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Intracranial hypertension management

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https://www.readbyqxmd.com/read/29348138/development-and-validation-of-outcome-prediction-models-for-aneurysmal-subarachnoid-haemorrhage-the-sahit-multinational-cohort-study
#1
Blessing N R Jaja, Gustavo Saposnik, Hester F Lingsma, Erin Macdonald, Kevin E Thorpe, Muhammed Mamdani, Ewout W Steyerberg, Andrew Molyneux, Airton Leonardo de Oliveira Manoel, Bawarjan Schatlo, Daniel Hanggi, David Hasan, George K C Wong, Nima Etminan, Hitoshi Fukuda, James Torner, Karl L Schaller, Jose I Suarez, Martin N Stienen, Mervyn D I Vergouwen, Gabriel J E Rinkel, Julian Spears, Michael D Cusimano, Michael Todd, Peter Le Roux, Peter Kirkpatrick, John Pickard, Walter M van den Bergh, Gordon Murray, S Claiborne Johnston, Sen Yamagata, Stephan Mayer, Tom A Schweizer, R Loch Macdonald
OBJECTIVE: To develop and validate a set of practical prediction tools that reliably estimate the outcome of subarachnoid haemorrhage from ruptured intracranial aneurysms (SAH). DESIGN: Cohort study with logistic regression analysis to combine predictors and treatment modality. SETTING: Subarachnoid Haemorrhage International Trialists' (SAHIT) data repository, including randomised clinical trials, prospective observational studies, and hospital registries...
January 18, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29313398/a-15-year-review-of-secondary-and-tertiary-optic-nerve-sheath-fenestration-for-idiopathic-intracranial-hypertension
#2
Andrew J Anzeljc, Patrick Frias, Brent R Hayek, Nancy Canter Weiner, Ted H Wojno, H Joon Kim
PURPOSE: Optic nerve sheath fenestration (ONSF) is a common surgical option for patients with idiopathic intracranial hypertension (IIH) with vision loss refractory to medical management. Little is known about the visual benefit of repeated ONSF. The authors aimed to assess the efficacy of secondary and tertiary ONSF in patients with IIH. METHODS: A retrospective chart review was performed on all patients with repeat ONSF for IIH at Emory University from 1999 to 2016...
January 9, 2018: Orbit
https://www.readbyqxmd.com/read/29305439/optic-nerve-head-edema-among-patients-presenting-to-the-emergency-department
#3
Virender Sachdeva, Caroline Vasseneix, Rabih Hage, Samuel Bidot, Lindsay C Clough, David W Wright, Nancy J Newman, Valérie Biousse, Beau B Bruce
OBJECTIVE: To determine the frequency of and predictive factors for optic nerve head edema (ONHE) among patients with headache, neurologic deficit, visual loss, or elevated blood pressure in the emergency department (ED). METHODS: Cross-sectional analysis was done of patients with ONHE in the prospective Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study. Demographics, neuroimaging results, management, and patient disposition were collected...
January 5, 2018: Neurology
https://www.readbyqxmd.com/read/29300374/clinical-history-and-management-recommendations-of-the-smooth-muscle-dysfunction-syndrome-due-to-acta2-arginine-179-alterations
#4
Ellen S Regalado, Lauren Mellor-Crummey, Julie De Backer, Alan C Braverman, Lesley Ades, Susan Benedict, Timothy J Bradley, M Elizabeth Brickner, Kathryn C Chatfield, Anne Child, Cori Feist, Kathryn W Holmes, Glen Iannucci, Birgit Lorenz, Paul Mark, Takayuki Morisaki, Hiroko Morisaki, Shaine A Morris, Anna L Mitchell, John R Ostergaard, Julie Richer, Denver Sallee, Sherene Shalhub, Mustafa Tekin, Anthony Estrera, Patricia Musolino, Anji Yetman, Reed Pyeritz, Dianna M Milewicz
PurposeSmooth muscle dysfunction syndrome (SMDS) due to heterozygous ACTA2 arginine 179 alterations is characterized by patent ductus arteriosus, vasculopathy (aneurysm and occlusive lesions), pulmonary arterial hypertension, and other complications in smooth muscle-dependent organs. We sought to define the clinical history of SMDS to develop recommendations for evaluation and management.MethodsMedical records of 33 patients with SMDS (median age 12 years) were abstracted and analyzed.ResultsAll patients had congenital mydriasis and related pupillary abnormalities at birth and presented in infancy with a patent ductus arteriosus or aortopulmonary window...
