Vitreous hemorrhages and sudden increased intracranial pressure

1974 ◽  
Vol 41 (2) ◽  
pp. 167-176 ◽  
Author(s):  
R. Graham Vanderlinden ◽  
Lionel D. Chisholm

✓ Six cases of bilateral hemorrhage into the vitreous body related to intracranial hypertension are presented. Four were associated with ruptured cerebral aneurysms, and the others followed head injury. The onset of vitreous hemorrhage was delayed in all cases, and in five patients subhyaloid hemorrhages were present from 2 to 27 days prior to their extension into the vitreous. Visual acuity was greatly reduced. The ophthalmoscopic and slit lamp appearance of the vitreous are described. The hemorrhages usually cleared spontaneously within 24 months, and vision returned to normal. Surgical treatment to remove residual vitreous blood in selected cases is outlined.

1993 ◽  
Vol 78 (2) ◽  
pp. 297-300 ◽  
Author(s):  
Zain Alabedeen B. Jamjoom ◽  
Vinita Raina ◽  
Abdulfattah Al-Jamali ◽  
Abdulhakim B. Jamjoom ◽  
Basim Yacub ◽  
...  

✓ The authors describe a 37-year-old man with the classic clinical features of Hand-Schüller-Christian disease. He presented with symptoms of increased intracranial pressure due to obstructive hydrocephalus secondary to a huge xanthogranuloma involving falx cerebri and tentorium cerebelli. Immunohistochemical and ultrastructural studies failed to demonstrate Langerhans histiocytes, however. The implication of this finding is discussed in light of the recent relevant literature.


1971 ◽  
Vol 34 (3) ◽  
pp. 405-407 ◽  
Author(s):  
Salvador Gonzalez-Cornejo

✓ The author reports the safe and satisfactory use of Conray ventriculography in 26 patients with increased intracranial pressure and discusses his technique for this procedure.


1979 ◽  
Vol 51 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Takehide Onuma ◽  
Jiro Suzuki

✓ The authors report the cases of 32 patients with aneurysms measuring 2.5 cm or greater in diameter found among 1080 patients with saccular cerebral aneurysms. Of the 32 patients, 24 patients were treated by direct operation, four by common carotid ligation, and the other four by conservative therapy. The appropriateness of surgery and surgical method are discussed.


1985 ◽  
Vol 63 (4) ◽  
pp. 532-536 ◽  
Author(s):  
John R. Ruge ◽  
Leonard J. Cerullo ◽  
David G. McLone

✓ The authors present two cases of pneumocephalus occurring in patients with permanent shunts and review nine previously reported cases. Mental status changes and headache are the most common presenting symptoms. Six of the 11 cases of pneumocephalus occurred in patients with shunt placement for hydrocephalus secondary to aqueductal stenosis. In these patients, thinned cerebrospinal fluid barriers secondary to longstanding increased intracranial pressure may predispose them to pneumocephalus. Temporary extraventricular drainage is an effective method of treatment in this group of patients. Two other etiologies are identified with significance to treatment, and the role of craniotomy is discussed.


2003 ◽  
Vol 98 (5) ◽  
pp. 1128-1132 ◽  
Author(s):  
Gabriel C. Tender ◽  
Scott Kutz ◽  
Deepak Awasthi ◽  
Peter Rigby

✓ The surgical treatment for cerebral spinal fluid (CSF) fistulas provides closure of the bone and dural defects and prevents the recurrence of brain herniation and CSF fistula. The two main approaches used are the transmastoid and middle fossa ones. The authors review the results of performing a modified middle fossa approach with a vascularized temporalis muscle flap to create a barrier between the repaired dural and bone defects. Fifteen consecutive cases of CSF fistulas treated at the authors' institution were retrospectively reviewed. All patients presented with otorrhea. Eleven patients had previously undergone ear surgery. A middle fossa approach was followed in all cases. The authors used a thin but watertight and vascularly preserved temporalis muscle flap that had been dissected from the medial side of the temporalis muscle and was laid intracranially on the floor of the middle fossa, between the repaired dura mater and petrous bone. The median follow-up period was 2.5 years. None of the patients experienced recurrence of otorrhea or meningitis. There was no complication related to the intracranial temporalis muscle flap (for example, seizures or increased intracranial pressure caused by muscle swelling). One patient developed hydrocephalus, which resolved after the placement of a ventriculoperitoneal shunt 2 months later. The thin, vascularized muscle flap created an excellent barrier against the recurrence of CSF fistulas and also avoided the risk of increased intracranial pressure caused by muscle swelling. This technique is particularly useful in refractory cases.


