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Intracranial hypertension management

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https://www.readbyqxmd.com/read/28628430/autosomal-dominant-polycystic-kidney-disease-and-the-heart-and-brain
#1
REVIEW
Vinod Krishnappa, Poornima Vinod, Divya Deverakonda, Rupesh Raina
Autosomal dominant polycystic kidney disease (ADPKD) has numerous systemic manifestations and complications. This article gives an overview of hypertension, cardiac complications, and intracranial aneurysms in ADPKD, their pathophysiology, and recent developments in their management.
June 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28625338/acute-diplopia-in-the-pediatric-emergency-department-a-cohort-multicenter-italian-study
#2
Umberto Raucci, Pasquale Parisi, Nicola Vanacore, Francesco La Penna, Valentina Ferro, Lucia Calistri, Claudia Bondone, Fabio Midulla, Agnese Suppiej, Raffaele Falsaperla, Duccio Maria Cordelli, Antonella Palmieri, Alberto Verrotti, Sabrina Becciani, Sonia Aguzzi, Mario Mastrangelo, Federica Pelizza, Filippo Greco, Giulia Carbonari, Ramona Tallone, Gabriella Bottone, Italo Trenta, Stefano Masi, Maria Pia Villa, Antonino Reale
BACKGROUND: Acute diplopia (AD) is an uncommon and distressing symptom of numerous ocular and neurological conditions, with potentially serious sequelaes. No data are present in pediatrics on the presentation and management of AD. AIM: This study investigated characteristics, etiology and health care utilization of the pediatric population with AD accessed to pediatric Emergency Departments (ED), trying to identify "red flags" associated with potentially life-threatening (LT) conditions...
June 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28611643/uncommon-presentation-of-idiopathic-intracranial-hypertension-in-a-patient-with-polycystic-ovary-syndrome-a-case-report
#3
Anas Mohammad Albarrak, Suleiman Kojan
INTRODUCTION: Idiopathic intracranial hypertension is a rare condition characterized by increased intracranial pressure without clinical, laboratory, or radiological evidence of intracranial pathology. Early management could prevent irreversible outcomes. CASE PRESENTATION: A 17-year-old single Arabian female of Arab origin presented with a 2-day complaint of horizontal diplopia and transient visual obscurations. She denied any history of headache or decreased vision...
January 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28605505/impact-of-young-age-on-the-presentation-of-saccular-intracranial-aneurysms-population-based-analysis-of-4082-patients
#4
Sari Räisänen, Juhana Frösen, Mitja I Kurki, Terhi Huttunen, Jukka Huttunen, Timo Koivisto, Katariina Helin, Mikael von Und Zu Fraunberg, Juha E Jääskeläinen, Antti E Lindgren
BACKGROUND: Formation and rupture of saccular intracranial aneurysms (sIAs) may have different pathobiologies in patients with younger age at first diagnosis of sIA disease. OBJECTIVE: To study the phenotype of sIA disease and formation of new (de novo) sIAs in patients below 40 yr. METHODS: A population-based cohort study was conducted in 613 young (<40 yr) sIA patients with first diagnosis between 1980 and 2014 and total angiographic follow-up of 3768 yr...
June 9, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28599841/changing-paradigm-in-the-management-of-elderly-patients-with-intracranial-aneurysms-an-institutional-review
#5
Oleg Y Chernyshev, Shyamal C Bir, Tanmoy K Maiti, Devi Prasad Patra, Cesar Liendo, Hugo Cuellar, Alireza Minagar, Anil Nanda
Optimal treatment of intracranial aneurysms (IAs) in elderly patients has not yet been well established. We have investigated the clinical and radiological outcomes and predictors of unfavorable outcome of IAs in elderly patients. Radiological and clinical data of 85 elderly patients from 2010 through 2015 were retrospectively reviewed. Significant differences between the groups were determined by a chi-square test. Regression analysis was performed to identify the predictors of unfavorable outcome. Among the 85 patients with IAs, the number of patients with >7mm size aneurysm (p=0...
June 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28560487/effect-of-venous-stenting-on-intracranial-pressure-in-idiopathic-intracranial-hypertension
#6
Samir A Matloob, Ahmed K Toma, Simon D Thompson, Chee L Gan, Fergus Robertson, Lewis Thorne, Laurence D Watkins
BACKGROUND: Idiopathic intracranial hypertension (IIH) is characterised by an increased intracranial pressure (ICP) in the absence of any central nervous system disease or structural abnormality and by normal CSF composition. Management becomes complicated once surgical intervention is required. Venous sinus stenosis has been suggested as a possible aetiology for IIH. Venous sinus stenting has emerged as a possible interventional option. Evidence for venous sinus stenting is based on elimination of the venous pressure gradient and clinical response...
