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Intracranial hypotension

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https://www.readbyqxmd.com/read/28419438/dinosaur-tail-sign-a-useful-spinal-mri-finding-indicative-of-cerebrospinal-fluid-leakage
#1
Keita Sakurai, Masafumi Kanoto, Motoo Nakagawa, Masashi Shimohira, Aya M Tokumaru, Masashi Kameyama, Keigo Shimoji, Satoru Morimoto, Noriyuki Matsukawa, Minoru Nishio, Yuta Shibamoto
OBJECTIVE: To evaluate the imaging characteristics and diagnostic utility of the "Dinosaur tail sign" in the diagnosis of cerebrospinal fluid (CSF) leakage. BACKGROUND: The authors propose the "Dinosaur tail sign," defined as a combination of the dorsal epidural hyperintensities, fat tissue, spinal cord, and cauda equine on lumbosacral sagittal fat-suppressed T2-weighted image (FST2WI), as a sensitive indicator for diagnosing CSF leakage. METHODS: Imaging characteristics of the "Dinosaur tail sign" was evaluated in seven spontaneous intracranial hypotension (SIH) and 23 iatrogenic CSF leakage (ICSFL) patients...
April 16, 2017: Headache
https://www.readbyqxmd.com/read/28402198/ventral-longitudinal-intraspinal-fluid-collection-rare-presentation-as-brachial-amyotrophy-and-intracranial-hypotension
#2
Veeramani Preethish-Kumar, Seena Vengalil, Sarbesh Tiwari, Kiran Polavarapu, M Netravathi, Aravinda Hanumanthapura Ramalingaiah, Atchayaram Nalini
CONTEXT: Ventral longitudinal intraspinal fluid collection (VLISFC) presenting as hand amyotrophy has been described only in a few cases and there are no reports on associated intracranial CSF hypovolemia (ICH). We describe the clinical and imaging findings of a case with combined brachial amyotrophy and ICH secondary to VLISFC. FINDINGS: A 31 year old man presented with severe positional neck discomfort, radiating pain, progressive asymmetrical wasting and weakness of distal upper limbs...
April 12, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28390510/acute-management-of-moderate-severe-traumatic-brain-injury
#3
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/28385881/quantitative-measurement-of-csf-in-patients-with-spontaneous-intracranial-hypotension
#4
H-C Chen, P-L Chen, Y-H Tsai, C-H Chen, C C-C Chen, J-W Chai
BACKGROUND AND PURPOSE: CSF hypovolemia is a core feature of spontaneous intracranial hypotension. Spontaneous intracranial hypotension is characterized by orthostatic headache and radiologic manifestations, including CSF along the neural sleeves, diffuse pachymeningeal enhancement, and/or venous engorgement. However, these characteristics are only qualitative. Quantifying intraspinal CSF volumes could improve spontaneous intracranial hypotension diagnosis and evaluation of hypovolemic statuses in patients with spontaneous intracranial hypotension...
April 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28377246/awake-surgery-for-brain-vascular-malformations-and-moyamoya-disease
#5
Rami James N Aoun, Mithun G Sattur, Chandan Krishna, Amen Gupta, Matthew E Welz, Allan D Nanney, Antoun H Koht, Matthew C Tate, Katherine H Noe, Joseph I Sirven, Barrett J Anderies, Patrick B Bolton, Terry L Trentman, Richard S Zimmerman, Kristin R Swanson, Bernard R Bendok
OBJECTIVE: While a significant amount of experience has accumulated for awake procedures for brain tumor, epilepsy and carotid surgery, its utility for intracranial neurovascular indications remains largely undefined. Awake surgery, for select neurovascular cases, offers the advantage of precise brain mapping and robust neurological monitoring during surgery for lesions in eloquent areas, avoidance of potential hemodynamic instability, and possible faster recovery. Additionally, it opens the window for perilesional epileptogenic tissue resection with potentially less risk for iatrogenic injury...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28357166/spontaneous-intracranial-hypotension-presenting-as-a-pseudo-chiari-1
#6
Ali S Haider, Suraj Sulhan, Ian T Watson, Dean Leonard, Eliel N Arrey, Umair Khan, Phu Nguyen, Kennith F Layton
Spontaneous intracranial hypotension (SIH) is classified as a decrease in cerebrospinal fluid (CSF) pressure secondary to a CSF leakage and consequent descent of the brain into the foramen magnum. Diagnosing SIH can be difficult due to its overlapping findings with Arnold-Chiari type 1 Malformation (CM1) where the cerebellar tonsils herniate into the foramen magnum. The similarity of both conditions calls for a more reliable imaging technique to localize the CSF leak which could narrow the differential diagnosis and aid in choosing the correct treatment...
