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Intracranial hypertension management

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https://www.readbyqxmd.com/read/28230585/decompressive-craniectomy-with-bifrontal-coronal-incision-in-the-management-of-fronto-temporal-contusion-and-laceration-for-early-cranioplasty
#1
Zhong Wang, Ning Su, Ri-Le Wu, Yi-Song Zhang, Xiao-Jun Zhang, Jian-Jun Qi, Wei-Ping Zhao, Zhong Zhang, Jun-Qing Wang
The present study aims to explore the effectiveness of decompressive craniectomy with bifrontal coronal incision in the management of severe contusion and laceration of bilateral fronto-temporal lobes, as well as the outcomes of early cranioplasty. The authors performed the bifrontal decompressive craniectomy on 56 patients with contusion and laceration of bilateral frontal and temporal lobes, and their follow-up treatment outcomes were tracked within 6 months using Glasgow Outcome Scale. The results showed that 33 patients (out of 56, 58...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28226898/inductive-passive-sensor-for-intraparenchymal-and-intraventricular-monitoring-of-intracranial-pressure
#2
Mohammad H Behfar, Emily Abada, Lauri Sydanheimo, Ken Goldman, Aaron J Fleischman, Nalin Gupta, Leena Ukkonen, Shuvo Roy, Mohammad H Behfar, Emily Abada, Lauri Sydanheimo, Ken Goldman, Aaron J Fleischman, Nalin Gupta, Leena Ukkonen, Shuvo Roy, Lauri Sydanheimo, Aaron J Fleischman, Leena Ukkonen, Mohammad H Behfar, Nalin Gupta, Shuvo Roy, Ken Goldman, Emily Abada
Accurate measurement of intracranial hypertension is crucial for the management of elevated intracranial pressure (ICP). Catheter-based intraventricular ICP measurement is regarded as the gold standard for accurate ICP monitoring. However, this method is invasive, time-limited, and associated with complications. In this paper, we propose an implantable passive sensor that could be used for continuous intraparenchymal and intraventricular ICP monitoring. Moreover, the sensor can be placed simultaneously along with a cerebrospinal fluid shunt system in order to monitor its function...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28213195/blunt-traumatic-brain-injury-patients-a-role-for-ct-angiography-of-the-head-to-evaluate-non-traumatic-etiologies
#3
REVIEW
Ha Nguyen, Ninh Doan, Michael Gelsomino, Saman Shabani
BACKGROUND: In the setting of trauma, the etiology of intracranial hemorrhage (ICH) is frequently attributed to the physical, traumatic event. Caution should still be directed towards non-traumatic (or spontaneous) etiologies responsible for the trauma, such as hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformation, and hemorrhagic infarcts. The role for immediate CT angiography (CTA) remains controversial to evaluate for non-traumatic etiologies. METHODS: A systematic review of the available literature in Medline PubMed database...
February 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28203185/reversible-cerebral-vasoconstriction-syndrome-with-intracranial-hypertension-should-decompressive-craniectomy-be-considered
#4
Ségolène Mrozek, Laurent Lonjaret, Aude Jaffre, Anne-Christine Januel, Nicolas Raposo, Sergio Boetto, Jean-François Albucher, Olivier Fourcade, Thomas Geeraerts
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracerebral hemorrhage (ICH) causing intracranial hypertension. METHODS: Case report. RESULTS: We report a case of RCVS-related ICH leading to refractory intracranial hypertension. A decompressive craniectomy was performed to control intracranial pressure. We discuss here the management of RCVS with intracranial hypertension. Decompressive craniectomy was preformed to avoid the risky option of high cerebral perfusion pressure management with the risk of bleeding, hemorrhagic complications, and high doses of norepinephrine...
