Database : MEDLINE
Search on : Intracranial and Hypotension [Words]
References found : 4014 [refine]
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[PMID]: 29524703
[Au] Autor:Liu JKC
[Ad] Address:Department of Neuro-Oncology, Moffitt Cancer Center. Electronic address: james.liu@moffitt.org.
[Ti] Title:Neurological Deterioration Due to Brain Sag Following Bilateral Craniotomy for Subdural Hematoma Evacuation.
[So] Source:World Neurosurg;, 2018 Mar 07.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Intracranial hypotension from cerebrospinal fluid hypovolemia resulting in cerebral herniation is a rare but known complication that can occur following neurosurgical procedures, usually encountered in correlation with perioperative placement of a lumbar subarachnoid drain. Decrease in CSF volume resulting in loss of buoyancy results in downward herniation of the brain without contributing mass effect, causing a phenomenon known as 'brain sag.' Unreported previously is brain sag occurring without concomitant occult CSF leak or lumbar drainage. CASE DESCRIPTION: This case report describes a patient who underwent bilateral craniotomies for subacute on chronic subdural hematomas with successful decompression, but suffered from an acute neurological deterioration secondary to brain sag. Despite an initial improvement in neurological exam, he subsequently exhibited a progressive neurologic deterioration with evidence of cerebral herniation on neuroimaging, without evidence of continued mass effect on the brain parenchyma. After a diagnosis of 'brain sag' was determined based on imaging criteria, the patient was placed in a flat position which resulted in a rapid improvement in neurological exam without any further intervention. CONCLUSIONS: This case is unique from previous reports of intracranial hypotension following craniotomy in that the symptoms were completely reversed with positioning alone, without any evidence of active or occult CSF drainage. This report emphasizes that the diagnosis of brain sag should be taken into consideration when there is an unknown reason for neurologic decline after craniotomy, particularly bilateral craniotomies, if the imaging indicates herniation with imaging findings consistent with intracranial hypotension, without evidence of overlying mass effect.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 4014 MEDLINE  
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[PMID]: 29513222
[Au] Autor:Önal H; Ersen A; Gemici H; Adal E; Güler S; Sander S; Albayram S
[Ti] Title:Acquired Chiari I Malformation Secondary to Spontaneous Intracranial Hypotension Syndrome and Persistent Hypoglycemia: A Case Report.
[So] Source:J Clin Res Pediatr Endocrinol;, 2018 Feb 27.
[Is] ISSN:1308-5735
[Cp] Country of publication:Turkey
[La] Language:eng
[Ab] Abstract:Spontaneous intracranial hypotension (SIH) is a rare and potentially serious condition in childhood. Cerebrospinal fluid (CSF) volume depletion is thought to be the main causative feature for intracranial hypotension, results from spontaneous CSF leak, often at the spine level. SIH is increasingly diagnosed in clinical practice, although it manifests into a variegated symptomatology. Indeed, downward displacement of the brain, sometimes mimicking a Chiari I malformation, but concomitant presentation of these syndromes has rarely been reported. We present herein a case of a SIH with Chiari 1 malformation accompanied with an unusual clinical presentation of persistent hypoglycemia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.4274/jcrpe.0042

  3 / 4014 MEDLINE  
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[PMID]: 29502270
[Au] Autor:Chai C; Li V; Bi X
[Ad] Address:Department of Neurology, Shanghai Changhai Hospital, Shanghai, China.
[Ti] Title:Cervical disc herniation as a rare cause of intracranial hypotension: a case report.
[So] Source:Neurol Sci;, 2018 Mar 03.
[Is] ISSN:1590-3478
[Cp] Country of publication:Italy
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1803
[Cu] Class update date: 180304
[Lr] Last revision date:180304
[St] Status:Publisher
[do] DOI:10.1007/s10072-018-3290-9

