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

The intracranial pressure (ICP) irregularities, i.e., pressure waves, were studied in dogs with experimental subarachnoid hemorrhage. Animals were lightly anesthetised, immobilised with panchronium bromide and respirated artificially. Subarachnoid infusion of hemolysed red blood cells was used to induce intracranial hypertension. Recordings of both systemic blood pressure (SBP) and ICP were undertaken continuously. After the infusion of hemolysed blood the ICP increased gradually and reached to 50 mmHg or more at the terminal stage. The pressure waves were classified into two types, i.e., the fast waves and the slow waves. The fast waves had a duration of 10-30 seconds, being accompanied by a marked increase of the SBP. The slow waves gradually increased their frequency and the duration, when the ICP increased more than 20 mmHg or more resembling plateau-like waves. Postmorten examination showed hemogenic meningitis at the base of the brain, especially the medulla oblongata. The results suggest that studies of the slow waves is of value for analyzing plateau waves.
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PMID:[Intracranial pressure irregularities in experimental subarachnoid hemorrhage]. 395 62

We report 3 cases of severe syphilitic neuro-meningitis during the secondary stage: acute transverse dorsal myelitis with permanent paraplegia in a 17 year old teenager (case no. 1), uveo-meningitis with intracranial hypertension and diminished vision in a 52 year old woman (case no. 2), lower medulla lesion in a 46 year old man (case no. 3). The diagnosis was based upon highly positive serological tests for syphilis, associated with a compatible clinical context and meningitis in CSF specimens. Treatment was successful in cases nos. 2 and 3, unsuccessful in case no. 1 due to the irreversible character of the medullar lesions. Based on these 3 cases, the following points are discussed: the relatively atypical clinical character in the current context, the difficulties of the diagnosis, and the treatment regimens recommended for neurological syphilis. Despite the rarity of such cases, their extreme severity early in the secondary stage strongly implies the necessity for prevention by detecting and treating early syphilis. Attention is drawn upon the importance of doing serological tests for syphilis when presented with any atypical neurological situation.
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PMID:[Early manifestations of neuromeningeal syphilis. Review of the literature apropos of 3 severe forms]. 400 28

Thirty-six patients with different clinical and topographic forms of cerebromeningeal tuberculosis: meningitis, meningo-encephalitis, tuberculoma, abscess and their complications, were investigated by CT scans. Whereas standard films allow diagnosis of intracranial hypertension, other neurological examinations are very insufficient when compared with CT imaging, a non-invasive procedure which provides presumptive signs of a tuberculous lesion and thus assists diagnosis, and assessment and follow up of results of treatment. Meningitis and meningo-encephalitis are seen as isodense images of cisternae of base of skull with marked increase after contrast, which may provoke the appearance of hyperdense nodules. More or less widespread hypodensities are provoked by meningoencephalitis, cerebral tuberculosis appearing as an iso- or hyperdense mass forming an annular shape after contrast. Calcification is a rare finding and appears as punctiform zones in the center of a tuberculoma, while a tuberculous abscess has the identical appearance to that of a nodular tuberculoma.
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PMID:[Cerebromeningeal tuberculosis. X-ray computed tomographic aspects apropos of 36 cases]. 408 31

The concentration of alpha-amino nitrogen (a measure of total amino-acids) was estimated in 58 samples of cerebrospinal fluid in which other findings were normal. Values for lumbar and ventricular cerebrospinal fluid in adults, and lumbar cerebrospinal fluid in children, are reported. A relationship was found between the concentrations of alpha-amino nitrogen in lumbar cerebrospinal fluid and in plasma.Alpha-amino nitrogen was also estimated in 79 samples of fluid from patients with meningitis, cerebral tumour, multiple sclerosis, and other neurological disorders. High concentrations were found in meningitis, spinal block, and xanthochromic fluids. In cerebral tumours, the concentrations were mostly normal. Low concentrations were found in children, in many cases of multiple sclerosis, and in benign intracranial hypertension. In some cases, the changes cannot yet be explained.
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PMID:Alpha-amino nitrogen in cerebrospinal fluid and its alterations in meningitis, multiple sclerosis, and some other neurological disorders. 584 5

The authors discuss the case of a 15-year-old girl suffering from intra-cranial hypertension. Neuroradiological examinations do not reveal any obstruction in the cerebral spinal fluid circulation. The CSF cylologic examination was the first to give etiological indications, showing the existence of malignant cells which the cerebral biopsy later enabled us to classify as glioblastoma. This case affords an opportunity to recall the three stages of the diagnosis: first, intra-cranial hypertension; secondly, chronic meningitis; thirdly, cytological difficulties in the examination of CSF in patients having undergone neuro-radiological examinations.
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PMID:[The interest of CSF examinations in the etiological diagnosis of intracranial hypertension (author's transl)]. 628 17