January 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28187815/principles-of-intracranial-pressure-monitoring-and-treatment
#5
M Czosnyka, J D Pickard, L A Steiner
Intracranial pressure (ICP) is governed by volumes of intracranial blood, cerebrospinal fluid, and brain tissue. Expansion of any of these volumes will trigger compensatory changes in the other compartments, resulting in initially limited change in ICP. Due to the rigid skull, once compensatory mechanisms are exhausted, ICP rises very rapidly. Intracranial hypertension is associated with unfavorable outcome in brain-injured patients. This chapter discusses the pathophysiology of raised ICP, as well as typical waveforms, monitoring techniques, and clinical management...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187799/management-of-intracerebral-hemorrhage
#6
A M Thabet, M Kottapally, J Claude Hemphill
Intracerebral hemorrhage (ICH) is a potentially devastating neurologic injury representing 10-15% of stroke cases in the USA each year. Numerous risk factors, including age, hypertension, male gender, coagulopathy, genetic susceptibility, and ethnic descent, have been identified. Timely identification, workup, and management of this condition remain a challenge for clinicians as numerous factors can present obstacles to achieving good functional outcomes. Several large clinical trials have been conducted over the prior decade regarding medical and surgical interventions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28159879/symptomatic-intracranial-hypertension-during-recovery-from-the-syndrome-of-headache-with-neurologic-deficits-and-cerebrospinal-fluid-lymphocytosis-handl
#7
Eoin Mulroy, Joel Yap, Helen Danesh-Meyer, Neil Anderson
The syndrome of headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HANDL) is rare; it comprises migrainous headaches (generally in headache-naïve people), fluctuating neurological symptoms and cerebrospinal fluid (CSF) lymphocytosis. The syndrome generally runs a benign, self-limiting course over weeks. A small proportion of patients develop intracranial hypertension as a consequence of the illness. Recurrence of headaches or development of visual symptoms following apparent recovery from HANDL should prompt urgent re-evaluation for elevated intracranial pressure...
February 3, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28157750/management-of-unruptured-intracranial-aneurysms-and-cerebrovascular-malformations
#8
Kelly D Flemming, Giuseppe Lanzino
PURPOSE OF REVIEW: Unruptured intracranial aneurysms and vascular malformations are detected more frequently because of the increased use and availability of brain imaging. Management of these entities requires knowledge of which patients are at high risk for hemorrhage and what treatment options are available. This article summarizes the epidemiology, natural history, and management strategies for unruptured intracranial aneurysms, arteriovenous malformations, cavernous malformations, developmental venous anomalies, and capillary telangiectasias...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157058/fibromuscular-dysplasia-results-of-a-multicentre-study-in-flanders
#9
Marie De Groote, Patricia Van der Niepen, Dimitri Hemelsoet, Bert Callewaert, Frank Vermassen, Jean-Marie Billiouw, An De Vriese, Jan Donck, Tine De Backer
BACKGROUND: Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic vascular disease, resulting in focal narrowing of small and medium-sized arteries. Systematic recording of clinical data in central databases as in the US and France provided new insights into FMD. The main objectives of this multicentre study were to explore the epidemiology, pattern of vascular involvement, clinical manifestations, and management of FMD patients in Flanders. PATIENTS AND METHODS: Multicentre, retrospective registry of patients diagnosed with FMD based on medical imaging...
February 3, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28154100/stroke-caused-by-atherosclerosis-of-the-major-intracranial-arteries
#10
Chirantan Banerjee, Marc I Chimowitz
Our goal in this review is to discuss the pathophysiology, diagnosis, and treatment of stroke caused by atherosclerosis of the major intracranial arteries. References for the review were identified by searching PubMed for related studies published from 1955 to June 2016 using search terms intracranial stenosis and intracranial atherosclerosis. Reference sections of published randomized clinical trials and previously published reviews were searched for additional references. Intracranial atherosclerotic disease is a highly prevalent cause of stroke that is associated with a high risk of recurrent stroke...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28144922/current-concepts-and-strategies-in-the-diagnosis-and-management-of-idiopathic-intracranial-hypertension-in-adults
#11
REVIEW
Jane W Chan
Since obesity has become an epidemic in industrialized nations, idiopathic intracranial hypertension (IIH) is now a more common neuro-ophthalmic disorder that causes visual loss and headaches. This review highlights the new diagnostic criteria for IIH and the new insights into the pathophysiologic mechanisms of IIH. Key diagnostic and monitoring techniques for papilledema include not only neuroimaging and the measurement of cerebrospinal fluid (CSF) pressure, but also perimetry, optical coherence tomography, and ocular sonography...
