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Intracranial hypertension

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https://www.readbyqxmd.com/read/28811212/incidence-and-risk-factors-of-delayed-intracranial-hemorrhage-in-emergency-department
#1
Byunghyun Kim, Hyeonjeong Jeong, Joonghee Kim, Tackeun Kim, Kyuseok Kim, Heeyoung Lee, Soyeon Ahn, Yoo Hwan Jo, Jae Hyuk Lee, Ji Eun Hwang
OBJECTIVES: This study was performed to identify the risk factors for delayed intracranial hemorrhage and develop a risk stratification system for disposition of head trauma patients with negative initial brain imaging. METHODS: The data source was National Health Insurance Service-National Sample Cohort of Korea. We analyzed adult patients presenting to the ER from January 2004 to September 2012, who underwent brain imaging and discharged with or without short-term observation no longer than two days...
August 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28809621/cardiovascular-risk-factors-and-mortality-in-children-with-chronic-kidney-disease
#2
Abdullahi Mudi, Caroline Dickens, Cecil Levy, Daynia Ballot
BACKGROUND: Cardiovascular disease (CVD) begins early in children with chronic kidney disease (CKD), and its progression is determined by the presence of single or multiple cardiovascular risk factors (CVRFs). OBJECTIVE: To determine the prevalence of CVRFs in children with CKD and their association with mortality in children on chronic dialysis. METHODS: This comparative cross-sectional study recruited children aged 5 - 18 years with all stages of CKD...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28808765/presentation-and-symptom-interval-in-children-with-central-nervous-system-tumors-a-single-center-experience
#3
Chiara Stocco, Chiara Pilotto, Eva Passone, Agostino Nocerino, Raffaello Tosolini, Anna Pusiol, Paola Cogo
PURPOSE: The aim of this study is to describe the symptoms and signs of central nervous system (CNS) tumors in a pediatric population and to assess the time interval between the onset of the disease and the time of the diagnosis. METHODS: A retrospective observational study was conducted at our Oncology Pediatric Unit between January 2000 and November 2011. We included 75 children between 5 months and 16 years (mean age of 7.8 ± 4.7 years), with male to female ratio of 3:2...
August 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28808759/life-threatening-bleeding-episodes-in-primary-immune-thrombocytopenia-a-single-center-retrospective-study-of-169-inpatients
#4
Hiroyuki Tsuda, Takahiro Tsuji, Mayumi Tsuji, Hiroshi Yamasaki
Bleeding is the most important clinical outcome in patients with immune thrombocytopenia (ITP), and the goal of therapy in such cases is to treat or prevent bleeding. The frequency of and risk factors for bleeding events in ITP have only recently been identified in several large-scale studies. However, there is little published information about severe life-threatening bleeding in ITP. To clarify the clinical features of life-threatening bleeding in patients with primary ITP, we systematically reviewed the medical records of all ITP patients that were admitted to our hospital between January 1, 1992, and December 31, 2015...
August 14, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28806347/pediatric-pseudotumor-cerebri-syndrome
#5
Paul H Phillips, Claire A Sheldon
Idiopathic intracranial hypertension, otherwise known as primary pseudotumor cerebri syndrome (PTCS), most frequently occurs in obese women of childbearing age. However, children may be affected as well. This review will address recent findings regarding demographics, diagnosis, and treatment of pediatric PTCS. Prepubertal children with primary PTCS have an equal sex distribution and less frequent obesity compared with adult patients. However, female gender and obesity are risk factors for primary PTCS in postpubertal children...
September 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28806209/refractory-intracranial-hypertension-the-role-of-decompressive-craniectomy
#6
Martin Smith
Raised intracranial pressure (ICP) is associated with worse outcomes after acute brain injury, and clinical guidelines advocate early treatment of intracranial hypertension. ICP-lowering therapies are usually administered in a stepwise manner, starting with safer first-line interventions, while reserving higher-risk options for patients with intractable intracranial hypertension. Decompressive craniectomy is a surgical procedure in which part of the skull is removed and the underlying dura opened to reduce brain swelling-related raised ICP; it can be performed as a primary or secondary procedure...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28800199/intracranial-elastance-is-increased-in-idiopathic-intracranial-hypertension
#7
Jason T Chisholm, Padmaja Sudhakar, Abdulnasser N Alhajeri, Jonathan H Smith
BACKGROUND: To date, no pathophysiologic model has sufficiently accounted for all the findings encountered in patients with idiopathic intracranial hypertension (IIH). Intracranial elastance is an index of volume-buffering capacity known to play a role in certain disorders of CSF dynamics, which has not been previously investigated in relation to IIH patients. METHODS: Single-center retrospective cohort study from July 1, 2011 to July 1, 2016. We collected values for opening pressure (PO ), closing pressure (PC ), volume (V) of CSF removed, as well as demographic and clinical covariates...
