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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a series of 30 older patients shunted for symptomatic hydrocephalus, we found 3 with a head circumference at or greater than the 98th percentile. In 2, we demonstrated deterioration over 6 and 12 months by serial videotaping of gait and neuropsychological testing. In the 3rd, serial lumbar punctures over a 6-month period gave temporary improvement. In each, CTs showed ventriculomegaly without transependymal flow. One patient had an Arnold-Chiari type I abnormality identified by MRI. All had systemic hypertension. CSF pressure monitoring showed CSF pressure greater than 15 mm Hg 39% of the time in 1 patient, and 100% in another. All improved with ventriculoperitoneal shunting. Patients with probable compensated congenital hydrocephalus who functioned well throughout most of their lives may become symptomatic as they age but improve with shunt surgery. The head circumference should be measured in all older hydrocephalic patients.
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PMID:Symptomatic congenital hydrocephalus in the elderly simulating normal pressure hydrocephalus. 258 76

The authors present the analysis of 27 computed tomography scans (CT) of 18 children which were divided in three groups according to clinical and tomographic criteria. Group 1 was characterized mainly by epilepsy and calcifications. Group 2 was characterized by intracranial hypertension and several tomographic aspects: edema, cysts and nodules were seen in three patients; hydrocephaly and calcifications were seen in two patients and CT was normal in one patient. Group 3 had patients with epilepsy or headache and variable tomographic patterns. The results are discussed based on the available literature.
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PMID:[Cranial computed tomography aspects in neurocysticercosis in childhood]. 259 7

A 6 year-old girl was admitted with symptoms of increased intracranial pressure. These manifestations spontaneously disappeared, then recurred a few days later, leading to the discovery of hydrocephalus with increased protein concentration in the cerebrospinal fluid. A cervical spine tumor was diagnosed by magnetic nuclear resonance examination. The patient was successfully operated on for a benign astrocytoma. In the absence of a cerebral tumor, cervical spinal tumors should be looked for when recurring symptoms of intracranial hypertension occur in a child.
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PMID:[Intermittent intracranial hypertension revealing a tumor of the cervical spine]. 260 27

A case of severe vasoconstriction treated as cardiorespiratory collapse in a woman given extraamniotic PGF2alpha for midtrimester abortion is described, with comments on management of this rare reaction. The patient was having elective termination because of confirmed spina bifida with hydrocephalus by ultrasound and elevated AFP at 18 weeks gestation. She was given a 4 mg test dose of PGF2alpha (Dinoprost, Upjohn Pty, Ltd) in viscous gel (Tylose MH300, Hoechst Australia Ltd) via extraamniotic Foley catheter. She immediately developed dyspnea, abdominal and breast pain, hypotension of 50 mm Hg systolic, peripheral vasoconstriction, cyanosis and confusion. She was treated with iv Hartmann's solution 600 ml, oxygen 8 1/min, and sc adrenaline 1/1000 0.5 ml. She seemed to improve after receiving 500 ml 3.5% polygeline colloid (Haemaccel, Behringwerke AG), and 5 ml 1/10,000 adrenaline iv, as her systolic blood pressure rose to 70 mm Hg measured indirectly. 500 ml more iv colloid was given, and blood pressure rose to 90 mm Hg. Then she suddenly deteriorated with florid pulmonary edema. Oxygen saturation fell and positive pressure ventilation was begun. She was given furosemide 160 mg iv and hydrocortisone 500 mg iv. Anaphylactic reaction was ruled out on the basis of blood count; amniotic fluid embolism was ruled out because of minor changes in clotting parameters. The events seen here most likely occurred as a result of inadvertent injection of PGF2alpha into the arterial circulation, causing increased pulmonary arterial pressure and vascular resistance, systemic vasoconstriction interpreted as hypotension, all exacerbated by adrenaline and exogenous fluid load. Severe hypertension after extraamniotic PGF2alpha has been reported before in a similar case of apparent hypotension treated with agents to increase blood pressure. PGF2a should not be used without facilities to treat such adverse reactions.
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PMID:Cardiorespiratory collapse and pulmonary oedema due to intravascular absorption of prostaglandin F2 alpha administered extraamniotically for midtrimester termination of pregnancy. 260 61

Simultaneous overnight recordings of intracranial pressure (ICP) and electroencephalography (EEG) were conducted on 85 neurosurgical patients with intracranial hypertension and/or ventriculomegaly. Intracranial pressure waves were classified into five types according to the pattern of appearance, and their correlation with sleep cycles and clinical conditions of patients were investigated. A-waves appeared exclusively in patients with long-standing intracranial hypertension, and episodic B-waves appeared in patients with chronic hydrocephalus or a postoperative tumor-free condition. When these episodic pressure waves appeared, the patients were conscious and sleep cycles including REM stage were observed. Persistent, high pressure B-waves were seen mostly in patients with an acute phase of intracranial hemorrhages. The consciousness of these patients ranged from drowsy to stupor. EEG showed alternate appearances of light sleep and waking rhythms in accordance with cyclic oscillations of B-waves which coincided with periodic, apneic respiratory rhythms. When markedly regular B-waves of moderately high pressure appeared continuously, the patients were severely impaired in consciousness and were mainly in a subacute phase of intracranial hemorrhages. EEG showed continuous slow activities and sleep stages were not scored in these patients. No characteristic clinical features were found in patients whose ICP remained within normal range without pressure waves throughout the recording.
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PMID:Overnight recordings of intracranial pressure and electroencephalography in neurosurgical patients. Part I: Intracranial pressure waves and their clinical correlations. 260 35

