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Hypertensive encephalopathy

Wanghui Jing, Bahman Jabbari, Nosratola D Vaziri
Chronic kidney disease (CKD) results in various central nervous systems (CNS) disorders including cognitive dysfunction, depression, anxiety, movement disorders, seizures and encephalopathy. Uremic retention products, oxidative stress, inflammation and impaired blood-brain barrier have been implicated as the major mediators of CKD-induced CNS disorders. However, mechanisms of CKD-induced cerebral tissue oxidative stress, inflammation and impaired blood brain barrier have not been fully elucidated and were explored...
2018: American Journal of Translational Research
Sreenivasa Rao Sudulagunta, Monica Kumbhat, Mahesh Babu Sodalagunta, Shiva Kumar Bangalore Raja
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome characterized by white matter vasogenic edema affecting the posterior occipital and parietal lobes of the brain predominantly. A 48-year-old female patient presented to ER with complaints of breathlessness and developed sudden painless loss of vision while eliciting history. The patient had a heart rate of 104/min and accelerated hypertension (BP of 220/120 mm of Hg). MRI Brain showed subcortical white matter T2/Fluid-attenuated inversion recovery hyperintensities, suggestive of PRES...
July 2018: Oxford Medical Case Reports
Jamie RiChard, Bartley Thornburg
Recently, new techniques and devices in transjugular intrahepatic portosystemic shunt (TIPS) placement have emerged that can improve upon the standard procedure. Ultrasound guidance during TIPS with intracardiac echocardiography (ICE), placement of controlled expansion (CX) stents, and portal vein recanalization (PVR) via transsplenic access are three techniques with new data supporting their implementation. ICE guidance can improve the technical success of difficult cases, decrease procedure time, and decrease complications such as capsular puncture, hemobilia, and hepatic artery injury...
August 2018: Seminars in Interventional Radiology
Mihir Patel, Christopher Molvar
Gastric variceal hemorrhage is a life-threatening complication of portal hypertension with a poorer prognosis compared with esophageal variceal hemorrhage. The presence of an infradiaphragmatic portosystemic shunt, often a gastrorenal shunt, allows for treatment with retrograde transvenous obliteration (RTO). RTO is an evolving treatment strategy, which includes balloon-assisted RTO, plug-assisted RTO, and coil-assisted RTO, for both gastric variceal hemorrhage and hepatic encephalopathy. RTO techniques are less invasive than transjugular intrahepatic portosystemic shunt creation, with the benefit of improved hepatic function, but at the expense of increased portal pressure...
August 2018: Seminars in Interventional Radiology
Roberto Miraglia, Luigi Maruzzelli, Ambra Di Piazza, Giuseppe Mamone, Settimo Caruso, Giovanni Gentile, Fabio Tuzzolino, Gaetano Floridia, Ioannis Petridis, Riccardo Volpes, Angelo Luca
OBJECTIVES: To evaluate short-term clinical efficacy, complications and possible passive stent expansion of transjugular intrahepatic portosystemic shunt (TIPS) creation using the new controlled expansion ePTFE covered stent (VCX), for portal hypertension complications. METHODS: Between 7/2016 and 3/2018, 75 patients received TIPS using VCX. Thirty-nine patients with VCX dilated with an 8-mm angioplasty balloon underwent computed tomography (CT) study during follow-up and CT data were used to measure stent diameter...
August 2, 2018: Cardiovascular and Interventional Radiology
Amrendra Kumar Mandal, Mukesh Sharma Paudel, Sudhamshu Kc, Sitaram Chaudhary, Bidhan Nidhi Paudel, Nandu Silwal Poudyal, Barun Shrestha, Binod Karki, Suresh Thapa, Dibas Khadka, Rajan Kanth, Paritosh Kafle
INTRODUCTION: Acute variceal bleeding in liver cirrhosis is an immediate life-threatening condition and amajor complication of portal hypertension associated with higher morbidity, mortality and hospital costs than any other causes of UGI bleeding. Therefore, early stratification and initiation of therapy based on several factors can reduce mortality associated with it. We aimed to study the predictors of mortality in acute variceal bleeding in LC. METHODS: An observational prospective study was conducted in Gastroenterology and Hepatology units of Bir Hospital, Kathmandu, Nepal from April 1, 2016 to May 30, 2017...
