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

Pial arterial and venous calibre changes during intracranial hypertension were studied in 11 cats under barbiturate- and nitrous oxide-anaesthesia by using a closed cranial window technique and multichannel videoangiometry. Intracranial pressure was elevated from a normal mean level of 6.4 mm Hg by cisternal infusion of mock CSF in steps to 20, 30, 40, 50 mm Hg and finally to the level of systolic pressure. Pial arteries dilated significantly, small ones more than large ones, by 42 +/- 5.6% and 33 +/- 3%, respectively at ICP 50. With a further elevation of ICP up to systolic pressure, dilatation diminished to 28 +/- 10% in small, and to near resting calibres in large arteries. Pial veins remained unreactive on the average. Grouping into veins smaller and larger than 100 microns of resting size revealed, however, minor though statistically significant 5-10% dilatation of small, and a 5-10% diminution of large veins. Blood flow stopped, when cerebral perfusion pressure was zero, however, neither arteries nor veins collapsed. The present data support the hypothesis that CBF during acute elevation of CSF pressure depends on perfusion pressure rather than local vascular compression.
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PMID:Cerebrovascular response to intracranial hypertension. 357 56

A 34-year-old woman was admitted for the chief complaints of headache and blurred vision. She had bilateral papilledema and slight increase in CSF pressure (175mmH2O) with normal visual acuity and field. Neurological and hormonal examination were normal except for over response of PRL and TSH to TRH test. The sella was enlarged and MRI and metrizamide CT demonstrated intrasellar CSF filling with remodeling of the pituitary gland. The patient was diagnosed as primary empty sella syndrome associated with benign intracranial hypertension. The complaints did not subside for six months. The patient was treated via the transsphenoidal approach. The dura mater of the floor of the sella was elevated by extradural balloon expansion filled with silicone, and subsequently the empty sella was obliterated. Her headache disappeared and amblyopic attack also improved. Obliteration of the empty sella with an extradural silicone balloon via the transsphenoidal approach seemed to have been effective for headache and visual complaints of primary empty sella syndrome which did not respond to medical therapy.
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PMID:[Primary empty sella syndrome treated by transsphenoidal extradural balloon expansion--a case report]. 362 70

The causes of visual loss in benign intracranial hypertension are related to long standing papilloedema, ischaemic optic neuropathy or haemorrhage into a subretinal neovascular membrane. Decompression procedures generally preserve or improve visual acuity but surgical treatment with subtemporal decompression may lead to visual impairment. Such a deficit has been recorded in the past as occurring with ventriculography. Postulated mechanisms have included brain herniation, spasm of vessels supplying the visual cortices or retinal vascular disturbance. To our knowledge treatment with lumboperitoneal shunting has not previously been reported as leading to further significant visual loss in this condition. This report describes such an occurrence in a patient. Retinal vascular disturbance is postulated on the basis of several normal CT scans, normal CSF pressure measured after surgery and visual evoked responses suggesting retinal or optic nerve damage.
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PMID:Lumboperitoneal shunting as a cause of visual loss in benign intracranial hypertension. 366 76

CSF-hydrodynamic investigation using the constant pressure infusion method was used in children. The CSF resting pressure was recorded and the CSF formation rate was measured. The conductance of the CSF outflow pathways and the pressure in the sagittal sinus were calculated. The method was used in children with suspicion of disturbed CSF hydrodynamics due to various neurological and other conditions. The method is applicable in paediatric neurological diagnostics and provides information for further understanding of the mechanisms behind cranial hypertension. The following mean values are offered as reference values in clinical work and in further research in this field: CSF-resting pressure 1.3 kPa, sagittal sinus pressure 1.1 kPa, pressure difference across arachnoid villi 0.5 kPa, conductance of CSF outflow pathways 22.6 mm3 kPa-1s-1, CSF formation rate 6.8 m3s-1.
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PMID:Cerebrospinal fluid hydrodynamic studies in children. 371 16

A population of 41 non-hydrocephalic patients in whom a lumbo-peritoneal shunt (LPS) was inserted for various conditions is reviewed. 19 had persistent cerebro-spinal fluid rhinorrhoea following cranial injury, basal skull surgery or of unknown origin, 3 had recalcitrant benign intra-cranial hypertension, 14 had a persistent bulging craniotomy site after operations for intra-cranial tumours or head trauma, 4 had syringomyelia and 1 had a postoperative cervical meningocele. There was no shunt-related mortality. LPS was effective in treating the initial symptomatology in 31 patients. Further revision or removal of LPS were needed on 9 occasions in 8 patients showing shunt-related mechanical or infectious complications or persistent postural headaches. This report demonstrates the safety of the LPS procedure experienced in another population of 146 patients with communicating hydrocephalus operated on in the meantime. According to the authors' experience, the versatility of the clinical applications of LPS seems well established. LPS should be considered when a CSF diversion is required in patients showing absent or minimal ventricular enlargement in the CT scan.
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PMID:Lumbo-peritoneal shunt in non-hydrocephalic patients. A review of 41 cases. 371 95