Changes in intracranial pressure (ICP) during sleep were investigated in 37 patients with chronic intracranial hypertension or chronic hydrocephalus, in whom episodic pressure waves characterized by A-waves or episodic B-waves were seen in Part I of this paper. The patients were conscious, and sleep stages including REM sleep were observed in all of them. During non-REM sleep, ICP significantly rose in Stage II on many occasions, and was always lower in Stage IV than in other sleep stages. A marked elevation of ICP was seen in REM sleep. ICP changes during REM sleep were characterized by frequent appearances of the pressure waves; 88.9% of A-waves and 95.1% of episodic B-waves appeared during REM sleep. The initiation of REM sleep scored on EEG began 1 to 2 minutes prior to or at the onset of the episodic pressure waves. The episodic pressure waves are assumed to be induced by the intracranial conditions in REM sleep, when increased brain activity and reduced sympathetic tone are known to occur simultaneously.
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PMID:Overnight recordings of intracranial pressure and electroencephalography in neurosurgical patients. Part II: Changes in intracranial pressure during sleep. 260 36

Primary Teratocarcinoma of Pineal Region. A case of a 12 year old boy admitted for intracranial hypertension of sudden onset has been reported. CT scanning and MR showed a triventricular hydrocephalus due to a space-occupying lesion of the pineal region. Tonic-clonic fits of the upper limbs and Parinaud syndrome were followed by loss of consciousness. Intervention I: ventriculo-peritoneal shunt with sampling of CSF and assay for beta-HCG, alpha FP and CEA, which proved negative. Cytology for neoplastic cells in cerebrospinal fluid was negative. Intervention II: grossly total removal of the tumor. This was followed by partial remission of Parinaud syndrome, total remission of the hypertensive symptoms and discharge on day 12. The 3 cm. whitish-pink tumor of rubbery consistency proved on histological examination to be a teratocarcinoma. The patient was further submitted to chemioterapy and irradiation but died 7 months after the second intervention. This is a rare tumor, much more than teratoma of the pineal gland, which is relatively frequent. It is interesting histologically because of the presence not only of chondroid and mesenchymal portions but also of adamantinomatous rudiments and of epithelial zones resembling embryonal carcinoma of the testis.
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PMID:[Primary teratocarcinoma of the pineal region]. 264 Nov 58

Binswanger's encephalopathy is reviewed in respect to history, computed tomography, magnetic resonance imaging, epidemiology, pathology, clinical picture, laboratory findings, differential diagnosis, and treatment. The various viewpoints on the pathogenesis of the process are discussed, in particular the role of ischemia, vascular disease, high blood pressure, lacunar infarction, hypoxia, edema, and hydrocephalus. The white matter hypomyelination of congophilic angiopathy and Alzheimer's disease should provide clues. A unifying hypothesis has not been attained.
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PMID:Binswanger's encephalopathy: a review. 265 69

Of 18 pregnancies in 11 renal transplant recipients, three were terminated and in the remaining 15 (in 8 women) there were 10 live births (including one set of twins), five intrauterine deaths, and one spontaneous abortion. Graft function deteriorated in six women, from obstruction of the transplanted ureter in two, recurrent glomerulonephritis in two, rejection in one, and pelvi-ureteric junction obstruction in one. Hypertension worsened or developed in all but one of the pregnancies and proteinuria appeared in eight. Of the 10 live births only one reached 38 weeks gestation (mean 35 weeks) and four neonates were small for gestational age. One infant died early from intraventricular hemorrhage and hyaline membrane disease, one fetus had hydrocephalus, and the others were normal. Factors associated with a poor fetal outcome were deterioration in graft function during pregnancy, pre-existing hypertension, or the development of hypertension before the third trimester.
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PMID:Problems associated with pregnancy in renal allograft recipients. 266 32

The concepts of serous meningitis, pseudotumour cerebri, hypertensive meningeal state and otitic hydrocephalus have not been considered historically as synonyms nor can they be superimposed on what is currently known as Benign Intracranial Hypertension (BIH). BIH is a syndrome of intracranial hypertension with no clinical, radiological or analytical evidence for the existence of focal or general neurological lesions or hydrocephalus, and which has a self-limiting "benign" development. At present, the diagnostic criteria usually accepted are: 1. Symptoms and signs of intracranial hypertension. 2. Absence of focal neurological symptoms and signs. 3. Absence of radiologically verified cerebral lesion. 4. C.S.F. of normal composition and high pressure. The requirement of other criteria for the diagnosis of BIH, such as angiography, to eliminate the possibility of thrombosis of venous sinuses, or continuous monitoring of C.S.F. pressure, is controversial.
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PMID:[Historical and current concept of benign intracranial hypertension]. 269 89


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