February 16, 2017: Curēus
https://www.readbyqxmd.com/read/28355333/intracranial-hypotension-secondary-to-spontaneous-spinal-cerebrospinal-fluid-leaks
#7
Antonio Eustáquio Silva, Patricia Pavan, Mariana Mari Oshima, Tânia Marchiori de Oliveira Cardoso, Fabiano Reis
No abstract text is available yet for this article.
March 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28348118/spontaneous-intracranial-hypotension-diagnosed-as-chiari-i-malformation
#8
William Kingston, Joseph Hoxworth, Rashmi Halker-Singh
No abstract text is available yet for this article.
March 28, 2017: Neurology
https://www.readbyqxmd.com/read/28343842/cranial-nerve-palsy-following-central-neuraxial-block-in-obstetrics-a-review-of-the-literature-and-analysis-of-43-case-reports
#9
D J Chambers, K Bhatia
BACKGROUND: Cranial nerve palsy is a rarely reported complication of central neuraxial block in obstetrics. The aetiology is diverse and includes both decreased and increased intracranial pressure. METHODS: Medline, CINAHL, and EMBASE databases were searched to identify cases of cranial nerve palsy following obstetric central neuraxial block. Possible aetiology, clinical symptoms and signs, treatment, and time to resolution were assessed. RESULTS: Forty-one articles containing 43 case reports of cranial nerve palsy following obstetric central neuraxial block were identified...
February 20, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#10
Yi-Chen Lai, Yuan-Yi Chia, Wei-Hung Lien
Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28283371/chiari-like-displacement-due-to-spontaneous-intracranial-hypotension-in-an-adolescent-successful-treatment-by-epidural-blood-patch
#11
Jan Schönberger, Markus Möhlenbruch, Angelika Seitz, Cornelia Bußmann, Heidi Bächli, Stefan Kölker
BACKGROUND: Spontaneous intracranial hypotension is a rarely diagnosed cause of headache, especially in children and adolescents. It is due to cerebrospinal fluid (CSF) leakage via spinal fistulae occurring without major trauma. CASE PRESENTATION: An adolescent patient presented with a 3-month history of strictly postural headache. Cranial magnetic resonance imaging (MRI) showed pronounced Chiari-like prolapse of the cerebellar tonsils, narrow ventricles and enlarged cerebral veins...
February 20, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28254591/a-small-leak-will-sink-the-brain-targeted-c1-c2-patching
#12
Thomas Decramer, Pieter Jan Van Dyck-Lippens, Tom P Franken, Philippe Demaerel, Johannes van Loon, Tom Theys
BACKGROUND: Spontaneous intracranial hypotension (SIH) syndrome results from spontaneous spinal CSF leaks. The first treatment of choice consists of lumbar epidural blood patching. If this fails further imaging is mandatory to explore the possibility of targeted therapy. CASE DESCRIPTION: We describe a case of a 50-year old woman who developed spontaneous intracranial hypotension after minor blunt cervical trauma, complicated with bilateral subdural hematomas. Two lumbar epidural blood patches were unsuccessful...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#13
Megan Moyer, Bethany Young, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
February 23, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28215135/rapid-response-team-diagnoses-frequencies-and-related-hospital-mortality
#14
Roger J Smith, John D Santamaria, Espedito E Faraone, Jennifer A Holmes, David A Reid
OBJECTIVES: To describe the frequency and hospital mortality of problems (diagnoses) encountered by a rapid response team (RRT), and to identify the most common diagnoses for RRT triggers and for treating units. DESIGN: For each RRT event in 2015 at a tertiary hospital for adults, we chose the diagnosis that best explained the RRT event from a pre-defined list after reviewing relevant test results and clinical notes. RESULTS: There were 937 RRT events during 700 admissions and there were 58 different RRT diagnoses in 11 diagnosis groups...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28202822/-idiopathic-intracranial-hypotension
#15
Iwao Takeshita, Satoshi O Suzuki, Toru Iwaki
Idiopathic intracranial hypotension (hypovolemia) is almost exclusively provoked by cerebrospinal fluid (CSF) leakage through spontaneously rent dural sac. An initial clinical feature of a severe headache with or without nausea/vomiting should be differentiated from a life-threatening stroke. An early diagnosis and proper therapy may guarantee a good outcome, while delays may promote complicated manifestations and irreversible poor outcome in a few patients. In this article, neuro-imaging studies of some demonstrable cases are presented and the outlets of the spinal CSF and spinal CSF pathways are shown with immunohistological staining...