May 31, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28553393/osteoblastoma-mimicking-an-idiopathic-intracranial-hypertension-syndrome
#7
Alessandro Boaro, Elisabetta Marton, Grazia Marina Mazzucco, Pierluigi Longatti
Osteoblastomas are rare, benign bone tumors mainly arising from the long bones and the posterior vertebral arches. Skull localizations account for approximately 15% of cases. A total amount of thirty cases involving the temporal bone are reported in the literature. Clinical presentation of temporal osteoblastomas often includes local pain and swelling, while 7(th) and 8(th) cranial nerve impairment is rare. We report the novel finding of increase intracranial pressure syndrome secondary to dominant transverse-sigmoid sinus junction compression caused by a small temporal bone osteoblastoma...
January 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28553032/stroke-in-patients-with-chronic-kidney-disease%C3%A2-how-do-we-approach-and-manage-it
#8
REVIEW
S Nayak-Rao, M P Shenoy
Renal failure is a potent risk factor for stroke, which is a leading cause of morbidity and mortality worldwide. The risk of stroke is 5-30 times higher in patients with chronic kidney disease (CKD), especially on dialysis. Case fatality rates are also higher reaching almost 90%. It is therefore important to understand the factors that predispose to stroke in this vulnerable population to better apply preventive strategies. The heightened risk of stroke in CKD represents the interplay of the vascular co-morbidities that occur with renal impairment and factors specific to renal failure such as malnutrition-inflammation-atherosclerosis complex, the effect of uremic toxins, dialysis techniques, vascular access, and the use of anticoagulants to maintain flow in the extracorporeal circuit...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28552700/analysis-of-factors-related-to-hypopituitarism-in-non-sellar-intracranial-tumor-patients
#9
Song-Song Lu, Jian-Jun Gu, Xiao-Hong Luo, Jian-He Zhang, Shou-Sen Wang
OBJECTIVES: Previous studies have suggested that postoperative hypopituitarism in patients with non-sellar intracranial tumors is caused by traumatic surgery. However, with development of minimally invasive and precise neurosurgical techniques, the degree of injury to brain tissue has been reduced significantly, especially for parenchymal tumors. Therefore, understanding pre-existing hypopituitarism and related risk factors can improve perioperative management for patients with non-sellar intracranial tumors...
May 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28552132/surgical-management-of-cerebral-dural-arteriovenous-fistulae
#10
Martin J Rutkowski, Brian Jian, Michael T Lawton
Dural arteriovenous fistulae are high flow, low resistance intracranial vascular malformations defined by an aberrant connection between an artery and dural vein or sinus. Symptomatology and presentation are highly dependent on location, generally categorized as supratentorial, tentorial, or infratentorial, and consist primarily of sequelae secondary to local venous hypertension, insufficiency, and cortical venous reflux. Surgery is generally reserved for high risk or persistently symptomatic lesions that are unamenable or unresponsive to endovascular therapy...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28536838/outcomes-of-ventriculoperitoneal-shunt-insertion-in-the-management-of-idiopathic-intracranial-hypertension-in-children
#11
J Heyman, Ronak Ved, A Amato-Watkins, I Bhatti, J Te Water Naude, F Gibbon, P Leach
PURPOSE: The ventriculoperitoneal (VP) shunt has become the procedure of choice for treatment of idiopathic intracranial hypertension (IIH). We aimed to assess the efficacy of frameless stereotactic placement of VP shunts for the management of medically resistant IIH in children and to assess the role of gender and obesity in the aetiology of the condition. METHODS: This is a retrospective analysis of the case notes of 10 patients treated surgically at the University Hospital of Wales in Cardiff, from May 2006 to September 2012...
May 23, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28532922/awake-craniotomy-anesthesia-a-comparison-between-the-monitored-anesthesia-care-versus-the-asleep-awake-asleep-technique
#12
Chikezie I Eseonu, Karim ReFaey, Oscar Garcia, Amballur John, Alfredo Quinones-Hinojosa, Punita Tripathi
BACKGROUND: The commonly used sedation techniques for an awake craniotomy includes monitored anesthesia care(MAC), using an unprotected airway, or the asleep-awake-asleep(AAA) technique, using a partially or totally protected airway. We present a comparative analysis between the MAC and AAA technique evaluating anesthetic management, perioperative outcomes, and complications in a consecutive series of patients undergoing the removal of an eloquent brain lesion. METHODS: Eighty-one patients underwent an awake craniotomy for an intracranial lesion over a nine-year period by a single-surgeon and a team of anesthesiologists...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28527856/a-bloody-mess
#13
Michael C Brodsky, Valérie Biousse
A 15-year-old girl presented with a unilateral sixth nerve palsy and papilledema following a severe headache. MR imaging showed thrombosis of the superior sagittal sinus and proximal right transverse sinus that were attributed to oral contraceptive use after a coagulation workup was negative. Systemic anticoagulation caused a hemorrhagic papillopathy in both eyes, raising the question as to whether anticoagulation should be discontinued. Diagnostic and management issues regarding cerebral venous sinus thrombosis with secondary intracranial hypertension are discussed...
