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Intracranial hypertension management

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https://www.readbyqxmd.com/read/28435117/use-of-intracranial-pressure-monitoring-frequently-refutes-diagnosis-of-idiopathic-intracranial-hypertension
#1
David S Xu, Randall J Hlubek, Celene B Mulholland, Kerry L Knievel, Kris A Smith, Peter Nakaji
OBJECTIVE: The diagnosis and management of patients with idiopathic intracranial hypertension (IIH) frequently relies on lumbar puncture to ascertain intracranial pressures. However, pressures derived this way may be spurious due to patient body habitus and behavior. We recently incorporated direct continuous intracranial pressure (ICP) monitoring into the work-up for IIH and review our experience and outcomes. METHODS: Through billing records, we identified all patients during a 3-year period who had a diagnosis of idiopathic intracranial hypertension and who underwent ICP monitoring prior to shunt placement or revision...
April 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28431144/effect-of-body-mass-index-on-venous-sinus-pressures-in-idiopathic-intracranial-hypertension-patients-before-and-after-endovascular-stenting
#2
Daniel M S Raper, Dale Ding, Thomas J Buell, R Webster Crowley, Robert M Starke, Kenneth C Liu
BACKGROUND: Elevated body mass index (BMI) has been correlated with worse outcomes after treatment for idiopathic intracranial hypertension (IIH). Venous sinus stenting (VSS) has emerged as a safe and effective treatment for a subset of patients with IIH and evidence of venous sinus stenosis. However, the association between BMI and the efficacy of VSS remains poorly characterized. OBJECTIVE: To determine, in a retrospective cohort study, the effect of BMI on preoperative mean intracranial venous pressure (MVP) and post-VSS outcomes...
April 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28398633/intracranial-hemorrhage-in-a-patient-with-sub-massive-pulmonary-embolism-treated-with-ekosonic-endovascular-system-directed-thrombolysis
#3
Sarju Ganatra, Arjun Majithia, Yun-Ting Eric Yeh, Michael S Levy
Ultrasound-assisted catheter-directed thrombolysis therapy has emerged more recently as a management strategy for patients with intermediate risk pulmonary embolism and has shown promising results in clinical trials by early reversal of right ventricle dilation, reduced pulmonary hypertension, and decreased anatomic thrombus burden. This therapeutic strategy requires a small fraction of the systemic fibrinolytic dose and is therefore associated with a reduced bleeding risk. Although intracranial hemorrhage has not been reported in clinical trials, it is a possible complication...
April 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28390510/acute-management-of-moderate-severe-traumatic-brain-injury
#4
REVIEW
Wittstatt Alexandra Whitaker-Lea, Alex B Valadka
Traumatic brain injury (TBI) continues to be a major public health problem. Proposed treatments have not withstood testing in clinical trials because of failure to account for different types of TBI and other weaknesses in trial design. Management goals continue to be prevention and prompt treatment of secondary insults (hypotension, hypoxia, and other physiologic derangements). This goal is best accomplished by careful attention to airway, breathing, circulation, and basic principles of intensive care unit management...
May 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28387055/feasibility-of-laparoscopic-cholecystectomy-in-patients-with-cerebrospinal-fluid-shunt
#5
Terukazu Yoshihara, Yoshito Tomimaru, Kozo Noguchi, Hirotsugu Nagase, Atsushi Hamabe, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Keizo Dono
INTRODUCTION: Previous reports of laparoscopic surgery in patients with cerebrospinal fluid (CSF) shunts for intracranial hypertension described shunt-related complications. Thus, the shunts have been considered a contraindication for laparoscopic procedures. However, with the implementation of recent improvements in surgical techniques, perioperative management, and shunt technology, laparoscopic surgery may now be safe in cases with shunts. The aim of the present study was to examine the safety of such procedures based on our own experiences with laparoscopic surgery in patients with CSF shunts...
April 7, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28383859/-ultrasonographic-measurement-of-the-optical-nerve-sheath-for-the-diagnosis-of-intracranial-hypertension-in-the-emergency-room-a-case-report
#6
R Levy, B Kerzmann, V Franssen, A S Schwab, J F Adam, Th Sottiaux
Early diagnosis and treatment of intracranial hypertension (ICHT) are major components of the management of neurological emergencies. The optic nerve sheath diameter is closely dependent on intracranial pressure and can be measured by bedside ultrasound (US). We report the story of a 70-year-old COPD patient initially admitted to the emergency room for a sepsis of pulmonary origin. An unusual confusion prompted us to perform an US of the optic nerve sheath. This exam clearly suggested the presence of an ICHT...
