1/10. pseudotumor cerebri caused by all-trans-retinoic acid: a case report.pseudotumor cerebri is a condition characterized by increased intracranial pressure with normal cerebrospinal fluid composition. It is usually associated with many medical conditions and drugs. It has been reported that all-trans-retinoic acid can induce pseudotumor cerebri. The authors report a 35-year-old patient diagnosed with acute promyelocytic leukemia who developed pseudotumor cerebri after receiving all-trans-retinoic acid. The patient was treated with 60 mg/day of all-trans-retinoic acid. Two weeks later, she had severe headache and blurred vision. The neurological examination revealed papilledema and decreased visual acuity. Other physical examinations were unremarkable. brain CT was normal. Additionally, lumbar puncture was performed and the CSF finding was normal except for high CSF pressure. According to modified Dandy criteria, the diagnosis was pseudotumor cerebri. The patient's symptoms disappeared after all-trans-retinoic acid was discontinued. To our knowledge, this is the first case report in thailand.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/10. pseudotumor cerebri complicating measles: a case report and literature review.A previously healthy 8-year-old girl patient was referred with the complaints of severe headache associated with nausea and vomiting. Three weeks prior to her admission, she had measles manifested with fever and typical skin eruptions. Fundoscopic examination revealed bilateral swollen optic discs with tortuous blood vessels. Other physical examinations were unremarkable, except for photophobia. Lumbar puncture demonstrated a cerebrospinal fluid opening pressure of 30 cm H(2)O, no cells, normal levels of glucose and protein. serum measles immunoglobulin m level was elevated (183 AU). Our further investigations revealed that the patient had pseudotumor cerebri (PTC) following measles infection.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
3/10. Benign intracranial hypertension in pregnancy.Benign intracranial hypertension, an unusual case of headaches, was associated with pregnancy in a gravid female with the chief complaint of headache. Symptoms resolved after three days of prednisone therapy. In benign intracranial hypertension, the possibilities of intracranial mass lesions, intracranial infection, obstruction of the cerebral ventricles, and hypertensive encephalopathy are excluded by evaluation with skull films, computerized axial tomography, electroencephalography and lumbar puncture. The only symptom may be headache and the only physical sign, papilledema. Therefore, neurological examination must include visualization of the fundi.- - - - - - - - - - ranking = 0.10410718822373keywords = physical (Clic here for more details about this article) |
4/10. Cushing's disease in childhood: benign intracranial hypertension after trans-sphenoidal adenomectomy. Case report.A 7-year-old girl presented with the physical and endocrinological stigmata of Cushing's disease. An adrenocorticotropic hormone (ACTH)-producing pituitary microadenoma was excised. Three weeks after trans-sphenoidal adenomectomy, the patient developed benign intracranial hypertension. Although ACTH levels had decreased to normal, the serum cortisol had fallen to subnormal levels. The child responded to exogenous steroid therapy, which was gradually tapered and discontinued after 5 months. Normal pituitary and adrenal functions persist 2 years later.- - - - - - - - - - ranking = 0.10410718822373keywords = physical (Clic here for more details about this article) |
5/10. Multiple suture synostosis, macrocephaly, and intracranial hypertension in a child with alpha-D-mannosidase deficiency. Case report.The authors present an unusual case in which increased intracranial pressure developed because of multiple-suture craniosynostosis and megaloencephaly in a child with a previously undiagnosed lysosomal storage disease, alpha-D-mannosidase deficiency. This 3-year-old boy presented with a history of frequent naps, headaches, florid papilledema, enlarged head (> 95th percentile), elevated opening pressure by lumbar puncture, a "beaten copper" appearance on skull radiographs, and no hydrocephalus. Multiple synostectomies were performed. Postoperatively, the child's headaches and papilledema resolved and his level of physical activity increased dramatically. The authors discuss the paradoxical presentation of prematurely fused sutures and macrocrania in light of this lysosomal storage disease and its subsequent management.- - - - - - - - - - ranking = 0.10410718822373keywords = physical (Clic here for more details about this article) |
