinal level of her cerebrospinal fluid leak. It revealed multiple cerebrospinal fluid leaks in the lumbar and upper thoracic regions...
March 2018: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29621631/spontaneous-intracranial-hypotension-is-diagnosed-by-a-combination-of-lipocalin-type-prostaglandin-d-synthase-and-brain-type-transferrin-in-cerebrospinal-fluid
#3
Yuta Murakami, Koichi Takahashi, Kyoka Hoshi, Hiromi Ito, Mayumi Kanno, Kiyoshi Saito, Kenneth Nollet, Yoshiki Yamaguchi, Masakazu Miyajima, Hajime Arai, Yasuhiro Hashimoto, Tatsuo Mima
BACKGROUND: Spontaneous intracranial hypotension (SIH) is caused by cerebrospinal fluid (CSF) leakage. Definitive diagnosis can be difficult by clinical examinations and imaging studies. METHODS: SIH was diagnosed with the following criteria: (i) evidence of CSF leakage by cranial magnetic resonance imaging (MRI) findings of intracranial hypotension and/or low CSF opening pressure; (ii) no recent history of dural puncture. We quantified CSF proteins by ELISA or Western blotting...
April 2, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29600909/spontaneous-occult-intracranial-hypotension-precipitating-life-threatening-cerebral-venous-thrombosis-case-report
#4
Avital Perry, Christopher S Graffeo, Waleed Brinjikji, William R Copeland, Alejandro A Rabinstein, Michael J Link
Spontaneous intracranial hypotension (SIH) is an uncommon headache etiology, typically attributable to an unprovoked occult spinal CSF leak. Although frequently benign, serious complications may occur, including cerebral venous thrombosis (CVT). The objective of this study was to examine a highly complicated case of CVT attributable to SIH as a lens for understanding the heterogeneous literature on this rare complication, and to provide useful, evidence-based, preliminary clinical recommendations. A 43-year-old man presented with 1 week of headache, dizziness, and nausea, which precipitously evolved to hemiplegia...
March 30, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29534203/behavioral-variant-frontotemporal-dementia-as-a-serious-complication-of-spontaneous-intracranial-hypotension
#5
Wouter I Schievink, M Marcel Maya, Zachary R Barnard, Franklin G Moser, Stacey Jean-Pierre, Alan D Waxman, Miriam Nuño
BACKGROUND: Behavioral variant frontotemporal dementia (bvFTD) is a devastating early onset dementia. Symptoms of bvFTD may be caused by spontaneous intracranial hypotension (SIH), a treatable disorder, but no comprehensive study of such patients has been reported. OBJECTIVE: To describe detailed characteristics of a large cohort of patients with SIH and symptoms of bvFTD. METHODS: We identified patients with SIH who met clinical criteria for bvFTD...
March 8, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29530694/repeated-spontaneous-intracranial-epidural-hemorrhage-after-hysterical-crying-a-case-report
#6
Chun-Ting Chen, Hung-Yi Lai, Ting-Wei Chang, Ching-Yi Lee
BACKGROUND: Spontaneous epidural hemorrhage (EDH) is a rare occurrence that may be caused by vascular anomalies, infections, coagulopathies, or tumors. Spontaneous EDH occurring in patients without specific underlying disease has been reported only as intraspinal lesion but has never been demonstrated in the intracranial area. This study presents a 19-year-old patient with repeated spontaneous intracranial EDH caused twice by hysterical crying. CASE DESCRIPTION: The patient had spontaneous left frontal EDH after hysterical crying...
March 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29513222/acquired-chiari-i-malformation-secondary-to-spontaneous-intracranial-hypotension-syndrome-and-persistent-hypoglycemia-a-case-report
#7
Hasan Önal, Atilla Ersen, Hakan Gemici, Erdal Adal, Serhat Güler, Serdar Sander, Sait Albayram
Spontaneous intracranial hypotension (SIH) is a rare and potentially serious condition in childhood. Cerebrospinal fluid (CSF) volume depletion is thought to be the main causative feature for intracranial hypotension, results from spontaneous CSF leak, often at the spine level. SIH is increasingly diagnosed in clinical practice, although it manifests into a variegated symptomatology. Indeed, downward displacement of the brain, sometimes mimicking a Chiari I malformation, but concomitant presentation of these syndromes has rarely been reported...
