- Rapid effect of depletive lumbar puncture on papilledema in intracranial hypertension. [Journal Article]
- JFJ Fr Ophtalmol 2018 Jun 11
- The intraocular pressure could not be used to determine the intracranial pressure in patients with hydrocephalus. [Journal Article]
- IJInt J Neurosci 2018 Jun 08; :1-19
- CONCLUSIONS: IOP was not an independent factor of ICP in patients with hydrocephalus, and could not be used to determine IOP. Papilledema might be a significant factor of ICP in hydrocephalus sufferers. Compared with NPH patients, patients with HPH were more prone to develop papilledema.
- Transverse venous sinus stenting for idiopathic intracranial hypertension: Safety and feasibility. [Journal Article]
- NJNeuroradiol J 2018 Jan 01; :1971400918782320
- Purpose Transverse sinus stenosis is commonly seen in patients with idiopathic intracranial hypertension. It is not clear whether it is the cause or the result of idiopathic intracranial hypertension...
Purpose Transverse sinus stenosis is commonly seen in patients with idiopathic intracranial hypertension. It is not clear whether it is the cause or the result of idiopathic intracranial hypertension. Stenting for idiopathic intracranial hypertension has been carried out in several prior series. Our goal was to evaluate the clinical and imaging follow-up results of patients with idiopathic intracranial hypertension that underwent stenting for this condition at our center. Materials and Methods We reviewed the clinical, venographic and follow-up imaging data in patients who underwent elective transverse sinus stenting during the period from 2011 to 2017. Results In total, 18 patients with idiopathic intracranial hypertension were identified. The mean lumbar cerebrospinal fluid opening pressure recorded was 408 mmH20. Overall, 16 patients met the inclusion criteria and underwent transverse sinus stenting. At venography, the mean pressure gradient across the dominant transverse sinus stenosis was 21 mmHg. The pressure gradient immediately after stenting in all of those measured was negligible. Following stenting, headaches improved in 10 of the 16 cases, with persistent headaches in four patients, one of which had persistent baseline migraines. All cases showed resolution of the papilledema on follow up. Follow-up imaging with computed tomography venography showed that the stents remained widely patent. The follow up in clinic was done for a mean period of 35.5 months. Follow up with computed tomography venography was done for a mean of 10.3 months. Conclusion Venous sinus stenting is a safe and effective procedure. It relieves papilledema in all cases and improves headaches in most cases.
- [Current diagnosis and treatment of idiopathic intracranial hypertension]. [Journal Article]
- ISIdeggyogy Sz 2017 Sep 30; 70(9-10):321-332
- CONCLUSIONS: This is a curable condition with early diagnosis and adequate treatment, and persistent visual loss can be prevented. Surgery is effective and safe, close neuro-ophthalmic monitoring is mandatory for its optimal timing. Visual function of all patients can be preserved when operated on in time, whereas severe visual loss appears to be irreversible despite surgery.
- Surgical Outcomes and Postoperative Management in Spontaneous Cerebrospinal Fluid Rhinorrhea. [Journal Article]
- JNJ Neurol Surg B Skull Base 2018; 79(2):193-199
- Background The etiology of spontaneous cerebrospinal fluid (CSF) rhinorrhea remains unknown, though emerging evidence suggests that this likely represents a variant of idiopathic intracranial hypert...
