Acute Paradoxical Herniation: A Case Report

2021 ◽  
Author(s):  
Vanessa Denny ◽  
Davina Shalev ◽  
Jahannaz Dastgir ◽  
Erin Johnson ◽  
Maria Escobar ◽  
...  
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Medical Therapy ◽  
Decompressive Craniectomy ◽  
Atmospheric Pressure ◽  
Rare Complication ◽  
Neurological Deficits ◽  
Increased Intracranial Pressure

AbstractDecompressive craniectomy is used to relieve acute increased intracranial pressure (ICP) when medical therapy has failed. Paradoxical herniation is a rare complication that occurs when the pressure of the intracranial contents falls abnormally below the atmospheric pressure. Symptoms often include neurological deficits, the etiology of which is often mistaken for elevated ICP. This diagnosis requires quick recognition, and treatment requires a change from ICP reduction therapies to those that increase the ICP, and ultimately cranioplasty.

scholarly journals Paradoxical Brain Herniation after Cranioplasty: Secondary Sunken Flap Syndrome

2022 ◽  
Author(s):  
Navneet Singla ◽  
Archit Latawa
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Decompressive Craniectomy ◽  
Atmospheric Pressure ◽  
Brain Herniation ◽  
Delay In Diagnosis ◽  
Life Saving ◽  
Acute Neurological Deterioration ◽  
The Brain ◽  
Syndrome Of The Trephined

AbstractDecompressive craniectomy is a life-saving procedure done for innumerable etiologies. Though, not a technically demanding procedure, it has its own complications. Among many, sinking flap syndrome or syndrome of the trephined or paradoxical herniation of brain is frequently underestimated. It results from the pressure difference between the atmospheric pressure and the intracranial pressure causing the brain to shift inward at the craniectomy site. This can present with either nonspecific symptoms leading to delay in diagnosis or acute neurological deterioration, memory disturbances, weakness, confusion, lethargy, and sometimes death if not treated. Cranioplasty is a time validated procedure used to treat paradoxical brain herniation with good and early neurological recovery. We, here in, are going to describe a case report in which the paradoxical herniation occurred after cranioplasty which has not been described in literature.

Cerebral leukoencephalopathy with calcifications and cysts operated for signs of increased intracranial pressure: case report

2009 ◽  
Vol 72 (2) ◽  
pp. 177-181 ◽  
Author(s):  
Ergun Daglioglu ◽  
Fikret Ergungor ◽  
Hatice Gul Hatipoglu ◽  
Onder Okay ◽  
Ali Dalgic ◽  
...  
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Increased Intracranial Pressure

Venous sinus stenting shortens the duration of medical therapy for increased intracranial pressure secondary to venous sinus stenosis

2017 ◽  
Vol 10 (3) ◽  
pp. 310-314 ◽  
Author(s):  
Tarek A Shazly ◽  
Ashutosh P Jadhav ◽  
Amin Aghaebrahim ◽  
Andrew F Ducruet ◽  
Brian T Jankowitz ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Medical Therapy ◽  
Venous Sinus ◽  
Increased Intracranial Pressure ◽  
Rnfl Thickness ◽  
Group A ◽  
Sinus Stenosis ◽  
The Mean ◽  
Group B

IntroductionMedical treatment, cerebrospinal fluid (CSF) shunting, and optic nerve sheath fenestration are standard treatments for increased intracranial pressure (ICP) in patients with idiopathic intracranial hypertension (IIH). Venous sinus stenting provides a novel alternative surgical treatment in cases of venous sinus stenosis with elevated ICP.Methods12 consecutive subjects with papilledema, increased ICP, and radiological signs of dural sinus stenosis underwent cerebral venography and manometry. All subjects had papilledema and demonstrated radiological evidence of dural venous sinus stenosis.ResultsSix subjects chose venous stenting (Group A) and six declined and were managed conservatively with oral acetazolamide (Group B). The relative pressure gradient across the venous narrowing was 29±16.3 mm Hg in Group A and 17.6±9.3 mm Hg in Group B (p=0.09). The mean lumbar puncture opening pressure was 40.4±7.6 cm H2O in Group A and 35.6±10.6 cm H2O in Group B (p=0.4). Spectral domain optical coherence tomography (SD-OCT) showed mean average retinal nerve fiber layer (RNFL) thickness of 210±44.8 µm in Group A and 235±124.7 µm in Group B. However, the mean average RNFL thickness at 6 months was 85±9 µm in Group A and 95±24 µm in Group B (p=0.6). The total duration of acetazolamide treatment was 188±209 days in Group A compared with 571±544 days in Group B (p=0.07).ConclusionsIn subjects with venous sinuses stenosis, endovascular stenting offers an effective treatment option for intracranial hypertension which may shorten the duration of medical therapy.

Increased intracranial pressure associated with neurobrucellosis: a case report

2011 ◽  
Vol 17 (2) ◽  
pp. 100 ◽  
Author(s):  
Sedat Isikay ◽  
Kutluhan Yilmaz ◽  
Seydi Okumus
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Increased Intracranial Pressure

Reversal of Increased Intracranial Pressure with Removal of a Torcular Epidermoid: Case Report

Neurosurgery ◽  
2001 ◽  
Vol 48 (4) ◽  
pp. 929-932 ◽  
Author(s):  
Cornelius H. Lam ◽  
Robin K. Solomon ◽  
H. Brent Clark ◽  
Sean O. Casey
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Increased Intracranial Pressure
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