January 4, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29283434/elevation-of-the-head-during-intensive-care-management-in-people-with-severe-traumatic-brain-injury
#5
REVIEW
Jose D Alarcon, Andres M Rubiano, David O Okonkwo, Jairo Alarcón, Maria José Martinez-Zapata, Gerard Urrútia, Xavier Bonfill Cosp
BACKGROUND: Traumatic brain injury (TBI) is a major public health problem and a fundamental cause of morbidity and mortality worldwide. The burden of TBI disproportionately affects low- and middle-income countries. Intracranial hypertension is the most frequent cause of death and disability in brain-injured people. Special interventions in the intensive care unit are required to minimise factors contributing to secondary brain injury after trauma. Therapeutic positioning of the head (different degrees of head-of-bed elevation (HBE)) has been proposed as a low cost and simple way of preventing secondary brain injury in these people...
December 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29247499/cardiac-output-changes-after-osmotic-therapy-in-neurosurgical-and-neurocritical-care-patients-a-systematic-review-of-the-clinical-literature
#6
Georgia Tsaousi, Elisabetta Stazi, Marco Cinicola, Federico Bilotta
AIM: Osmotherapy constitutes a first-line intervention for intracranial hypertension management. However, hyperosmolar solutes exert various systematic effects, among which their impact on systemic hemodynamics is poorly clarified. This review aims to appraise the clinical evidence of the effect of mannitol and hypertonic saline (HTS) on cardiac performance in neurosurgical and neurocritical care patients. METHOD: A database search was conducted to identify randomized clinical trials and observational studies reporting HTS or mannitol use in acute brain injury setting...
December 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29246672/recurrent-stroke-and-bleeding-events-after-acute-cardioembolic-stroke-analysis-using-japanese-healthcare-database-from-acute-care-institutions
#7
Masahiro Yasaka, Yukihiro Koretsune, Takeshi Yamashita, Eisei Oda, Daisuke Matsubayashi, Kaori Ota, Masafumi Kobayashi, Yasuyuki Matsushita, Jumpei Kaburagi, Kei Ibusuki, Atsushi Takita, Mikio Iwashita, Takuhiro Yamaguchi
BACKGROUND: To understand the reality of patients who experienced a cardioembolic stroke (CES) is important because of the high incidence of recurrent stroke and the need to account for bleeding risk in relation to the need for anticoagulation treatment. We elucidated the current real-world medical care in patients who had a CES and identified the risk factors for recurrent stroke. METHODS AND RESULTS: The study comprised 9804 patients who were diagnosed with CES between April 2008 and September 2013 as identified in a healthcare database used by acute-care institutions in Japan...
December 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29223519/efficacy-of-reinforced-restriction-of-physical-activity-on-chronic-subdural-hematoma-prospective-pilot-study
#8
Kun Hou, Xiaobo Zhu, Jinchuan Zhao, Yang Zhang, Xianfeng Gao, Kai Jiang, Guichen Li
BACKGROUND: Chronic subdural hematoma (CSDH) is a common entity in neurosurgical practice. However, as a result of the high rate in recurrence, morbidity, and mortality for surgical management, conservative management of CSDH is emerging as a new treatment strategy. Head trauma is a known risk factor of CSDH and plays as an initiator in the genesis of CSDH. We hypothesized that physical activity might also play an important role in the progression of an asymptomatic CSDH. METHODS: A prospective pilot study aiming to evaluate the efficacy of reinforced restriction of physical activity for the management of asymptomatic or mild symptomatic CSDH was conducted...