Background The etiology of spontaneous cerebrospinal fluid (CSF) rhinorrhea remains unknown, though emerging evidence suggests that this likely represents a variant of idiopathic intracranial hypertension. Long-term success rates for repair and postoperative management strategies remain variable. Methods Retrospective review of patients undergoing surgical management of spontaneous CSF rhinorrhea was conducted over a 5-year period. Analysis was performed to correlate recurrence with demographics and perioperative variables. Lumbar puncture usage and neuro-ophthalmological examinations in clinical management were also assessed. Results Forty-eight patients were included in the study. The mean age was 51.4 years with 94% females. Leaks were most commonly located in the sphenoid (43.8%) and cribriform region (33.3%). The most common findings on magnetic resonance imaging were empty sella (48%) and Meckel's cave diverticula (24%). Nine patients (18.8%) had recurrent CSF leaks. Six occurred >1 month postoperatively. Three had repeat endoscopic repairs, two received ventriculoperitoneal shunts, and one was managed with a lumbar drain, with overall success rate of 93.8%. Acetazolamide was utilized in 19 cases (39.6%) postoperatively. Overall, 59% of patients had elevated opening pressures on postoperative lumbar puncture ( n = 32). Neuro-ophthalmology evaluated 28 patients; 25% had visual field deficits, and 7.1% had papilledema. Conclusions Management of spontaneous CSF leaks remains a significant challenge. Endoscopic repair is successful in most patients with little morbidity; however, postoperative management remains inconsistent, and further studies are warranted to establish consensus on post-surgical care. The association with elevated intracranial pressure and visual field deficits/papilledema suggests opening pressures, and neuro-ophthalmologic evaluation should be considered in the treatment algorithm.
- Diffusion-Weighted Imaging Changes in a Child With Posterior Ischemic Optic Neuropathy. [Journal Article]
- PNPediatr Neurol 2018 Apr 04
- CONCLUSIONS: As targeted therapies for retinoblastoma and other diseases amenable to intravascular treatment delivery are more frequently used, the risk of grave vision-related side effects increases. Posterior ischemic optic neuropathy should be considered in the differential diagnosis of any child presenting with acute loss of vision. Dedicated imaging of the orbits can elucidate specific findings that may aid in the diagnosis of this entity in children.
- Papilledema: Point-of-Care Ultrasound Diagnosis in the Emergency Department. [Journal Article]
- CPClin Pract Cases Emerg Med 2018; 2(2):125-127
- Point-of-care ultrasound (POCUS) has the potential to diagnose papilledema, a sign of increased intracranial pressure, through optic disc elevation as well as optic nerve sheath diameter measurements...
Point-of-care ultrasound (POCUS) has the potential to diagnose papilledema, a sign of increased intracranial pressure, through optic disc elevation as well as optic nerve sheath diameter measurements. Idiopathic intracranial hypertension (IIH) is a syndrome resulting in increased intracranial pressure. We present a case of IIH where the emergency physician diagnosed papilledema by POCUS via presence of both optic disc elevation and a widened optic nerve sheath diameter.
- Pseudotumor cerebri syndrome in a pregnant woman with systemic lupus erythematous. [Journal Article]
- BBiomedica 2018 05 01; 38(0):10-14
- Systemic lupus erythematous is a chronic multi-systemic autoimmune disease that affects multiple organ systems, including the central nervous system. Pseudotumor cerebri is a disorder associated with...
Systemic lupus erythematous is a chronic multi-systemic autoimmune disease that affects multiple organ systems, including the central nervous system. Pseudotumor cerebri is a disorder associated with increased intracranial pressure in the absence of a space-occupying lesion or other identifiable cause that affects young and obese women.We present the case of a pregnant woman with both pseudotumor cerebri and a new diagnosis of active systemic lupus erythematous.
- Update on Idiopathic Intracranial Hypertension. [Review]
- CTCurr Treat Options Neurol 2018 May 28; 20(7):24
- This review presents a critical appraisal of current therapeutic strategies for patients with idiopathic intracranial hypertension (IIH). We present the reader with the most recent evidence to suppor...
This review presents a critical appraisal of current therapeutic strategies for patients with idiopathic intracranial hypertension (IIH). We present the reader with the most recent evidence to support medical and surgical interventions in patients with IIH and provide recommendations about treatment initiation and escalation. We also indicate areas where knowledge gaps exist regarding therapeutic efficacy and superiority of one intervention over another.
New Search Next
- Intracranial fluid dynamics changes in idiopathic intracranial hypertension: pre and post therapy. [Journal Article]
- CNCurr Neurovasc Res 2018 May 27
- CONCLUSIONS: The data provide valuable information regarding changes in different fluid compartments suggesting a profound redistribution of pressures along fluid compartments after different treatments. We discuss how increased intracranial venous blood could be "tumoral" in IIH and facilitating its outflow could be therapeutic.