January 2018: JNMA; Journal of the Nepal Medical Association
Omar Abughanimeh, Mouhanna Abu Ghanimeh, Ayman Qasrawi, Laith A Al Momani, Sheshadri Madhusudhana
Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiographic syndrome that presents with neurological manifestations, including seizures, headache, or confusion, and is associated with posterior cerebral white matter edema on imaging. PRES is typically a benign and reversible condition. However, PRES can be fatal or associated with permanent deficits. Numerous conditions are associated with PRES, including hypertensive encephalopathy, renal diseases, and cytotoxic or immunosuppressant drugs...
May 24, 2018: Curēus
Mudasir Ahmad Magray, Gowhar Nazir Mufti, Nisar Ahmad Bhat, Aejaz Ahsan Baba, Mudasir Hamid Buch, Faheem Ul Hasan, Shahid Bashir Banday
Posterior reversible encephalopathy syndrome (PRES) or leukoencephalopathy syndrome was introduced into clinical practice in 1996 by Hinchey et al ., to describe unique syndrome, clinically expressed during hypertensive and uremic encephalopathy, eclampsia, and immunosuppressive therapy. Hyperperfusion with resultant disruption of the blood-brain barrier results in vasogenic edema, but not infarction, most commonly in the parieto-occipital regions. The severity of this clinical symptom varies. For example, the visual disturbance can manifest as blurred vision, homonymous hemianopsia, or even cortical blindness...
July 2018: Journal of Indian Association of Pediatric Surgeons
Antonio Sesar, Ivan Cavar, Anita Pusic Sesar, Irena Sesar
Posterior reversible encephalopathy syndrome (PRES) is a clinical condition that can cause different ophthalmological and neurological symptoms. Preeclampsia toxemia or eclampsia is one of the leading causes of PRES. Herein, we present a study of a 35-year old woman who gave birth to healthy twins at 35 weeks of gestation by cesarean section because of threatened preterm delivery. On the 1st postoperative day, the woman developed a severe headache, arterial hypertension, tachycardia, generalized tonic-clonic seizures, and loss of consciousness that persisted for about 2 min...
April 2018: Taiwan Journal of Ophthalmology
Simone Vincenzo Saverio Verdesca, Chiara Villani, Michele Rossini, Carlo Manno, Loreto Gesualdo, Vincenzo Montinaro
Small and medium vessel vasculitides, either ANCA-associated or caused by anti-GBM antibodies, are multisystemic diseases with predominantly renal involvement that often require dialysis support; clinical remission can be induced with immunosuppressive therapies including apheretic treatments, high doses of steroids, and immune suppressants. In addition to the complications resulting from the primary pathological process, those associated with the immunosuppressive therapies are not negligible. Reversible Posterior Encephalopathy Syndrome (PRES) is a clinical condition with a hyperacute onset, which can complicate the evolution of vasculitides while treated by immunosuppressive therapy...
July 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Ana Ponciano, Vera Vieira, José Leite, Célio Fernandes
Posterior reversible encephalopathy syndrome is an encephalopathy that can be clinically characterized by headache, altered mental status and/or seizures. Neuroimaging demonstrates usually reversible bilateral subcortical vasogenic occipital-parietal edema. Exact pathophysiology remains unclear but is commonly associated with hypertension, renal failure, sepsis and use of immunosuppressive therapy. Its development in the setting of severe hypercalcemia is extremely rare. The authors report a case of posterior reversible encephalopathy syndrome in a normotensive patient with severe hypercalcemia as the only identifiable cause...
June 29, 2018: Acta Médica Portuguesa
Ioanna Aggeletopoulou, Christos Konstantakis, Spilios Manolakopoulos, Christos Triantos
AIM: To summarize and critically examine the role of band ligation in secondary prophylaxis of variceal bleeding in patients with cirrhosis. METHODS: A literature review was performed using the MEDLINE and PubMed databases. The search terms consisted of the words "endoscopic band ligation" OR "variceal band ligation" OR "ligation" AND "secondary prophylaxis" OR "secondary prevention" AND "variceal bleeding" OR "variceal hemorrhage" AND "liver cirrhosis"...
