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Intracranial hypotension

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https://www.readbyqxmd.com/read/27913508/risk-stratification-and-management-of-acute-pulmonary-embolism
#1
Cecilia Becattini, Giancarlo Agnelli
The clinical management of patients with acute pulmonary embolism is rapidly changing over the years. The widening spectrum of clinical management strategies for these patients requires effective tools for risk stratification. Patients at low risk for death could be candidates for home treatment or early discharge. Clinical models with high negative predictive value have been validated that could be used to select patients at low risk for death. In a major study and in several meta-analyses, thrombolysis in hemodynamically stable patients was associated with unacceptably high risk for major bleeding complications or intracranial hemorrhage...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27910096/de-novo-migraine-with-aura-after-surgical-repair-of-aortic-coarctation
#2
Yuji Kato, Takeshi Hayashi, Toshiki Kobayashi, Ayumu Masuoka, Tetsuya Abe, Takahiro Hasebe, Norio Tanahashi, Masaki Takao
Coarctation of the aorta (CoA) is reported to be associated with an increased risk for migraine. We describe here the case of a 13-year-old female patient who presented migraine with aura after surgical repair of CoA with a stent. As possible reasons for her condition, we postulate host responses to stent placement and/or disturbed cerebral autoregulation related to intracranial hypertension before the surgical repair and hypotension afterward, leading to hypoperfusion. This case demonstrates that de novo migraine with aura can occur after surgical repair of CoA and should be recognized as a potential complication...
December 2, 2016: Headache
https://www.readbyqxmd.com/read/27906941/epidural-blood-patch-for-the-treatment-of-spontaneous-and-iatrogenic-orthostatic-headache
#3
Yun So, Jung Min Park, Pil-Moo Lee, Cho Long Kim, Cheolhan Lee, Jae Hun Kim
BACKGROUND: The cerebrospinal fluid (CSF) leakage could be happened spontaneously or related to the procedures such as spinal anesthesia, epidural anesthesia, CSF tapping, intrathecal chemotherapy or other spinal procedures. The leakage of CSF leads to intracranial hypotension of which distinguishing clinical feature is orthostatic headache. The epidural blood patch is a gold-standard treatment for intracranial hypotension-related orthostatic headaches. OBJECTIVE: We conducted this study to compare the efficacy and number of epidural blood patches for spontaneous and iatrogenic orthostatic headaches...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27905574/reply-to-spontaneous-intracranial-hypotension-and-its-association-with-movement-disorders
#4
COMMENT
Richard Salazar
In Response To: Onder H. Spontaneous intracranial hypotension and its association with movement disorders? Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D84B31NS Original Article: Salazar R. Spontaneous intracranial hypotension associated with kinetic tremor and ataxia. Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D8HQ3ZN5.
2016: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/27897276/spontaneous-intracranial-hypotension-and-its-association-with-movement-disorders
#5
Halil Onder
In Response To: Salazar R. Spontaneous intracranial hypotension associated with kinetic tremor and ataxia. Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D8HQ3ZN5.
2016: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/27894887/ultrasound-tissue-pulsatility-imaging-suggests-impairment-in-global-brain-pulsatility-and-small-vessels-in-elderly-patients-with-orthostatic-hypotension
#6
Julie Biogeau, Thomas Desmidt, Paul-Armand Dujardin, Redouane Ternifi, Charlotte Eudo, Emilie Vierron, Jean-Pierre Remenieras, Frédéric Patat, Vincent Camus, Thierry Constans
BACKGROUND: Orthostatic hypotension (OH) is highly prevalent in the elderly, and this population can be exposed to serious complications, including falls and cognitive disorders, as well as overall mortality. However, the pathophysiology of OH is still poorly understood, and innovative methods of cerebral blood flow (CBF) assessment have been required to accurately investigate cerebrovascular reactivity in OH. OBJECTIVES: We want to compare brain tissue pulsatility (BTP) changes during an orthostatic challenge in elderly patients over 80 with and without OH...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27861828/postural-headaches-due-to-cerebrospinal-fluid-leakage-through-subarachnoid-pleural-fistula-a-case-report
#7
Sheng-Feng Lin, Hsing-Yu Weng
BACKGROUND: Postural headaches are commonly associated with spontaneous intracranial hypotension and cerebrospinal fluid (CSF) leakage from the spine. A subarachnoid-pleural fistula (SPF) is a very rare and serious type of CSF fistula that has mostly been reported following traumatic causes. CASE REPORT: Here, the case of a 36-year-old woman who suffered from postural headaches after chiropractic manipulation of her neck was reported. Brain and spinal magnetic resonance (MR) imaging showed brain sagging, a C7-T1 dural defect, and overt CSF leakage...
