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

Hypertension-hypervolemia therapy (HHT) is widely employed for treatment against vasospasm after subarachnoid hemorrhage (SAH). A few investigations have been reported to establish the fact that HHT results in a high incidence of congestive heart failure and pulmonary edema as well as deterioration of brain edema. From the point of view that the cerebral circulation is not independent of the systemic circulation, the authors investigated the effect of HHT on the systemic circulation of patients with SAH. In 72 patients, intracranial pressure (ICP), pulmonary catheter wedge pressure (PCWP), pulmonary arterial pressure (PA), central venous pressure (CVP), arterial pressure (AP), cardiac index (CI), arterial blood gas (ABGS), electrocardiogram (ECG), serum and urine electrolytes were monitored postoperatively. Furthermore, among these patients, the flow (Flow), volume (Volume) and velocity (Velocity) of the cortical vessels were monitored by means of a Laser Doppler in 25 patients. A cisternal or spinal drain was placed in all of the patients. Elevation of PCWP and CVP and Flow were observed when 300ml of 10% glycerol was administered within a period of 30 minutes, whereas administration of the same dose of glycerol over a period of 60 or 120 minutes caused no significant changes on these parameters. Elevation of PCWP and CVP and decrease of CI and Flow, occasionally associated with premature ventricular contraction (PVC), were observed in some patients when 100ml of 25% albumin was administered. However, administration of the same dose of albumin over a period of 120 or 240 minutes did not cause deterioration of the cardiac function. These facts could be explained by Guyton's law in which massive transfusion causes cardiac dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Serious pitfalls which can be encountered in a course of hypertension-hypervolemia therapy for vasospasm]. 157 56

In the management of neurological intensive care patients with an intracranial space-consuming process the measurement and recording of intracranial pressure together with arterial blood pressure is of special interest. These parameters can be used to monitor the treatment of brain edema and hypertension. Intracranial pressure measurement is also important in the diagnosis of the various subtypes of hydrocephalus. Not only the absolute figures, but also the recognition of specific pressure-patterns is of particular clinical and scientific interest. This new, easily installed and inexpensive system comprises a PC and a conventional monitor, which are connected by an AD-conversion card. Our software, specially developed for this system demonstrates, stores and prints the online-course and the trend of the measurements. In addition it is also possible to view the online-course of conspicuous parts of the trend curve retrospectively and to use these values for statistical analyses. Object-orientated software development techniques were used for flexible graphic output on the screen, printer or to a file. Though developed for this specific purpose, this system is also suitable for recording continuous, longer-term measurements in general.
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PMID:[A personal computer-based system for online monitoring of neurologic intensive care patients]. 158 76

Negative consequences of the impact of alpine factors on the body of man are described. Alpine acute lung edema is one of the dangerous diseases that may develop under alpine conditions. This may affect not only beginners but also aborigines of the mountains, who return to the places they come from after a temporary stay in lowlands. Acute brain edema is regarded as no less severe condition. It may occur in about 1.2% of the people who climb to a height of 4500-5000 m. Primary alpine pulmonary arterial hypertension and chronic alpine cor pulmonale are fairly prevalent under alpine conditions.
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PMID:[The effect of altitude factors on the human body]. 158 27

A case of systemic lupus erythematosus (SLE) with benign intracranial hypertension (BIH) is reported. A 41-year-old male with a history of SLE starting in 1982 was admitted to our hospital in December 1989 because of headache and vertigo. Laboratory examinations on admission showed proteinuria, mild anemia, and positive antinuclear and anti-Sm antibodies. No abnormal findings except high pressure of 350 mmH2O were observed in his cerebrospinal fluid (CSF). Fundoscopic examinations showed marked bilateral papilledema and retinal bleeding. Brain CT, MRI and angiography revealed diffuse brain edema without space occupying lesion and cerebrovascular diseases. Because there were no diseases such as endocrinological disorders, severe anemia, and no history of the administration of drugs which might cause intracranial hypertension, the diagnosis of BIH was made. Subsequently, he was treated with intravenous methylprednisolone therapy and osmotic diuretics and his clinical symptoms and pressure of CSF gradually improved. The decrease of CSF adsorption was observed with RI cisternography in our case. Psychosis, seizures and meningitis are common CNS manifestations in SLE patients. But BIH is very rare and its cause is unclear. Only 17 cases of SLE with BIH have been reported. The pathogenesis and treatment of BIH in SLE patients were discussed in this paper.
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PMID:[Systemic lupus erythematosus associated with benign intracranial hypertension: a case report]. 160 19