  4 / 4014 MEDLINE  
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[PMID]: 29269069
[Au] Autor:Robles LA; Cuevas-Solórzano A
[Ad] Address:Section of Neurosurgery, Hospiten, Puerto Vallarta, Mexico. Electronic address: larob@prodigy.net.mx.
[Ti] Title:Massive Brain Swelling and Death After Cranioplasty: A Systematic Review.
[So] Source:World Neurosurg;111:99-108, 2018 Mar.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Although cranioplasty is a common procedure, it may cause a variety of complications. Massive brain swelling after cranioplasty (MBSC) is an unusual complication that has been reported more frequently in recent years. Most of the existing information about this condition is speculative and the cause remains unclear. METHODS: A PubMed and Scopus search adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed to include studies reporting patients with MBSC. Different information was analyzed in these cases to describe the characteristics and identify risk factors for MBSC. RESULTS: The search yielded 19 articles with a total of 26 patients. All studies were case reports and small case series. In most patients, preoperative intracranial hypotension and a considerable degree of sinking of skin flap were identified; this was the only constant finding observed in these cases. In addition, we propose a grading system to estimate the degree of preoperative sinking of skin flap and an algorithm with recommendations to decrease the incidence of MBSC. CONCLUSIONS: MBSC is an unusual, highly lethal, and probably underreported condition. The information gathered in this review indicates that MBSC occurs secondary to a cascade of pathologic events triggered by the bone flap implantation. This evidence suggests that the primary pathologic change is a sudden increase in the intracranial pressure acting on a brain chronically exposed to intracranial hypotension.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review

  5 / 4014 MEDLINE  
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[PMID]: 29248773
[Au] Autor:Fredrickson VL; Patel A; Pham MH; Strickland BA; Ohiorhenuan I; Chen T
[Ad] Address:Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. Electronic address: vance.fredrickson@gmail.com.
[Ti] Title:Spine Surgery Complicated by an Engorged Lumbar Epidural Venous Plexus from Cerebrospinal Fluid Overshunting: A Case Report and Review of the Literature.
[So] Source:World Neurosurg;111:68-72, 2018 Mar.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Overshunting of cerebrospinal fluid may lead to intracranial hypotension and dilation of spinal epidural veins. Radiculopathy may rarely occur secondary to engorged spinal epidural veins. In addition, the cause of radiculopathy may be obscured by concomitant spinal degenerative changes. We present a case and review the pathogenesis as well as the current clinical literature. CASE DESCRIPTION: A 29-year-old woman presented with positional headaches from intracranial hypotension in the setting of cerebrospinal fluid overshunting. The patient also had back pain and lumbar radiculopathy, which became more severe after lumboperitoneal shunt placement. On radiographic work-up, there was evidence of right L5 nerve root impingement secondary to a disc bulge and an engorged lumbar epidural venous plexus secondary to overshunting. The patient underwent surgery for a planned L4-5 decompression with a transforaminal lumbar interbody fusion. The operation was complicated by rapid blood loss originating from the epidural venous plexus, and we were unable to safely place the interbody graft. CONCLUSIONS: Spinal surgeons need to be aware of the rare diagnosis of radiculopathy secondary to epidural venous plexus engorgement, as it may change the treatment approach or lead to deleterious intraoperative consequences, such as hemorrhage.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review

