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

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.
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PMID:Benign intracranial hypertension in pregnancy. 45 93

Seven children studied because of clinical macrocephaly and suspected hydrocephalus ultimately proved to have megalencephaly apparently due to an increase in sagittal sinus venous pressure as established from infusion studies. Unexplainably, these patients were all males. All were seen initially between 2 and 8 months of age. Head enlargement exceeded two standard deviations in all seven. Pneumoencephalography, ventriculography, or computerized tomography demonstrated normal or minimally enlarged ventricles that did not progress in size. Isotope cisternography was abnormal. Studies of CSF formation and absorption demonstrated normal absorption rates but high calculated sagittal sinus pressures. Though therapy was usually not required, in one unusual infant, severe progressive macrocephaly with minimal hydrocephalus required a shunt. Another had a transient episode of acute hydrocephalus associated with a low CSF absorption rate and ventricular enlargement. In this report, we review the intracranial hydrodynamics of benign intracranial hypertension (BIH), communicating hydrocephalus, and the pathogenesis of megalencephaly. Benign intracranial hypertension and the type of megalencephaly demonstrated by our patients appear to develop similarly except that the presence of open cranial sutures may allow a transient nonhydrostatic loading of brain parenchyma in infants, resulting in mild, nonprogressive macrocephaly.
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PMID:Megalencephaly in infants and children. The possible role of increased dural sinus pressure. 64 83

Benign intracranial hypertension (BICH) is a rare adverse event. We report the case of a 31-year-old female drug addict who had been seropositive for HIV since 1987. She had stage IV C1 AIDS, and was receiving intravenous amphotericin B for generalized cryptococcosis with no neuromeningeal involvement. She developed BICH that regressed when the antifungal drug was withdrawn and treatment for cerebral edema was started. BICH is a clinical entity involving intracranial hypertension with no focal neurological signs or detectable intracranial lesion. The manifestations include headache, transitory or permanent visual disturbances (diplopia, loss of visual acuity) and the perception of intracranial noise. The cerebrospinal fluid is under increased pressure but the composition is normal. The eye fundus examination shows papillary edema, and the neuroradiological workup is normal. BICH can only be diagnosed once an expansive intracranial process, neuromeningeal infection, and non-communicative hydrocephalus have been ruled out. In the majority of cases, no etiology is found. Such cases of idiopathic BICH usually occur in overweight young women, although drugs can be implicated. Amphotericin B has not previously been held responsible for BICH. On the basis of this observation, we present a review of the literature.
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PMID:[Drug-induced benign intracranial hypertension. Apropos of a case with amphotericin B. Review of the literature]. 129 80

Benign intracranial hypertension (also called pseudotumor cerebri, otitic hydrocephalus, or meningeal hydrops) is a syndrome of markedly elevated intracranial pressure in the absence of intracranial mass, inflammation, or obstruction. Numerous disease processes and medications have been associated with it. However, renal failure has not been documented as an associated condition. In this report, the case of a 27-year-old Native American man with chronic renal failure of unknown etiology is described, with new-onset headache, papilledema, and elevated intracranial pressure. After normal cerebrospinal fluid, computed tomography, and magnetic resonance imaging studies, a diagnosis of benign intracranial hypertension was made. Despite repeated lumbar punctures with cerebrospinal fluid removal, the patient's headaches persisted, and intracranial pressures remained in the 200 to 400 mm H2O range. After initiation of hemodialysis due to progressive deterioration of renal function, the patient's headaches became less severe and eventually disappeared. This case represents a unique association of chronic renal failure with benign intracranial hypertension.
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PMID:Benign intracranial hypertension and chronic renal failure. 152 75

Benign intracranial hypertension or pseudotumor cerebri is an collective term for a number of diverse syndromes characterized by increased intracranial pressure. Neither intracranial mass nor ventricular dilatation is observed in this disorder. Moreover, the pathogenesis of this syndrome has yet to be determined. We report a case of 36-year-old female diagnosed as benign intracranial hypertension, who has developed superior sagittal sinus thrombosis and dural AV fistula during the follow up period. The patient was pointed out to have papilledema and elevated intracranial pressure six years ago. Although she was examined by both DSA and CT scan, no abnormal intracranial lesions were observed. Consequently, she was diagnosed as the benign intracranial hypertension and had been followed as an out patient. Three years later, lumboperitoneal shunting was performed because of severe headache and visual impairment. Postoperatively, the patient had been well for two years. Recently, occipital headache recurred and she was readmitted to our hospital. MRI studies demonstrated dilated vessels in the right occipital area. Additionally, angiograms revealed not only the superior sagittal sinus thrombosis but also the rich network of dural AV fistula adjacent to the occlusion. According to those results, the superior sagittal sinus was supposed to have the incomplete occlusion or delayed blood flow that were not observed by DSA, MRI and CT scan performed previously. Those occlusive change in the superior sagittal sinus impeded the CSF absorption and elevated the pressure of venous inflow, then the arterio-venous communication has been developed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An unusual case of superior sagittal sinus thrombosis accompanied with dural AV fistula]. 179 2

