Subarachnoid hemorrhage and papilledema due to a cervical neurilemmoma

1978 ◽  
Vol 48 (6) ◽  
pp. 1015-1018 ◽  
Author(s):  
Linda M. Luxon ◽  
Michael J. G. Harrison
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Pressure ◽  
Unusual Case ◽  
Acute Onset ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Clinical Clue ◽  
Symptoms And Signs ◽  
Fine Print

✓ An unusual case of a cervical neurilemmoma is presented. A 67-year-old man developed papilledema on two occasions in association with the symptoms and signs of a subarachnoid hemorrhage (SAH). He proved to have an otherwise asymptomatic cervical neurilemmoma. It is suggested that both acute and subclinical bleeding from such tumors may sometimes underlie the development of raised intracranial pressure occasionally encountered. The clinical clue to the spinal origin of the SAH was an acute onset with root pain. This case is discussed with reference to similar cases in the literature.

Oligodendroglioma and cerebral cavernous angioma

1985 ◽  
Vol 62 (1) ◽  
pp. 145-147 ◽  
Author(s):  
Chee Pin Chee ◽  
Robin Johnston ◽  
David Doyle ◽  
Peter Macpherson
Keyword(s):  
Intracranial Pressure ◽  
Contrast Enhancement ◽  
Computerized Tomography ◽  
Vascular Malformation ◽  
Signs And Symptoms ◽  
Cavernous Angioma ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Vascular Component ◽  
Fine Print

✓ The authors report a case of frontal lobe oligodendroglioma associated with a cavernous angioma. The patient presented with signs and symptoms of raised intracranial pressure. Computerized tomography with contrast enhancement failed to detect the vascular component. The clinical and pathological significance of the presence of this vascular malformation in an oligodendroglioma is discussed.

Thoracic disc herniation associated with papilledema

1984 ◽  
Vol 61 (6) ◽  
pp. 1132-1134 ◽  
Author(s):  
Shalom D. Michowiz ◽  
Harry Z. Rappaport ◽  
Itzchak Shaked ◽  
Allon Yellin ◽  
Abraham Sahar
Keyword(s):  
Spinal Cord ◽  
Intracranial Pressure ◽  
Intervertebral Disc ◽  
Spastic Paraparesis ◽  
Raised Intracranial Pressure ◽  
Thoracic Disc Herniation ◽  
Spinal Cord Lesions ◽  
Content Type ◽  
Thoracic Disc ◽  
Fine Print

✓ The occurrence of papilledema in a patient with progressive spastic paraparesis due to herniation of the T11–12 intervertebral disc is reported. The papilledema resolved following discectomy. The association and possible pathogenetic mechanisms between spinal cord lesions and signs of raised intracranial pressure are reviewed.

Relationship between intracranial pressure and other clinical variables in patients with aneurysmal subarachnoid hemorrhage

2004 ◽  
Vol 101 (3) ◽  
pp. 408-416 ◽  
Author(s):  
Gregory G. Heuer ◽  
Michelle J. Smith ◽  
J. Paul Elliott ◽  
H. Richard Winn ◽  
Peter D. Leroux
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Pressure ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Clinical Grade ◽  
Icp Monitoring ◽  
Content Type ◽  
Poor Grade ◽  
Symptomatic Vasospasm ◽  
Increased Icp ◽  
Fine Print

Object. Increased intracranial pressure (ICP) is well known to affect adversely patients with head injury. In contrast, the variables associated with ICP following aneurysmal subarachnoid hemorrhage (SAH) and their impact on outcome have been less intensely studied. Methods. In this retrospective study the authors reviewed a prospective observational database cataloging the treatment details in 433 patients with SAH who had undergone surgical occlusion of an aneurysm as well as ICP monitoring. All 433 patients underwent postoperative ICP monitoring, whereas only 146 (33.7%) underwent both pre- and postoperative ICP monitoring. The mean maximal ICP was 24.9 ± 17.3 mm Hg (mean ± standard deviation). During their hospital stay, 234 patients (54%) had elevated ICP (> 20 mm Hg), including 136 of those (48.7%) with a good clinical grade (Hunt and Hess Grades I–III) and 98 (63.6%) of the 154 patients with a poor grade (Hunt and Hess Grades IV and V) on admission. An increased mean maximal ICP was associated with several admission variables: worse Hunt and Hess clinical grade (p < 0.0001), a lower Glasgow Coma Scale (GSC) motor score (p < 0.0001); worse SAH grade based on results of computerized tomography studies (p < 0.0001); intracerebral hemorrhage (p = 0.024); severity of intraventricular hemorrhage (p < 0.0001); and rebleeding (p = 0.0048). Both intraoperative cerebral swelling (p = 0.0017) and postoperative GCS score (p < 0.0001) were significantly associated with a raised ICP. Variables such as patient age, aneurysm size, symptomatic vasospasm, intraoperative aneurysm rupture, and secondary cerebral insults such as hypoxia were not associated with raised ICP. Increased ICP adversely affected outcome: 71.9% of patients with normal ICP demonstrated favorable 6-month outcomes postoperatively, whereas 63.5% of patients with ICP between 20 and 50 mm Hg and 33.3% with ICP greater than 50 mm Hg demonstrated favorable outcomes. Among 21 patients whose raised ICP did not respond to mannitol therapy, all experienced a poor outcome and 95.2% died. Among 145 patients whose elevated ICP responded to mannitol, 66.9% had a favorable outcome and only 20.7% were dead 6 months after surgery (p < 0.0001). According to results of multivariate analysis, however, ICP was not an independent outcome predictor (odds ratio 1.26, 95% confidence interval 0.28–5.68). Conclusions. Increased ICP is common after SAH, even in patients with a good clinical grade. Elevated ICP post-SAH is associated with a worse patient outcome, particularly if ICP does not respond to treatment. This association, however, may depend more on the overall severity of the SAH than on ICP alone.