6/10. Colloid cyst of the third ventricle.BACKGROUND: Colloid cyst of the third ventricle has rarely been reported in the ophthalmic literature. The incidence is about one per 1000 in asymptomatic patients and accounts for 0.55 to 2 percent of all intracranial tumors. Although it is an uncommon benign tumor, nearly half of symptomatic patients present with papilledema and hydrocephalus. Consideration of this intracranial tumor should be included in the differential diagnosis of papilledema and apparent unilateral disc edema. methods: A patient with highly asymmetrical papilledema and vague visual symptomatology involving the right eye was studied. Computer axial tomography (CT) without contrast enhancement revealed a colloid cyst of the third ventricle. Typical symptoms of the condition include headaches, nausea, vomiting, visual obscuration, transient diplopia and weakness of the lower extremities, which are due to acute hydrocephalus caused by increased intracranial pressure from cystic obstruction of the foramen of Monro. Intermittency of symptoms is characteristic of this lesion. RESULTS: The patient underwent frontal craniotomy with total tumor excision and reopening of the cerebrospinal fluid pathway. CONCLUSIONS: Colloid cyst of the third ventricle discovered incidentally on CT in asymptomatic patients with no evidence of hydrocephalus can be monitored periodically. If symptomatic, neurosurgery is usually indicated since prolonged increased intracranial pressure can lead to mental and physical deterioration as well as sudden death.- - - - - - - - - - ranking = 0.10410718822373keywords = physical (Clic here for more details about this article) |
7/10. Idiopathic intracranial hypertension in a young child without visual symptoms or signs.A 7-year-old boy presented with a 4-week history of daily headache. His parents reported that he was unable to attend school the week prior to presentation. Intermittent nausea without vomiting was reported, but no blurred vision, photophobia, or diplopia were described. There was no history of trauma or recent systemic illness. The physical examination showed mild neck discomfort, no papilledema, and normal cranial nerve, motor and sensory functioning. Both a CT scan of the sinuses and an MRI of the brain were normal. Although the opening pressure was elevated, the cerebrospinal fluid was also normal. In previous accounts of idiopathic intracranial hypertension in children, concomitant papilledema, visual symptoms and/or palsy of the sixth cranial nerve are described. This case demonstrates that idiopathic intracranial hypertension in a young child can present as a daily headache without any visual symptoms or signs.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
8/10. Cerebral venous thrombosis occurring during an ectopic pregnancy and complicated by intracranial hypertension.Thrombosis of the cerebral dural sinuses and veins has been described since the early 19th century. Clinically the process is characterised by diverse symptomatology and physical findings and in spite of advances in diagnostic radiological techniques it remains an under-recognised condition. It has been most commonly associated with sepsis, trauma, pregnancy, the puerperium and many other hypercoagulable states. We describe an apparently unique case of sagittal sinus thrombosis occurring during an ectopic pregnancy. This was subsequently complicated by intracranial hypertension in spite of clinical improvement and magnetic resonance imaging (MRI) evidence suggesting a return of venous patency. The clinical presentation, radiological features and management is discussed.- - - - - - - - - - ranking = 0.10410718822373keywords = physical (Clic here for more details about this article) |
9/10. Non-organic failure to thrive complicated by benign intracranial hypertension during catch-up growth.Severe non-organic failure to thrive associated with physical and emotional abuse including food deprivation was diagnosed in a 9-y-old boy. Rapid catch-up growth (weight and height) followed change of carer. Recovery of poor growth hormone response to clonidine stimulation was associated with benign intracranial hypertension accompanied by headaches and vomiting. Possible mechanisms are discussed.- - - - - - - - - - ranking = 0.10410718822373keywords = physical (Clic here for more details about this article) |
10/10. Pseudopapilledema and congenital disc anomalies in growth hormone deficiency.optic nerve hypoplasia is a congenital disc anomaly associated with growth hormone deficiency (GHD). pseudotumor cerebri is an adverse event associated with growth hormone treatment (hGH) and manifested by increased intracranial pressure and papilledema. Pseudopapilledema is a generic ophthalmologic term encompassing several conditions, including congenital disc anomalies. It is benign and can be distinguished from papilledema by physical examination. The objective of this report is to document that congenital disc abnormalities, which can be confused with papilledema, occur in children with GHD. Three patients with GHD had fundoscopic examinations suggestive of papilledema and possibly pseudotumor cerebri. The abnormal optic nerves were characteristic of pseudo-papilledema, and appear to be a variant of optic nerve hypoplasia. The finding of optic disc abnormality during hGH may reflect pseudo-papilledema and not pseudotumor cerebri. Of equal importance, the reported patients indicate that the finding of pseudopapilledema in short children should suggest the possibility of GHD.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
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