July 14, 2018: World Journal of Gastroenterology: WJG
Mehmet Sayiner, Pegah Golabi, Maria Stepanova, Issah Younossi, Fatema Nader, Andrei Racila, Zobair M Younossi
BACKGROUND: Primary biliary cholangitis (PBC) is a disease of small bile-ducts, which can lead to morbidity and mortality. Our aim was to assess recent trends in mortality and healthcare utilization of PBC patients in Medicare program. METHODS: Data from Medicare beneficiaries between 2005 and 2015 (5% random samples) were used. The diagnosis of PBC was established with ICD-9 code 571.6 used for both primary and secondary diagnoses. Mortality was assessed by Medicare-linked death registry...
July 17, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Jason J Chang, Jeffrey C Mai
No abstract text is available yet for this article.
July 13, 2018: Neurosurgery
J Wang, X N Zhu, Y R Zhang, Y Q Gao, Y P Yang
Portal hypertension refers to a series of clinical manifestations caused by elevated pressure of the portal vein system, which can cause portal hypertension by causing portal venous obstruction and / or increased blood flow. A typical clinical manifestation in patients with decompensated cirrhosis is portal hypertension. A severe complication of portal hypertension is esophagogastric varices bleeding, refractory ascites, and hepatic encephalopathy. The effective reduction of portal pressure can reduce the incidence of complications, improve the prognosis and reduce the mortality...
April 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Moon Kyu Lee, Yang-Je Cho, Seung-Koo Lee, Sang Ku Jung, Kyoung Heo
OBJECTIVE: The effect of blood pressure (BP) on the lesion distribution of posterior reversible encephalopathy syndrome (PRES) is controversial. The aim of this study was to identify the relationship between brain lesion distribution patterns and BP. METHODS: Sixty-five patients with PRES were selected from the database. Data regarding brain MRI findings, clinical symptoms, medical conditions, and BP at the presymptomatic period (24 hr before the symptom onset) and at the symptom onset were collected...
July 11, 2018: Brain and Behavior
Sertaç Usta, Koray Karabulut
Posterior reversible encephalopathy syndrome is a rare condition of the central nervous system that may occur in adults as well as in children. Clinically, it presents with mental status changes, visual loss, headaches, seizures, or coma. The diagnosis of posterior reversible encephalopathy syndrome is based on the typical appearance in occipital and parietal lobes in radiologic imaging studies, such as computed tomography or magnetic resonance imaging of the brain, which exhibit the typical appearance due to vasogenic edema...
July 11, 2018: Experimental and Clinical Transplantation
Orlando Garner, Ana Ramirez, Alfredo Iardino
Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder characterised by parieto-occipital vasogenic oedema seen on MRI. Infection and sepsis has been reported as a possible cause for this disorder.We present a 19-year-old immunocompetent Caucasian man with known type 1 diabetes mellitus who presented to the emergency department with acute onset of bilateral visual loss, headaches and hypertension; he had been discharged 2 weeks ago for severe diabetic ketoacidosis and Staphylococcus aureus bacteraemia...
July 10, 2018: BMJ Case Reports
Florent Guérin, Lionel Charre, Stéphanie Jasienski, Mathieu Duché, Stéphanie Franchiabella, Olivier Bernard, Emmanuel Jacquemin, Hélène Agostini, Frédéric Gauthier, Sophie Branchereau
BACKGROUND: To assess the outcome of patients with biliary atresia (BA) who underwent a surgical shunt (SS) for severe portal hypertension (PH) following a Kasai procedure. METHODS: We collected and analyzed the data and outcomes of patients with BA who underwent SS for severe PH following a Kasai procedure between 1974 and 2014, focusing on complications related to the procedure, overall survival (OS), and transplant-free survival (TFS). RESULTS: SS was performed at a median age of 5...
June 25, 2018: Journal of Pediatric Surgery
Ramy Schoucair, Gregory Nicolas, Rechdi Ahdab, Noha Bejjani, Eddie K Abdalla
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a syndrome characterized by headache, confusion, visual loss and seizures. Many factors influence the appearance of this syndrome, predominantly eclampsia, certain medical treatments and malignant hypertension. Diagnosed by typical transient lesions on magnetic resonance imaging. CASE REPORT: We present a case of mesenteric leiomyosarcoma in a 52 year old woman, who had severe headache, abdominal heaviness, and hypertension...
May 29, 2018: International Journal of Surgery Case Reports
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