February 27, 2018: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29495052/-image-findings-in-spontaneous-intracranial-hypotension-sih
#8
Anja Örgel, Benjamin Bender, Maria-Ioanna Stefanou, Helene Hurth, Till-Karsten Hauser, Marius Horger
No abstract text is available yet for this article.
March 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/29491335/-cerebrospinal-fluid-leakage-and-abducens-nerve-palsy-caused-by-bowling-activity
#9
Hiroyasu Inoue, Masaya Takemoto, Masahiro Muto, Taro Kitamura, Kentaro Yamada
Cerebrospinal fluid leakage can develop due to traffic trauma or lumbar puncture; however, in many cases, it develops spontaneously without any obvious cause. This report describes a case of cerebrospinal fluid leakage caused by bowling activity. A 57-year-old woman adjusted her bowling form, which led to the development of an orthostatic headache and double vision. Cerebrospinal fluid leakage and right abducens nerve palsy was diagnosed, which was resistant to conservative treatment. An epidural blood patch was performed, leading to an improvement in the headache and abducens nerve palsy...
February 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29449521/-spontaneous-intracranial-hypotension-presenting-with-de-novo-orthostatic-headache-and-subdural-hematoma-after-meningeal-biopsy
#10
Yasuhiro Takeda, Shohei Nambu, Yoshiaki Goto, Shiko Shimada, Keiichiro Maeda
No abstract text is available yet for this article.
February 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29437266/noninvasive-assessment-of-intracranial-elastance-and-pressure-in-spontaneous-intracranial-hypotension-by-mri
#11
Yi-Hsin Tsai, Hung-Chieh Chen, Hsin Tung, Yi-Ying Wu, Hsian-Min Chen, Kuan-Jung Pan, Da-Chuan Cheng, Jeon-Hor Chen, Clayton Chi-Chang Chen, Jyh-Wen Chai, Wu-Chung Shen
BACKGROUND: Spontaneous intracranial hypotension (SIH) is often misdiagnosed, and can lead to severe complications. Conventional MR sequences show a limited ability to aid in this diagnosis. MR-based intracranial pressure (MR-ICP) may be able to detect changes of intracranial elastance and pressure. PURPOSE: To determine whether MR-ICP is able to differentiate SIH patients from normal subjects, improve diagnostic sensitivity, and provide an insight into the pathophysiology...
February 13, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29372863/ossified-ligamentum-flavum-of-the-thoracic-spine-presenting-as-spontaneous-intracranial-hypotension-case-report
#12
Mazda K Turel, Mena G Kerolus, John E O'Toole
Ossification of the ligament flavum in the thoracic spine is an uncommon radiological finding in the Western population but can present with back pain, varying degrees of myelopathy, and even paraplegia on occasion. The authors here present the case of a 50-year-old woman with a history of progressive back pain and symptoms of spontaneous intracranial hypotension who was found to have an ossified ligamentum flavum of the thoracic spine resulting in a dural erosion cerebrospinal fluid leak. Surgery involved removal of the ossified ligament flavum at T10-11, facetectomy, ligation of the nerve root, and primary closure of the dura, which resulted in complete resolution of the patient's symptoms...
April 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29217497/prevalence-of-hyperdense-paraspinal-vein-sign-in-patients-with-spontaneous-intracranial-hypotension-without-dural-csf-leak-on-standard-ct-myelography
#13
Michael S Clark, Felix E Diehn, Jared T Verdoorn, Vance T Lehman, Greta B Liebo, Jonathan M Morris, Kent R Thielen, John T Wald, Neeraj Kumar, Patrick H Luetmer
PURPOSE: A recently identified and treatable cause of spontaneous intracranial hypotension (SIH) is cerebrospinal fluid (CSF)-venous fistula, and a recently described computed tomography myelogram (CTM) finding highly compatible with but not diagnostic of this entity is the hyperdense paraspinal vein sign. We aimed to retrospectively measure the prevalence of the hyperdense paraspinal vein sign on CTMs in SIH patients without dural CSF leak, in comparison with control groups. METHODS: Three CTM groups were identified: 1) SIH study group, which included dural CSF leak-negative standard CTMs performed for SIH, with early and delayed imaging; 2) Early control CTMs, which were performed for indications other than SIH, with imaging shortly after intrathecal contrast administration; 3) Delayed control CTMs, which included delayed imaging...
