Glomus jugulare tumor presenting with increased intracranial pressure

1979 ◽  
Vol 50 (6) ◽  
pp. 823-825 ◽  
Author(s):  
David W. Beck ◽  
Neal F. Kassell ◽  
Charles G. Drake
Keyword(s):  
Intracranial Pressure ◽  
Visual Loss ◽  
Intracranial Extension ◽  
Increased Intracranial Pressure ◽  
Content Type ◽  
Glomus Jugulare Tumor ◽  
Glomus Jugulare ◽  
Venous Sinuses ◽  
Arterial Blood ◽  
Fine Print

✓ 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.

Evaluation of a method for noninvasive intracranial pressure assessment during infusion studies in patients with hydrocephalus

2000 ◽  
Vol 92 (5) ◽  
pp. 793-800 ◽  
Author(s):  
Bernhard Schmidt ◽  
Marek Czosnyka ◽  
Jens Jürgen Schwarze ◽  
Dirk Sander ◽  
Werner Gerstner ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Intracranial Pressure ◽  
Time Course ◽  
Cerebral Blood Flow Velocity ◽  
Absolute Error ◽  
Content Type ◽  
Arterial Blood ◽  
Potential Clinical Benefit ◽  
The Mean ◽  
Fine Print

Object. A mathematical model previously introduced by the authors allowed noninvasive intracranial pressure (nICP) assessment. In the present study the authors investigated this model as an aid in predicting the time course of raised ICP during infusion tests in patients with hydrocephalus and its suitability for estimating the resistance to outflow of cerebrospinal fluid (Rcsf).Methods. Twenty-one patients with hydrocephalus were studied. The nICP was calculated from the arterial blood pressure (ABP) waveform by using a linear signal transformation, which was dynamically modified by the relationship between ABP and cerebral blood flow velocity. This model was verified by comparison of nICP with “real” ICP measured during lumbar infusion tests. In all simulations, parallel increases in real ICP and nICP were evident. The simulated Rcsf was computed using nICP and then compared with Rcsf computed from real ICP. The mean absolute error between real and simulated Rcsf was 4.1 ± 2.2 mm Hg minute/ml. By the construction of simulations specific to different subtypes of hydrocephalus arising from various causes, the mean error decreased to 2.7 ± 1.7 mm Hg minute/ml, whereas the correlation between real and simulated Rcsf increased from R = 0.73 to R = 0.89 (p < 0.001).Conclusions. The validity of the mathematical model was confirmed in this study. The creation of type-specific simulations resulted in substantial improvements in the accuracy of ICP assessment. Improvement strategies could be important because of a potential clinical benefit from this method.

Intracranial xanthogranuloma of the dura in Hand-Schüller-Christian disease

1993 ◽  
Vol 78 (2) ◽  
pp. 297-300 ◽  
Author(s):  
Zain Alabedeen B. Jamjoom ◽  
Vinita Raina ◽  
Abdulfattah Al-Jamali ◽  
Abdulhakim B. Jamjoom ◽  
Basim Yacub ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Clinical Features ◽  
Obstructive Hydrocephalus ◽  
Relevant Literature ◽  
Increased Intracranial Pressure ◽  
Falx Cerebri ◽  
Content Type ◽  
Tentorium Cerebelli ◽  
Ultrastructural Studies ◽  
Fine Print

✓ 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.

Conray ventriculography in the diagnosis of intraventricular and posterior fossa lesions

1971 ◽  
Vol 34 (3) ◽  
pp. 405-407 ◽  
Author(s):  
Salvador Gonzalez-Cornejo
Keyword(s):  
Intracranial Pressure ◽  
Posterior Fossa ◽  
Increased Intracranial Pressure ◽  
Content Type ◽  
Conray Ventriculography ◽  
Fine Print

✓ 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.

Pneumocephalus in patients with CSF shunts

1985 ◽  
Vol 63 (4) ◽  
pp. 532-536 ◽  
Author(s):  
John R. Ruge ◽  
Leonard J. Cerullo ◽  
David G. McLone
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Mental Status ◽  
Aqueductal Stenosis ◽  
Increased Intracranial Pressure ◽  
Csf Shunts ◽  
Content Type ◽  
Presenting Symptoms ◽  
Fine Print

✓ 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.

