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Intracranial hypotension

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https://www.readbyqxmd.com/read/29449521/-spontaneous-intracranial-hypotension-presenting-with-de-novo-orthostatic-headache-and-subdural-hematoma-after-meningeal-biopsy
#1
Yasuhiro Takeda, Shohei Nambu, Yoshiaki Goto, Shiko Shimada, Keiichiro Maeda
No abstract text is available yet for this article.
February 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29437266/noninvasive-assessment-of-intracranial-elastance-and-pressure-in-spontaneous-intracranial-hypotension-by-mri
#2
Yi-Hsin Tsai, Hung-Chieh Chen, Hsin Tung, Yi-Ying Wu, Hsian-Min Chen, Kuan-Jung Pan, Da-Chuan Cheng, Jeon-Hor Chen, Clayton Chi-Chang Chen, Jyh-Wen Chai, Wu-Chung Shen
BACKGROUND: Spontaneous intracranial hypotension (SIH) is often misdiagnosed, and can lead to severe complications. Conventional MR sequences show a limited ability to aid in this diagnosis. MR-based intracranial pressure (MR-ICP) may be able to detect changes of intracranial elastance and pressure. PURPOSE: To determine whether MR-ICP is able to differentiate SIH patients from normal subjects, improve diagnostic sensitivity, and provide an insight into the pathophysiology...
February 13, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29381927/comparison-of-coblation-annuloplasty-and-radiofrequency-thermocoagulation-for-treatment-of-lumbar-discogenic-pain
#3
Dongguang Sun, Quancheng Li, Yuanzhang Tang, Weiyi Gong, Liangliang He, Zhi Dou, Jiaxiang Ni
This study aimed to compare the effectiveness and safety of coblation annuloplasty and radiofrequency thermocoagulation for lumbar discogenic pain.Patients who suffered from lumbar discogenic pain and underwent coblation annuloplasty and radiofrequency thermocoagulation surgery were included. A questionnaire, including the visual analo scale (VAS), MacNab criteria, pain relief rate, and any complications due to surgery, was completed by the patients with the help of a trained volunteer who was blinded to the study...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29372863/ossified-ligamentum-flavum-of-the-thoracic-spine-presenting-as-spontaneous-intracranial-hypotension-case-report
#4
Mazda K Turel, Mena G Kerolus, John E O'Toole
Ossification of the ligament flavum in the thoracic spine is an uncommon radiological finding in the Western population but can present with back pain, varying degrees of myelopathy, and even paraplegia on occasion. The authors here present the case of a 50-year-old woman with a history of progressive back pain and symptoms of spontaneous intracranial hypotension who was found to have an ossified ligamentum flavum of the thoracic spine resulting in a dural erosion cerebrospinal fluid leak. Surgery involved removal of the ossified ligament flavum at T10-11, facetectomy, ligation of the nerve root, and primary closure of the dura, which resulted in complete resolution of the patient's symptoms...
January 26, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29300676/intracranial-hypotension-mimicking-chronic-progressive-external-ophthalmoplegia
#5
Kaveh Vahdani, Katherine McVeigh, Rhys Harrison, Mandy Williams, Helen Garrott
Intracranial hypotension (ICH) is characterized by low cerebrospinal fluid pressure, postural headaches, and diffuse pachymeningeal enhancement on magnetic resonance imaging (MRI). A variety of ophthalmoparetic manifestations have been reported in the context of the ICH. The authors describe an unusual case of a 64-year-old woman who presented with rapid onset of headaches, bilateral upper-lid ptosis, and blurring of vision within 4 days after sustaining a trivial head injury. She was noted to have bilateral symmetrical ophthalmoplegia and ptosis-simulating chronic progressive external ophthalmoplegia...