Hydrocephalic patients with shunt infections frequently develop multiple cerebrospinal-fluid-density cysts that cause midline shift and life-threatening intracranial hypertension and respond poorly, if at all, to shunt diversion of cerebrospinal fluid. These cysts have been considered to represent multiloculation of the ventricular system by ependymal adhesions and veils resulting from ventriculitis. Studies using an experimental model of E. coli meningitis/ventriculitis in the hy-3 mouse suggest these cysts: (1) develop by the coalescence of lakes of white-matter edema, (2) grow to large size entirely within the periventricular white matter, and (3) cause pseudoloculation of the ventricle by compression from without. The so-called intraventricular septa or "veils" are the ependyma displaced inward by subependymal cysts or sheets of residual pericystic white matter. This finding permits better interpretation of computed tomographic images depicting persistent enlargement of the so-called multiloculations despite functioning ventricular shunt catheters, the multiplicity of cysts, and the white-matter location of these cysts.
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PMID:Periventricular white-matter cysts in a murine model of gram-negative ventriculitis. 641 Jul 72

In a group of forty cases of cysticercosis of the central nervous system, 59% presented with intracranial hypertension due to obstructive hydrocephalus. Ventricular or cisternal cysts, and chronic cysticercus meningitis were the most common causes of hydrocephalus. Seizures occurred in 40% of the patients, in one-half of them in association with CT-detected parenchymatous cysts. In 20% of the cases progressive mental deterioration was the main clinical feature, at times associated with hydrocephalus. CT scan provided the highest diagnostic yield, being abnormal in 90% of cases. Long term prognosis was poor, with a mortality rate of 38% over a 40-month follow-up period. The most common cause of death (60%) was meningitis. CSF shunting is the treatment of choice for hydrocephalus, irrespective of its mechanism. Surgical resection is indicated in some cases with a single superficial (cortical) or posterior fossa cyst. Supratentorial cysts carry a relatively benign prognosis.
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PMID:Cysticercosis of the central nervous system: clinical and therapeutic considerations. 647 Jul 20

The association between admission coma score and eventual outcome was assessed using a coma scale developed for children with a variety of central nervous system injuries. As opposed to the Glasgow coma scale, this scale does not demand assessment of verbalization, and thus can be applied to the preverbal or previously intubated child. Cortical function is graded from 6 (purposeful, spontaneous movements) to 0 (flaccid), and brainstem function is graded from 3 (intact) to 0 (absent and apneic). Maximum total score is 9. In 91 children treated for intracranial hypertension, the association was moderately good. The scale was better in predicting the outcome of patients with hypoxic encephalopathy and head trauma than that of patients with Reye's syndrome, meningitis, or encephalitis. No child with a score of less than 3 survived in spite of intensive therapy. Most of these children were flaccid with depressed or absent brainstem reflexes. No child with flaccidity on admission survived.
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PMID:Coma scale for use in brain-injured children. 650 97

CSF fistulas are a major complication of head injury but also occur spontaneously or symptomatically in connection with tumours of the skull base, empty sella syndrome, ethmoidal encephalomyelocele, intracranial hypertension or postoperatively in connection with operations on skull base tumours or ENT operations. Their main risk is the possibility of meningitis. The main clinical symptom is CSF leakage from the nose, but meningitis may be the first manifestation. Isotope cisternography and metrizamide CT cisternography are the most important methods for precise localization, sometimes also for verification of a suspected fistula. Most traumatic CSF fistulas of the frontal and ethmoidal region have to be treated operatively. The method of choice is the transfrontal approach and the closure of the fistula opening using a pedicled pericranial flap or fascia lata graft. Most sphenoidal fistulas have to be treated by packing the sphenoidal sinus with muscle. The treatment methods of the rare spontaneous and symptomatic CSF fistulas are also described. The results of operative treatment are satisfactory. About 6% recurrences, which as a rule can be cured by reoperation, and a mortality rate of about 1-3% seem to be an acceptable price for prevention of an otherwise unavoidable and oftenly deadly meningitis. Future efforts are necessary to improve the operative technique in order to reduce the incidence of anosmia. Our descriptions and advice are based not only on literature reports but also on our own experiences with a combined material of 237 cases operated on for rhinorrhea.
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PMID:Traumatic, spontaneous and postoperative CSF rhinorrhea. 653 67

The authors report the results of intracranial pressure measurements in 3 cases with pneumococcal meningitis. Severe intracranial hypertension should be quickly investigated and treated in cases rapidly leading to coma.
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PMID:[Intracranial hypertension in pneumococcal meningitis. Reality, risks, treatment]. 666 94


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