Cerebral perfusion pressure, intracranial pressure, and head elevation

1986 ◽  
Vol 65 (5) ◽  
pp. 636-641 ◽  
Author(s):  
Michael J. Rosner ◽  
Irene B. Coley
Keyword(s):  
Intracranial Pressure ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Pressure Waves ◽  
Content Type ◽  
Arterial Blood ◽  
Head Elevation ◽  
Adequate Hydration ◽  
Fine Print

✓ Previous investigations have suggested that intracranial pressure waves may be induced by reduction of cerebral perfusion pressure (CPP). Since pressure waves were noted to be more common in patients with their head elevated at a standard 20° to 30°, CPP was studied as a function of head position and its effect upon intracranial pressure (ICP). In 18 patients with varying degrees of intracranial hypertension, systemic arterial blood pressure (SABP) was monitored at the level of both the head and the heart. Intracranial pressure and central venous pressure were assessed at every 10° of head elevation from 0° to 50°. For every 10° of head elevation, the average ICP decreased by 1 mm Hg associated with a reduction of 2 to 3 mm Hg CPP. The CPP was not beneficially affected by any degree of head elevation. Maximal CPP (73 ± 3.4 mm Hg (mean ± standard error of the mean)) always occurred with the head in a horizontal position. Cerebrospinal fluid pressure waves occurred in four of the 18 patients studied as a function of reduced CPP caused by head elevation alone. Thus, elevation of the head of the bed was associated with the development of CPP decrements in all cases, and it precipitated pressure waves in some. In 15 of the 18 patients, CPP was maintained by spontaneous 10- to 20-mm Hg increases in SABP, and pressure waves did not occur if CPP was maintained at 70 to 75 mm Hg or above. It is concluded that 0° head elevation maximizes CPP and reduces the severity and frequency of pressure-wave occurrence. If the head of the bed is to be elevated, then adequate hydration and avoidance of pharmacological agents that reduce SABP or prevent its rise are required to maximize CPP.

Vascularized temporalis muscle flap for the treatment of otorrhea

2003 ◽  
Vol 98 (5) ◽  
pp. 1128-1132 ◽  
Author(s):  
Gabriel C. Tender ◽  
Scott Kutz ◽  
Deepak Awasthi ◽  
Peter Rigby
Keyword(s):  
Intracranial Pressure ◽  
Muscle Flap ◽  
Middle Fossa ◽  
Temporalis Muscle ◽  
Increased Intracranial Pressure ◽  
Content Type ◽  
Middle Fossa Approach ◽  
Medial Side ◽  
Temporalis Muscle Flap ◽  
Fine Print

✓ 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.

Posterior fossa subdural hematoma of the newborn

1971 ◽  
Vol 34 (3) ◽  
pp. 423-426 ◽  
Author(s):  
L. Philip Carter ◽  
Hal W. Pittman
Keyword(s):  
Intracranial Pressure ◽  
Posterior Fossa ◽  
Newborn Infant ◽  
Subdural Hematoma ◽  
Communicating Hydrocephalus ◽  
Increased Intracranial Pressure ◽  
Content Type ◽  
Surgical Evacuation ◽  
Increased Pressure ◽  
Fine Print

✓ 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.

Intracranial pressure changes induced during papaverine infusion for treatment of vasospasm

1995 ◽  
Vol 83 (3) ◽  
pp. 430-434 ◽  
Author(s):  
William McAuliffe ◽  
Murphy Townsend ◽  
Joseph M. Eskridge ◽  
David W. Newell ◽  
M. Sean Grady ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Carotid Artery ◽  
Pulse Rate ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Clinical Signs ◽  
Average Dose ◽  
Content Type ◽  
Arterial Blood ◽  
Fine Print