Cerebral edema complicates many neurosurgical conditions, such as head injuries, neoplasms and infections, and is the direct result of operative trauma. The recognition and the treatment of brain edema are of great practical importance, particularly in those conditions leading to brain herniations and/or intracranial hypertension. Brain edema can be distinguished into two major categories, based on the integrity of the blood brain-barrier (BBB). With intact BBB edema, the crucial pathogenic event is related to disturbances of cellular metabolism and ionic transport. All the cellular elements of brain may undergo swelling, with a concomitant reduction of the extracellular-fluid space of the brain. Open BBB edema, the most common form of brain edema, is characterized by increased permeability of the brain endothelial cells. Brain edema results from the oncotic forces generated from a serum protein influx into the nervous tissue, and edema fluid accumulates primarily in the extracellular space. The non-operative management of brain edema requires attention to the causes that have induced brain edema. Specific pharmacologic therapy with corticosteroids, hyperosmolar agents and furosemide or acetazolamide depend upon accurate assessment of BBB integrity.
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PMID:[Postoperative cerebral edema. Physiopathology of the edema and medical therapy]. 162 Apr 60

Hypertension consequent upon increasing brain edema, and intercerebral pressure gradient which is the cause of transverse dislocation diminish with the use of a method which provides for hydrodynamic equilibrium. The method consists in connecting the ventricle of the intact cerebral hemisphere to a balloon located in the cavity of the removed hematoma according to the principle of communicating vessels. The craniospinal pressure gradient is removed by additional catheterization of the spinal subarachnoid space and its connection to the ventricle and balloon according to the same principle.
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PMID:[A method for correcting dislocation in hemorrhages into the cerebral hemispheres]. 164 26

Modern experimental and clinical data suggest that physiological mechanism, responsible for maintaining adequate brain blood supply under different conditions has a complex functional task, which besides sufficient metabolic transport to brain tissue, consists in supporting of water balance of brain tissue and evacuation of wastes. These functions realize by synergistic acting of several control links--neurogenic, metabolic, myogenic and humoral, every one of them has its own channel of input information and feedback. Physiological reactions of cerebrovascular system to adequate sensory activation have a task, first of all, to support of metabolic supply of nerve tissue. Therefore, after the beginning of sensory activation, oxygen availability in brain tissue is significantly increase, but at the same time some changes of hydratation nerve tissue is taking place. The last is possible to observe by analysis of changes in amplitude and configuration of electrical impedance pulsations, recording from brain implanted electrodes. These changes of hydratation of nerve tissue is observing during short time period and then is compensating. During during neuronal activation the concentration of wastes in brain tissue is slightly increase, which reflects in changes of brain tissue pH and pCO2. However, in situations, closed to extreme ones, a some hierarchic relationships between particular functional tasks of cerebrovascular control mechanism are observed. (1) Under arterial hypertension, when it is impossible to maintain at the same time both metabolic supply of brain tissue and to support water balance of nerve tissue, experimental and clinical data indicates, that the leader place take processes, responsible for the hydration of nerve tissue. So, the same decrease of cerebral blood flow during arterial hypertension indicates, that the action of control mechanism of cerebral circulatory system directed to minimization of a risk of developing of brain edema. (2) In cases of arterial hypotension, which accompanying by chronic cerebral circulatory insufficiency, the main functional task of cerebrovascular control mechanism becomes to direct to evacuation of wastes, because they are slowly collecting in brain tissue, although the metabolic supply of brain tissue is often in sufficient limits. In such conditions vasodilator drugs with a short time period of action (30-40 min.) have a comparative long (3-5 hours) positive effect for patients. During time period of increased brain blood flow, washing out of brain tissue from wastes is taking place. Generally, the first of mentioned processes is forming the left and the second--right parts of the curve, which represents the autoregulator phenomenon.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The functional tasks of the activity of the mechanism regulating the cerebral circulation]. 166 14