  6 / 4014 MEDLINE  
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[PMID]: 29229352
[Au] Autor:Bonow RH; Barber J; Temkin NR; Videtta W; Rondina C; Petroni G; Lujan S; Alanis V; La Fuente G; Lavadenz A; Merida R; Jibaja M; Gonzáles L; Falcao A; Romero R; Dikmen S; Pridgeon J; Chesnut RM; Global Neurotrauma Research Group
[Ad] Address:Department of Neurological Surgery, University of Washington, Seattle, Washington, USA. Electronic address: rbonow@uw.edu.
[Ti] Title:The Outcome of Severe Traumatic Brain Injury in Latin America.
[So] Source:World Neurosurg;111:e82-e90, 2018 Mar.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: 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. METHODS: 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 Glasgow Coma Scale score ≤8. The primary outcome was Glasgow Outcome Scale, Extended (GOS-E) score at 6 months. Predictors were analyzed using a multivariable proportional odds model created by forward stepwise selection. RESULTS: A total of 550 patients were identified. Six-month outcomes were available for 88%, of whom 37% had died and 44% had achieved a GOS-E score of 5-8. In multivariable proportional odds modeling, higher Glasgow Coma Scale motor score (odds ratio [OR], 1.41 per point; 95% confidence interval [CI], 1.23-1.61) and epidural hematoma (OR, 1.83; 95% CI, 1.17-2.86) were significant predictors of higher GOS-E score, whereas advanced age (OR, 0.65 per 10 years; 95% CI, 0.57-0.73) and cisternal effacement (P < 0.001) were associated with lower GOS-E score. Study site (P < 0.001) and race (P = 0.004) significantly predicted outcome, outweighing clinical variables such as hypotension and pupillary examination. CONCLUSIONS: Mortality from severe TBI is high in Latin American LMIC, although the rate of favorable recovery is similar to that of high-income countries. Demographic factors such as race and study site played an outsized role in predicting outcome; further research is required to understand these associations.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review

  7 / 4014 MEDLINE  
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[PMID]: 29495052
[Au] Autor:Örgel A; Bender B; Stefanou MI; Hurth H; Hauser TK; Horger M
[Ti] Title:Bildgebung bei spontaner intrakranieller Hypotension (SIH). [Image Findings in Spontaneous Intracranial Hypotension (SIH)].
[So] Source:Rofo;190(3):219-224, 2018 Mar.
[Is] ISSN:1438-9010
[Cp] Country of publication:Germany
[La] Language:ger
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.1055/s-0043-122166

  8 / 4014 MEDLINE  
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[PMID]: 29492522
[Au] Autor:Young AMH; Donnelly J; Liu X; Guilfoyle MR; Carew M; Cabeleira M; Cardim D; Garnett MR; Fernandes HM; Haubrich C; Smielewski P; Czosnyka M; Hutchinson PJ; Agrawal S
[Ad] Address:Division of Academic Neurosurgery, Department of Clinical Neurosciences, Cambridge University Hospitals, University of Cambridge, Cambridge, UK. ay276@cam.ac.uk.
[Ti] Title:Pre-hospital Predictors of Impaired ICP Trends in Continuous Monitoring of Paediatric Traumatic Brain Injury Patients.
[So] Source:Acta Neurochir Suppl;126:7-10, 2018.
[Is] ISSN:0065-1419
[Cp] Country of publication:Austria
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Although secondary insults such as raised intracranial pressure (ICP) or cardiovascular compromise strongly contribute to morbidity, a growing interest can be noticed in how the pre-hospital management can affect outcomes after traumatic brain injury (TBI). The objective of this study was to determine whether pre-hospital co-morbidity has influence on patterns of continuously measured waveforms of intracranial physiology after paediatric TBI. MATERIALS AND METHODS: Thirty-nine patients (mean age, 10 years; range, 0.5-15) admitted between 2002 and 2015 were used for the current analysis. Pre-hospital motor score, pupil reactivity, pre-hospital hypoxia (SpO < 90%) and hypotension (mean arterial pressure < 70 mmHg) were documented. ICP and arterial blood pressure (ABP) were monitored continuously with an intraparenchymal microtransducer and an indwelling arterial line. Pressure monitors were connected to bedside computers running ICM+ software. Pressure reactivity was determined as the moving correlation between 30 10-s averages of ABP and ICP (PRx). The mean ICP and PRx were calculated for the whole monitoring period for each patient. RESULTS: Those with pre-hospital hypotension were susceptible to higher ICP [20 (IQR 8) vs 13 (IQR 6) mmHg; p = 0.01] and more frequent ICP plateau waves [median = 0 (IQR 1), median = 4 (IQR 9); p = 0.001], despite having similar MAP, CPP and PRx during monitoring. Those with unreactive pupils tended to have higher ICP than those with reactive pupils (18 vs 14 mmHg, p = 0.08). Pre-hospital hypoxia, motor score and pupillary reactivity were not related to subsequent monitored intracranial or systemic physiology. CONCLUSION: In paediatric TBI, pre-hospital hypotension is associated with increased ICP in the intensive care unit.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.1007/978-3-319-65798-1_2

