Anesthetic Management for Patients with Increased Intracranial Pressure

Introduction: Patients with congenital heart disease especially with systemic shunting between systemic and pulmonary circulation often develop pulmonary hypertension and left-to-right shunt (Eisenmenger syndrome) if left untreated. These patients are at risk of developing spontaneous brain abscess due to brain infarction caused by polycythemia, impaired immune function, and loss of lung phagocytosis. Such patients were often admitted to the emergency room with signs of increased intracranial pressure (ICP), and needed specific consideration during surgery. Case: a 31-year old female diagnosed with intracranial space occupying lesion (SOL) due to suspected brain abscess with concurrent heart defects (atrial septal defect / ASD and Eisenmenger syndrome) was consulted to the operating theatre for emergency burrhole aspiration. The surgery was performed for an hour and the postoperatively the patient was admitted to the intensive care unit (ICU). Conclusion: perioperative management of patients with brain abscess and concurrent ASD and Eisenmenger syndrome consists of preoperative management, methods of anesthesia, monitoring, and interventions to prevent the worsening of left-to-right shunt and increasing intracranial pressure. These managements consist of optimal pain management, perioperative oxygen therapy, and prevention of precipitating factor that increases left-to-right shunting.

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Anesthetic Management in Patient with Suspected Brain Abscess, Atrium Septal Defect, and Eisenmenger Syndrome

10.31219/osf.io/tu95w ◽

2021 ◽

Author(s):

Galantry Ahmad Azhari ◽

Budiana Rismawan

Keyword(s):

Intracranial Pressure ◽

Brain Abscess ◽

Septal Defect ◽

Heart Defects ◽

Brain Infarction ◽

Anesthetic Management ◽

Eisenmenger Syndrome ◽

Preoperative Management ◽

Increased Intracranial Pressure ◽

Anesthesia Monitoring

Introduction: Patients with congenital heart disease especially with systemic shunting between systemic and pulmonary circulation often develop pulmonary hypertension and left-to-right shunt (Eisenmenger syndrome) if left untreated. These patients are at risk of developing spontaneous brain abscess due to brain infarction caused by polycythemia, impaired immune function, and loss of lung phagocytosis. Such patients were often admitted to the emergency room with signs of increased intracranial pressure (ICP), and needed specific consideration during surgery. Case: a 31-year old female diagnosed with intracranial space occupying lesion (SOL) due to suspected brain abscess with concurrent heart defects (atrial septal defect / ASD and Eisenmenger syndrome) was consulted to the operating theatre for emergency burrhole aspiration. The surgery was performed for an hour and the postoperatively the patient was admitted to the intensive care unit (ICU). Conclusion: perioperative management of patients with brain abscess and concurrent ASD and Eisenmenger syndrome consists of preoperative management, methods of anesthesia, monitoring, and interventions to prevent the worsening of left-to-right shunt and increasing intracranial pressure. These managements consist of optimal pain management, perioperative oxygen therapy, and prevention of precipitating factor that increases left-to-right shunting.

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RISPERIDONE AND INCREASED INTRACRANIAL PRESSURE-LIKE SYNDROME IN CHILDREN AND ADOLESCENTS

Neuropediatrics ◽

10.1055/s-2006-945632 ◽

2006 ◽

Vol 37 (S 1) ◽

Author(s):

O Back-Bennett ◽

N Zelnik

Keyword(s):

Intracranial Pressure ◽

Children And Adolescents ◽

Increased Intracranial Pressure

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Faculty Opinions recommendation of Novel methods to predict increased intracranial pressure during intensive care and long-term neurologic outcome after traumatic brain injury: development and validation in a multicenter dataset.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717973786.793474446 ◽

2013 ◽

Author(s):

Jean Charchaflieh ◽

Kellie Park

Keyword(s):

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Intracranial Pressure ◽

Neurologic Outcome ◽

Increased Intracranial Pressure ◽

Novel Methods ◽

Development And Validation

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Evaluation of cerebrovascular hemodynamics in patients with idiopathic intracranial hypertension using transcranial Doppler

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00250-8 ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Mahmoud M. Allam ◽

Hatem A. Almasry ◽

Sandra M. Ahmed ◽

Youssuf G. Taha ◽

Mohammed I. Oraby

Keyword(s):