1978 ◽  
Vol 49 (6) ◽  
pp. 794-804 ◽  
Author(s):  
Sean Mullan ◽  
Kathy Hanlon ◽  
Frederick Brown

✓ A series of 103 consecutive cases admitted to the University of Chicago Hospitals with a recently ruptured supratentorial aneurysm were medically managed by antifibrinolytic medication, and, when applicable, by hypotension, intracranial pressure control, and respiratory support. Nine patients deteriorated and died, and six rebled and died before they were judged fit for surgical treatment. Four were treated by carotid occlusion. Nine, because of refusal or medical judgment, did not have surgical treatment. Sixty-nine of these patients and a further 33, electively admitted, underwent craniotomy. In these 102 patients, there was no mortality. Seven developed postoperative hemiparesis or hemiplegia. Six recovered. One has a residual monoparesis.


1979 ◽  
Vol 50 (6) ◽  
pp. 823-825 ◽  
Author(s):  
David W. Beck ◽  
Neal F. Kassell ◽  
Charles G. Drake

✓ The authors report a case of glomus jugulare tumor presenting with papilledema and visual loss. The tumor was extremely vascular with significant shunting of arterial blood into venous sinuses. There was no intracranial extension of tumor, and papilledema resolved after removal of the lesion.


1971 ◽  
Vol 34 (3) ◽  
pp. 423-426 ◽  
Author(s):  
L. Philip Carter ◽  
Hal W. Pittman

✓ A newborn infant with a posterior fossa subdural hematoma is described, and nine similar cases from the literature summarized. A postnatal asymptomatic period was followed by signs of increased intracranial pressure. The diagnosis was established on the basis of negative subdural taps, bloody or xanthochromic ventricular fluid under increased pressure, and demonstration of a posterior fossa mass on the ventriculogram. Surgical evacuation with careful observation for an associated intracerebellar hematoma is the treatment of choice. Five of the 10 cases developed postoperative communicating hydrocephalus.


1974 ◽  
Vol 40 (2) ◽  
pp. 267-271 ◽  
Author(s):  
E. Fletcher Eyster ◽  
Surl L. Nielsen ◽  
Glenn E. Sheline ◽  
Charles B. Wilson

✓ Two years after undergoing irradiation for a malignant ethmoid tumor, a 50-year-old man developed signs of increased intracranial pressure, an expanding right frontal lobe mass, and tentorial herniation. Operation revealed a mass that grossly appeared to be a glioma, but microscopically proved to be radiation necrosis of the brain.


1981 ◽  
Vol 54 (6) ◽  
pp. 726-732 ◽  
Author(s):  
Andrew H. Kaye ◽  
David Brownbill

✓ The postoperative intracranial pressure (ICP) in 36 patients operated on for cerebral aneurysm following subarachnoid hemorrhage was studied. Not only was the baseline ICP significantly lower in patients whose outcome was assessed as “good” as compared with those patients with a worse outcome at 1 month after surgery, but also the height of the plateau waves and B-waves was significantly less in the patients who did well. The baseline ICP and the height of the B-wave formation were unrelated to the position of the aneurysm. Plateau waves were marginally significantly higher in aneurysms of the anterior communicating artery complex. Neither preoperative hypertension nor the use of antifibrinolytic agents made any difference to postoperative ICP. In patients with cerebral arterial vasospasm found preoperatively on the angiograms, the ICP tended to be lower in the postoperative period than in those without spasm.


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