January 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29150776/hyperpyrexia-as-the-presenting-symptom-of-intracranial-hypotension
#14
Omar Hussein, Michel Torbey
INTRODUCTION: Hyperpyrexia is a severely elevated core body temperature secondary to an elevated hypothalamic set thermo-regulatory threshold. Hyperthermia is an elevated core body temperature beyond the normal hypothalamic set thermo-regulatory threshold. Intracranial hypotension can present with a wide variety of symptoms ranging from orthostatic headache up to coma. We report a rare case of hyperpyrexia associated with intracranial hypotension. METHODS: A case report of a 55-year-old female patient with a history of angiogram-negative subarachnoid hemorrhage status post-ventriculoperitoneal (VP) shunt placement six years prior to admission who suddenly developed encephalopathy and high fever...
November 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29140961/cervical-foraminal-epidural-blood-patch-for-the-targeted-treatment-of-refractory-cerebrospinal-fluid-leakage-from-a-dural-sleeve
#15
Nuj Tontisirin, Pannawit Benjhawaleemas, Sasikaan Nimmaanrat, Pornchai Sathirapanya, Teeranan Laohawiriyakamol, De Q Tran, Roderick J Finlayson
Epidural blood patches (EBPs) are routinely used to treat symptoms (eg, headaches) associated with spontaneous intracranial hypotension. Although cerebrospinal fluid leakage commonly involves the periforaminal areas of the cervical or thoracic spine, EBPs have been historically performed at the lumbar level. Recent evidence suggests that targeting the causative spinal segment may provide greater clinical benefits. While previous reports have targeted foraminal leaks with segmental thoracic or cervical injections, we present a case report detailing the novel use of a navigable epidural catheter to perform a selective EBP at the C7/T1 foramen...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29110769/impaired-cerebrospinal-fluid-pressure
#16
Jan Hoffmann
Abnormalities of cerebrospinal fluid (CSF) pressure are relatively common and may lead to a variety of symptoms, with headache usually being the most prominent one. The clinical presentation of alterations in CSF pressure may vary significantly and show a striking similitude to several primary headache syndromes. While an increase in CSF pressure may be of primary or secondary origin, a pathologic decrease of CSF pressure is usually the result of a meningeal rupture with a resulting leakage of CSF. The pathophysiologic mechanisms of idiopathic intracranial hypertension (IIH) remain largely unknown...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29103382/spontaneous-intracranial-hypotension-induced-headaches-and-onabotulinum-toxin-a-a-case-report
#17
Tommy L H Chan, Werner J Becker, William Y Hu, Farnaz Amoozegar
No abstract text is available yet for this article.
January 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29052799/treatment-and-outcome-of-subdural-hematoma-in-patients-with-spontaneous-intracranial-hypotension-a-report-of-35-cases
#18
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
https://www.readbyqxmd.com/read/29023155/csf-venous-fistulas-in-spontaneous-intracranial-hypotension-imaging-characteristics-on-dynamic-and-ct-myelography
#19
Peter G Kranz, Timothy J Amrhein, Linda Gray
OBJECTIVE: The objective of this study is to describe the anatomic and imaging features of CSF venous fistulas, which are a recently reported cause of spontaneous intracranial hypotension (SIH). MATERIALS AND METHODS: We retrospectively reviewed the records of patients with SIH caused by CSF venous fistulas who received treatment at our institution. The anatomic details of each fistula were recorded. Attenuation of the veins involved by the fistula was compared with that of adjacent control veins on CT myelography (CTM)...
December 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28984516/multilevel-ultra-large-volume-epidural-blood-patch-for-the-treatment-of-neurocognitive-decline-associated-with-spontaneous-intracranial-hypotension-case-report
#20
Michael D Staudt, Stephen H Pasternak, Manas Sharma, Sachin K Pandey, Miguel F Arango, David M Pelz, Stephen P Lownie
Spontaneous intracranial hypotension (SIH) is a progressive clinical syndrome characterized by orthostatic headaches, nausea, emesis, and occasionally focal neurological deficits. Rarely, SIH is associated with neurocognitive changes. An epidural blood patch (EBP) is commonly used to treat SIH when conservative measures are inadequate, although some patients require multiple EBP procedures or do not respond at all. Recently, the use of a large-volume (LV) EBP has been described to treat occult leak sites in treatment-refractory SIH...
October 6, 2017: Journal of Neurosurgery
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