June 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28349763/radiographic-evidence-of-occult-intracranial-hypertension-in-patients-with-m%C3%A3-ni%C3%A3-re-s-disease
#7
Kareem O Tawfik, Shawn M Stevens, David Mihal, Mark S Costello, Rebecca S Cornelius, Ravi N Samy, Myles L Pensak
Objectives (1) Describe the prevalence of radiographic signs of intracranial hypertension (ICH) in Ménière's disease (MD) and (2) compare the prevalence of radiographic signs of ICH in MD patients managed medically to those managed surgically. Study Design Case-control study. Setting Academic neurotologic practice. Subjects and Methods Adult MD patients (aged ≥17 years) treated from 2011 to 2015 were reviewed. Inclusion required magnetic resonance imaging (MRI) of the head and follow-up >6 months. Patients with intracranial tumors, mass effect, trauma, previous intracranial surgery, and glaucoma were excluded...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28349571/idiopathic-intracranial-hypertension-contemporary-review-and-implications-for-the-otolaryngologist
#8
Shawn M Stevens, Habib G Rizk, Karl Golnik, Norberto Andaluz, Ravi N Samy, Ted A Meyer, Paul R Lambert
OBJECTIVES: 1) Review controversies pertaining to the pathophysiology, diagnosis, and treatment of idiopathic intracranial hypertension. 2) Discuss the evolving role of otolaryngologists in managing this disease and related disorders. DATA SOURCES: Primary literature review, Centers for Disease Control and Prevention website, International Classification of Headache Disorders, Second Edition. METHODS: A comprehensive review of the primary literature was performed from 1990 to 2016 utilizing keywords idiopathic intracranial hypertension, pseudotumor cerebri, benign intracranial hypertension, spontaneous cerebrospinal fluid leak, and encephalocele...
March 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28301882/infantile-hemangioma-of-the-posterior-fossa-in-a-newborn-early-management-and-long-term-follow-up
#9
Elsa Haine, Annick Sevely, Sergio Boetto, Marie-Bernadette Delisle, Claude Cances
A 21-day-old male infant was admitted with signs of intracranial hypertension. Brain magnetic resonance imaging (MRI) revealed a voluminous mass in the posterior fossa with an intense peripheral enhancement on T1 images with gadolinium. The child was treated secondarily by surgical decompression of the posterior fossa and the lesion was biopsied. The pathological findings indicated infantile hemangioma. Treatment with oral prednisolone was initiated at 3 months, given the lack of tumor involution. Six months after corticotherapy was stopped, repeated MRIs indicated a significant reduction in tumor size and then complete disappearance...
March 16, 2017: Neuropediatrics
https://www.readbyqxmd.com/read/28283868/intracranial-aneurysms-in-patients-with-autosomal-dominant-polycystic-kidney-disease-prevalence-risk-of-rupture-and-management-a-systematic-review
#10
REVIEW
Federico Cagnazzo, Carlo Gambacciani, Riccardo Morganti, Paolo Perrini
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder associated with high incidences of intracranial aneurysms. We performed a systematic review with the purpose of clarifying the prevalence, risk of rupture, and appropriate management of intracranial aneurysms in the ADPKD population. METHOD: PRISMA guidelines were followed. We conducted a comprehensive literature search of three databases (PubMed, Ovid MEDLINE, and Ovid EMBASE) on all series reporting ADPKD patients with intracranial aneurysms...
May 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28268710/inductive-passive-sensor-for-intraparenchymal-and-intraventricular-monitoring-of-intracranial-pressure
#11
Mohammad H Behfar, Emily Abada, Lauri Sydanheimo, Ken Goldman, Aaron J Fleischman, Nalin Gupta, Leena Ukkonen, Shuvo Roy
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/28257639/management-and-long-term-evolution-of-a-patient-with-3-hydroxy-3-methylglutaryl-coenzyme-a-lyase-deficiency
#12
Juan Ignacio Muñoz-Bonet, María Del Carmen Ortega-Sánchez, José Luis León Guijarro
BACKGROUND: 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) lyase deficiency is a rare inborn error of metabolism characterized by recurrent metabolic crises caused by fasting, intercurrent illness and excessive physical exercise. Non ketotic hypoglycemia is normally the cause of primary symptoms but without an immediate treatment the illness can evolve into a worsening metabolic state resembling the Reye's syndrome that may cause the patient's death. We report a case with some clinical and therapeutic features not previously described...
January 19, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28236181/intracranial-pressure-monitoring-after-primary-decompressive-craniectomy-in-traumatic-brain-injury-a-clinical-study
#13
Edoardo Picetti, Maria Luisa Caspani, Corrado Iaccarino, Giulia Pastorello, Pierpaolo Salsi, Edoardo Viaroli, Franco Servadei
BACKGROUND: Intracranial pressure (ICP) monitoring represents an important tool in the management of traumatic brain injury (TBI). Although current information exists regarding ICP monitoring in secondary decompressive craniectomy (DC), little is known after primary DC following emergency hematoma evacuation. METHODS: Retrospective analysis of prospectively collected data. Inclusion criteria were age ≥18 years and admission to the intensive care unit (ICU) for TBI and ICP monitoring after primary DC...
April 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28230585/decompressive-craniectomy-with-bifrontal-coronal-incision-in-the-management-of-fronto-temporal-contusion-and-laceration-for-early-cranioplasty
#14
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
#15
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
#16
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
#17
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
#18
REVIEW
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
#19
REVIEW
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
#20
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...
April 2017: Practical Neurology
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