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Intracranial hypertension management

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https://www.readbyqxmd.com/read/29747285/-expert-consensus-on-the-diagnosis-and-treatment-of-cryptococcal-meningitis
#1
Z Y Liu, G Q Wang, L P Zhu, X J Lyu, Q Q Zhang, Y S Yu, Z H Zhou, Y B Liu, W P Cai, R Y Li, W H Zhang, F J Zhang, H Wu, Y C Xu, H Z Lu, T S Li
Cryptococcal meningitis is a common and refractory central nervous system infection, with high rates of mortality and disability. The experts of the Society of Infectious Diseases of Chinese Medical Association have reached this consensus after a thorough discussion. Based on the current situation of cryptococcal meningitis in China, the management of cryptococcal meningitis includes 6 aspects: introduction, microorganism identification, clinical manifestations and diagnosis, principles of antifungal therapy, treatment of refractory and recurrent meningitis, treatment of intracranial hypertension...
May 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29735026/modern-management-of-acute-liver-failure
#2
REVIEW
Ruben Khan, Sean Koppe
Acute liver failure is a rare but life-threatening disease that can lead to progressive encephalopathy, intracranial hypertension, and multiorgan failure. In the developed world, the most common cause remains acetaminophen overdose, but there are still many cases in which there is acute liver failure of unknown etiology. The mainstay of acute liver failure management remains supportive care in the critical care setting. If supportive treatment does not stabilize the disease process, the patient may require emergent liver transplantation...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29731820/multimodal-monitoring-combined-with-hypothermia-for-the-management-of-severe-traumatic-brain-injury-a-case-report
#3
Jun-Hui Chen, Yi-Nong Xu, Meng Ji, Pei-Pei Li, Li-Kun Yang, Yu-Hai Wang
Traumatic brain injury (TBI) is a prominent public health issue that has a significant negative impact on patients and their family members. It is the leading cause of mortality and disability among young (below 50 years old) individuals. Intracranial hypertension (ICH) remains the single most difficult therapeutic challenge for the management of severe TBI. Therapeutic hypothermia may reduce intracranial hypertension and improve patient outcomes; however, the use of hypothermia is controversial. It has been reported that therapeutic hypothermia elicits no therapeutic benefit for patients with TBI...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29730051/multimodal-management-of-severe-herpes-simplex-virus-encephalitis-a-case-report-and-literature-review
#4
REVIEW
J Todeschi, A Gubian, T Wirth, H-A Coca, F Proust, H Cebula
BACKGROUND: Herpes simplex encephalitis (HSE) is the most frequent sporadic encephalitis in the world. In severe cases of HSE, the pathology usually progresses with an increase in intracranial pressure secondary to cerebral edema and/or hemorrhagic necrosis. Currently no high-power studies exist regarding the management of severe HSE and most of the papers reported in the literature are case reports. Decompressive craniectomy, effective in some cases of pharmaco-resistant intracranial hypertension (ICH) resulting from other causes, may be suggested in severe HSE, with several good results reported in the literature...
May 2, 2018: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29722746/spot-sign-in-acute-intracerebral-hemorrhage-in-magnetic-resonance-imaging-a-case-report-and-review-of-the-literature
#5
Zalan Khan, Premkumar Nattanmai, Pravin George, Christopher R Newey
INTRODUCTION: Intracranial hemorrhage (ICH) is associated with significant mortality and morbidity. Current treatment paradigms focus on correcting hypertension and coagulopathy to prevent hematoma expansion. Magnetic resonance imaging (MRI) is becoming more common in the hyperactive phase of ICH management. The finding of contrast extravasation (ie, spot sign) on MRI may be a marker of active bleeding. We present a case of MRI spot sign and review of the literature. CASE REPORT: We present a patient on oral coumadin for history of deep venous thrombosis and pulmonary embolus who presented with a right basal ganglia hemorrhage...
