1/110. Cerebral edema and priapism in an adolescent with acute lymphoblastic leukemia.priapism and increased intracranial pressure are both rare, but recognized, manifestations of leukemia. However, they have never been reported in the same patient. We report a 15-year-old male with acute lymphoblastic leukemia who presented with hyperleukocytosis, priapism, and increased intracranial pressure. central nervous system leukostasis and cerebral edema may have been detected earlier, had his history of priapism been known. Management of hyperleukocytosis complicated by priapism and increased intracranial pressure is discussed.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/110. indomethacin for brain edema following stroke.Conventional therapies for raised intracranial pressure (ICP) frequently are not effective. We report a patient with raised ICP following a large hemispheric stroke. After conventional therapies had failed, indomethacin was repeatedly administered. After bolus infusion (50 mg), the ICP fell by a mean of 8.1 mm Hg, and the mean arterial blood pressure increased by a mean of 7.1 mm Hg, leading to a mean increase in the cerebral perfusion pressure by 15.3 mm Hg. After 1 h, the ICP had returned to baseline values after most infusions. Continuous infusion of indomethacin was not effective. We conclude that indomethacin may reduce elevated ICP over a short time in patients with ischemic brain edema even after conventional therapy has failed.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/110. subarachnoid hemorrhage following permissive hypercapnia in a patient with severe acute asthma.In this article, we describe a case of a subarachnoid hemorrhage (SAH) in an acute severe asthma patient following mechanical hypoventilation. A 49-year-old man was admitted to an intensive care Unit with an acute exacerbation of asthma. After 3 days of mechanical ventilation (hypercapnia and normoxaemia), it was noted that his right pupil was fixed, dilated, and unreactive to light. Computed tomography (CT) scan showed localized SAH within the basilar cisterns and diffuse cerebral swelling. On the fourth day, a new CT scan showed hemorrhage resorption and a cerebral swelling decrease. In the following days, the patient's condition continued improving with no detectable neurological deficits. A review of similar published reports showed that all patients performed respiratory acidosis, normoxaemia, and hypercapnia. The most frequent neurological sign was mydriasis, and all subjects showed cerebral edema. Since normoxaemic hypercapnia has been associated with absence, or less cerebral edema, we considered additional factors to explain cerebral edema and intracranial hypertension causes. Thus, intrathoracic pressures due to patient's efforts by forcibly exhaling, or during mechanical ventilation, would further increase intracranial pressure by limiting cerebral venous drainage. This case emphasizes the fact that patients with acute severe asthma who have developed profoundly hypercarbic without hypoxia before or during mechanical ventilation, may have raised critical intracranial pressure.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/110. Unusual MR findings of the brain stem in arterial hypertension.MR imaging findings have been reported in only a few cases of severe arterial hypertension. We report two cases of severe paroxysmal arterial hypertension associated with unusual brain stem hyperintensity. The lesions improved dramatically after stabilization of blood pressure, suggesting that edema could be the main cause of the MR imaging-observed hyperintensity.- - - - - - - - - - ranking = 0.33333333333333keywords = pressure (Clic here for more details about this article) |
5/110. flushing in relation to a possible rise in intracranial pressure: documentation of an unusual clinical sign. Report of five cases.This report documents clinical features in five children who developed transient reddening of the skin (epidermal flushing) in association with acute elevations in intracranial pressure (ICP). Four boys and one girl (ages 9-15 years) deteriorated acutely secondary to intracranial hypertension ranging from 30 to 80 mm Hg in the four documented cases. Two patients suffered from ventriculoperitoneal shunt malfunctions, one had diffuse cerebral edema secondary to traumatic brain injury, one was found to have pneumococcal meningitis and hydrocephalus, and one suffered an intraventricular hemorrhage and hydrocephalus intraoperatively. All patients were noted to have developed epidermal flushing involving either the upper chest, face, or arms during their period of neurological deterioration. The response was transient, typically lasting 5 to 15 minutes, and dissipated quickly. The flushing reaction is postulated to be a centrally mediated response to sudden elevations in ICP. Several potential mechanisms are discussed. flushing has clinical importance because it may indicate significant elevations in ICP when it is associated with neurological deterioration. Because of its transient nature, the importance of epidermal flushing is often unrecognized; its presence confirms the need for urgent treatment.- - - - - - - - - - ranking = 1.6666666666667keywords = pressure (Clic here for more details about this article) |
