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

Results obtained with three different CSF ventricular drainage methods (intermittent with no outflow resistance, continuous against a positive pressure, continuous with pre-arranged positive pressure), were evaluated in fifty nine cases of traumatic cerebral lesions and spontaneous intracerebral hematomas with intracranial hypertension. Continuous CSF withdrawal gives better clinical results and is more effective in controlling intracranial pressure than intermittent drainage (50% vs 13% successes respectively). Results obtained with continuous drainage against a steady positive pressure and with a pre-arranged pressure ("tidal drainage") are almost similar. However an outflow resistance 3-5 mmHg higher than diastolic level of ICP represents a rational approach to the problem.
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PMID:The role of CSF ventricular drainage in controlling intracranial hypertension in patients with brain lesions. Comparison of three methods. Preliminary results. 130 4

Eighteen macrocephalic children with enlargement of the subarachnoid space (ESAS), with or without mild ventricular dilatation, were followed prospectively to a mean age of 56 months. All were born at term, with uneventful neonatal period and negative tests for congenital infections. There were 17 boys and 1 girl and the mean follow-up period was 46 months (8-58 months). The initial neurologic evaluation, between ages of 2 to 33 months, disclosed abnormalities in 2 cases. At the follow-up one was still abnormal and the other had a normal neurological examination. Another child, who had a normal neurological examination at the age of 5 months, at the age of 7 years and 7 months had an IQ of 77. Thus the abnormality rate at follow-up was 11%. The OFC returned to the normal range in 45% of the children at the follow-up period. There were no cases of intracranial hypertension. One infant had subdural taps performed at the age of 13 months that disclosed a fluid with the same characteristics as the CSF. All the children had a CT-scan performed at the beginning of the study that revealed a large subarachnoid space; in 77% it was associated with mild ventricular dilatation. Eleven had CT-scans repeated, during the study period, which showed resolution of the process in 3 cases, improvement in 2, and unchanged in 6. We conclude that enlargement of the subarachnoid space in macrocephalic children is often a benign entity. ESAS and macrocephaly will still be present in the majority of children in the long-term follow-up.
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PMID:Follow-up study of macrocephalic children with enlargement of the subarachnoid space. 130 83

We report here nine cases of encephalitis secondary to exanthematous diseases diagnosed from March to June 1990 at the University Hospital in Monterrey, Mexico. Two of the cases were secondary to measles, three to rubella, and four to varicella. One patient with varicella died, and the histopathological study showed findings compatible with viral encephalitis. The sex distribution was four males and five females with ages ranging from two to fourteen years. The most common clinical manifestations were hemiparesia, intracranial hypertension, meningism and altered consciousness. The CSF examination showed lymphocytic pleocytosis (mean = 295 cells), increased protein levels (mean = 118 mg/dL) and a normal glucose value in eight cases. These findings and the presence of an exanthematous disease suggested viral invasion of the CNS. Magnetic resonance imaging showed high intensity signal areas mainly in the frontal and temporal lobes. In this paper we compare the relative incidence of encephalitis secondary to exanthematous diseases in our geographical area during the last four years.
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PMID:[9 cases of encephalitis in an epidemic outbreak of exanthematous diseases]. 148 78

A 39-year-old woman presented with a 2-month history of repeated severe headache, nausea and diplopia. On admission she was obese with bilateral papilledma and abducens weakness. Mass lesion and sinus thrombosis were ruled out by brain CT and angiography. CSF pressure was normal initially. CSF pressure fluctuated with menstrual cycle, sometimes showing over 600 mmH2O with worsening of the symptoms. She was diagnosed as benign intracranial hypertension (BIH). Diuretics did not improve the symptoms, and visual disturbances ensued and deteriorated. A spinal subarachnoid space-peritoneal shunt was inserted to control CSF pressure, showing rapid improvement of headache and diplopia but visual disturbances remained almost unchanged. Optic nerve sheath fenestration was performed without improvement of visual deterioration. We postulated multiple factors such as obesity, menstrual abnormality, iron deficiency anemia and analgesic drugs played important roles to produce BIH in this case. Careful quantitative perimetry should be done to decide a suitable time for surgical treatment in BIH.
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PMID:[A case of benign intracranial hypertension with fluctuated symptoms and CSF pressure synchronized with menstrual cycle]. 149 Mar 15

To examine CSF hydrodynamics, we studied 16 patients with idiopathic intracranial hypertension and 45 control subjects with a constant-pressure infusion method. Fifteen patients had 155 examinations up to 15 years after the onset of disease. In most patients, the disturbances of CSF hydrodynamics persisted for many years. We identified at least two mechanisms for the development of the increased CSF pressure: a rise of sagittal sinus pressure, probably explained by extracellular edema causing partial compression of the major venous sinus (type 1), or a low conductance with a compensatory increase in CSF pressure in order to sustain the bulk flow (type 2).
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PMID:CSF hydrodynamics in idiopathic intracranial hypertension: a long-term study. 156 41