November 10, 2016: Headache
https://www.readbyqxmd.com/read/27861178/use-of-prothrombin-complex-concentrate-for-warfarin-reversal-before-the-performance-of-an-epidural-blood-patch-in-a-patient-with-cortical-vein-thrombosis-and-subdural-hematoma
#8
Kallol Chaudhuri, Cooper W Phillips, Swapna Chaudhuri, John Wasnick
Compared to conventional therapy, several studies with prothrombin complex concentrate (PCC) have recently demonstrated its superior efficacy in rapidly replacing vitamin K-dependent factors for patients with life-threatening hemorrhage. We present a novel use of PCC in a patient with intracranial hypotension, who had received warfarin for treatment of cortical vein thrombosis. However, after anticoagulation, she proceeded to develop bilateral subdural hematomas with descent of cerebellar tonsils. Given the possibility of an occult dural puncture during labor analgesia, an epidural blood patch was performed after administration of PCC and normalization of coagulation parameters, with prompt improvement of the patient's headache...
November 17, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27857927/a-fatal-adverse-effect-of-barbiturate-coma-therapy-dyskalemia
#9
Hyun Mook Kwon, Jin Wook Baek, Sang Pyung Lee, Jae Ik Cho
The management guideline for traumatic brain injury (TBI) recommends high-dose barbiturate therapy to control increased intracranial pressure refractory to other therapeutic options. High-dose barbiturate therapy, however, may cause many severe side effects; the commonly recognized ones include hypotension, immunosuppression, hepatic dysfunction, renal dysfunction, and prolonged decrease of cortical activity. Meanwhile, dyskalemia remains relatively uncommon. In this study, we report the case of a hypokalemic patient with severe rebound hyperkalemia, which occurred as a result of barbiturate coma therapy administered for TBI treatment...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27854087/spontaneous-intracranial-hypotension-complicated-by-malignancyinduced-disseminated-intravascular-coagulation-a-case-report
#10
Hung-Yi Wu, Shu-Shya Hseu, Shih-Pin Chen, Jiing-Feng Lirng, Yen-Feng Wang, Shuu-Jiun Wang, Jong-Ling Fuh
PURPOSE: Spontaneous intracranial hypotension (SIH) is a rare type of headache. The association of SIH with malignancy and disseminated intravascular coagulation (DIC) has not previously been reported. CASE REPORT: A 60-year-old woman had orthostatic headache for more than one month before admission. MRI of brain showed diffuse pachymeningeal enhancement with bilateral subdural hematoma. MR myelography revealed epidural fluid collection and possible CSF leakage at the level of C5 to C6...
September 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27848124/reversible-cerebral-vasoconstriction-syndrome-and-posterior-reversible-encephalopathy-syndrome-associated-with-intracranial-hypotension
#11
Katharina Feil, Robert Forbrig, Franziska S Thaler, Julian Conrad, Suzette Heck, Franziska Dorn, Hans-Walter Pfister, Andreas Straube
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES) are both rare disorders. The pathophysiology of both diseases is not yet fully understood. METHODS: We report the unique case of a 19-year-old comatose woman who was brought to the ER after a series of generalized tonic-clonic seizures 6 days post peridural anesthesia for cesarean section. Vital signs and initial laboratory testing including urine analysis and drug screening were unremarkable...
November 15, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27832615/-changes-in-spinal-mri-findings-for-epidural-fluid-collection-in-the-treatment-of-intracranial-hypotension
#12
Norimitsu Nakagawa
We have experienced 30 cases of intracranial hypotension in the last three years. Spinal MRI was performed in all cases, and 27 patients demonstrated epidural fluid collection(EFC). Of these 30 patients, 6 were treated conservatively with bed rest and hydration, and 24 were treated with epidural blood patch(EBP). Twenty-two patients were cured, 4 were improved significantly, and 4 were improved partially. We examined spinal MR images of 22 patients after 3 months of treatment. The EFC wasn't visible in 11 cases;however, residual EFC was found in the 11 remaining cases...
November 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27789620/scalp-congenital-hemangioma-with-associated-high-output-cardiac-failure-in-a-premature-infant-case-report-and-review-of-literature
#13
Sumedh S Shah, Brian M Snelling, Samir Sur, Alexandra R Ramnath, Emmalee S Bandstra, Dileep R Yavagal
INTRODUCTION: Scalp congenital hemangiomas (CHs) are rare vascular malformations among infants; they can be associated with an array of complications, including cardiac and cosmetic issues. Here, we report the endovascular treatment of a premature infant with a suspected large right parietal scalp hemangioma and associated high-output cardiac failure. CASE DESCRIPTION: A two-day-old female premature infant (29 weeks gestational age; 1330 g birth weight) was referred by the neonatologists to our department for consultation and potential treatment of a large right parietal CH causing abrupt hypotension and high-output cardiac failure...