January 4, 2018: Orbit
https://www.readbyqxmd.com/read/29249074/prognostic-factors-of-acute-neurological-outcomes-in-infants-with-traumatic-brain-injury
#6
Shunsuke Amagasa, Satoshi Tsuji, Hikoro Matsui, Satoko Uematsu, Takashi Moriya, Kosaku Kinoshita
PURPOSE: The purpose of this study is to clarify risk factors for poor neurological outcomes and distinctive characteristics in infants with traumatic brain injury. METHODS: The study retrospectively reviewed data of 166 infants with traumatic intracranial hemorrhage from three tertiary institutions in Japan between 2002 and 2013. Univariate and multivariate analyses were used to identify clinical symptoms, vital signs, physical findings, and computed tomography findings associated with poor neurological outcomes at discharge from the intensive care unit...
December 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29248773/spine-surgery-complicated-by-an-engorged-lumbar-epidural-venous-plexus-from-cerebral-spinal-fluid-over-shunting-a-case-report-and-review-of-the-literature
#7
Vance L Fredrickson, Arati Patel, Martin H Pham, Ben A Strickland, Ifije Ohiorhenuan, Thomas Chen
BACKGROUND: Over-shunting of cerebral spinal fluid may lead to intracranial hypotension and dilation of spinal epidural veins. Radiculopathy may rarely occur secondary to these engorged spinal epidural veins. In addition, the etiology of the radiculopathy may be obscured by concomitant spinal degenerative changes. CASE DESCRIPTION: We present a case of a 29-year-old female with positional headaches from intracranial hypotension in the setting of cerebral spinal fluid over-shunting...
December 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29244842/intensive-care-treatments-associated-with-favorable-discharge-outcomes-in-argentine-children-with-severe-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#8
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Michael J Bell, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Carly K Farr, Gustavo J Petroni
OBJECTIVE: Little is known about the critical care management of children with traumatic brain injury (TBI) in low middle income countries. We aimed to identify indicators of intensive care unit (ICU) treatments associated with favorable outcomes in Argentine children with severe TBI. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with severe TBI who were admitted to an ICU in one of the seven study centers...
2017: PloS One
https://www.readbyqxmd.com/read/29229352/the-outcome-of-severe-traumatic-brain-injury-in-latin-america
#9
Robert H Bonow, Jason Barber, Nancy R Temkin, Walter Videtta, Carlos Rondina, Gustavo Petroni, Silvia Lujan, Victor Alanis, Gustavo La Fuente, Arturo Lavadenz, Roberto Merida, Manuel Jibaja, Luis Gonzáles, Antonio Falcao, Ricardo Romero, Sureyya Dikmen, James Pridgeon, Randall M Chesnut
Traumatic brain injury (TBI) disproportionately affects lower and middle income countries (LMIC). The factors influencing outcomes in LMIC have not been examined as rigorously as in higher-income countries (HIC). This study was conducted to examine clinical and demographic factors influencing TBI outcomes in Latin American LMIC. Data were prospectively collected during a randomized trial of intracranial pressure monitoring in severe TBI and a companion observational study. Participants were aged ≥ 13 years and admitted to study hospitals with GCS ≤ 8...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29217497/prevalence-of-hyperdense-paraspinal-vein-sign-in-patients-with-spontaneous-intracranial-hypotension-without-dural-csf-leak-on-standard-ct-myelography
#10
Michael S Clark, Felix E Diehn, Jared T Verdoorn, Vance T Lehman, Greta B Liebo, Jonathan M Morris, Kent R Thielen, John T Wald, Neeraj Kumar, Patrick H Luetmer
PURPOSE: A recently identified and treatable cause of spontaneous intracranial hypotension (SIH) is cerebrospinal fluid (CSF)-venous fistula, and a recently described computed tomography myelogram (CTM) finding highly compatible with but not diagnostic of this entity is the hyperdense paraspinal vein sign. We aimed to retrospectively measure the prevalence of the hyperdense paraspinal vein sign on CTMs in SIH patients without dural CSF leak, in comparison with control groups. METHODS: Three CTM groups were identified: 1) SIH study group, which included dural CSF leak-negative standard CTMs performed for SIH, with early and delayed imaging; 2) Early control CTMs, which were performed for indications other than SIH, with imaging shortly after intrathecal contrast administration; 3) Delayed control CTMs, which included delayed imaging...
