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Increased intracranial pressure

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https://www.readbyqxmd.com/read/28821777/decompressive-craniectomy-in-the-management-of-intracranial-hypertension-after-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#1
Danfeng Zhang, Qiang Xue, Jigang Chen, Yan Dong, Lijun Hou, Ying Jiang, Junyu Wang
We aim to perform a systematic review and meta-analysis to examine the prognostic value of decompressive craniectomy (DC) in patients with traumatic intracranial hypertension. PubMed, EMBASE, Cochrane Controlled Trials Register, Web of Science, http://clinicaltrials.gov/ were searched for eligible studies. Ten studies were included in the systematic review, with four randomized controlled trials involved in the meta-analysis, where compared with medical therapies, DC could significantly reduce mortality rate [risk ratio (RR), 0...
August 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28818998/lower-body-negative-pressure-reduces-optic-nerve-sheath-diameter-during-head-down-tilt
#2
Karina Marshall-Goebel, Robert Terlević, Darius A Gerlach, Simone Kuehn, Edwin Mulder, Jörn Rittweger
The microgravity ocular syndrome (MOS) results in significant structural and functional ophthalmic changes during 6-month spaceflight missions consistent with an increase in cerebrospinal fluid (CSF) pressure compared to the preflight upright position. A ground-based study was performed to assess two of the major hypothesized contributors to MOS, headward fluid shifting and increased ambient CO2, on intracranial and periorbital CSF. In addition, lower body negative pressure (LBNP) was assessed as a countermeasure to headward fluid shifting...
August 17, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28817088/the-role-of-neurogenic-inflammation-in-blood-brain-barrier-disruption-and-development-of-cerebral-oedema-following-acute-central-nervous-system-cns-injury
#3
REVIEW
Annabel J Sorby-Adams, Amanda M Marcoionni, Eden R Dempsey, Joshua A Woenig, Renée J Turner
Acute central nervous system (CNS) injury, encompassing traumatic brain injury (TBI) and stroke, accounts for a significant burden of morbidity and mortality worldwide, largely attributable to the development of cerebral oedema and elevated intracranial pressure (ICP). Despite this, clinical treatments are limited and new therapies are urgently required to improve patient outcomes and survival. Originally characterised in peripheral tissues, such as the skin and lungs as a neurally-elicited inflammatory process that contributes to increased microvascular permeability and tissue swelling, neurogenic inflammation has now been described in acute injury to the brain where it may play a key role in the secondary injury cascades that evolve following both TBI and stroke...
August 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28815322/headache-in-patients-with-chronic-subdural-hematoma-analysis-in-1080-patients
#4
Shoko M Yamada, Yusuke Tomita, Hideki Murakami, Makoto Nakane, So Yamada, Mineko Murakami, Katsumi Hoya, Tadayoshi Nakagomi, Akira Tamura, Akira Matsuno
Headache is a major symptom in chronic subdural hematoma (CSDH) patients. However, some CSDH patients do not complain headache although the hematoma is thick with definite midline shift. This clinical study was performed to identify the mechanism of headache in CSDH patients. We compiled clinical data of 1080 surgically treated CSDH patients (711 males and 369 females), and in 54 cases, the pressure of hematoma was measured during burr hole surgery using a glass-stick manometer. Headache was recognized in 22...
August 16, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28814093/role-of-ischemic-modified-albumin-in-the-early-diagnosis-of-increased-intracranial-pressure-and-brain-death
#5
I Kara, H K Pampal, F Yildirim, E Dilekoz, G Emmez, F P U, M Kocabiyik, C B Demirel
AIM: Increased intracranial pressure following trauma and subsequent possible development of brain death are important factors for morbidity and mortality due to ischemic changes. We aimed to establish the role of ischemic modified albumin (IMA) in the early diagnosis of the process, starting with increased intracranial pressure and ending with brain death. MATERIALS AND METHODS: Eighteen Wistar-Albino rats were divided into three groups; control (CG, n = 6), increased intracranial pressure (ICPG, n = 6), and brain death (BDG, n = 6)...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28812113/-pathophysiology-of-intracranial-injuries
#6
REVIEW
D Lahner, G Fritsch
Traumatic brain injury (TBI) constitutes a heterogeneous condition that affects the most complex organ of the human body. It is commonly classified by its location as focal injury (e.g. epidural hematoma) and diffuse injury (e.g. diffuse axonal shearing injury) as well as by primary and secondary tissue injury. Accordingly, direct mechanical force causes the primary insult. The tissue damage occurring afterwards is subsumed under the term secondary brain damage. Some of these processes are overlapping and include in the early phase local cerebral ischemia resulting in excitotoxicity, which together with the triggered neuroinflammatory cascade causes the formation of cerebral edema and ultimately increased intracranial pressure once the intracranial compliance is exhausted...
