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

Cerebral hemispheric blood flow and metabolism were measured before and after therapy with intracarotid infusion of combined PBZ and PPL in 15 patients with recent cerebral infarction. HBF was unaltered despite decrease in cerebral perfusion pressure. Cerebral hemispheric oxygen comsumption and carbon dioxide production decreased while cerebral hemispheric lactate production increased. Biphasic cerebral uptake of tyrosine was observed during and immediately after PBZ and PPL infusion. CSF HVA increased, indicating altered DA turnover. CSF 5HIAA levels also increased, suggesting altered 5HT turnover after PBZ and PPL. Release of cyclic AMP from ischemic brain into cerebral venous blood seen in the steady state was abolished after therapy. Cerebral hemodynamic studies suggest a functional balance between monaminergic neurogenic influences in the control of cerebral circulation. Imbalance of such controlling factors in ischemic brain may lead to paradoxical vascular responses to induced hypertension and hypotension. PBZ and PPL enhance such responses perhaps by increasing central neurotransmitter turnover and release. Further shift toward cerebral anaerobic metabolism may occur in ischemic brain following the use of phenoxybenzamine and propranolol. Worsening of neurological deficit occurred in four cases. Combined therapy with PBZ and PPL does not appear beneficial in the therapy of patients with recent stroke.
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PMID:Influence of adrenergic receptor blockade on circulatory and metabolic effects of disordered neurotransmitter function in stroke patients. 0 7

In case of cranial trauma, early respiratory troubles either of central or peripheral origin often accelerate the deterioration of the neurological situation. The different values of PCO2, PO2, pH and alcaline reserve measured on samples of CSF in comatose patients prove the central acidosis related to metabolic and vascular disorders in the damaged areas. Our results confirm the correlation between the importance of this disturbances and the severity of the trauma. It is thus necessary to insure patients of satisfactory respiration conditions. The tracheobronchial cleansing is applicable to intubated or tracheotomized patients by an instillation of 5ml of simple or bicarbonated physiological serum 4 to 6 times a day, followed by repeated aspirations and associated to a preventive endotracheal instillation of 80 mg of Gentamycin 4 times a day. Moreover we use controlled respiration which does not modify the gazometric parameters in the CSF but which assures patients a normoxia and moderate hypocapnia with a decrease of intracranial hypertension. Treatment by controlled hyperventilation must be precocious, because the recuperation at the level of the damaged zones is very slow.
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PMID:Treatment of comatose patients by mechanical hyperventilation. 0 50

The major changes in clinical condition during and after encephalography may be explained by intracranial pressure variations. If neither intracranial hypertension nor CSF dynamic perturbations exist, minimal complications may be predicted, but in intracranial hypertension immediate deterioration may occur. Despite an apparently good level of tolerance, complications may develop if the compensation phenomena cannot occur: normal pressure hydrocephalus, craniosynostosis. In the cases with good clinical tolerance, minimal changes occur when air injection is administered at a slow rate and with a small volume.
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PMID:[Effect of fractionated pneumoencephalography on intracranial pressure]. 20 16

The presence of CSF in cases with intracranial hypertension is a favourable prognostic sign; its absence is indicative of a progressive and potentially lethal intracranial hypertension. 2. A series of characteristic changes in the absolute value of the VFP as well as in the amplitude and rate of the cerebral pulse can provide reliable evidence of the integrity of the cerebral circulation. 3. Short-lasting disappearance of the diastolic pressure towards the end of the ultimate plateau wave and subsequent significant lowering of both the systolic and diastolic pressures is an additional bad prognostic sign.
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PMID:Prognostic signs during continuous monitoring of the ventricular fluid pressure in patients with severe brain injury. 29 Jan 92

Thirty-six patients with benign intracranial hypertension (BIH) were reviewed. Follow-up was obtained on 33 patients (91%) after a mean period of 7 1/2 years. Precipitating factors were found in 27 patients (75%). On admission, 5 patients had retro-ocular pain, especially on eye movements, a complaint not yet described in BIH. Seven patients had nystagmus, two of them horizontal positional nystagmus. It is questionable whether all signs in BIH are caused by the raised CSF pressure. The general outcome was good. Only two patients sustained severe ultimate visual impairment. Both presented with retro-ocular pain and sudden loss of vision on admission. Papilloedema can persist for years in BIH without serious visual impairment. Sometimes "causal" treatment is possible. No symptomatic treatment which is free from complications has been proved to prevent visual failure.
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PMID:Benign intracranial hypertension. A retrospective and follow-up study. 43 Jan

In 6 cases of oxycephaly, isotope (RIHSA) cisternography showed an altered CSF circulation with ventricular reflux or cisternal block and accumulation of the contrast at lumbosacral level. These changes express increased absorption of the CSF by the spinal arachnoid villi to compensate for reduced or nonexistent absorption by the subarachnoid villi of the vault, obstructed by chronic intracranial hypertension secondary to craniosynostosis. The possible clinical implications are outlined.
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PMID:Contribution to the study of craniostenosis: disturbance of the cerebrospinal fluid flow in oxycephaly. 50 Mar 83

A case is reported of a young girl who developed benign intracranial hypertension, with severe bilateral papiledema and a left sixth cranial nerve palsy, after minocylcine therapy. This drug is a semisynthetic tetracycline which has proven to pass into the CSF more effectively and to have a greater lipoid solubility than the other antibiotics of the same group.
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PMID:Benign intracranial hypertension after minocycline therapy. 62 95

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

Arrested hydrocephalus probably results from improvement of CSF circulation during growth. Although a generally accepted condition, its mode of onset, its presence in a given patient, and time required to establish the absence of progressive hydrocephalus have not been defined. Five patients are presented with ostensibly arrested hydrocephalus due to: aqueductal stenosis, communicating hydrocephalus, and Dandy-Walker malformation. In a period ranging from 4 to 13 years, they presented clinical signs of decompensation with intracranial hypertension. One had never had a shunt procedure. Another two were performing well in school until they suddenly deteriorated. The diagnosis of arrested hydrocephalus requires close follow-up well into adolescence, with periodical neurological and psychomotor evaluations. Sequential observation of the ventricular size with computed tomography (CT) is recommended.
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PMID:Pitfalls in the diagnosis of arrested hydrocephalus. 70 70

Seven patients with Candida meningitis are reported. These 7, plus 21 previously cited cases, were reviewed. This infection arose by two distinct mechanisms: hematogenous dissemination and direct inoculation. Recent antibiotic therapy, corticosteroid administration and severe underlying diseases were important predisposing factors. Fever, meningismus, elevated CSF pressures and localizing neurologic signs were commonly noted. Organisms were seen on gram-stain of CSF in only 43% of cases. Mortality rate in patients receiving inadequate or no antifungal therapy was high (greater than 90%), while those patients given appropriate antifungal drugs, especially intravenous amphotericin B, had a significantly lower mortality rate (38%). Several factors associated with poor prognosis were delineated in this study: diagnostic interval after symptomatic onset longer than two weeks, CSF glucose levels below 35 mg/100 ml and presence of intracranial hypertension and focal neurologic deficits.
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PMID:Candida meningitis. Report of seven cases and review of the english literature. 79 28


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