December 7, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29212405/a-description-of-a-new-continuous-physiologic-index-in-tbi-using-the-correlation-between-pulse-amplitude-of-icp-and-cerebral-perfusion-pressure
#11
Frederick Adam Zeiler, Joseph Donnelly, David Menon, Peter Smieleweski, Peter John Hutchinson, Marek Czosnyka
To describe a new continuous index of physiologic measurement in a TBI population, the moving correlation coefficient between intracranial pressure (ICP) pulse amplitude (AMP) and cerebral perfusion pressure (CPP), which we refer to as RAC. We use patient examples of sustained intracranial hypertension, systemic arterial hypotension and plateau waves, as well as the retrospective analysis of 358 non-decompressive craniectomy (DC) traumatic brain injury (TBI) patients with high frequency ICP and ABP data, to explore the relationships of this new index, RAC, with AMP, ICP, CPP, RAP, pressure reactivity index (PRx) and pulse amplitude index (PAx)...
December 6, 2017: Journal of Neurotrauma
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
#12
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/29192867/reduction-of-hyperthermia-in-pediatric-patients-with-severe-traumatic-brain-injury-a-quality-improvement-initiative
#13
Marlina E Lovett, Melissa Moore-Clingenpeel, Onsy Ayad, Nicole O'Brien
OBJECTIVE Severe traumatic brain injury remains a leading cause of morbidity and mortality in the pediatric population. Providers focus on reducing secondary brain injury by avoiding hypoxemia, avoiding hypotension, providing normoventilation, treating intracranial hypertension, and reducing cerebral metabolic demand. Hyperthermia is frequently present in patients with severe traumatic brain injury, contributes to cerebral metabolic demand, and is associated with prolonged hospital admission as well as impaired neurological outcome...
December 1, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29181526/cortical-structures-associated-with-human-blood-pressure-control
#14
Nuria Lacuey, Johnson P Hampson, Wanchat Theeranaew, Bilal Zonjy, Ajay Vithala, Norma J Hupp, Kenneth A Loparo, Jonathan P Miller, Samden D Lhatoo
Importance: A better understanding of the role of cortical structures in blood pressure control may help us understand cardiovascular collapse that may lead to sudden unexpected death in epilepsy (SUDEP). Objective: To identify cortical control sites for human blood pressure regulation. Design, Setting, and Participants: Patients with intractable epilepsy undergoing intracranial electrode implantation as a prelude to epilepsy surgery in the Epilepsy Monitoring Unit at University Hospitals Cleveland Medical Center were potential candidates for this study...
November 27, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29158865/-anesthesiological-aspects-and-complications-of-intracranial-meningiomas-operated-at-the-sylvanus-olympio-university-hospital-center-lom%C3%A3-about-21-cases
#15
Pilakimwé Egbohou, Tabana Mouzou, Kadanga Beketi, Essossinam Kpelao, Abdel Kader Moumouni, Hamza Doles Sama, Sarakawabalo Assénouwé, Gnimdou Akala-Yoba, Kadjika Tomta
This study aimed to point to both the anesthesiological aspects and the perioperative complications of intracranial meningiomas operated at the Sylvanus Olympio University Hospital Center, Lomé. We conducted a retrospective study by reviewing the medical records of patients with intracranial meningiomas undergoing surgery over the period December 2010-December 2015 (5 years) at the Sylvanus Olympio University Hospital Center, Lomé. Out of 46 patients operated fo brain tumors, 21 (45.6%) had meningioma. The average age was 49 ±20 years, with a male predominance (52...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29150776/hyperpyrexia-as-the-presenting-symptom-of-intracranial-hypotension
#16
Omar Hussein, Michel Torbey
INTRODUCTION: Hyperpyrexia is a severely elevated core body temperature secondary to an elevated hypothalamic set thermo-regulatory threshold. Hyperthermia is an elevated core body temperature beyond the normal hypothalamic set thermo-regulatory threshold. Intracranial hypotension can present with a wide variety of symptoms ranging from orthostatic headache up to coma. We report a rare case of hyperpyrexia associated with intracranial hypotension. METHODS: A case report of a 55-year-old female patient with a history of angiogram-negative subarachnoid hemorrhage status post-ventriculoperitoneal (VP) shunt placement six years prior to admission who suddenly developed encephalopathy and high fever...
