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

Idiopathic intracranial hypertension (IIH) is a syndrome of unknown etiology characterized by elevated intracranial pressure (ICP). Although a stenosis of the transverse sinus has been observed in many IIH patients, the role this feature plays in IIH is in dispute. In this paper, a lumped-parameter model is developed for the purpose of analytically investigating the elevated pressures associated with IIH and a collapsible transverse sinus. This analysis yields practical predictions regarding the degree of elevated ICPs and the effectiveness of various treatment methods. Results suggest that IIH may be caused by a sufficiently collapsible transverse sinus, but it is also possible that a stenosed sinus may persist following resolution of significant intracranial hypertension.
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PMID:Idiopathic intracranial hypertension and transverse sinus stenosis: a modelling study. 1707 63

Idiopathic intracranial hypertension is a rare syndrome characterised by prolonged elevation of intracranial pressure in the absence of hydrocephalus, intracranial mass lesion or infection, and with increased cerebrospinal fluid pressure but a normal composition. We report a case of uncontrolled idiopathic intracranial hypertension successfully managed using an intrathecal catheter for analgesia in labour and delivery as well as temporary control of intracranial pressure.
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PMID:Anaesthetic management of uncontrolled idiopathic intracranial hypertension during labour and delivery using an intrathecal catheter. 1722 12

Idiopathic intracranial hypertension is an enigmatic disorder of elevated cerebrospinal fluid pressure. In adulthood, patients are typically obese women of childbearing age; however, in young children the clinical picture is strikingly different, indicating age-related differences in the aetiology of idiopathic intracranial hypertension. To investigate this phenomenon, we analysed the clinical details of 15 pre-pubertal children with the diagnosis of idiopathic intracranial hypertension. Evaluating the date of initial presentation, we discovered a distinct seasonal variation. Ten patients presented between November and March, thus coinciding with the typical season of paediatric viral and bacterial infections in Germany. Therefore, we suggest an association between intracranial hypertension and possibly concurrent infections in these children. Moreover, eight children presented only with ophthalmologic findings without any other obvious symptoms, raising questions regarding the incidence of undetected cases, particularly in this age group.
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PMID:Seasonal variation and atypical presentation of idiopathic intracranial hypertension in pre-pubertal children. 1791 6

Pseudotumor cerebri (PTC) is a seldom seen entity characterized by signs and symptoms associated with the intracranial hypertension (IH) without obvious causes. Some medical disorders and exogenous agents have been implicated in the development of PTC. Danazol is a popular gonadotropin inhibitor used for the treatment of endometriosis, breast disease and hereditary angioedema. While PTC has been occasionally reported in patients receiving danazol treatment, it is barely mentioned in those who discontinued danazol therapy abruptly. Here we report a case of IH developed soon after the withdrawal of danazol.
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PMID:Intracranial hypertension associated with danazol withdrawal: a case report. 1796 58

Idiopathic intracranial hypertension, also known as pseudotumor cerebri, is a condition of increased intracranial pressure without the presence of mass lesions and with normal cerebrospinal fluid composition. Patients may experience papilledema and vision loss. Optic nerve sheath fenestration (ONSF) is one method of stabilizing visual function and decreasing optic nerve edema. The authors report on 10 patients who underwent bilateral ONSF and in whom visual function was stable or improved postoperatively. The results obtained in these cases suggest that ONSF plays a role in visual preservation in idiopathic intracranial hypertension patients in the acute setting.
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PMID:Optic nerve sheath fenestration for vision preservation in idiopathic intracranial hypertension. 1800 69

Our understanding of pediatric idiopathic intracranial hypertension has been refined since Dr. Simmons Lessell's review in 1992. The use of rigorous methodologies and standard definitions in recent studies has demonstrated distinct demographic trends. Specifically, the incidence of idiopathic intracranial hypertension seems to be increasing among adolescent children, and among older children its clinical picture is similar to that of adult idiopathic intracranial hypertension (female and obese). Within younger age groups there are more boys and nonobese children who may develop idiopathic intracranial hypertension. The pathogenesis of the disease has yet to be elucidated. Idiopathic intracranial hypertension among young children has been associated with several new etiologies, including recombinant growth hormone and all-trans-retinoic acid. More modern neuroimaging techniques such as MRI and MRI-venograms are being used to exclude intracranial processes. Although most cases of pediatric idiopathic intracranial hypertension improve with medical treatment, those who have had visual progression despite medical treatment have undergone optic nerve sheath fenestration and lumboperitoneal shunting. Because idiopathic intracranial hypertension in young children appears to be a different disorder than in adolescents and adults, separate diagnostic criteria for younger children are warranted. We propose new criteria for pediatric idiopathic intracranial hypertension in which children should have signs or symptoms consistent with elevated intracranial pressure, be prepubertal, have normal sensorium, can have reversible cranial nerve palsies, and have an opening cerebrospinal fluid pressure greater than 180 mm H(2)O if less than age 8 and papilledema is present, but greater than 250 mm H(2)0 if age 8 or above or less than 8 without papilledema.
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PMID:Pediatric idiopathic intracranial hypertension. 1802 69