August 15, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28810281/-hyponatremia-differential-diagnosis-and-treatment
#7
Heiner Mönig, Alexander Arlt
Hyponatremia is the most common electrolyte abnormality seen in hospitalized patients, with up to 30 % having a plasma sodium concentration below 135 mmol/l. It is now clear that the clinical problem extends beyond the neurological symptoms, which can be explained by intracerebral osmotic fluid shifts and brain edema. Instead, chronic hyponatremia is associated with impaired gait stability and an increased risk of bone fragility fractures. Moreover, hyponatremia has been demonstrated to be an indicator of poor prognosis in a variety of conditions...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28807120/spontaneous-upper-eyelid-ecchymosis-a-cutaneous-clue-to-increased-intracranial-pressure
#8
Muhammed Razmi T, Deeksha Katoch, Sunil Dogra
No abstract text is available yet for this article.
September 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28806347/pediatric-pseudotumor-cerebri-syndrome
#9
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/28801417/optic-nerve-sheath-diameter-sonography-for-the-diagnosis-of-increased-intracranial-pressure-a-systematic-review-and-meta-analysis-protocol
#10
Alex Koziarz, Niv Sne, Fraser Kegel, Waleed Alhazzani, Siddharth Nath, Jetan H Badhiwala, Timothy Rice, Paul Engels, Faidi Samir, Andrew Healey, Kamyar Kahnamoui, Laura Banfield, Sunjay Sharma, Kesava Reddy, Gregory W J Hawryluk, Andrew W Kirkpatrick, Saleh A Almenawer
INTRODUCTION: Increased intracranial pressure (ICP) is a significant neurological issue that may lead to permanent neurological sequelae. When evaluating patients with traumatic brain injury, it is crucial to identify those with high ICP in order to expedite ICP lowering measures and maintain adequate cerebral perfusion. Several measures are used to recognise patients with increased ICP including CT scan, MRI, ICP monitor, and lumbar puncture (LP). However, these tests can be invasive, associated with radiation exposure, contraindicated, or not readily available...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800199/intracranial-elastance-is-increased-in-idiopathic-intracranial-hypertension
#11
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/28799879/the-pathophysiology-of-chronic-noncommunicating-hydrocephalus-lessons-from-continuous-intracranial-pressure-monitoring-and-ventricular-infusion-testing
#12
Per Kristian Eide
OBJECTIVE The pathophysiology of chronic noncommunicating hydrocephalus (ncHC) is poorly understood. This present study explored whether lessons about the pathophysiology of this clinical entity might be retrieved from results of overnight monitoring of pulsatile and static intracranial pressure (ICP) and ventricular infusion testing. METHODS The study cohort included adult patients (> 20 years of age) with chronic ncHC due to aqueductal stenosis in whom symptoms had lasted a minimum of 6 months. A reference cohort consisted of age- and sex-matched patients managed for communicating HC (cHC)...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28799016/intraparenchymal-intracranial-pressure-monitoring-for-hydrocephalus-and-cerebrospinal-fluid-disorders
#13
Aswin Chari, Debayan Dasgupta, Alexander Smedley, Claudia Craven, Edward Dyson, Samir Matloob, Simon Thompson, Lewis Thorne, Ahmed K Toma, Laurence Watkins
BACKGROUND: Elective intraparenchymal intracranial pressure (ICP) monitoring is useful for the diagnosis and treatment of hydrocephalus and cerebrospinal fluid (CSF) disorders. This retrospective study analyzes median ICP and pulse amplitude (PA) recordings in neurosurgically naïve patients undergoing elective ICP monitoring for suspected CSF disorders. METHODS: Retrospective review of prospectively collated database of neurosurgically naïve patients undergoing elective ICP monitoring for suspected hydrocephalus and CSF disorders...
