scholarly journals Possible Spironolactone Induced Intracranial Hypertension in a Patient with Androgenetic Alopecia: A Case Report

2018 ◽  
Vol 12 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Hamad Albraidi ◽  
Omar Alzuman ◽  
Abdulmajeed Alajlan
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Adverse Events ◽  
Intracranial Hypertension ◽  
Androgenetic Alopecia ◽  
Androgen Level

Spironolactone is a well-known drug with many indications. In dermatology, it may be used for treating androgenetic alopecia with a high androgen level. A patient with idiopathic papilledema that was inactive for many years experienced a significant increase in intracranial pressure after receiving spironolactone. The symptoms were resolved soon after the medication was discontinued. This report draws physicians’ attention to such rare adverse events that may have unwanted consequences.

scholarly journals Idiopathic Intracranial Hypertension Developing After Levothyroxine Replacement in a Patient with Acquired Primary Hypothyroidism- A Case Report

2011 ◽  
Vol 29 (1) ◽  
pp. 49-51 ◽  
Author(s):  
MA Haque ◽  
LS Sharmin ◽  
QT Islam
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Iron Deficiency ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Primary Hypothyroidism ◽  
Steroid Withdrawal ◽  
Cushing Disease ◽  
Levothyroxine Replacement ◽  
Intracranial Lesions

Idiopathic intracranial hypertension (IIH) is the persistent increase in intracranial pressure in the absence of any intracranial lesions. Though termed idiopathic IIH is known to be associated with a wide variety of disease conditions and drugs i.e. SLE, adrenal insufficiency, Cushing disease, hypoparathyroidism, hypothyroidism, iron deficiency, vitamin A, tetracycline, nalidixic acid, steroid withdrawal and many others. IIH is a rare disease, but IIH developing after replacement of levothyroxine is even rarer. Only a handful of cases of IIH associated with levothyroxine therapy have been mentioned in the literature. We are reporting a case of IIH developing after starting levothyroxine replacement and then the literature is reviewed. DOI: 10.3329/jbsp.v29i1.7173J Bangladesh Coll Phys Surg 2011; 29:49-51

Efficacy, Safety, and Timing of 5% Sodium Chloride Compared With 23.4% Sodium Chloride for Osmotic Therapy

2017 ◽  
Vol 51 (8) ◽  
pp. 625-629 ◽  
Author(s):  
Chris Carter ◽  
Theresa Human
Keyword(s):  
Sodium Chloride ◽  
Intracranial Pressure ◽  
Adverse Events ◽  
Intracranial Hypertension ◽  
Median Time ◽  
Infusion Site ◽  
Median Percentage ◽  
Intravenous Access

Background: Bolus doses of 23.4% sodium chloride (NaCl) are commonly used for the treatment of intracranial hypertension; however, delays in administration may occur in patients without central intravenous access. At our institution, equiosmolar bolus doses of 5% NaCl have emerged as potential alternatives to 23.4% NaCl because they may be safely administered through peripheral lines. Objectives: We sought to assess the efficacy in reducing intracranial pressure (ICP), time to administration, and safety of 5% NaCl as compared with 23.4% NaCl for the treatment of intracranial hypertension. Methods: Patients admitted from July 2012 to June 2014 who received boluses of 5% NaCl or 23.4% NaCl for a sustained ICP >20 mm Hg were included. Data collected included measurements of ICP, time to administration, and adverse events. Results: A total of 44 patients were identified; 11 received 5% NaCl, and 33 received 23.4% NaCl. The median percentage reductions in ICP at 30, 60, and 120 minutes in patients who received 5% versus 23.4% NaCl were 34% versus 26% ( P = 0.850), 48% versus 40% ( P = 0.700), and 46% versus 30% ( P = 0.064), respectively. The median time to administration was shorter in the 5% NaCl group (7 vs 11 minutes, P = 0.364). Both groups had a 27% rate of adverse events and no infusion site reactions. Conclusions: These data suggest that 5% NaCl may be as effective as 23.4% NaCl at lowering ICP if given at equiosmolar doses, has a shorter time to administration, and has no difference in the prevalence of adverse events.

scholarly journals Intracranial hypertension and empty Sella from adrenal adenoma and excessive and prolonged steroid usage: a case report

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Naiqian Zhao ◽  
Weixia Yang ◽  
Xiaoyan Li ◽  
Li Wang ◽  
Ying Feng
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Low Dose ◽  
Adrenal Adenoma ◽  
Empty Sella ◽  
Elevated Intracranial Pressure ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Free Cortisol

Abstract Background There is only one documented case of intracranial hypertension (IH) and empty sella from cortisol-producing adrenal adenoma so far. And IH and empty sella caused by long-term exogenous hypercortisolism has never been reported before. The purpose of this case report is to alert clinicians to glucocorticoid-induced IH. Case presentation We present retrospectively a 50-year-old woman with cortisol-secreting adrenal adenoma, who progressed to intractable intracranial hypertension and a markedly expanded empty sella due to improper treatment. In 2011, the patient presented with hypertension, lack of cortisol circadian rhythm, low ACTH, a left adrenal adenoma and a partial empty sella, but did not receive low-dose dexamethasone suppression test (LDDST) and 24-h urinary cortisol. In 2014, she exhibited truncal obesity, raised cortisol, LDDST non-suppression, high urinary free cortisol and low ACTH, proving her cortisol-producing adrenal adenoma. She was simultaneously diagnosed with unexplained IH because of papilledema and elevated intracranial pressure, and her partial empty sella changed to a complete empty sella. In 2015, she underwent adrenal adenoma resection. From 2015 to 2018, she kept taking dexamethasone at least 2 mg daily without her doctors’ consent. During this period, she developed transient cerebrospinal fluid rhinorrhea, and her empty sella further worsened. After switching to low dose hydrocortisone, her papilledema disappeared completely, but optic atrophy has become irreversible. Conclusions The patient seems to be just an extreme case, but it may reveal and illustrate a general phenomenon: Both cortisol-producing adrenal adenoma and long-term exogenous hypercortisolism could cause varying degrees of elevated intracranial pressure and empty sella. Clinicians should remain vigilant for this phenomenon in patients with cortisol-producing adrenal adenoma or excessive and prolonged steroid usage and give them corresponding examinations to identify this complication.