✓ The authors reviewed the cases of 21 patients who received intraarterial infusions of papaverine to determine the drug's effects on intracranial pressure (ICP), mean arterial blood pressure, pulse rate, and cerebral perfusion pressure (CPP). The study focused on patients with aneurysmal subarachnoid hemorrhage who developed clinical signs and symptoms of vasospasm, which was documented by cerebral angiography. In 18 patients, an average dose of 300 mg papaverine was administered over 20 to 35 minutes using a No. 5 French catheter inserted into the high cervical internal carotid artery or vertebral artery. Two other patients received superselective infusions via a microcatheter placed in the anterior cerebral artery. Sixteen patients (76%) experienced good angiographic results, and 11 (52%) obtained objective clinical improvement within 48 hours. Significant elevations in ICP, blood pressure, and pulse rate were noted during papaverine infusion. In contrast, no statistically significant sustained change in CPP was observed, although it tended to decrease during papaverine infusion. In one elderly patient, infusion of the common carotid artery resulted in profound bradycardia and hypotension with a subsequent significant increase in ICP and a marked decrease in CPP. The increase in ICP in these patients correlates well with changes seen in animal models and is probably related to increased cerebral blood flow. A careful, titrated infusion of papaverine, with constant reference to the patient's ICP, blood pressure, and pulse rate, minimizes the transient increase in ICP while maintaining adequate blood pressure and CPP. Failure to monitor these parameters during the infusion, with appropriate modification of the rate of titration, could potentially produce an uncontrolled change in ICP or CPP.

Cerebral radiation necrosis simulating a brain tumor

1974 ◽  
Vol 40 (2) ◽  
pp. 267-271 ◽  
Author(s):  
E. Fletcher Eyster ◽  
Surl L. Nielsen ◽  
Glenn E. Sheline ◽  
Charles B. Wilson
Keyword(s):  
Brain Tumor ◽  
Intracranial Pressure ◽  
Frontal Lobe ◽  
Radiation Necrosis ◽  
Increased Intracranial Pressure ◽  
Content Type ◽  
Cerebral Radiation Necrosis ◽  
Tentorial Herniation ◽  
The Brain ◽  
Fine Print

✓ 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.

Age, intracranial pressure, autoregulation, and outcome after brain trauma

2005 ◽  
Vol 102 (3) ◽  
pp. 450-454 ◽  
Author(s):  
Marek Czosnyka ◽  
Marcella Balestreri ◽  
Luzius Steiner ◽  
Piotr Smielewski ◽  
Peter J. Hutchinson ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Older Patients ◽  
Brain Trauma ◽  
Reactivity Index ◽  
Content Type ◽  
Cerebrovascular Autoregulation ◽  
Arterial Blood ◽  
Pressure Reactivity ◽  
Age Related ◽  
Fine Print

Object. The object of this study was to investigate whether a failure of cerebrovascular autoregulation contributes to the relationship between age and outcome in patients following head injury. Methods. Data obtained from continuous bedside monitoring of intracranial pressure (ICP), arterial blood pressure (ABP), and cerebral perfusion pressure (CPP = ABP — ICP) in 358 patients with head injuries and intermittent monitoring of transcranial Doppler blood flow velocity (FV) in the middle cerebral artery in 237 patients were analyzed retrospectively. Indices used to describe cerebral autoregulation and pressure reactivity were calculated as correlation coefficients between slow waves of systolic FV and CPP (autoregulation index [ARI]) and between ABP and ICP (pressure reactivity index [PRI]). Older patients had worse outcomes after brain trauma than younger patients (p = 0.00001), despite the fact that the older patients had higher initial Glasgow Coma Scale scores (p = 0.006). When age was considered as an independent variable, it appeared that ICP decreased with age (p = 0.005), resulting in an increasing mean CPP (p = 0.0005). Blood FV was not dependent on age (p = 0.58). Indices of autoregulation and pressure reactivity demonstrated a deterioration in cerebrovascular control with advancing age (PRI: p = 0.003; ARI: p = 0.007). Conclusions. An age-related decline in cerebrovascular autoregulation was associated with a relative deterioration in outcome in elderly patients following head trauma.

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