Ventriculoatrial shunt in tuberculous meningitis with hydrocephalus

1971 ◽  
Vol 35 (3) ◽  
pp. 309-313 ◽  
Author(s):  
S. N. Bhagwati
Keyword(s):  
Intracranial Pressure ◽  
Tuberculous Meningitis ◽  
Raised Intracranial Pressure ◽  
Ventriculoatrial Shunt ◽  
Active Stage ◽  
Content Type ◽  
Fine Print

✓ Raised intracranial tension affects the course of tuberculous meningitis adversely. The development of hydrocephalus may account for the raised intracranial pressure. Insertion of a ventriculoatrial shunt significantly alters the course of the disease. The results in seven cases have been detailed and discussed. The levels of consciousness improved, hemiplegia and aphasia practically cleared up, and vision returned even in children who were blind for 4 to 6 weeks. Operation could be performed even in an active stage of the disease without much fear of miliary dissemination.

Use of long-term intracranial pressure measurement to assess hydrocephalic patients prior to shunt surgery

1975 ◽  
Vol 42 (3) ◽  
pp. 258-273 ◽  
Author(s):  
Lindsay Symon ◽  
Nicholas W. C. Dorsch
Keyword(s):  
Intracranial Pressure ◽  
Pressure Measurement ◽  
Pressure Profile ◽  
Shunt Surgery ◽  
Raised Intracranial Pressure ◽  
Epidural Pressure ◽  
Content Type ◽  
Pressure Recording ◽  
Fine Print

✓ The authors present their experience with long-term epidural pressure recording in hydrocephalic patients. The technique identifies those with episodically raised intracranial pressure. The effect of shunts on the pressure profile in these patients is described.

Considerations in early surgery on good-risk patients with ruptured intracranial aneurysms

1982 ◽  
Vol 56 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Herman Hugenholtz ◽  
Robert G. Elgie
Keyword(s):  
Intracranial Pressure ◽  
Retrospective Analysis ◽  
Intracranial Aneurysms ◽  
Early Operation ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Risk Patients ◽  
Ruptured Intracranial Aneurysms ◽  
Good Risk ◽  
Fine Print

✓ A retrospective analysis of 100 consecutive patients with proven ruptured intracranial aneurysms, classified as Botterell Grades I to III on admission, was carried out to evaluate the efficacy of early operation. Surgical and management mortality/morbidity rates were lower for cases in which a single hemorrhage was operated on within 48 hours than when surgery was delayed for 7 days or more. Surgical and management mortality/morbidity rates were worse in good-risk patients treated surgically between the 3rd and 7th days following a hemorrhage, reflecting the increased incidence of postoperative vasospasm and raised intracranial pressure encountered at surgery during this interval.

Enigma of raised intracranial pressure in patients with complex craniosynostosis: the role of abnormal intracranial venous drainage

2001 ◽  
Vol 94 (3) ◽  
pp. 377-385 ◽  
Author(s):  
Wendy J. Taylor ◽  
Richard D. Hayward ◽  
Pierre Lasjaunias ◽  
Jonathan A. Britto ◽  
Dominic N. P. Thompson ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Venous Drainage ◽  
Venous Hypertension ◽  
Apert Syndrome ◽  
Raised Intracranial Pressure ◽  
Icp Monitoring ◽  
Venous Anatomy ◽  
Content Type ◽  
Complex Forms ◽  
Fine Print