January 31, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28090185/characteristics-and-outcomes-of-patients-with-anterior-circulation-intracranial-aneurysm-managed-with-clipping-in-hospital-sungai-buloh
#12
Ailani Ab Ghani, Saiful Azli Mat Nayan, Regunath Kandasamy, Azmin Kas Rosman, Abdul Rahman Izani Ghani
INTRODUCTION: The annual incidence of intracranial aneurysm in Malaysia is estimated to be 1.1-1.7 per 100,000 population based on a study done conducted in 1988. Since then, little epidemiological research has been conducted in Malaysia, and the real incidence is therefore probably unreported despite advancements in the diagnosis and treatment of this disorder. Intracranial aneurysm may be treated by microsurgical clipping or embolisation depending on its location and the surgeon's preference...
November 2016: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28017759/the-monro-kellie-doctrine-in-action-posterior-reversible-leukoencephalopathy-syndrome-pres-due-to-intracranial-hypotension-from-lumbo-peritoneal-shunt-placement
#13
Ioannis Karakis, Audrey H Nuccio, Jordan P Amadio, Arthur J Fountain
BACKGROUND: Posterior reversible leukoencephalopathy syndrome (PRES) is linked to various etiologies, foremost systemic hypertension. Its association with intracranial hypotension (IH), a potential sequela of various neurosurgical procedures, is under-recognized. We report a case of lumbo-peritoneal shunt induced IH resulting in PRES with the goal to increase awareness, and elaborate on the potential biological mechanism, based on the Monro-Kellie hypothesis. CASE DESCRIPTION: A 26-year-old woman with acquired immunodeficiency syndrome and epilepsy was admitted for recurrent cryptococcal meningitis and breakthrough seizures...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28013373/an-update-on-idiopathic-intracranial-hypertension
#14
Mark Portelli, Panagiotis N Papageorgiou
BACKGROUND: Idiopathic intracranial hypertension (IIH) is still a grey area in the knowledge of the aetiology, diagnosis and management of neurosurgical diseases. The definition of IIH has been reviewed over time and many hypotheses have been expressed as cause of the disease. The literature supplies very little evidence-based information to guide our decision-making process when it comes to treat the disease. In this review we sum up the latest information regarding the aetiology and therapy of IIH...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28006941/early-changes-of-brain-perfusion-after-subarachnoid-hemorrhage-the-effect-of-sodium-nitroprusside
#15
M Kolar, K Nohejlova, J Mares, J Pachl
Causes of early hypoperfusion after subarachnoid hemorrhage (SAH) include intracranial hypertension as well as vasoconstriction. The aim of the study was to assess the effect of intracerebroventricular (ICV) administration of sodium nitroprusside (SNP) on early hypoperfusion after SAH. Male Wistar rats (220-240 g) were used, SAH group received 250 microl of fresh autologous arterial blood into the prechiasmatic cistern; sham-operated animals received 250 microl of isotonic solution. Therapeutic intervention: ICV administration of 10 microg SNP; 5 microl 5 % glucose (SNP vehicle) and untreated control...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/27994696/primary-hydatid-cyst-of-the-brain-in-a-child-a-case-report
#16
Alessia Imperato, Alessandro Consales, Marcello Ravegnani, Elio Castagnola, Roberto Bandettini, Andrea Rossi