May 2018: Neurologist
https://www.readbyqxmd.com/read/29721718/an-up-to-date-review-of-pseudotumor-cerebri-syndrome
#6
REVIEW
John Glenn Burkett, Jessica Ailani
PURPOSE OF REVIEW: Idiopathic intracranial hypertension (IIH), pseudotumor cerebri syndrome (PTCS), and benign intracranial hypertension are all terms that have been used for a neurologic syndrome consisting of elevated intracranial pressure (ICP), headache and vision loss without mass lesion or underlying infection or malignancy. In this review article, categorization, diagnostic criteria, symptom management strategies, and disease treatment options for pseudotumor cerebri syndrome will be discussed...
May 2, 2018: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/29705803/lipid-lowering-pretreatment-and-outcome-following-intravenous-thrombolysis-for-acute-ischaemic-stroke-a-post-hoc-analysis-of-the-enhanced-control-of-hypertension-and-thrombolysis-stroke-study-trial
#7
Jatinder S Minhas, Xia Wang, Hisatomi Arima, Philip M Bath, Laurent Billot, Joseph P Broderick, Geoffrey A Donnan, Jong S Kim, Pablo M Lavados, Tsong-Hai Lee, Sheila Cristina Ouriques Martins, Verónica V Olavarría, Jeyaraj D Pandian, Octávio Marques Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K Sharma, Nguyen H Thang, Ji-Guang Wang, Mark Woodward, John Chalmers, Craig S Anderson, Thompson G Robinson
BACKGROUND: Debate exists as to whether statin pretreatment confers an increased risk of 90-day mortality and symptomatic intracranial haemorrhage (sICH) in acute ischaemic stroke (AIS) patients treated with intravenous thrombolysis. We assessed the effects of undifferentiated lipid-lowering pretreatment on outcomes and interaction with low-dose versus standard-dose alteplase in a post hoc subgroup -analysis of the Enhanced Control of Hypertension and Thrombolysis Stroke Study. METHODS: In all, 3,284 thrombolysis-eligible AIS patients (mean age 66...
April 27, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29688821/risk-of-postoperative-complications-in-patients-with-obstructive-sleep-apnea-following-skull-base-surgery
#8
Phillip Huyett, Ryan J Soose, Amy E Schell, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman, Eric W Wang
Objectives Obstructive sleep apnea (OSA) presents several challenges in skull base surgery, including increased intracranial pressure, worsened OSA with nasal packing, and avoidance of positive airway pressure (PAP) therapy postoperatively. The objective of this study was to examine the risk of postoperative complications in a skull base population with OSA in which PAP therapy is withheld. Study Design Retrospective cohort study. Setting Tertiary care hospital. Subjects and Methods Medical records of 414 adult patients undergoing anterior skull base procedures between January 1, 2014, and January 7, 2017, were retrospectively reviewed...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29680416/electrocardiographic-variables-in-children-with-syndromic-craniosynostosis-and-primary-snoring-to-mild-obstructive-sleep-apnea-significance-of-identifying-respiratory-arrhythmia-during-sleep
#9
Ellaha Kakar, Linda J A Corel, Robert C Tasker, Robbin de Goederen, Eppo B Wolvius, Irene M J Mathijssen, Koen F M Joosten
BACKGROUND: In the spectrum of children with symptomatic sleep disordered breathing (SDB), some individuals - such as those with upper airway resistance syndrome (UARS) - do not have abnormalities on polysomnography (PSG). In this study we have assessed whether assessment of respiratory arrhythmia (RA) and heart rate variability (HRV) analysis helps in management of children with syndromic craniosynostosis and none-to-mild obstructive sleep apnea (OSA). METHODS: Prospective cohort study in children aged 1-18 years old with syndromic craniosynostosis...