October 27, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27776795/early-plasma-transfusion-is-associated-with-improved-survival-after-isolated-traumatic-brain-injury-in-patients-with-multifocal-intracranial-hemorrhage
#14
Ronald Chang, Lindley E Folkerson, Duncan Sloan, Jeffrey S Tomasek, Ryan S Kitagawa, H Alex Choi, Charles E Wade, John B Holcomb
BACKGROUND: Plasma-based resuscitation improves outcomes in trauma patients with hemorrhagic shock, while large-animal and limited clinical data suggest that it also improves outcomes and is neuroprotective in the setting of combined hemorrhage and traumatic brain injury. However, the choice of initial resuscitation fluid, including the role of plasma, is unclear for patients after isolated traumatic brain injury. METHODS: We reviewed adult trauma patients admitted from January 2011 to July 2015 with isolated traumatic brain injury...
October 13, 2016: Surgery
https://www.readbyqxmd.com/read/27766904/intraspinal-hypotension-syndrome-presents-as-transient-quadriplegia
#15
Miki Katzir, Svetlana Tov, Ayelet Eran, Gill E Sviri
Intracranial hypotension can be a complication of epidural anaesthesia. Pure clinical spinal hypotension manifesting as acute transient quadriplegia following epidural anaesthesia is a severe, life-threatening complication that have not been described before. This complication can be solved with an epidural blood patch; thus, it should be familiar to doctors across all specialities.
October 21, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27765822/dizziness-caused-by-meningocele-associated-intracranial-hypotension-in-neurofibromatosis-type-1
#16
Lawren VandeVrede, Rene A Colorado, Jong Woo Lee
No abstract text is available yet for this article.
October 11, 2016: Neurology
https://www.readbyqxmd.com/read/27743810/patterns-of-cerebrospinal-fluid-csf-distribution-in-patients-with-spontaneous-intracranial-hypotension-assessed-with-magnetic-resonance-myelography
#17
Chuan-Han Chen, Jeon-Hor Chen, Hung-Chieh Chen, Jyh-Wen Chai, Po-Lin Chen, Clayton Chi-Cheng Chen
BACKGROUND: Diagnosis of spontaneous intracranial hypotension (SIH) relies on the ability of medical staff to recognize cerebrospinal fluid (CSF) leakage at the spine. However, difficulties with interobserver discrepancy sometimes occurred while reading magnetic resonance myelography (MRM) because clear image definition was lacking. In this study, we tried to determine which pattern of CSF distribution is more reliable for diagnosis of CSF leakage by using MRM. METHODS: From January 2012 to August 2014, 19 SIH patients and 27 healthy controls (HC) were recruited into our study; 10 of the 19 patients were recovered (SIH-R) after treatment...
October 12, 2016: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/27742514/transient-diabetes-insipidus-after-discontinuation-of-vasopressin-in-neurological-icu-patients-case-series-and-literature-review
#18
Michael A Bohl, James Forseth, Peter Nakaji
BACKGROUND: Arginine vasopressin (AVP) is a common second-line or third-line vasopressor used in critically ill neurosurgical patients. Neurosurgical indications include hyperdynamic therapy for vasospasm, maintenance of cerebral perfusion pressure in patients with intracranial hypertension, and prevention of hypotension in patients with sepsis. CASE DESCRIPTION: A series of six neurosurgical patients receiving AVP infusions developed severe but transient diabetes insipidus (tDI) after cessation of AVP...
October 11, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27717720/the-quantitative-evaluation-of-intracranial-pressure-by-optic-nerve-sheath-diameter-eye-diameter-computed-tomographic-measurement
#19
Inessa Bekerman, Tal Sigal, Itzhak Kimiagar, Anna Ben Ely, Michael Vaiman
BACKGROUND: The changes of the optic nerve sheath diameter (ONSD) have been used to assess changes of the intracranial pressure for 20 years. The aim of this research was to further quantify the technique of measuring the ONSD for this purpose. METHODS: Retrospective study of computed tomographic (CT) data of 1766 adult patients with intracranial hypotension (n=134) or hypertension (n=1632) were analyzed. The eyeball transverse diameter (ETD) and ONSD were obtained bilaterally, and the ONSD/ETD ratio was calculated...
August 26, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27707618/insight-into-the-cerebral-hyperperfusion-syndrome-following-carotid-endarterectomy-from-the-national-vascular-quality-initiative
#20
Grace J Wang, Adam W Beck, Randall R DeMartino, Philip P Goodney, Caron B Rockman, Ronald M Fairman
BACKGROUND: Cerebral hyperperfusion syndrome (CHS), characterized by severe ipsilateral headache, seizures, and intracranial hemorrhage, is a rare, poorly understood complication that can be fatal following carotid endarterectomy (CEA). The purpose of the study was to determine the factors associated with CHS as captured in the Vascular Quality Initiative. METHODS: Analysis was conducted on 51,001 procedures captured from the CEA module of the Vascular Quality Initiative from 2003 to 2015...
October 1, 2016: Journal of Vascular Surgery
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