6/110. ECT in the presence of brain tumor and increased intracranial pressure: evaluation and reduction of risk.The presence of brain tumor and increased intracranial pressure has long been considered an absolute contraindication to electroconvulsive therapy. Recently, however, the American Psychiatric association Task Force Report questioned the absolute nature of this contraindication and recommended a detailed evaluation of the risk-benefit ratio and measures to decrease the risks involved in treatment of affected persons. After a careful review, electroconvulsive therapy was administered to a 61-year-old patient who had severe medication-resistant major depression and a left temporal anaplastic astrocytoma with brain edema. Special attention was given to reduce intracranial pressure and minimize neurologic side effects. A course of eight nondominant unilateral electroconvulsive therapy treatments improved the depression significantly, without serious complications at the 4-month follow-up examination. With appropriate modifications, electroconvulsive therapy may be considered a treatment option even in the presence of clinical evidence of increased intracranial pressure. Further studies are needed to assess and minimize risks of electroconvulsive therapy in association with brain tumor.- - - - - - - - - - ranking = 2.3333333333333keywords = pressure (Clic here for more details about this article) |
7/110. Recurrent neurovascular hypertension: MR findings before and after surgical treatments.A case of recurrent brain stem edema after surgical vascular decompression in a patient with neurogenic hypertension is presented. The surgical treatment resulted in occlusion of the left vertebral artery, stable blood pressure values, and no recurrence of the brain stem edema. MR imaging and MR angiography are excellent methods with which to assess patients suspected of having neurovascular hypertension, both before and after surgical treatment.- - - - - - - - - - ranking = 0.33333333333333keywords = pressure (Clic here for more details about this article) |
8/110. Craniectomy in severe, life-threatening encephalitis: a report on outcome and long-term prognosis of four cases.OBJECTIVE: To report the feasibility of craniectomy with duraplasty in four patients with life-threatening encephalitis and, in particular, their long-term outcome. DESIGN: Report of four cases, analysis of the acute clinical course and neurological long-term sequelae. RESULTS: Generous craniectomy with duraplasty was performed in four patients with life-threatening encephalitis leading to decortication and decerebration. This treatment approach reduced intracranial pressure. The long-term sequelae (1.5-8 years after craniectomy) confirmed its appropriateness, having led to full neurological (cerebral) function, resocialization, and reintegration into their professional life in all four patients. CONCLUSION: Craniectomy with dural augmentation is a treatment approach in cases of severe space-occupying encephalitis, not only saving the patient's life but also leading to favorable long-term outcome.- - - - - - - - - - ranking = 0.33333333333333keywords = pressure (Clic here for more details about this article) |
9/110. Isolated cerebellar edema and obstructive hydrocephalus in a child with cerebral malaria.An important complication of cerebral malaria is increased intracranial pressure which, when severe, is associated with high mortality or neurologic sequelae. We describe a 7-month-old child with cerebral malaria for whom cerebellar edema and obstructive hydrocephalus were initial radiologic findings. Despite significant hydrocephalus, the child had normal intracranial pressure during the course of the infection, and he recovered with minimal sequelae.- - - - - - - - - - ranking = 0.66666666666667keywords = pressure (Clic here for more details about this article) |
10/110. Cerebral blood flow imaging in arteriovenous malformation complicated by normal perfusion pressure breakthrough.BACKGROUND: A patient with normal perfusion pressure breakthrough (NPPB) after surgical removal of an arteriovenous malformation (AVM) was evaluated using single photon emission computed tomography cerebral blood flow (CBF) imaging. CASE DESCRIPTION: A 48-year-old man suffered consciousness disturbance because of an intraventricular hemorrhage and underwent ventricular drainage. cerebral angiography showed a medium-sized AVM in the left parietal lobe. Three months after the ictus, a left parietal craniotomy was performed and total removal of the AVM was achieved. A brain region adjacent to the AVM with preoperative decreased vasoreactivity to acetazolamide showed marked hyperperfusion after AVM excision. Hemorrhage subsequently occurred in this area. CONCLUSION: CBF mapping seems to offer a noninvasive method for the preoperative identification of AVM patients at risk for NPPB, and to allow for early postoperative diagnosis of NPPB.- - - - - - - - - - ranking = 1.6666666666667keywords = pressure (Clic here for more details about this article) |
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