August 11, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28797978/correlation-of-circulating-t-lymphocytes-and-intracranial-hypertension-in-intracerebral-hemorrhage
#8
Wanqiang Su, Chuang Gao, Peng Wang, Jinhao Huang, Yu Qian, Linyue Guo, Jianning Zhang, Rongcai Jiang
BACKGROUND: The close correlation between intracerebral pressure (ICP) and immunological responses has been well disclosed but the role of T lymphocytes in this process remains unknown. This study targets to inspect the relationship of circulating T lymphocytes and ICP in intracranial hemorrhage (ICH). METHODS: From 2015.10-2016.06, the patients of 18∼65 years old suffering from ICH were enrolled, according to the conditions we set in the text. ICP values were recorded hourly for 5 days...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28795057/side-effects-of-indomethacin-in-refractory-post-traumatic-intracranial-hypertension-a-comprehensive-case-study-and-review
#9
REVIEW
Daniel Agustín Godoy, Pablo David Guerrero Suarez, Luis Rafael Moscote-Salazar, Mario Di Napoli
Intracranial hypertension (IH) is one of the final pathways of acute brain injury. In severe traumatic brain injury (sTBI), it independently predicts poor outcomes. Its control represents a key aspect of the management. Lack of response to conventional therapies signals a state of ''refractory IH'', with an associated mortality rate of 80-100%. In such cases, hypothermia, barbiturates at high doses (BBT), decompressive craniectomy (DC), and extreme hyperventilation are utilized. However, none of them has proven efficacy...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28794092/optic-disc-swelling-in-a-patient-with-tuberculous-meningitis-a-diagnostic-challenge
#10
Hanis Zuhaimy, Sue Ngein Leow, Suresh K Vasudevan
We discuss the diagnostic challenge in an adult patient presented with purely ocular symptoms diagnosed with tuberculous meningitis (TBM). A 38-year-old woman presented with bilateral painless blurring of vision. There were bilateral sixth cranial nerve palsy and bilateral optic disc swelling. Optic nerve function tests were normal. Patient was lucid with no signs of meningism. Brain imaging were normal. She had a positive Mantoux test, high erythrocyte sedimentation rate but no clinical evidence of active pulmonary tuberculosis infection...
August 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28793057/noninvasive-intracranial-pressure-monitoring-for-hiv-associated-cryptococcal-meningitis
#11
V R Bollela, G Frigieri, F C Vilar, D L Spavieri, F J Tallarico, G M Tallarico, R A P Andrade, T M de Haes, O M Takayanagui, A M Catai, S Mascarenhas
Mortality and adverse neurologic sequelae from HIV-associated cryptococcal meningitis (HIV-CM) remains high due to raised intracranial pressure (ICP) complications. Cerebrospinal fluid (CSF) high opening pressure occurs in more than 50% of HIV-CM patients. Repeated lumbar puncture with CSF drainage and external lumbar drainage might be required in the management of these patients. Usually, there is a high grade of uncertainty and the basis for clinical decisions regarding ICP hypertension tends to be from clinical findings (headache, nausea and vomiting), a low Glasgow coma scale score, and/or fundoscopic papilledema...
August 7, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28791520/external-ventricular-drain-causes-brain-tissue-damage-an-imaging-study
#12
Fabrizio Ortolano, Marco Carbonara, Antonella Stanco, Vittorio Civelli, Giorgio Carrabba, Tommaso Zoerle, Nino Stocchetti
BACKGROUND: An external ventricular drain (EVD) is used to measure intracranial pressure (ICP) and to drain cerebrospinal fluid (CSF). The procedure is generally safe, but parenchymal sequelae are reported as a possible side effect, with variable incidence. We investigated the mechanical sequelae of EVD insertion and their clinical significance in acute brain-injured patients, with a special focus on hemorrhagic lesions. METHODS: Mechanical sequelae of EVD insertion were detected in patients by computed tomography (CT) and magnetic resonance imaging (MRI), performed for clinical purposes...
August 8, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28790967/rethinking-neuroprotection-in-severe-traumatic-brain-injury-toward-bedside-neuroprotection
#13
REVIEW
Tommaso Zoerle, Marco Carbonara, Elisa R Zanier, Fabrizio Ortolano, Giulio Bertani, Sandra Magnoni, Nino Stocchetti
Neuroprotection after traumatic brain injury (TBI) is an important goal pursued strenuously in the last 30 years. The acute cerebral injury triggers a cascade of biochemical events that may worsen the integrity, function, and connectivity of the brain cells and decrease the chance of functional recovery. A number of molecules acting against this deleterious cascade have been tested in the experimental setting, often with preliminary encouraging results. Unfortunately, clinical trials using those candidate neuroprotectants molecules have consistently produced disappointing results, highlighting the necessity of improving the research standards...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28781057/multiple-lacunar-infarcts-in-paroxysmal-nocturnal-hemoglobinuria
#14
Alex Tiburtino Meira, Gabriel Sampaio Froehner, André Petean Trindade, Silméia Garcia Zanati Bazan, Gabriel Pereira Braga, Rodrigo Bazan
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disease characterized by clonal hematopoietic stem cell disorder, with increased mortality and morbidity. Venous thrombosis is the most common cause of mortality in PNH. The relationship between PNH and cerebrovascular disease is unclear; few cases are reported in the literature, most of them related to cerebral venous thrombosis; In PNH the involvement of intracranial and extracranial arterial sites is very rare. We report a case of a 49-year-old woman who has a medical history of diabetes mellitus, hypertension, and PNH and presented multiple lacunar strokes in a routine consultation with a hematologist...