Intracranial Pressure ◽

Intracranial Hypertension ◽

Lumbar Puncture ◽

Transcranial Doppler ◽

Idiopathic Intracranial Hypertension ◽

Pulsatility Index ◽

Research Work ◽

Increased Intracranial Pressure ◽

Significant Relation ◽

Before And After

Abstract Background Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure without a clear cause and can have serious visual effects. Previous research work suggests that transcranial Doppler measurements of pulsatility index correlate accurately with elevated intracranial pressure. Objective To assess the cerebrovascular hemodynamic changes in patients with IIH using transcranial Doppler before and after lumbar puncture and CSF withdrawal. Methods An interventional study conducted on 40 patients (31 females and 9 males) fulfilling the modified Dandy criteria for diagnosis of idiopathic intracranial hypertension, MRI brain, and MRV was done to the patients. Lumbar puncture was done for all included patients to measure intracranial pressure and CSF withdrawal. Transcranial Doppler was performed for all included before and after lumbar puncture and CSF withdrawal and the following parameters were measured: peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI). Results Significant relation was found between grades of papilledema and PSV, RI, and PI (p value 0.012, 0.025, 0.016) but no significant relation was found between grades of papilledema and EDV (0.102). Significant changes occurred in parameters of TCD pre- and post-CSF withdrawal including PSV, EDV, and PI (p value 0.001, 0.015, 0.019) denoting a significant change in cerebral hemodynamics after CSF withdrawal which denotes a decrease in intracranial pressure. Conclusion Increased intracranial pressure significantly affects cerebral blood flow. A normalization of transcranial Doppler parameters occurs following lowering of intracranial pressure through lumbar puncture and CSF withdrawal.

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INCREASED INTRACRANIAL PRESSURE IN CEREBRAL TUMOUR

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1925.tb11667.x ◽

1925 ◽

Vol 2 (1) ◽

pp. 16-17

Keyword(s):

Intracranial Pressure ◽

Increased Intracranial Pressure ◽

Cerebral Tumour

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Lumbar Puncture Opening Pressure in Patients with Spinal Muscular Atrophy

Neuropediatrics ◽

10.1055/s-0040-1722687 ◽

2021 ◽

Author(s):

Lena-Luise Becker ◽

Claudia Weiß ◽

Anna Tietze ◽

Viktoria Martiny ◽

Angela M. Kaindl

Keyword(s):

Intracranial Pressure ◽

Spinal Muscular Atrophy ◽

Lumbar Puncture ◽

Clinical Data ◽

Side Effect ◽

Treatment Initiation ◽

Muscular Atrophy ◽

Underlying Disease ◽

Increased Intracranial Pressure ◽

Opening Pressure

AbstractThe announcement of a hydrocephalus as a possible side effect in patients with spinal muscular atrophy (SMA) receiving the drug nusinersen, promoted major concern and warrants further evaluation. In this retrospective monocentric study, we analyzed clinical data, lumbar puncture opening pressure (LOP) measurement, and ophthalmologic and neuroimaging results in 34 patients with SMA types 1 to 3 undergoing treatment with nusinersen. None of the patients reported symptoms indicative of increased intracranial pressure. In our cohort, the LOP was >20 cm H2O in 25 patients (70.5%), and within this group ≥28 cm H2O in 12 patients (35.3%), in two patients, it was increased prior to treatment initiation. Signs of increased intracranial pressure in ophthalmological assessments or brain imaging were only seen in one patient. We did not identify a correlation between increased LOP and SMA type, scoliosis, or age of the patients; however, it was slightly higher in patients receiving sedation. Our results raise the question whether the LOP is generally increased in SMA as part of the underlying disease, if so, what the etiology is, and whether the increased LOP needs to be treated.

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Lhermitte–Duclos Disease: Incidental Finding in Traumatic Cerebral Hemorrhage

Indian Journal of Neurotrauma ◽

10.1055/s-0041-1729136 ◽

2021 ◽

Author(s):

Hemant Kumar Beniwal ◽

Thatikonda Satish ◽

Gollapudi Prakash Rao ◽

Musali Siddartha Reddy ◽

Srikrishnaaditya Manne

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Intracranial Pressure ◽

Cerebellar Ataxia ◽

Cerebral Hemorrhage ◽

Incidental Finding ◽

Cowden Syndrome ◽

Young Female ◽

Resonance Imaging ◽

Increased Intracranial Pressure

AbstractLhermitte–Duclos disease, also known as dysplastic cerebellar gangliocytoma, is a rare hamartomatous tumor localized in cerebellum. An association with Cowden syndrome is observed in 50% of cases who present with symptoms of increased intracranial pressure and cerebellar ataxia. These patients have specific magnetic resonance imaging and histopathological findings. Surgical resection is the treatment of choice. Here, we report a case of a young female with traumatic frontal hemorrhage associated with Lhermitte–Duclos disease.

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