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Intracranial hypotension

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
Lawren VandeVrede, Rene A Colorado, Jong Woo Lee
No abstract text is available yet for this article.
October 11, 2016: Neurology
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
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
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
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
Yad R Yadav, Vijay Parihar, Hemant Namdev, Jitin Bajaj
Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. There is lack of uniformity in the treatment of CSDH amongst surgeons in terms of various treatment strategies. Clinical presentation may vary from no symptoms to unconsciousness. CSDH is usually diagnosed by contrast-enhanced computed tomography scan. Magnetic resonance imaging (MRI) scan is more sensitive in the diagnosis of bilateral isodense CSDH, multiple loculations, intrahematoma membranes, fresh bleeding, hemolysis, and the size of capsule...
October 2016: Asian Journal of Neurosurgery
Leigh A Rettenmaier, Brian J Park, Marshall T Holland, Youssef J Hamade, Shuchita Garg, Rahul Rastogi, Chandan G Reddy
Spontaneous intracranial hypotension (SIH) is a more common than previously noted condition (1-2.5 per 50,000) typically caused by cerebrospinal fluid (CSF) leakage. Initial treatment involves conservative therapies, but the mainstay of treatment for patients who fail conservative management is the epidural blood patch (EBP). Subdural hematoma (SDH) is a common complication occurring with SIH, but its management remains controversial. In this report, we discuss a 62-year-old female who presented with a 5-week history of orthostatic headaches associated with nausea, emesis, and neck pain...
September 27, 2016: World Neurosurgery
Jos├ęphine Grange, Gilbert Lorre, Guillaume Ducarme
A 30-year-old woman at 28 weeks presented with sudden onset of intense headache, epigastric pain, hot flushes, nausea, vomiting, and stiff neck. Cerebral magnetic resonance imaging showed pathognonomic signs of spontaneous intracranial hypotension (SIH). Epidural blood patch was performed 2 times during pregnancy for symptoms relief in spite of medical treatments. No other recurrence was noted until the spontaneous delivery. SIH is a rare entity during pregnancy which may be diagnosed using magnetic resonance imaging...
November 2016: Journal of Clinical Anesthesia
Dattaraj Paramanand Sawarkar, Satish Varma, Pankaj Kumar Singh, Ramesh Doddamani, Amandeep Jagdevan, Bhawani Shanker Sharma
INTRODUCTION: Cerebral venous sinus thrombosis (CVST) is a rare condition with the potential to cause severe morbidity and mortality. CVST can also occur after vestibular schwannoma (VS) surgery with the thrombosis of transverse and sigmoid sinus. However, there is not a single report of superior sagittal sinus (SSS) thrombosis after VS surgery reported in the literature. CASE REPORT: A 45-year-old lady presented to our centre with large left sided solid cystic VS...
September 26, 2016: World Neurosurgery
Charlotte Dandurand, Charles S Haw
No abstract text is available yet for this article.
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Kirsten Morrissey, Hilary Fairbrother
More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged < 14 years. Traumatic brain injury is a significant cause of morbidity and mortality in pediatric trauma patients. Early identification and management of severe traumatic brain injury is crucial in decreasing the risk of secondary brain injury and optimizing outcome. The main focus for early management of severe traumatic brain injury is to mitigate and prevent secondary injury, specifically by avoiding hypotension and hypoxia, which have been associated with poorer outcomes...
October 2016: Pediatric Emergency Medicine Practice
J H Chen, X Q Liu, R Huang, Y Zhou, Z Liu, X H Shi, X Chen
Objective: To investigate the pathogenesis, clinical presentation, imaging features and prognosis of spontaneous intracranial hypotension. Methods: Clinical manifestation and imaging changes of 12 patients with spontaneous intracranial hypotension were reported. They were followed up regularly. The clinical and neuroimaging characteristics were summarized. Results: All the 12 cases were adults, presenting with orthostatic headache. They all recovered with conservative therapy. Head MRI demonstrated cerebral lobe hemorrhage, subdural hematoma, pituitary hyperemia, subarachnoid hemorrhage, enhancement of the pachymeninges, sagging of the brain, etc...
September 6, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Christopher S Graffeo, Avital Perry, Eelco F M Wijdicks
BACKGROUND: Intracranial subarachnoid hemorrhage (SAH) and spinal subdural hematoma (SDH) are rare complications of spine surgery, thought to be precipitated by cerebrospinal fluid (CSF) hypotension in the setting of an intraoperative durotomy or postoperative CSF leak. Considerable clinical variability has been reported, requiring a high level of clinical suspicion in patients with a new, unexplained neurologic deficit after spine surgery. METHODS: Case report...
September 22, 2016: Neurocritical Care
Christine Vien, Paul Marovic, Brendan Ingram
Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia.
2016: Case Reports in Anesthesiology
Kazuaki Yamaguchi, Daniel Lonic, Chit Chen, Lun-Jou Lo
BACKGROUND: Although previous studies have reported soft-tissue management in surgical treatment of Sturge-Weber syndrome (SWS), there are few reports describing facial bone surgery in this patient group. The purpose of this study is to examine the validity of our multidisciplinary algorithm for correcting facial deformities associated with SWS. To the best of our knowledge, this is the first study on orthognathic surgery for SWS patients. METHODS: A retrospective chart review included 2 SWS patients who completed the surgical treatment algorithm...
August 2016: Plastic and Reconstructive Surgery. Global Open
Peyman Petramfar, S Saeed Mohammadi, Farideh Hosseinzadeh
INTRODUCTION: The syndrome of spontaneous intracranial hypotension has been increasingly diagnosed since its discovery through magnetic resonance imaging (MRI). It is a rare syndrome that is due to the leakage of cerebrospinal fluid (CSF) from a tear in the dura and can occur at any age, even among adolescents, but is most frequently seen among females in late middle age. CASE PRESENTATION: Here, we describe a 32-year-old woman with a two-month history of headaches and occasional nausea and vomiting (N/V)...
June 2016: Iranian Red Crescent Medical Journal
Martin Seule, Rimmon Isaak, Renan Sanchez-Porras, Oliver Sakowitz, Emanuela Keller, Andreas Unterberg, Berk Orakcioglu
BACKGROUND: Bedside monitoring of cerebral blood flow (CBF) may provide new insights into the pathophysiology of brain injury, allow early detection of secondary ischemia, and help guide therapy. OBJECTIVE: To evaluate a new brain tissue probe for serial CBF monitoring using near-infrared spectroscopy and indocyanine green dye dilution (NeMo Probe) compared with the existing thermal diffusion probe (QFlow 500 Probe). METHODS: In 7 pigs, the NeMo Probe and QFlow 500 Probe were inserted into the subcortical white matter...
September 9, 2016: Neurosurgery
Atsushi Arai, Hirohito Miyamoto, Ryoji Shiomi, Shotaro Tatsumi, Eiji Kohmura
Spontaneous cerebrospinal fluid leak and intracranial hypotension associated with cervical spondylosis have rarely been observed, and only a few cases are reported. A 69-year-old woman, previously treated for rectal and thyroid cancer, complained of a non-postural persistent headache. The patient regularly practiced aerobic exercise, but a month earlier she had started experiencing headache and neck pain while exercising. Computed tomography(CT)showed bilateral chronic subdural hematomas, and magnetic resonance imaging(MRI)revealed diffuse dural enhancement and tonsillar herniation...
September 2016: No Shinkei Geka. Neurological Surgery
Soo Jin Yoon, Jae Guk Kim
No abstract text is available yet for this article.
September 7, 2016: European Neurology
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