Pseudotumor cerebri, also referred to as idiopathic intracranial hypertension, is a syndrome characterized by increased intracranial pressure and excludes underlying structural or systemic causes. Pseudotumor cerebri/idiopathic intracranial hypertension has been reported commonly in obese young women but can occur in children and adolescents. With the rise in overweight children, it is important to include this condition as a differential diagnosis, particularly when patients present with complaints of headache.
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PMID:Pseudotumor cerebri: yet another reason to fight obesity. 1817 88

Idiopathic intracranial hypertension (IIH) is a syndrome of unknown cause characterized by elevated intracranial pressure (ICP). While imaging often reveals a stenosis of the transverse sinuses, the role of this feature in IIH has been in dispute. Many patients with chronic daily headache have been found to actually be suffering from a milder form of IIH without papilledema (IIHWOP). These patients often demonstrate hypertensive B-waves and plateau-like waves upon continuous ICP monitoring. Recently, we presented modeling studies which suggest that the sinus stenosis and hypertension of IIH are physiological manifestations of a stable state of elevated pressures that exists when the transverse sinus is sufficiently collapsible. Many of the features of IIH were explained by this model but the prevalence of pathological ICP wave-forms observed in IIHWOP remained unresolved. The model presented here is a modified version of a previous model with a semi-collapsible sinus represented by a refined downstream Starling-like resistor based on experimental data. The qualitative behavior of this model is presented in terms of the collapsibility of the transverse sinus. For a sufficiently rigid sinus, there is a unique stable state of normal pressures. As the degree of collapsibility increases, there is a Hopf bifurcation, the normal state becomes unstable, low-frequency, high-amplitude ICP waves prevail, and small perturbations can lead to hypertensive ICP spikes. As the collapsibility increases further, so does the duration of the waves, until they are replaced by two stable states: one of normal pressures and one of elevated pressures. In this parameter domain, temporary perturbations can now cause permanent transitions between states. The model presented here retains the capability of our previous model to elucidate many features of IIH and additionally provides insight into the prevalence of the low-frequency, high-amplitude waves observed in IIHWOP.
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PMID:A model for idiopathic intracranial hypertension and associated pathological ICP wave-forms. 1826 74

Pseudotumor cerebri (PTC) is characterized by intracranial hypertension without ventriculomegaly, in the absence of a mass lesion or meningeal process. When there is no secondary cause, it is termed 'idiopathic intracranial hypertension'. Headache is the most common symptom of PTC, present in over 90% of patients. The headache is often disabling and nonspecific in character; thus, ophthalmoscopy is imperative for all patients being evaluated for headache. Visual loss is the major morbidity of PTC, requiring prompt diagnosis and treatment to prevent permanent deficits. Medical and surgical treatments are employed, although evidence-based treatment guidelines do not exist. This review discusses the diagnosis, differential diagnosis and management strategies for patients with PTC.
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PMID:Pseudotumor cerebri presenting as headache. 1834 70

Idiopathic intracranial hypertension remains a disease of unknown etiology. Epidemiology, associations, features, and prognosis in children have changed over the years. The main clinical complaint of pediatric idiopathic intracranial hypertension is headache with visual disturbance. We report on a patient with childhood idiopathic intracranial hypertension, who presented without headache after hemodialysis for acute renal failure. Idiopathic intracranial hypertension without headache is believed to have a poor prognosis. However, this child demonstrated a favorable outcome with medical therapy. The child was followed with serial optical coherence tomography of retinal nerve fiber layer thickness around the optic nerve head. In the absence of a reliable procedure to evaluate the therapeutic efficacy in the follow-up of patients with idiopathic intracranial hypertension, the importance of optical coherence tomography, a noninvasive, objective, and reproducible procedure, is highlighted as a useful adjunct in the management of idiopathic intracranial hypertension.
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PMID:Idiopathic intracranial hypertension in a child after hemodialysis. 1880 66


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