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

Three new cases of chronic vitamin A intoxication are reported and a review of the literature with special reference to chronic intoxication in adolescents and adults is presented. The most prominent features are intracranial hypertension, skin and hair deviations, pain in the musculoskeletal system, and fatigue. Intracranial hypertension occurs in 50% of chronic intoxications, but is not invariably linked with the other symptoms. Young women are the major age group represented. There seems to be no relation between the severity of the clinical picture and the vitamin A serum level. Discontinuance of vitamin A intake is sufficient for cure.
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PMID:Benign intracranial hypertension due to A-hypervitaminosis in adults and adolescents. 13 26

An obese young man presented the typical features of benign intracranial hypertension (BIH), including raised intracranial pressure. Despite elevated intracranial pressure, papilledema did not develop. The syndrome resolved after medical treatment and, on examination 6 months later, the patient was normal. The absence of papilledema in this case is discussed together with data available from the literature.
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PMID:Benign intracranial hypertension without papilledema: case report. 50 1

Two patients presenting with headache and radiological features of an enlarged sella turcica were found to have the primary empty sell syndrome. Whilst under observation, 1 patient developed papilloedema and was shown to have benign intracranial hypertension. The second patient also had raised intracranial pressure. A relationship between the empty sella syndrome and benign intracranial hypertension has previously been reported and it is suggested that in a patient with a congenitally incompetent diaphragma sella, chronically raised intracranial pressure caused herniation of the subarachnoid space into the sella turcica. Subsequently, sella turcica enlargement and remodelling occurs, sometimes with endocrine, visual and other sequelae. The clinical, radiological and CT scan features of the empty sella syndrome are discussed and the indications for major radiological studies are considered.
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PMID:Primary empty sella syndrome and benign intracranial hypertension. 75 18

In anesthetized, artificially ventilated dogs, the intracranial cerebrospinal fluid (CSF) pulse waves were studied simultaneously with the central aortic pressure, central venous pressure (CVP), and the sagital sinus pressure under physiological conditions and in normovolemic arterial hypotension and hypertension, in acute cardiac insufficiency of the right atrium, in raised intracranial pressure (ICP), and in arterial hypoxemia. The physiological CSF pulsations are shown to be mainly arterial in origin. In the diastolic phase, the descending part of the pulse curve can be modified by venous superpositions coinciding with the right atrial "A" wave. With increase of ICP the configuration of the CSF pulsations changes: the venous superpositions disappear and the waves become more and more arterial in shape. Furthermore, the pulse amplitude increases considerably. The same change can be observed when cerebral vessels are dilated by arterial hypoxemia. During cardiac insufficiency and consecutive increase of CVP, the CSF pulse curve is venous in shape and the right atrial "A" wabe predominates. In arterial hypotension, CSF pressure decreased. Conversely, in angiotensin-induced systemic arterial hypertension, CSF pressure and its pulse amplitude increased. It is concluded that both systemic arterial blood pressure and cerebrovascular reactivity are major determinants for the shape and the pressure amplitude of the intracranial CSF pulse waves. In the presence of cerebral vasodilatation, systemic arterial blood pressure may be an important factor in raising ICP and altering the brain tissue compliance, because cerebral vascular damping of the arterial pulse is diminished and the arterial pressure head may be directly transmitted to the cerebral capillary bed.
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PMID:Influence of systemic and cerebral vascular factors on the cerebrospinal fluid pulse waves. 83 Aug 13

The development of an intracerebral pneumatocele following ventricular catheterization for benign intracranial hypertension is described. The importance of skull radiography in the diagnosis of this previously unreported complication ist emphasized. This case demonstrates that air can accumulate without the need to implicate increased pharyngeal pressure, and despite raised intracranial pressure.
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PMID:Intracerebral pneumatocele: an unusual complication following intraventricular drainage in case of benign intracranial hypertension. 100 1

Raised intracranial pressure is common in neurosurgical practice, but the clinical effects are variable. The factors which initiate intracranial hypertension are now fairly well established; the extent of the increase of intracranial pressure produced by any combination of these factors is a function of the volume-pressure status of the patient at that particular time and may be expressed in terms of brain clastance. The effects of raised intracranial pressure on the function of the brain are mediated through both changes in cerebral blood flow and brain shift or herniation. Understanding of these principles helps in selection of effective therapy for raised intracranial pressure. Ideal clinical management of raised intracranial pressure should be directed toward the identification of those situations in which intracranial pressure may become increased and should attempt to prevent intracranial hypertension before it actually occurs.
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PMID:Volume and pressure in the craniospinal axis. 110 10