December 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29209510/milrinone-in-congenital-diaphragmatic-hernia-a-randomized-pilot-trial-study-protocol-review-of-literature-and-survey-of-current-practices
#9
REVIEW
Satyan Lakshminrusimha, Martin Keszler, Haresh Kirpalani, Krisa Van Meurs, Patricia Chess, Namasivayam Ambalavanan, Bradley Yoder, Maria V Fraga, Holly Hedrick, Kevin P Lally, Leif Nelin, Michael Cotten, Jonathan Klein, Stephanie Guilford, Ashley Williams, Aasma Chaudhary, Marie Gantz, Jenna Gabrio, Dhuly Chowdhury, Kristin Zaterka-Baxter, Abhik Das, Rosemary D Higgins
Background: Congenital diaphragmatic hernia (CDH) is commonly associated with pulmonary hypoplasia and pulmonary hypertension (PH). PH associated with CDH (CDH-PH) is frequently resistant to conventional pulmonary vasodilator therapy including inhaled nitric oxide (iNO) possibly due to right and left ventricular dysfunction. Milrinone is an intravenous inotrope and lusitrope with pulmonary vasodilator properties and has been shown anecdotally to improve oxygenation in PH. We developed this pilot study to determine if milrinone infusion would improve oxygenation in neonates ≥36 weeks postmenstrual age (PMA) with CDH...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29203307/a-method-of-managing-severe-traumatic-brain-injury-in-the-absence-of-intracranial-pressure-monitoring-the-ice-protocol
#10
Peter Hendrickson, Jim Pridgeon, Nancy Temkin, Sureyya Dikmen, Walter Videtta, Gustavo Petroni, Silvia Lujan, Nahuel Guadagnoli, Zulma Urbina, Perla Blanca Pahnke, Daniel Godoy, Gustavo Pinero, Freddy Sandi Lora, Sergio Aguilera, Andres Rubiano, Caridad Soler Morejon, Manuel Jibaja, Hubiel Lopez, Ricardo Romero, Kelley Chaddock, Randall M Chesnut
BACKGROUND: Severe TBI (sTBI) is a significant global health problem disproportionately affecting Low and Middle Income Countries (LMICs). Management of intracranial hypertension in sTBI is crucial to survival and optimal recovery. High Income Country practitioners routinely use Intracranial Pressure (ICP) monitors although their utility has been questioned. ICP monitors are usually unavailable in LMICs. No consensus based/tested protocols or literature exists for sTBI treatment without ICP monitoring...
December 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29189676/disseminated-cryptococcosis-with-severe-increased-intracranial-pressure-complicated-with-cranial-nerve-palsy-in-a-child
#11
Bilge Aldemir Kocabaş, Mehmet Emin Parlak, Betil Özhak Baysan, Kamil Karaali, Ayşen Bingöl, Şenay Haspolat
Cryptococcosis is less common in children than adults but remains an important cause of pneumonia and meningoencephalitis in both immunocompromised and immunocompetent patients. Intracranial hypertension commonly complicates cryptococcal meningitis and may cause significant visual and neurological morbidity and mortality. Early and aggressive management of intracranial hypertension in accordance with established guidelines reduces the risk of long term complications and death. In this case report, we present a 12-year-old girl with cryptococcal meningitis, pneumonitis and dermatitis complicated with cranial nerve palsy and loss of vision...
November 17, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29184342/risk-factors-vascular-lesion-distribution-outcome-and-recurrence-of-strokes-due-to-intracranial-atherosclerosis-one-year-data-from-hyderabad-stroke-registry
#12
Raghu Ram, Subhash Kaul, Suvarna Alladi, Jabeen S Afshan, T Surya Prabha, Abhijeet Kohat, Swetha Tandra, Jyotsna Y Rani
Background: Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke in Asian countries and probably in India. Aim: The aim of this study was to describe the risk factors, distribution of vascular lesions, recurrence and outcome of stroke due to ICAS. Methodology: A total of 100 consecutive patients of ischemic stroke due to ICAS were enrolled prospectively from January 1, 2015, to December 31, 2015, and followed for 1 year for treatment compliance and recurrence...
October 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29123886/sudden-cerebral-depression-detected-by-bispectral-index-monitoring-in-cryptococcal-meningitis-with-elevated-near-fatal-cerebrospinal-fluid-pressure
#13
Hironori Matsumoto, Suguru Annen, Kensuke Umakoshi, Jun Takeba, Satoshi Kikuchi, Yuki Nakabayashi, Naoki Moriyama, Muneaki Ohshita, Mayuki Aibiki
Case: An increase in cerebrospinal fluid pressure (CSFP) is usually prominent in cryptococcal meningitis, which has a high mortality rate, so aggressive management to control CSFP is crucial. In this case, a 40-year-old-man survived cryptococcal meningitis treated with continuous spinal drainage under bispectral index (BIS) monitoring. He unexpectedly showed hypertension, went into a coma, and even loss his light reflexes due to CSFP elevation. His BIS values had abruptly dropped before developing these symptoms, but dramatically recovered after lumbar puncture drainage, suggesting that BIS monitoring could reflect cerebral function changes due to CSFP alternations...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29118788/mechanical-thrombectomy-for-m2-occlusions-a-single-centre-experience
#14
Pervinder Bhogal, Philipp Bücke, Marta Aguilar Pérez, Oliver Ganslandt, Hansjörg Bäzner, Hans Henkes
Background: The recent success of several mechanical thrombectomy trials has resulted in a significant change in the management of patients presenting with stroke. However, questions still remain as to whether certain groups will benefit from mechanical thrombectomy. In particular, it is still uncertain whether mechanical thrombectomy should be performed in the M2 branches and, more generally, in the distal vasculature. Methods: We retrospectively analysed our prospectively maintained database of all patients undergoing mechanical thrombectomy between January 2008 and August 2016...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29095707/long-term-management-and-outcomes-after-repair-of-cerebrospinal-fluid-rhinorrhea-related-to-idiopathic-intracranial-hypertension
#15
Theodore A Schuman, Brent A Senior
PURPOSE OF REVIEW: To identify long-term management strategies and outcomes for the treatment of spontaneous cerebrospinal fluid (CSF) rhinorrhea related to idiopathic intracranial hypertension (IIH). RECENT FINDINGS: Adjuvant treatments following surgical repair of spontaneous CSF leaks are aimed at normalizing intracranial pressure (ICP) to minimize the risk of recurrence. IIH is closely linked to obesity, and growing evidence suggests that weight loss, both through conservative and surgical approaches, is effective at addressing the root cause of this disorder...