A new technique is described that utilises a novel magnetic resonance pulse sequence to produce a quantitative index both for ventricular and, for the first time, extraventricular intracranial CSF volumes. The pulse sequence is a combination of a null-point inversion recovery sequence with an extended spin-echo read (echo time = 400 ms), which produces a contrast of CSF to white or grey matter of approximately 120:1. A series of experiments are performed on phantoms representing CSF filled ventricles and sulci over a wide range of volume values, and it is found that the standard deviation of differences between true and estimated values is 3.9% for ventricles, 4.6% for total cranial CSF, and 7.9% for CSF within the sulci. Normal volunteer reproducibility studies revealed corresponding standard deviations of less than 5.5%. Using the technique to produce absolute estimates of CSF volumes in normal subjects and patients produced results in good agreement with previously published necropsy studies. The technique has wide neurological and neurosurgical applicability particularly in terms of differential diagnosis and as an objective monitor of therapy or progression in conditions such as hydrocephalus, atrophy, and benign intracranial hypertension.
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PMID:A quantitative index of ventricular and extraventricular intracranial CSF volumes using MR imaging. 374 50

26 patients harbouring a CSF shunt for non-tumoral aqueductal stenosis hydrocephalus underwent Brainstem Acoustic Evoked Potentials (BAEPs) recording, to evaluate brainstem function. Only 6 patients presented with normal responses both at standard and at sensitized tests. In the remaining 19 patients, BAEPs were abnormal, bilaterally in 10 cases, monolaterally in 9. Four out of the 6 normal responses belonged to the group recognized of congenital origin. As refers to ventricular size BAEPs were abnormal in 62% of patients with normal ventricle and in 92% of patients with enlarged ventricles. The most significant BAEPs abnormalities were found in patients with maximal ventricular dilation. It appears that BAEPs abnormalities are to the ascribed to both primary and secondary brainstem dysfunction: no reliable criterion to differentiate between these two possibilities is evident. In the individual patient, serial BAEPs recording may contribute to recognize the early phase of supratentorial hypertension due to shunt dysfunction.
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PMID:Evaluation of brainstem function, using acoustic evoked potentials, in 26 patients harbouring a CSF shunt for non-tumoral aqueductal stenosis hydrocephalus. 377 98

Nineteen patients affected by Pseudotumor Cerebri and treated in the Neurosurgical Department of U.S.L. 10/D of Florence, are considered by Authors. Patients age varied from 4 to 14 years and their selection was made following Boddie, Banna and Bradley criteria published in 1974. Plain X Ray of the Skull was positive in 5 cases while ventriculography (when executed) were always normal. Quite normal were Angiography and CT scan. There were no pathological findings in CSF. The series of patients is considered analyzing somatic features, sex and possible aetiologic noxae. An interesting data is the presence of fever (39 degrees C) from 7 to 20 days before the onset of cranial hypertension. The possibility of blood-brain barrier alteration following infectious disease which causes an interstitial edema is considered and proposed by authors as a starting point for future research.
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PMID:[Pseudotumor cerebri: 19 cases in childhood]. 378 86

Time course of changes of the CSF and the elastic properties of the cerebrospinal system were studied in 25 patients with normotensive hydrocephalus and in 26 patients suffering from benign intracranial hypertension. In 66% of cases with the normotensive hydrocephalus syndrome and in 60% of those with benign intracranial hypertension CSF resorption resistance and the elasticity gradient increased. Shunting operations proved effective in such cases.
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PMID:[Elastic properties of the cerebrospinal system and cerebrospinal fluid dynamics in intracranial hypertension and normotensive hydrocephalus in adults]. 381 47

The levels of calcium and magnesium (by atomic absorption spectrophotometry), sodium and potassium (by flame photometry), inorganic phosphate and proteins (by spectrophotometry) were measured in the CSF of 27 children with hydrocephalus and compared with the CSF data on 10 controls, so as to study the effect of the blood-brain and blood-CSF barrier alterations observed in hydrocephalus, on the CSF electrolytes. Ca (P less than 0.001), Mg (P less than 0.01) and phosphate (P less than 0.05) were found to be increased, K (P less than 0.01) decreased, and Na levels not significantly altered. Linear regression analysis of hydrocephalic patients showed a linear correlation (r = +0.62) between phosphate and proteins (P less than 0.01) and (r = +0.66) between phosphate and Ca (P less than 0.001). Comparison of control CSF electrolyte levels with those found in the CSF of hydrocephalic patients were grouped according to clinical variables: sex (F, M), age (less than or equal to 1.5 months, greater than 1.5 months), etiological variants (congenital, acquired), treated infection (no, yes), surgical treatment (no, yes), time of onset (less than or equal to 1 month, greater than 1 month), ventricular dilation (mild, severe) and intracranial hypertension (mild or severe). These comparisons showed specific increases of Mg for males (P less than 0.05), acquired hydrocephalus (P less than 0.05) and severe intracranial hypertension (ICH) (P less than 0.001), moderate decrease in the Na levels in acquired hydrocephalus (P less than 0.05) and mild ICH (P less than 0.05), specific increases of phosphate in females (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Electrolyte levels in the CSF of children with nontumoral hydrocephalus. Relation to clinical parameters. 383 31


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