Eight cases of obstructive hydrocephalus manifesting palsy of upward gaze and other features of the Sylvian aqueduct syndrome are reported. During the crisis of intracranial hypertension, all of them developed upward gaze palsy and variable abnormalities of the convergence mechanism such as paralysis, spasm, and convergence nystagmus. The frequent apparent blindness was probably related to gaze paralysis, since visual evoked responses were present. All these ocular abnormalities disappeared after shunting. Periaqueductal dysfunction on the basis of raised intracranial pressure is postulated as the possible mechanism for the above ocular manifestations. The 'setting sun' sign is frequently seen in infants and children with hydrocephalus and has been considered in the past to result from displacement of eyeballs by pressure from the orbital roof plate. Our observations would suggest periaqueductal dysfunction rather than the mechanical displacement as the possible mechanism for this sign.
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PMID:Sylvian aqueduct syndrome as a sign of acute obstructive hydrocephalus in children. 115 9

The authors report a boy aged 9 years in whom a giant meningioma of the small wing of the sphenoidal bone was removed surgically. Attention is called to the rarity of these tumours in the first decade of life. Developmental retardation, speech beginning at the age of 4 years, large head and epileptic seizures developing at the age of 7 years without signs of intracranial hypertension suggested the possibility of organic brain disease and development of massive hemiparesis, speech disturbances and choked disc in the last period of the disease were the cause of referral of the child to a neurosurgical unit. Plain skull films and angiography demonstrated changes typical of raised intracranial pressure and presence of an expanding lesion in the left cerebral hemisphere. Meningioma was found on operation hidden within the left frontal and temporal lobes but connected by means of a narrow band to the dura of the small wing of the sphenoidal bone. A good result was obtained. Follow-up examination after 2 years demonstrated slight neurological abnormalities and a very good general state of the child.
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PMID:[Case of giant meningioma of the small wing of the sphenoid bone in a 9-year-old boy]. 118 62

12 patients (8 males and 4 females) operated on for intramedullary hemangioblastomas, using microsurgical techniques are presented. Special consideration is given to the clinical and pathological aspects. The results of surgery are discussed. The family history is positive in 4 cases. Clinical aspect : a) the initial symptoms is usually pain (9 patients) motor deficits were present in 2 cases. Only 1 patient presented visual disturbances at the beginning of the disease. b) the interval of time between the first symptom and the fully developped clinical picture is shorter than 1 year in 4 patients and longer (up to 18 years) in 8 patients. c) the full clinical picture consists of motor deficit, sensory disturbances (especially dorsal columns), cerebellar signs, raised intracranial pressure, sphincter disturbances, retinal angiomas, arterial hypertension and psychoorganic syndrome in decreasing order of frequence. Pathological findings at opsurgery : There are. a) 3 cases of hemangioblastomas at the bulbo-cervical junction b) 5 cases of cerebello-medullary hemangoblastomas. c) 4 cases of medullary hemangioblastomas. 1 patient had renal and pancreatic cysts. 2 patients had pheochromocytomas with arterial hypertension. Operative technique. Microsurgical techniques, bipolar coagulation, and continuous irrigation of the operative field are of primordial importance. The tumor must be approached from the periphery and never from the center. One should coagulate the afferent vessels first and the efferent vessels only at the end. Results of surgery. In 1 case, only a partial removal was possible and the patient did not improve. A complete removal was possible in 11 patients with the following results : -- 4 patients are in excellent condition and have a normal socio-professional life. -- 5 patients improved and are independant. The are able to perform partial time-work. -- 1 patient, with bulbar extension of the tumor improved from the motor point of view, but he presents a permanent. deficit of the IX, X, XI cranial nerves. He has a permanent tracheal canula. -- 1 patient improved following surgery, but he died 12 months later (stress ulcer and cardiac decompensation). The autopsy revealed a recurrence of the cerebellar tumor.
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PMID:[Microsurgical experiments in 12 cases of intramedullary hemangioblastomas]. 124 11

Raised intracranial pressure (ICP) occurs at some time in 50-75% of severely head injured patients. Measurement of ICP alone is not sufficient. Arterial pressure must also be monitored: the important physiological variable is cerebral perfusion pressure. Detailed analysis of the ICP recording yields valuable information on the nature and cause of ICP, with implications for appropriate therapy. Additional measurements of importance include brain electrical activity, arterial and jugular venous oxygen saturation, and blood flow velocity in major intracranial arteries measured by transcranial Doppler sonography. These assessments not only add information about the cause of intracranial hypertension (vascular vs. nonvascular) but also help to regulate therapy, providing early warning that a treatment for reducing the ICP is actually producing global brain ischemia. In the management of raised ICP, all correctable factors must first of all be dealt with, then a choice made between hypnotic drugs and osmotic therapy according to whether the cause of raised ICP is, respectively, vascular or nonvascular.
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PMID:Control of intracranial pressure in patients with severe head injury. 158 23


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