October 31, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29094154/racial-differences-in-prevalence-and-risk-for-intracranial-atherosclerosis-in-a-us-community-based-population
#16
Ye Qiao, Fareed K Suri, Yiyi Zhang, Li Liu, Rebecca Gottesman, Alvaro Alonso, Eliseo Guallar, Bruce A Wasserman
Importance: Intracranial atherosclerotic disease (ICAD) is an important cause of stroke; however, little is known about racial differences in ICAD prevalence and its risk factors. Objective: To determine racial differences in ICAD prevalence and the risk factors (both midlife and concurrent) associated with its development in a large, US community-based cohort. Design, Setting, and Participants: Analysis of 1752 black and white participants recruited from the Atherosclerosis Risk in Communities (ARIC) cohort study who underwent 3-dimensional intracranial vessel wall magnetic resonance imaging from October 18, 2011 to December 30, 2013; data analysis was performed from October 18, 2011 to May 13, 2015...
November 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29094066/surgical-repair-of-spontaneous-cerebrospinal-fluid-csf-leaks-a-systematic-review
#17
REVIEW
Brian C Lobo, Maraya M Baumanis, Rick F Nelson
Objectives: To review the safety and efficacy of surgical management for spontaneous cerebrospinal fluid (CSF) leaks of the anterior and lateral skull base. Data Sources: A systematic review of English articles using MEDLINE. Review Methods: Search terms included spontaneous, CSF, cerebrospinal fluid, endoscopic, middle fossa, transmastoid, leak, rhinorrhea. Independent extraction of articles by 3 authors. Results: Patients with spontaneous CSF leaks are often obese (average BMI of 38 kg/m2) and female (72%)...
October 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29088962/complications-of-invasive-intracranial-pressure-monitoring-devices-in-neurocritical-care
#18
Samon Tavakoli, Geoffrey Peitz, William Ares, Shaheryar Hafeez, Ramesh Grandhi
Intracranial pressure monitoring devices have become the standard of care for the management of patients with pathologies associated with intracranial hypertension. Given the importance of invasive intracranial monitoring devices in the modern neurointensive care setting, gaining a thorough understanding of the potential complications related to device placement-and misplacement-is crucial. The increased prevalence of intracranial pressure monitoring as a management tool for neurosurgical patients has led to the publication of a plethora of papers regarding their indications and complications...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29088943/the-role-of-icp-monitoring-in-meningitis
#19
Areej Tariq, Pedro Aguilar-Salinas, Ricardo A Hanel, Neeraj Naval, Mohamad Chmayssani
Intracranial pressure (ICP) monitoring has been widely accepted in the management of traumatic brain injury. However, its use in other pathologies that affect ICP has not been advocated as strongly, especially in CNS infections. Despite the most aggressive and novel antimicrobial therapies for meningitis, the mortality rate associated with this disease is far from satisfactory. Although intracranial hypertension and subsequent death have long been known to complicate meningitis, no specific guidelines targeting ICP monitoring are available...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29081393/cisternostomy-for-refractory-post-traumatic-intracranial-hypertension-a-case-report
#20
L Giammattei, M Messerer, M Oddo, F Borsotti, M Levivier, R T Daniel
BACKGROUND: The current surgical treatment of choice for refractory intracranial hypertension following traumatic brain injury (TBI) is decompressive craniectomy. Despite efficacy in control of intracranial pressure, its contribution towards an improved outcome is debatable. CASE DESCRIPTION: We present here a case of refractory intracranial hypertension successfully managed with cisternostomy. The rationale of this surgical technique is discussed with a focus on the pathophysiological processes underlying elevated intracranial pressure (ICP) and its improvement following surgery...
October 25, 2017: World Neurosurgery
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