Object. In this study the authors investigated whether patterns of intracranial venous drainage in children with complex craniosynostosis associated with raised intracranial pressure (ICP) were abnormal and, thus, could support the theory that venous hypertension is a major contributor to raised ICP that can lead to impaired visual function or even blindness in these patients. Methods. The authors analyzed the anatomy of intracranial venous drainage as demonstrated in the results of 24 angiography studies obtained in 23 patients, all of whom had either a craniosynostosis-related syndrome (18 patients) or a nonsyndromic multisutural synostosis (five patients). Twenty-one patients had experienced raised ICP (in 19 patients diagnosis was based on invasive ICP monitoring and in two patients on clinical grounds alone) 1 to 6 weeks before undergoing angiography. Of the two remaining patients (both with Apert syndrome) whose ICP monitoring was normal immediately before angiography, each had undergone two previous cranial vault expansion procedures. On results of 18 angiography studies a 51 to 99% stenosis or no flow at all could be observed in the sigmoid—jugular sinus complex either bilaterally (11 patients) or unilaterally (seven patients). In 11 of these patients a florid collateral circulation through the stylomastoid emissary venous plexus was also seen. Two angiography studies were performed in one patient with Crouzon syndrome. A comparison of the two studies demonstrated a progression of the abnormal venous anatomy in that case. The authors found no obvious correlation between each patient's baseline ICP and the degree of abnormality of their venous anatomy, as judged on the basis of a venous-phase angiography severity score. Conclusions. Based on their findings, the authors assert that in children with complex forms of craniosynostosis in whom other factors, such as hydrocephalus, are absent, abnormalities of venous drainage that particularly affect the sigmoid—jugular sinus complex produce a state of venous hypertension that, in turn, is responsible for the majority of cases of raised ICP. The incidence of these changes is unknown, but an analysis of the ages of the children in this study indicated that the period of particular vulnerability to the effects of venous hypertension lasts until the affected child is approximately 6 years old. After that age the collateral venous drainage through the stylomastoid plexus will likely become sufficient to allow ICP to normalize.

Multiple cerebral gummata

1983 ◽  
Vol 58 (6) ◽  
pp. 959-961 ◽  
Author(s):  
Jonathan Punt
Keyword(s):  
Intracranial Pressure ◽  
Computerized Tomography ◽  
Cerebral Edema ◽  
Ct Scanning ◽  
Raised Intracranial Pressure ◽  
Serological Testing ◽  
Serological Tests ◽  
Content Type ◽  
Fine Print

✓ The case of a patient with multiple small cerebral gummata presenting with severely raised intracranial pressure is reported. The diagnosis, which was quite unexpected, was based on positive serological tests for syphilis. Computerized tomography (CT) showed small enhancing lesions with intense cerebral edema. The patient was treated successfully with penicillin, and resolution of the lesions was observed on CT scanning over a 1-year period. The importance of “routine” serological testing is noted.

Effect of intermittently raised intracranial pressure on breathing pattern, ventilatory response to CO2, and blood gases in anesthetized cats

1976 ◽  
Vol 44 (2) ◽  
pp. 156-167 ◽  
Author(s):  
Sheila Jennett ◽  
J. Brian North
Keyword(s):  
Intracranial Pressure ◽  
Gas Exchange ◽  
Breathing Pattern ◽  
Ventilatory Response ◽  
Blood Gases ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Central Depression ◽  
Ventilatory Response To Co2 ◽  
Fine Print

✓ In anesthetised cats, breathing pattern, blood gases, and ventilatory response to CO2 were recorded before and during intermittent 10-minute episodes of hydrostatically raised intracranial pressure. The first effect on breathing was a stimulation which was followed at higher pressures by irregularity, depression, and periods of apnea; hyperventilation at high intracranial pressure (ICP) was rare. Raised ICP did not consistently depress the ventilatory response to CO2 until ventilation during airbreathing was already depressed; therefore, we cannot experimentally justify applying this test clinically to detect incipient ventilatory depression. When hypoxemia developed during raised ICP, it was compatible with the degree of hypoventilation due to central depression of breathing; thus, there was no evidence of a neurally mediated effect on the lungs, causing defective gas exchange.

Postoperative intracranial pressure in patients operated on for cerebral aneurysms following subarachnoid hemorrhage

1981 ◽  
Vol 54 (6) ◽  
pp. 726-732 ◽  
Author(s):  
Andrew H. Kaye ◽  
David Brownbill
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Pressure ◽  
Postoperative Period ◽  
Cerebral Aneurysms ◽  
Anterior Communicating Artery ◽  
Antifibrinolytic Agents ◽  
Content Type ◽  
Plateau Waves ◽  
Arterial Vasospasm ◽  
Fine Print

✓ 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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