August 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28797752/efficacy-of-continuous-positive-airway-pressure-and-incentive-spirometry-on-respiratory-functions-during-the-postoperative-period-following-supratentorial-craniotomy-a-prospective-randomized-controlled-study
#14
Hulya Kahraman Sah, Eren Fatma Akcil, Yusuf Tunali, Hayriye Vehid, Ozlem Korkmaz Dilmen
STUDY OBJECTIVE: Volume controlled ventilation with low PEEP is used in neuro-anesthesia to provide constant PaCO2 levels and prevent raised intracranial pressure. Therefore, neurosurgery patients prone to atelectasis formation, however, we could not find any study that evaluates prevention of postoperative pulmonary complications in neurosurgery. DESIGN: A prospective, randomized controlled study. SETTING: Intensive care unit in a university hospital in Istanbul...
August 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28795287/recent-advances-in-the-classification-and-treatment-of-ependymomas
#15
REVIEW
Heather Leeper, Michelle M Felicella, Tobias Walbert
Ependymomas are a subgroup of ependymal glia-derived neoplasms that affect children as well as adults. Arising within any CNS compartment, symptoms at presentation can range from acute onset due to increased intracranial pressure to insidious myelopathy. The overall survival (OS) outcomes in adult patients across the subgroups is heterogeneous with subependymoma having an excellent prognosis often even in the absence of any treatment, whereas supratentorial ependymomas tend to be higher grade in nature and may have an OS of 5 years despite gross total resection and adjuvant radiation...
August 10, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28794252/white-matter-hyperintensity-reduction-and-outcomes-after-minor-stroke
#16
Joanna M Wardlaw, Francesca M Chappell, Maria Del Carmen Valdés Hernández, Stephen D J Makin, Julie Staals, Kirsten Shuler, Michael J Thrippleton, Paul A Armitage, Susana Muñoz-Maniega, Anna K Heye, Eleni Sakka, Martin S Dennis
OBJECTIVE: To assess factors associated with white matter hyperintensity (WMH) change in a large cohort after observing obvious WMH shrinkage 1 year after minor stroke in several participants in a longitudinal study. METHODS: We recruited participants with minor ischemic stroke and performed clinical assessments and brain MRI. At 1 year, we assessed recurrent cerebrovascular events and dependency and repeated the MRI. We assessed change in WMH volume from baseline to 1 year (normalized to percent intracranial volume [ICV]) and associations with baseline variables, clinical outcomes, and imaging parameters using multivariable analysis of covariance, model of changes, and multinomial logistic regression...
August 9, 2017: Neurology
https://www.readbyqxmd.com/read/28791520/external-ventricular-drain-causes-brain-tissue-damage-an-imaging-study
#17
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/28781914/will-clinical-parameters-reliably-predict-external-ventricular-drain-associated-ventriculitis-is-frequent-routine-cerebrospinal-fluid-surveillance-necessary
#18
Omid Hariri, Saman Farr, Shokry Lawandy, Bailey Zampella, Dan Miulli, Javed Siddiqi
BACKGROUND: The placement of an external ventricular drain (EVD) for monitoring and treatment of increased intracranial pressure is not without risk, particularly for the development of associated ventriculitis. The goal of this study was to investigate whether changes in cerebrospinal fluid (CSF), serum, or clinical parameters are correlated with the development of ventriculitis before it occurs, allowing for the determination of optimal timing of CSF collection. METHODS: An observational retrospective study was conducted between January 2006 and May 2012...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28768582/blind-overnight-a-case-of-fulminant-idiopathic-intracranial-hypertension
#19
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
https://www.readbyqxmd.com/read/28762591/ean-consensus-review-on-prevention-diagnosis-and-management-of-tick-borne-encephalitis
#20
REVIEW
P Taba, E Schmutzhard, P Forsberg, I Lutsar, U Ljøstad, Å Mygland, I Levchenko, F Strle, I Steiner
BACKGROUND AND PURPOSE: Tick-borne encephalitis (TBE) is an infection of the central nervous system (CNS) caused by tick-borne encephalitis virus (TBEV) and transmitted by ticks, with a variety of clinical manifestations. The incidence of TBE in Europe is increasing due to an extended season of the infection and the enlargement of endemic areas. Our objectives are to provide recommendations on the prevention, diagnosis and management of TBE, based on evidence or consensus decisions. METHODS: For systematic evaluation, the literature was searched from 1970 to 2015 (including early online publications of 2016), and recommendations were based on evidence or consensus decisions of the Task Force when evidence-based data were not available...
August 1, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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