May 17, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28516363/posterior-reversible-encephalopathy-syndrome-presenting-in-the-anterior-circulation-with-malignant-intracranial-hypertension-requiring-surgical-decompression-a-case-report-and-literature-review
#14
S Hernández-Durán, A Barrantes-Freer, V Rohde, C von der Brelie
Posterior reversible encephalopathy syndrome (PRES) is thought to result from endothelial dysfunction and breakdown of the blood-brain barrier with subsequent vasogenic edema. Abrupt hypertension has been identified as one of its risk factors. We present a rare case of PRES in the anterior circulation with sudden onset of left hemiparesis and rapid neurological deterioration on the basis of hypertensive crisis. Due to refractory intracranial hypertension, the patient required emergent right decompressive craniectomy...
July 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28512741/intervention-for-elevated-intracranial-pressure-improves-success-rate-after-repair-of-spontaneous-cerebrospinal-fluid-leaks
#15
William Teachey, Jessica Grayson, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
OBJECTIVES/HYPOTHESIS: Spontaneous cerebrospinal fluid (CSF) leaks are associated with increased intracranial pressure (ICP) and considered a manifestation of idiopathic intracranial hypertension. Although postoperative acetazolamide and placement of CSF shunt systems are considered valuable interventions for elevated ICP, the impact on recurrence rate remains unclear. The objective of this study was to systematically review evidence from reported literature to evaluate whether postoperative ICP management reduces recurrence rates after primary endoscopic repair...
May 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28511969/the-current-role-of-decompressive-craniectomy-for-severe-traumatic-brain-injury
#16
REVIEW
S Honeybul, K M Ho, C R P Lind, G R Gillett
There is little doubt that decompressive craniectomy can reduce mortality however, the results of a recent study has provided more evidence to inform the debate regarding clinical and ethical concerns that it merely converts death into survival with severe disability or in a vegetative state. The recently published RESCUEicp trial compared last-tier secondary decompressive craniectomy with continued medical management for refractory intracranial hypertension after severe traumatic brain injury. Patients were randomly assigned to decompressive craniectomy with medical therapy or to receive continued medical therapy with the option of adding barbiturates...
May 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28492874/peripapillary-retinal-pigment-epithelium-layer-shape-changes-from-acetazolamide-treatment-in-the-idiopathic-intracranial-hypertension-treatment-trial
#17
Jui-Kai Wang, Randy H Kardon, Johannes Ledolter, Patrick A Sibony, Mark J Kupersmith, Mona K Garvin
Purpose: Recent studies indicate that the amount of deformation of the peripapillary retinal pigment epithelium and Bruch's membrane (pRPE/BM) toward or away from the vitreous may reflect acute changes in cerebrospinal fluid pressure. The study purpose is to determine if changes in optic-nerve-head (ONH) shape reflect a treatment effect (acetazolamide/placebo + weight management) using the optical coherence tomography (OCT) substudy of the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) at baseline, 3, and 6 months...
May 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28489610/invasive-and-noninvasive-means-of-measuring-intracranial-pressure-a-review
#18
Xuan Zhang, Joshua Medow, Bermans Iskandar, Fa Wang, Mehdi Shokoueinejad, Joyce Koueik, John Webster
Measurement of intracranial pressure (ICP) can be invaluable in the management of critically ill patients. Cerebrospinal fluid (CSF) is produced by the choroid plexus in the brain ventricles (a set of communicating chambers), after which it circulates through the different ventricles and exits into the subarachnoid space (SAS) around the brain, where it is reabsorbed into the venous system. If the fluid does not drain out of the brain or get reabsorbed, the ICP increases, which may lead to brain damage or death...
May 10, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28487359/venous-sinus-stenting-shortens-the-duration-of-medical-therapy-for-increased-intracranial-pressure-secondary-to-venous-sinus-stenosis
#19
Tarek A Shazly, Ashutosh P Jadhav, Amin Aghaebrahim, Andrew F Ducruet, Brian T Jankowitz, Tudor G Jovin, Gabrielle R Bonhomme
INTRODUCTION: Medical treatment, cerebrospinal fluid (CSF) shunting, and optic nerve sheath fenestration are standard treatments for increased intracranial pressure (ICP) in patients with idiopathic intracranial hypertension (IIH). Venous sinus stenting provides a novel alternative surgical treatment in cases of venous sinus stenosis with elevated ICP. METHODS: 12 consecutive subjects with papilledema, increased ICP, and radiological signs of dural sinus stenosis underwent cerebral venography and manometry...
May 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28483156/-bilateral-papilledema
#20
REVIEW
M-B Rougier
This article will review the current standard of care in the diagnosis and management of bilateral optic disc edema. Two emergent conditions must be considered first: secondary intracranial hypertension (cerebral tumor, cerebral thrombophlebitis…) and arteritic ischemic optic neuropathy (or giant cell arteritis). Having ruled out these two diagnoses, the management follows various steps in order to: (i) rule out pseudo-edema, and (ii) determine the underlying cause of the edema: papilledema, non-arteritic ischemic optic neuropathy or papillitis...
May 2017: Journal Français D'ophtalmologie
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