BACKGROUND: Primary intracranial hydatid cyst is a rare location of human echinococcosis whose spontaneous, traumatic or even iatrogenic rupture, as in case of misdiagnosis, may cause anaphylactic reactions and dissemination. CASE REPORT: We discuss the management of a 9-year-old boy who was admitted to our Emergency Department with an intracranial hypertension syndrome. Head CT scan and brain MRI showed a huge intra-axial right temporo-parieto-occipital cyst with a marginal calcification, associated with left ventricular uncompensated hydrocephalus...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27981458/bariatric-surgery-or-non-surgical-weight-loss-for-idiopathic-intracranial-hypertension-a-systematic-review-and-comparison-of-meta-analyses
#17
REVIEW
James H Manfield, Kenny K-H Yu, Evangelos Efthimiou, Ara Darzi, Thanos Athanasiou, Hutan Ashrafian
BACKGROUND: Idiopathic intracranial hypertension (IIH) is associated with obesity and weight loss by any means is considered beneficial in this condition. OBJECTIVES: This study aims to appraise bariatric surgery vs. non-surgical weight-loss (medical, behavioural and lifestyle) interventions in IIH management. METHODS: A systematic review and meta-analyses of surgical and non-surgical studies. RESULTS: Bariatric surgery achieved 100% papilloedema resolution and a reduction in headache symptoms in 90...
February 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27980126/prevention-of-stroke-in-patients-with-silent-cerebrovascular-disease-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association-american-stroke-association
#18
Eric E Smith, Gustavo Saposnik, Geert Jan Biessels, Fergus N Doubal, Myriam Fornage, Philip B Gorelick, Steven M Greenberg, Randall T Higashida, Scott E Kasner, Sudha Seshadri
Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis and management of silent cerebrovascular disease to prevent stroke, the Stroke Council of the American Heart Association convened a writing committee to evaluate existing evidence, to discuss clinical considerations, and to offer suggestions for future research on stroke prevention in patients with 3 cardinal manifestations of silent cerebrovascular disease: silent brain infarcts, magnetic resonance imaging white matter hyperintensities of presumed vascular origin, and cerebral microbleeds...
February 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27974106/fulminant-bilateral-papilloedema-during-low-dose-steroid-taper-in-a-child-with-systemic-idiopathic-arthritis-treated-with-tocilizumab
#19
Lulu Burstzyn, Simon Levin, Brian Rotenberg, Tamara Van Hooren, Andrew Leung, Roberta Berard, Daniela S Ardelean
Systemic juvenile idiopathic arthritis (SJIA) is one of the most severe forms of arthritis that affects children younger than 16 years of age at onset. SJIA often requires corticosteroids to control the inflammation. However, long-term corticosteroid use may have adverse effects, including intracranial hypertension (IH). Biologic therapies have been used as corticosteroid sparing agents. We report the first case of a child with steroid-dependent SJIA treated with tocilizumab, an IL-6 receptor monoclonal antibody, who developed fulminant IH, bilateral papilloedema and vision loss when oral prednisone was weaned from 2 to 1 mg per day...
December 14, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27965382/predictors-for-venous-sinus-stent-retreatment-in-patients-with-idiopathic-intracranial-hypertension
#20
Amgad El Mekabaty, Nancy A Obuchowski, Mark G Luciano, Seby John, Charlotte Y Chung, Abhay Moghekar, Stephen Jones, Ferdinand K Hui
BACKGROUND: Venous sinus stenting for dural sinus stenoses is an emerging alternative to cerebrospinal fluid diversion in cases of medically refractory idiopathic intracranial hypertension. Juxta-stent 're-stenoses' have been reported and managed alternatively with ventricular shunting or stent revision. Identification of factors that might predispose patients to recurrent narrowing may help to select or exclude patients with idiopathic intracranial hypertension for venous sinus stenting...
December 13, 2016: Journal of Neurointerventional Surgery
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