February 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28192268/spontaneous-intracranial-hypotension-a-review-and-introduction-of-an-algorithm-for-management
#16
REVIEW
Benjamin Davidson, Farshad Nassiri, Alireza Mansouri, Jetan H Badhiwala, Christopher D Witiw, Mohammed F Shamji, Philip W Peng, Richard I Farb, Mark Bernstein
Spontaneous intracranial hypotension (SIH) is a condition of low cerebrospinal fluid (CSF) volume and pressure caused by a leak of CSF through a dural defect. Diagnosis and management can be difficult, often requiring coordination between multiple disciplines for myelography, blood patching, and possible surgical repair. Patients should be monitored closely, as they can deteriorate into a coma or even death. There are no widely accepted guidelines for the management of SIH. Herein, we review the existing SIH literature, illustrate management challenges via a case review, and propose an algorithm developed by neurosurgeons, radiologists, and anesthesiologists intended to simplify and streamline the management of SIH...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28188356/brain-trauma-foundation-guidelines-for-intracranial-pressure-monitoring-compliance-and-effect-on-outcome
#17
Alberto Aiolfi, Elizabeth Benjamin, Desmond Khor, Kenji Inaba, Lydia Lam, Demetrios Demetriades
BACKGROUND: Brain Trauma Foundation (BTF) guidelines recommend intracranial pressure (ICP) monitoring in patients who sustained severe traumatic brain injury (TBI). Compliance to BTF guidelines is variable, and the effect of ICP monitoring on outcomes remains a controversial issue. The purpose of this study was to assess guidelines compliance in patients who sustain a severe TBI and to analyze the effect of ICP monitoring on outcomes. METHODS: Trauma Quality Improvement Program database study, which included patients with isolated severe blunt head trauma (head Abbreviated Injury Scale ≥3 with Glasgow Coma Scale <9)...
February 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28166156/incidental-99mtc-dtpa-uptake-in-tarlov-cysts-on-radionuclide-spect-ct-cisternography
#18
Shankar Vamadevan, Ken Le, Chuong Bui, Robert Mansberg
Sacral perineural cysts are also known as Tarlov cysts. A 58-year-old man with suspected intracranial hypotension was evaluated with Tc-DTPA radionuclide cisternography. Radionuclide planar and SPECT/CT cisternography revealed Tc-DTPA uptake in sacral lesions. Spine MRI confirmed Tarlov cysts at the S1 and S2 levels.
February 3, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28130464/spinal-meningeal-diverticula-spontaneous-intracranial-hypotension-and-superficial-siderosis
#19
Wouter I Schievink, M Marcel Maya
No abstract text is available yet for this article.
January 27, 2017: Neurology
https://www.readbyqxmd.com/read/28122469/dexmedetomidine-for-refractory-intracranial-hypertension
#20
Kendra J Schomer, Christian M Sebat, Jason Y Adams, Jeremiah J Duby, Kiarash Shahlaie, Erin L Louie
Dexmedetomidine (DEX) is a selective α2 adrenergic agonist that is commonly used for sedation in the intensive care unit (ICU). The role of DEX for adjunctive treatment of refractory intracranial hypertension is poorly defined. The primary objective of this study was to determine the effect of DEX on the need for rescue therapy (ie, hyperosmolar boluses, extraventricular drain [EVD] drainages) for refractory intracranial hypertension. Secondary objectives included the number of intracranial pressure (ICP) excursions, bradycardic, hypotensive, and compromised cerebral perfusion pressure episodes...
January 1, 2017: Journal of Intensive Care Medicine
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