Clinical studies have demonstrated the prognostic importance of increased intracranial pressure in central nervous system infections. To delineate development of intracranial pressure in meningitis experiments were carried out in rabbits. Meningitis was induced by injecting streptococcus pneumoniae bacteria into the cisterna magna and blood, and intracranial pressures were continuously recorded. In the experimental model, three stages were seen: incubation period (0-8 h)--in which CSF becomes positive for the infecting organism and biochemical changes occur, but there are no hemodynamic or intracranial pressure changes; stage of slowly increasing intracranial pressure - because blood pressure remains normal, cerebral perfusion pressure is maintained adequate for cerebral metabolic need (9-24 h); terminal stage (greater than 25 h)--with hemodynamic collapse, critical reduction of cerebral perfusion pressure, cerebral ischemia, and death of the experimental animals. It is suggested that a similar sequence occurs in human disease. The clinical implication stresses the need for early recognition and treatment of intracranial hypertension as an important adjunct to antibiotic treatment of the infecting organism.
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PMID:Intracranial pressure and cerebral perfusion pressure in experimental streptococcus pneumoniae meningitis. 157 Apr 13

The effect of halothane on regional myocardial metabolism and blood flow, when used as an adjunct to fentanyl-nitrous oxide anaesthesia, to treat intraoperative hypertension was investigated. Fifteen patients with two- or three-vessel coronary artery disease with an ejection-fraction greater than 0.5 and on beta-blockers up to the morning of surgery were studied during elective coronary artery by-pass grafting. Systemic and pulmonary haemodynamics, global (coronary sinus, CSF) and regional (great cardiac vein, GCVF) myocardial blood flow were measured. Measurements were made: 1) after induction of anaesthesia but prior to skin incision, 2) during sternotomy, and 3) during halothane administration after its use to reduce arterial pressure to the pre-sternotomy level. The increase in systemic arterial pressure during sternotomy was due to an increase in systemic vascular resistance index (SVRI), and was accompanied by an increase in pulmonary capillary wedge pressure (PCWP), regional myocardial oxygen consumption and extraction, GCFV and CSF. Halothane reduced arterial blood pressure to pre-sternotomy levels within 7.1 +/- 0.6 min at an end-tidal concentration of 0.96 +/- 0.11%. Halothane caused a decrease in SVRI, total coronary vascular resistance, regional myocardial oxygen consumption and extraction, while cardiac index, heart rate and GCVF/CSF ratio remained unchanged. Mean regional myocardial lactate extraction was not affected by sternotomy or halothane. During halothane administration one patient developed regional myocardial lactate production which was not present during sternotomy. However, another two patients, who had regional myocardial lactate production during sternotomy, did not produce lactate or had less negative value of regional myocardial lactate extraction during halothane administration.
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PMID:Myocardial circulatory and metabolic effects of halothane when used to control intraoperative hypertension in patients with coronary artery disease. 157 78

The paper weighs the indication and the timing of surgery in hydrocephalus mostly due to ventricular haemorrhage in premature infants with an average of 31 weeks of gestational age and of 1.409 g average birth weight. The authors suggest to wait with the intervention until the intraventricular haemorrhage has subsided because the hypertension may often cease when the CSF is not bloody anymore. In case of a progressive process they gained favourable results with early surgery. They give a detailed account about the choice of the various shunts, list eventual complications, the US and CT controls.
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PMID:On early surgery of hydrocephalus in low-birth-weight infants. 159 14

Analysis is made of the efficacy of the treatment of CSF hypertension in 40 patients in the phase of exacerbation of multiple sclerosis. Use was made of sorption detoxication methods: hemoperfusion (the author's certificate No.1466754) and enterosorption (the priority certificate No.4465054/14 (115542) dated July 22, 1988). SKH-IK and SKH-2K sorbents were employed as hemoperfusion, using the venovenous scheme of perfusion, the volumetric rate of the blood flow being 100-120 ml/min during 2-3 hours. Altogether 2-3 sessions were carried out, with an interval of 5 to 7 days. For enterosorption, use was made of a crumbled up filamentous carbonic sorbent in a dose of 50-60 mg per kg bw 3 times a day for 20 days in 2 hourly intervals between food intake. Regression of the neurological symptoms began 2-3 hours after the first session of hemoperfusion and 5-6 days after the beginning of the intake of the filamentous carbonic sorbent, increasing throughout the whole treatment course. That coincided with the disappearance of CSF hypertension and normalization of the immunological spectrum of the blood serum. Sorption detoxication brought about no complications and is a method of choice in the treatment of CSF hypertension in patients in the phase of multiple sclerosis exacerbation.
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PMID:[Efferent methods of the treatment of cerebrospinal fluid hypertension in exacerbation of multiple sclerosis]. 164 18

The CSF-encephalic barrier of brain ventricles was examined at the submicroscopic level at different times of experimental aseptic leptomeningitis. In the acute period of the pathology, (3 to 7 days) the integrity of the bar was found to be disturbed because of acute inflammatory phenomena. In the subacute period (15 to 30 days), CSF hypertension was demonstrable. In the chronic period (90 days), the development of dystrophic and degenerative processes in the structures of the ependyma and vascular plexus were related to the disorders in CSF- and hemodynamics of the brain. Occlusion of the CSF tract was found to be associated with the impairment of the integrity of the blood- and CSF-encephalic barriers, marked edema end disintegration of the nerve tissue.
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PMID:[Ultrastructure of the cerebrospinal fluid-brain barrier of the cerebral ventricles and blood-brain barrier of the vascular plexus in experimental aseptic leptomeningitis]. 166 63


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