We describe 10 patients with idiopathic intracranial hypertension who did not have papilledema. Idiopathic intracranial hypertension without papilledema, although rarely reported, may well be a clinically important headache syndrome. Historical and demographic features of patients with idiopathic intracranial hypertension without papilledema are similar to those of patients with papilledema. Obese women with chronic daily headache and symptoms of increased intracranial pressure, pulsatile tinnitus, history of head trauma or meningitis, an empty sella on imaging studies, or a headache that is unrelieved by standard therapy should have a diagnostic lumbar puncture. Findings from laboratory and neurologic investigations are normal in most patients with idiopathic intracranial hypertension without papilledema. Initial management should include removal of possible inciting agents, weight loss if applicable, and standard headache therapy. Lumbar puncture and diuretic therapy should precede a trial of corticosteroids. Surgery (lumboperitoneal or ventriculoperitoneal shunt or perhaps optic nerve sheath fenestration) may be indicated for prolonged incapacitating headache that is not responsive to medical management or lumbar puncture.
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PMID:Idiopathic intracranial hypertension without papilledema. 172 57

Pseudotumor cerebri, or benign intracranial hypertension, is known to produce visual symptoms. Central retinal vein occlusion has been linked with pseudotumor cerebri but rarely as an initial manifestation. We describe a 46-year-old patient--who was obese and mildly hypertensive with bilateral central retinal vein occlusions--who was subsequently diagnosed as having pseudotumor cerebri. In patients with simultaneous bilateral central retinal vein occlusions, unusual underlying systemic conditions such as pseudotumor cerebri should be considered in the diagnostic evaluation.
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PMID:Bilateral central retinal vein occlusion as an initial manifestation of pseudotumor cerebri. 202 13

The incidence of permanent visual loss in Benign Intracranial Hypertension (BIH) was assessed. 17 out of 100 patients with BIH had permanent visual loss which was severe in only three cases. We tried to identify the risk factors in this group of patients. Statistical analysis showed that the following factors were related with a bad visual outcome: atrophy of the disc, visual loss and field defects (other than enlargement of the blind stop) present at the first exam; delay of treatment; BIH in patients older than 40 years and, overall, presence of systemic hypertension. The identification of this risk factors may help in planning the treatment of the disorder.
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PMID:[Prognostic factors in benign intracranial hypertension]. 209 18

Previously, the authors reported that objective pulsatile tinnitus can be the major or only manifestation of benign intracranial hypertension. This report updates the authors' experience with 31 patients managed over the past 7 years. Benign intracranial hypertension should be suspected in all patients with pulsatile-objective tinnitus, especially when the patient is a young, obese female with headaches and/or visual disturbances. Papilledema and small ventricles or an empty sella on computerized tomography are almost diagnostic. The diagnosis is confirmed by elevated spinal fluid pressure on lumbar puncture. In such patients, angiography is not indicated. Furosemide and acetazolamide are very effective. Ligation of the internal jugular vein is contraindicated.
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PMID:Objective tinnitus in benign intracranial hypertension: an update. 229 99

Idiopathic intracranial hypertension (pseudotumor cerebri) is a condition that occurs predominantly in obese women. It consists of elevated spinal fluid pressure, normal spinal fluid contents, papilledema, and headaches with normal imaging studies. Long lists of putative causes and associations have arisen, many consisting of individual case reports. We did a retrospective case-control study on 40 patients and 39 age- and sex-matched control subjects to examine the incidence of these associated conditions. Our results are only suggestive due to the small sample size; however, obesity and recent weight gain occurred more commonly in patients with idiopathic intracranial hypertension than in control subjects. All forms of menstrual abnormalities, incidence of pregnancy, antibiotic use, and oral contraceptive use were equal in both groups. A larger multicenter study will be needed to more completely characterize the risk factors for this condition.
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PMID:The search for causes of idiopathic intracranial hypertension. A preliminary case-control study. 231 Mar 15


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