scholarly journals Non-invasive intracranial pressure monitoring in idiopathic intracranial hypertension and lumbar puncture in pediatric patient: Case report

2021 ◽  
Vol 12 ◽  
pp. 493
Author(s):  
Thomas Markus Dhaese ◽  
Leonardo C. Welling ◽  
Alice Magro Kosciasnki ◽  
Gustavo Frigeri ◽  
Judy Auada ◽  
...  
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Lumbar Puncture ◽  
Idiopathic Intracranial Hypertension ◽  
Intracranial Pressure Monitoring ◽  
Invasive Technique ◽  
Icp Monitoring ◽  
Pressure Monitoring ◽  
Non Invasive

Background: Intracranial pressure (ICP) monitoring has been variously explored as a diagnostic and therapeutic modality in many pathological conditions leading neurological injury. This monitoring standardly depends on an invasive procedure such as cranial or lumbar catheterization. The gold standard for ICP monitoring is through an intraventricular catheter, but this invasive technique is associated with certain risks such as haemorrhage and infection. (1) Also, it is a high-cost procedure and consequently not available in a variety of underprivileged places and clinical situations in which intracranial hypertension is prevalent (3). An accurate non-invasive and low-priced method to measure elevated ICP would therefore be desirable. Under these circumstances, Brazilian scientists developed a non-invasive method for intracranial pressure monitoring (ICP-NI), which uses an electric resistance extensometer that measures micro deformations of the skull and transforms it into an electrical signal. In this case report, the authors describe a pediatrician patient with the diagnosis of idiopathic intracranial hypertension who was successfully submitted to a lumbar puncture under monitorization with this device. Case description: 7 year old girl with progressive symptoms that lead to the diagnosis of idiopathic intracranial hypertension. The patient was submitted to a lumbar punction with continuous non-invasive ICP monitoring. Conclusion: Estimating ICP (non-invasive) from LP monitoring (invasive) often reflect inaccurate ICP results, and affects negatively on IIH diagnosis and a non-invasive diagnostic method could reduce the requirement for invasive approaches, improving patient health outcomes.

scholarly journals A progressive and complex clinical course in two family members with ERF-related craniosynostosis: a case report

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Izabella Körberg ◽  
Daniel Nowinski ◽  
Marie-Louise Bondeson ◽  
Malin Melin ◽  
Lars Kölby ◽  
...  
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Broad Spectrum ◽  
Clinical Course ◽  
Family Members ◽  
Late Presentation ◽  
Pressure Monitoring ◽  
Sagittal Synostosis ◽  
Case Presentation

Abstract Background ERF-related craniosynostosis are a rare, complex, premature trisutural fusion associated with a broad spectrum of clinical features and heterogeneous aetiology. Here we describe two cases with the same pathogenic variant and a detailed description of their clinical course. Case presentation Two subjects; a boy with a BLSS requiring repeated skull expansions and his mother who had been operated once for sagittal synostosis. Both developed intracranial hypertension at some point during the course, which was for both verified by formal invasive intracranial pressure monitoring. Exome sequencing revealed a pathogenic truncating frame shift variant in the ERF gene. Conclusions Here we describe a boy and his mother with different craniosynostosis patterns, but both with verified intracranial hypertension and heterozygosity for a truncating variant of ERF c.1201_1202delAA (p.Lys401Glufs*10). Our work provides supplementary evidence in support of previous phenotypic descriptions of ERF-related craniosynostosis, particularly late presentation, an evolving synostotic pattern and variable expressivity even among affected family members.

Transcranial Doppler ultrasonography in raised intra-cranial pressure and in intracranial circulatory arrest

1988 ◽  
Vol 68 (5) ◽  
pp. 745-751 ◽  
Author(s):  
Werner Hassler ◽  
Helmuth Steinmetz ◽  
Jan Gawlowski
Keyword(s):  
Intracranial Pressure ◽  
Brain Death ◽  
Intracranial Hypertension ◽  
Cerebral Perfusion Pressure ◽  
Transcranial Doppler ◽  
Cerebral Perfusion ◽  
Doppler Ultrasonography ◽  
Perfusion Pressure ◽  
Circulatory Arrest ◽  
Transcranial Doppler Ultrasonography

✓ Transcranial Doppler ultrasonography was used to monitor 71 patients suffering from intracranial hypertension with subsequent brain death. Among these, 29 patients were also assessed for systemic arterial pressure and epidural intracranial pressure, so that a correlation between cerebral perfusion pressure and the Doppler ultrasonography waveforms could be established. Four-vessel angiography was also performed in 33 patients after clinical brain death. With increasing intracranial pressure, the transcranial Doppler ultrasonography waveforms exhibited different characteristic high-resistance profiles with first low, then zero, and then reversed diastolic flow velocities, depending on the relationship between intracranial pressure and blood pressure (that is, cerebral perfusion pressure). This study shows that transcranial. Doppler ultrasonography may be used to assess the degree of intracranial hypertension. This technique further provides a practicable, noninvasive bedside monitor of therapeutic measures.

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