  9 / 4014 MEDLINE  
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[PMID]: 29492523
[Au] Autor:Meshcheryakov SV; Semenova ZB; Lukianov VI; Sorokina EG; Karaseva OV
[Ad] Address:Children's Clinical and Research Institute of Emergency Surgery and Trauma, Moscow, Russia. msaemon@rambler.ru.
[Ti] Title:Prognosis of Severe Traumatic Brain Injury Outcomes in Children.
[So] Source:Acta Neurochir Suppl;126:11-16, 2018.
[Is] ISSN:0065-1419
[Cp] Country of publication:Austria
[La] Language:eng
[Ab] Abstract:OBJECTIVES: We aimed to determine prognostic factors that can influence the outcome of severe traumatic brain injury (TBI) in children. MATERIALS AND METHODS: One hundred and sixty-nine patients with severe TBI were included. Consciousness was evaluated using the Glasgow Coma Scale (GCS). Severity of concomitant injuries was evaluated using the Injury Severity Score (ISS). Computer tomography (CT) scanning was used on admission and later. Intracranial injuries were classified using the Marshall CT scale. Intracranial pressure (ICP) monitoring took place in 80 cases. Serum samples of 65 patients were tested for S-100ß protein and of 43 patients for neuron specific enolase (NSE). Outcomes were evaluated 6 months after trauma using the Glasgow Outcome Scale (GOS). Statistical and mathematical analysis was conducted. The accuracy of our prognostic model was defined in another group of patients (n = 118). RESULTS: GCS, pupil size and photoreaction, ISS, hypotension and hypoxia are significant predictors of outcome of severe TBI in children. CT results complement the forecast significantly. The accuracy of surviving prognosis came to 76% (0.76) in case of S-100ß protein level ≤ 0.25 µg/l and NSE level < 19 µg/l. A mathematical model of outcome prognosis was based on discriminant function analysis. The model of prognosis was tested on the control group. The accuracy of prognosis was 86%. CONCLUSIONS: A personalised prognostic model makes it possible to predict the outcome of severe TBI in children on the first day after trauma.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.1007/978-3-319-65798-1_3

  10 / 4014 MEDLINE  
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[PMID]: 29491335
[Au] Autor:Inoue H; Takemoto M; Muto M; Kitamura T; Yamada K
[Ad] Address:Department of Neurology, Nagoya City East Medical Center.
[Ti] Title:[Cerebrospinal fluid leakage and abducens nerve palsy caused by bowling activity].
[So] Source:Rinsho Shinkeigaku;, 2018 Feb 28.
[Is] ISSN:1882-0654
[Cp] Country of publication:Japan
[La] Language:jpn
[Ab] Abstract:Cerebrospinal fluid leakage can develop due to traffic trauma or lumbar puncture; however, in many cases, it develops spontaneously without any obvious cause. This report describes a case of cerebrospinal fluid leakage caused by bowling activity. A 57-year-old woman adjusted her bowling form, which led to the development of an orthostatic headache and double vision. Cerebrospinal fluid leakage and right abducens nerve palsy was diagnosed, which was resistant to conservative treatment. An epidural blood patch was performed, leading to an improvement in the headache and abducens nerve palsy. The hypotension and nerve palsy may have been caused by small amounts of cerebrospinal fluid leakage due to repeated traction of the brachial plexus and nerve root resulting from an irregular bowling form. To the best of our knowledge, there are no reported cases of cerebrospinal fluid leakage caused by bowling; therefore, this is a valuable case to investigate the mechanism of onset. Similar mechanisms may have remained undiscovered in other cases of spontaneous intracranial hypotension.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:Publisher
[do] DOI:10.5692/clinicalneurol.cn-001124


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