November 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29140961/cervical-foraminal-epidural-blood-patch-for-the-targeted-treatment-of-refractory-cerebrospinal-fluid-leakage-from-a-dural-sleeve
#17
Nuj Tontisirin, Pannawit Benjhawaleemas, Sasikaan Nimmaanrat, Pornchai Sathirapanya, Teeranan Laohawiriyakamol, De Q Tran, Roderick J Finlayson
Epidural blood patches (EBPs) are routinely used to treat symptoms (eg, headaches) associated with spontaneous intracranial hypotension. Although cerebrospinal fluid leakage commonly involves the periforaminal areas of the cervical or thoracic spine, EBPs have been historically performed at the lumbar level. Recent evidence suggests that targeting the causative spinal segment may provide greater clinical benefits. While previous reports have targeted foraminal leaks with segmental thoracic or cervical injections, we present a case report detailing the novel use of a navigable epidural catheter to perform a selective EBP at the C7/T1 foramen...
November 14, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29132231/the-use-of-desflurane-for-neurosurgical-procedures-in-rhesus-macaque-macaca-mulatta
#18
Henri Gmj Bertrand, Charlotte Sandersen, Paul A Flecknell
Volatile agents are widely used to anaesthetise laboratory non-human primates as they allow a rapid induction and recovery as well as an easy adjustment of the anaesthesia plan. Desflurane is currently the volatile agent with the lowest solubility in blood, and hence enables the most rapid onset of anaesthesia and most rapid recovery. This study aimed to investigate the suitability of desflurane for maintenance of general anaesthesia in rhesus macaques undergoing elective experimental neurosurgery. Fourteen primates (five males and nine females) were sedated with ketamine (10 mg kg(-1)) and anaesthesia was induced with propofol (usually 8 mg kg(-1) IV)...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/29114315/intracranial-hypotension-associated-cerebral-swelling-following-cranioplasty-report-of-two-cases
#19
Masashi Nomura, Takahiro Ota, Mitsugu Ishizawa, Shinsuke Yoshida, Takayuki Hara
Cranioplasty is a comparatively simple neurosurgical procedure, and fatal complications are rare. This report describes two cases of critical brain swelling after otherwise uneventful cranioplasty. Both cases had subarachnoid hemorrhage and extremely similar clinical courses. They underwent decompressive craniotomy and clipping in the acute phase and had cranioplasty in the chronic phase, resulting in serious cerebral swelling and death. Deep venous sinus thrombosis was revealed in the autopsy for one case...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29114312/a-case-of-high-dose-adenosine-usage-for-anterior-communicating-artery-aneurysm-clip-ligation-what-is-the-dose-limit-for-a-resistant-response
#20
Shahid M Nimjee, David L McDonagh, Abhishek Agrawal, Gavin W Britz
Intraoperative adenosine is used to induce asystole to facilitate clip ligation of intracranial aneurysms. Typically, 5-10 mg doses are used per administration and approximately 30 mg is used for a given case. An obvious concern with using adenosine is that the patient can remain in asystole or that prolonged hypotension can result in cerebral or cardiovascular ischemia. The upper limit of adenosine administration remains unclear. We present a case of a patient with a large anterior communicating artery aneurysm requiring large doses of adenosine, far exceeding previously reported cases...
October 2017: Asian Journal of Neurosurgery
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