August 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28780516/diagnosis-of-endocrine-disease-primary-empty-sella-a-comprehensive-review
#15
Sabrina Chiloiro, Antonella Giampietro, Antonio Bianchi, Tommaso Tartaglione, Antonio Capobianco, Carmelo Anile, Laura De Marinis
Primary empty sella (PES) is characterized by the herniation of the subarachnoid space within the sella, which is often associated with variable degree of flattening of the pituitary gland in patients without previous pituitary pathologies. PES pathogenetic mechanism are not well known but seem due to a sellar diaphragm incompetence, associated to the occurrence of upper sellar or pituitary factors, as intracranial hypertension and change of pituitary volume. As PES represents in majority of cases a neuroradiological findings, without any clinical implication, the occurrence of endocrine, neurological and opthalmological symptoms, due to the above describes anatomical alteration, delineates the so called PES syndrome...
August 5, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28774294/temperature-variability-in-the-day-night-cycle-is-associated-with-further-intracranial-pressure-during-therapeutic-hypothermia
#16
Adriano Barreto Nogueira, Eva Annen, Oliver Boss, Faraneh Farokhzad, Christopher Sikorski, Emanuela Keller
BACKGROUND: To assess whether circadian patterns of temperature correlate with further values of intracranial pressure (ICP) in severe brain injury treated with hypothermia. METHODS: We retrospectively analyzed temperature values in subarachnoid hemorrhage patients treated with hypothermia by endovascular cooling. The circadian patterns of temperature were correlated with the mean ICP across the following day (ICP24). RESULTS: We analyzed data from 17 days of monitoring of three subarachnoid hemorrhage patients that underwent aneurysm coiling, sedation and hypothermia due to refractory intracranial hypertension and/or cerebral vasospasm...
August 3, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28769872/intracranial-arterial-dolichoectasia
#17
REVIEW
Victor J Del Brutto, Jorge G Ortiz, José Biller
An increased diameter (ectasis) and/or long and tortuous course (dolichosis) of at least one cerebral artery define intracranial arterial dolichoectasia (IADE). IADE could be detected incidentally or may give rise to an array of neurological complications including ischemic stroke, intracranial hemorrhage, or compression of surrounding neural structures. The basilar artery is preferentially affected and has been studied in more detail, mainly due to the presence of accepted diagnostic criteria proposed by Smoker and colleagues in 1986 (1)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28769863/application-of-texture-analysis-to-study-small-vessel-disease-and-blood-brain-barrier-integrity
#18
Maria Del C Valdés Hernández, Victor González-Castro, Francesca M Chappell, Eleni Sakka, Stephen Makin, Paul A Armitage, William H Nailon, Joanna M Wardlaw
OBJECTIVES: We evaluate the alternative use of texture analysis for evaluating the role of blood-brain barrier (BBB) in small vessel disease (SVD). METHODS: We used brain magnetic resonance imaging from 204 stroke patients, acquired before and 20 min after intravenous gadolinium administration. We segmented tissues, white matter hyperintensities (WMH) and applied validated visual scores. We measured textural features in all tissues pre- and post-contrast and used ANCOVA to evaluate the effect of SVD indicators on the pre-/post-contrast change, Kruskal-Wallis for significance between patient groups and linear mixed models for pre-/post-contrast variations in cerebrospinal fluid (CSF) with Fazekas scores...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28769857/hyperventilation-therapy-for-control-of-posttraumatic-intracranial-hypertension
#19
REVIEW
Daniel Agustín Godoy, Ali Seifi, David Garza, Santiago Lubillo-Montenegro, Francisco Murillo-Cabezas
During traumatic brain injury, intracranial hypertension (ICH) can become a life-threatening condition if it is not managed quickly and adequately. Physicians use therapeutic hyperventilation to reduce elevated intracranial pressure (ICP) by manipulating autoregulatory functions connected to cerebrovascular CO2 reactivity. Inducing hypocapnia via hyperventilation reduces the partial pressure of arterial carbon dioxide (PaCO2), which incites vasoconstriction in the cerebral resistance arterioles. This constriction decrease cerebral blood flow, which reduces cerebral blood volume and, ultimately, decreases the patient's ICP...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28768582/blind-overnight-a-case-of-fulminant-idiopathic-intracranial-hypertension
#20
Janpreet Singh Bhandohal, Taimur Mirza
Idiopathic Intracranial Hypertension (IIH) is a syndrome seen predominantly in obese women of reproductive age group, characterized by signs and symptoms of increased intracranial pressure due to an unknown cause. Some individuals have a more malignant form of disease called fulminant idiopathic intracranial hypertension with rapid worsening of symptoms over days. We report a case of 33year-old obese female (BMI 36.9) who presented with a severe headache and blurred vision for one week, found to have idiopathic intracranial hypertension with rapid worsening of symptoms suggestive of a fulminant course of disease...
July 5, 2017: American Journal of Emergency Medicine
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