The clinical status of patients with glioma is influenced by 1) the histological malignancy of the tumor, 2) the tumor volume, 3) secondary status such as brain edema or intracranial hypertension due to the tumor, and 4) the host immunity. Due to some improvement in at least 2) and 3) by the initial treatment, most low grade glioma cases pass through a clinically silent postsurgical period. However, at a certain point, transition to a high grade tumor malignant transformation may occur with exacerbation of the symptoms. Twenty-two cases of histologically established low grade glioma experienced over the past 7 years, in which immunological status was evaluated, were analyzed. Nine cases (41%) showed malignant transformation. Characteristic pictures of the clinical symptoms, computed tomography (CT) scan findings, immunological status, and morphological findings (mainly immunohistochemical examination) in nine cases were delineated. The findings at the time of exacerbation of the symptoms were as follows. In all cases CT scan demonstrated the change in the main lesion from low density to mixed density and were compatible with a high grade glioma. Reduction in host immunity was verified. Morphological increase in the tumor volume, increase in histological malignancy and deterioration in the secondary status due to the tumor were confirmed. Necrosis of the tumor cells as well as increase in giant cells and gemistocytes were observed. Immunohistochemical analysis revealed a decrease and irregularity in glial fibrillary acidic protein positive cells and positive processes as well as increase in vimentin intensity. These findings demonstrate change in the biological characteristics of the tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinicopathological study on low grade glioma. In relation to malignant transformation]. 170 58

The effect of induced hypertension instituted after a 2-h delay following middle cerebral artery occlusion (MCAO) on brain edema formation and histochemical injury was studied. Under isoflurane anesthesia, the MCA of 14 spontaneously hypertensive rats was occluded. In the control group (n = 7), the mean arterial pressure (MAP) was not manipulated. In the hypertensive group (n = 7), the MAP was elevated by 25-30 mm Hg beginning 2 h after MCAO. Four hours after MCAO, the rats were killed and the brains harvested. The brains were sectioned along coronal planes spanning the distribution of ischemia produced by MCAO. Specific gravity (SG) was determined in the subcortex and in two sites in the cortex (core and periphery of the ischemic territory). The extent of neuronal injury was determined by 2,3,5-triphenyltetrazolium staining. In the ischemic core, there was no difference in SG in the subcortex and cortex in the two groups. In the periphery of the ischemic territory, SG in the cortex was greater (less edema accumulation) in the hypertensive group (1.041 +/- 0.001 vs 1.039 +/- 0.001, P less than 0.05). The area of histochemical injury (as a percent of the cross-sectional area of the hemisphere) was less in the hypertensive group (33 +/- 3% vs 21 +/- 2%, P less than 0.05). The data indicate that phenylephrine-induced hypertension instituted 2 h after MCAO does not aggravate edema in the ischemic core, that it improves edema in the periphery of the ischemic territory, and that it reduces the area of histochemical neuronal dysfunction.
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PMID:Delayed institution of hypertension during focal cerebral ischemia: effect on brain edema. 171 60

Differences in cytochemical and pathophysiologic abnormalities in experimental meningitis caused by pneumococcal strains A, B, and C were determined. Strain C produced the most severe abnormalities of cerebrospinal fluid (CSF) concentrations of lactate (P less than .01), protein (P less than .02), and glucose (P less than .01), CSF white blood cell count (P less than .04), cerebral blood flow (P less than .02), and clinical signs (P less than .05). Brain edema occurred only with strains A anc C, with no association with disease severity; intracranial hypertension was also independent of disease severity. Strain B, not C, achieved the highest bacterial titers in the CSF (P less than .005). The widely different abilities of strains of Streptococcus pneumoniae to induce intracranial abnormalities suggest that virulence determinants affect not only evasion of defense during colonization and invasion, as shown in other models, but also determine the course of disease once infection has been established. Differences of cell-wall metabolism among pneumococcal strains may play a role in this latter phase of the development of meningitis.
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PMID:Differences of pathophysiology in experimental meningitis caused by three strains of Streptococcus pneumoniae. 190 31


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