May 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29628552/ultrasonographic-optic-nerve-sheath-diameter-as-a-surrogate-measure-of-raised-intracranial-pressure-in-severe-pregnancy-induced-hypertension-patients
#10
Shiv Kumar Singh, Kiran Bhatia
Context: It is a well-known fact that severe pregnancy-induced hypertension (PIH) can be disastrous at times as it can cause a lot of complications to both pregnant women and her baby. Hence, it is always desirable to know the extent of severity by a real-time and easily accessible modality like ultrasound. Aims: The aim of the study was to evaluate the incidence of raised intracranial pressure (ICP) in severe preeclampsia and eclampsia patients using ocular ultrasonography with optic nerve sheath diameter (ONSD) measurement...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627171/comparison-of-nicardipine-with-clevidipine-in-the-management-of-hypertension-in-acute-cerebrovascular-diseases
#11
Zachary Rosenfeldt, Katelyn Conklen, Breck Jones, Don Ferrill, Maithili Deshpande, Fazeel M Siddiqui
BACKGROUND AND PURPOSE: In acute stroke, hypertension worsens outcomes. Guidelines do not mention a preferred antihypertensive agent. This present study aimed to compare the efficacy and safety of nicardipine and clevidipine in acute stroke. METHODS: This retrospective review compared nicardipine with clevidipine for hypertension in acute stroke patients from March 17, 2015 to December 23, 2016. Ischemic and hemorrhagic stroke types were evaluated. Patients were excluded if under 18 years, had traumatic brain injury, had intracranial neoplasm, were on dialysis, had both study drugs during the stroke admission, or the study drug was infused for less than 1 hour...
April 4, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29619550/perspectives-on-diagnosis-and-management-of-adult-idiopathic-intracranial-hypertension
#12
Irini Chatziralli, Panagiotis Theodossiadis, George Theodossiadis, Ioannis Asproudis
PURPOSE: The purpose of this review is to shed light into the diagnostic challenges regarding idiopathic intracranial hypertension (IIH), giving more emphasis to the role of optical coherence tomography (OCT) in IIH, while it also presents recent advances in the management of IIH. METHODS: A literature search in PubMed was performed for studies about the diagnosis and management of IIH published before June 30, 2017. Then, a comprehensive review of the eligible studies and the relevant references was performed...
April 4, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29582945/-spontaneous-parenchymal-intracranial-hemorrhage-a-diagnostic-challenge
#13
Ruth Eliahou, Auriel Eitan, Moshe Gomori, Jacob Sosna, Asaf Honig
Non-traumatic intracranial hemorrhage (ICH) is a devastating event associated with a high rate of morbidity and mortality. Patient age, hemorrhage location, number of foci, and underlying diseases are important clues to the etiology. Non-contrast head CT, given its availability and high sensitivity in detecting blood products, is frequently the first tool to readily detect ICH; however, different types of hemorrhages may share a common appearance on CT and the optimal therapeutic approach varies depending on etiology...
March 2018: Harefuah
https://www.readbyqxmd.com/read/29556806/cerebral-hyperperfusion-syndrome-after-carotid-revascularization-and-acute-ischemic-stroke
#14
REVIEW
Kathryn F Kirchoff-Torres, Ekaterina Bakradze
PURPOSE OF REVIEW: Cerebral hyperperfusion syndrome (CHS) is a rare but significant complication after carotid revascularization and is increasingly recognized after acute stroke treatments. In this review, we discuss the epidemiology and pathophysiology of CHS, clinical presentation including ipsilateral headache, seizures, and focal neurological deficits, and radiographic presentation. We propose preventive therapies with emphasis on acute stroke post-thrombectomy hyperperfusion. RECENT FINDINGS: CHS was first described after carotid revascularization but is now also reported in patients with acute ischemic stroke...
March 19, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29531602/survey-about-the-extubation-practice-among-anaesthesiologists-in-kosovo
#15
Nehat Baftiu, Islam Krasniqi, Kastriot Haxhirexha, Rudin Domi
BACKGROUND: Tracheal extubations may be performed before or after awakening from anaesthesia. The advantage of extubation during anaesthesia may avoid all the unpleasant effects of fully awake extubation such as severe hypertension and tachycardia, malignant dysrhythmias, myocardial ischemia laryngospasm, and cough induced high intraocular and intracranial pressure. AIM: To show the current practice of performing extubations in Kosovo, as well as the advantage and disadvantage in performing this procedure in an awake patient or inpatient in light anaesthesia...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29530704/phases-and-elapss-scores-are-associated-with-aneurysm-growth-a-study-of-431-unruptured-intracranial-aneurysms
#16
Waleed Brinjikji, Vitor M Pereira, Rujimas Khumtong, Alex Kostensky, Michael Tymianski, Timo Krings, Ivan Radovanovich
BACKGROUND: Understanding risk factors for intracranial aneurysm growth is important for patient management. We performed a retrospective study examining risk factors for the growth of unruptured intracranial aneurysms followed at our institution, evaluating both traditional risk factors and the PHASES (Population, Hypertension, Age, Size, Earlier Subarachnoid Hemorrhage, Site) score. METHODS: We retrospectively reviewed a consecutive series of unruptured intracranial aneurysms followed at our institution for a minimum of 6 months over a 15-year period...
March 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29507847/does-a-spontaneous-intracerebral-hemorrhage-predispose-to-a-secondary-distant-intracerebral-hemorrhage-a-case-report-and-review-of-the-literature
#17
Nakul Katyal, Christopher R Newey
Cerebrovascular autoregulation may be dysfunctional after acute intracerebral hemorrhage (ICH). This disruption in autoregulation can potentially result in secondary neurological damage that may present as an intracranial hemorrhage at locations distant from the primary site of hemorrhage. We discuss a case of 68-year-old female who presented with acute left hemiparesis from a spontaneous right frontal ICH. Magnetic resonance imaging (MRI) was negative for any other blooming artifact. Her weakness was improving, but after 72 hours from admission, she had an acute change in her mental status and was found to have a new left frontal ICH distant from the primary hemorrhage...
December 29, 2017: Curēus
https://www.readbyqxmd.com/read/29506598/headache-in-guillain-barr%C3%A3-syndrome-diagnostic-and-management-implications
#18
Anas Alrohimi, Rajive Jassal
Headache is an uncommon symptom in Guillain-Barré syndrome (GBS). We review four clinical settings related to GBS in which headache may be present. We focus on pathophysiological explanations, alerting the clinician to further potential investigations and treatment. Most reports of headache in GBS occur in the context of the posterior reversible encephalopathy syndrome, an increasingly recognized dysautonomia-related GBS complication. Less frequent is headache in the setting of increased intracranial pressure and papilledema (secondary intracranial hypertension), Miller Fisher syndrome, and cerebral venous sinus thrombosis...
March 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29502712/management-of-traumatic-brain-injury-an-update
#19
REVIEW
Mohamed H Abou El Fadl, Kristine H O'Phelan
The care of patients with traumatic brain injury can be one of the most challenging and rewarding aspects of clinical neurocritical care. This article reviews the approach to unique aspects specific to the care of this patient population. These aspects include appropriate use of sedation and analgesia, and the principles and the clinical use of intracranial monitors. Common clinical challenges encountered in these patients are also discussed, including the treatment of intracranial hypertension, temperature management, and control of sympathetic hyperactivity...
April 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29502711/pathophysiology-and-management-of-intracranial-hypertension-and-tissular-brain-hypoxia-after-severe-traumatic-brain-injury-an-integrative-approach
#20
REVIEW
Daniel Agustín Godoy, Santiago Lubillo, Alejandro A Rabinstein
Monitoring intracranial pressure in comatose patients with severe traumatic brain injury (TBI) is considered necessary by most experts. Acute intracranial hypertension (IHT), when severe and sustained, is a life-threatening complication that demands emergency treatment. Yet, secondary anoxic-ischemic injury after brain trauma can occur in the absence of IHT. In such cases, adding other monitoring modalities can alert clinicians when the patient is in a state of energy failure. This article reviews the mechanisms, diagnosis, and treatment of IHT and brain hypoxia after TBI, emphasizing the need to develop a physiologically integrative approach to the management of these complex situations...
April 2018: Neurosurgery Clinics of North America
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