Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ultrasonic imaging of the human fetal brain has allowed ventriculomegaly and hydrocephalus to be categorized. In this study 40 fetuses with ventriculomegaly and 21 with an Arnold-Chiari malformation and a myelomeningocele had ventriculomegaly that resolved, stabilised or progressed in utero. Within the progressive group were those with hydrocephalus, hydrocephalus being defined as expansion of the cerebral ventricular atria together with disproportionate increase in the head circumference. The prognosis for fetuses with resolving and stable ventriculomegaly was good, reflecting the fact that the ventricular dilatation in these cases was probably caused by delayed parenchymal and cerebrospinal fluid pathway development. Whereas the prognosis for progressive ventriculomegaly was generally poor, suggesting that the causes were likely to have been chromosomal, genetic, an infective agent or a catastrophic event which had an adverse effect on parenchymal development. The causes of hydrocephalus also adversely affected brain development but additional damage was caused by raised intracranial pressure.
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PMID:Pre-natal ventriculomegaly and hydrocephalus. 1067 79

The clinical history, neuroimaging features, treatments, and outcome of 4 patients with histologically verified subependymal giant cell astrocytomas (SEGA) were retrospectively reviewed. The average age at the time of surgery was 13.3 years. Headache related to raised intracranial pressure was the first and only sign in 2 patients, with the remaining 2 being admitted because of sequential neuroimaging studies over several years revealing the growth of 'subependymal nodules' into intraventricular tumours. In each case the tumour was in the region of Monro's foramen and was associated with ventricular dilatation. On computed tomography (CT), multiple subependymal nodules were found in 3 patients, and these well circumscribed isodense SEGAs were markedly enhanced by contrast medium. On magnetic resonance imaging (MRI), which was obtained in 3 patients, 2 SEGAs were isointense with the cerebral cortex and one with the white matter on T1-weighted images, and on T2-weighted images, 2 were isointense with the cortex and one with the white matter. At surgery the tumours appeared to originate from the inferolateral wall of the lateral ventricle in the region of the head of the caudate nuclei. Total macroscopic removal was achieved in 3 patients, and subtotal removal in one patient. Follow up ranged from 4.6 to 13.2 years, and all patients have exhibited similar physical and mental conditions to preoperative. So far there has been no evidence of any recurrences. The diagnosis and the surgical indications for SEGA are discussed, with periodic monitoring with neuroimaging studies being recommended even for asymptomatic patients with 'subependymal nodules'.
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PMID:Subependymal giant cell astrocytoma: clinical and neuroimaging features of four cases. 1132 23

Summary The case is described of a 12-year-old girl presenting with raised intracranial pressure without ventricular dilatation and a type 1 Chiari malformation. This was taken to be a coincidental association of pseudotumour cerebri and the Chiari malformation. Treatment of the pseudotumour with Diamox gave rapid and sustained relief of the intracranial hypertension without change in the Chiari malformation. In addition, a series of 156 cases of pseudotumour cerebri was reviewed for evidence of the Chiari malf ormation. An overall incidence of 1.3%, rising to 2.7% in patients with MR scanning [excluding the case described] was found.
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PMID:Pseudotumour cerebri occurring in association with the Chiari malformation. 1174 33

Significant shunt malfunction is nearly always followed by headache, nausea, vomiting, lethargy and/or visual disturbances. In many cases there are also signs of raised intracranial pressure on computed tomography (CT). In six hydrocephalic, shunt dependent children (8-14,5 years) with no or slight symptoms shunt malfunction was detected because of papilloedema. The oedema was detected in three children at routine check up, in two at regular visual check up and in one at an ophthalmological examination because of slight headache. At neurological examination five had no new symptoms, but one was ataxic. In five patients a CT scan was done, three showed slight ventricular dilatation. Splayed sutures were found in two children. At shunt revision the measured intracranial pressure was increased, varying between 25-52 cm H(2)O. In five children the oedema disappeared after shunt-revision without any visual reduction, but in one the visual deficit did not improve. Older children can have shunt malfunction leading to increased intracranial pressure, with no or discrete symptoms and no obvious ventricular dilatation but with asymptomatic papilloedema. Ophthalmoscopy can therefore be of great value at routine check up in these children.
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PMID:Asymptomatic shunt malfunction detected fortuitously by observation of papilloedema. 1466 66

Raised intracranial pressure in the absence of ventricular dilatation is common in cryptococcal meningitis and associated with increased mortality. We report the case of a patient with HIV-associated cryptococcal meningitis, who developed increasing CSF pressure and visual impairment on therapy despite serial lumbar punctures. Insertion of a temporary lumbar drain controlled the opening pressure and resulted in full visual recovery. The advantages and necessary precautions with this approach are reviewed, and alternative protocols for the use of lumbar drains discussed.
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PMID:Lumbar drainage for control of raised cerebrospinal fluid pressure in cryptococcal meningitis: case report and review. 1629 Dec 74

Posthaemorrhagic ventricular dilatation (PHVD) is a major complication of intraventricular haemorrhages in very preterm infants. Posthaemorrhagic ventricular dilatation is associated with a high rate of disability, multiple impairments and adverse effects of shunt surgery for hydrocephalus. It may lead to an impaired neurological prognosis, caused by a raised intracranial pressure (ICP) and concomitant decreased cerebral blood perfusion. Therefore, early intervention to decrease the ICP may improve the long term outcome. Different treatment modalities have been studied, of which repetitive removal of cerebrospinal fluid (CSF) seems to be the only effective one. Studies performed in several institutions showed, that intermittent CSF drainage in very preterm infants with PHVD is an effective way to treat increased ICP and its negative effect on cerebral blood perfusion. The cut off point for CSF drainage is about 6.0 cm H(2)O ICP, as drainage below that level no longer results in improvement in perfusion. From this single case study it can be concluded, that in preterm infants with PHVD, repetitive CSF tapping from a ventricular access device guided by ICP measurements and ICP targeted treatment strategy is a useful technique for determining the frequency and volume of CSF removal. In neonatal intensive care units with poor capabilities and resources this is possible even by placing the simple intravenous single lumen catheter.
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PMID:The role of permanent invasive monitoring of intracranial pressure in the treatment of infants with posthaemorrhagic ventricular dilatation after intraventricular haemorrhage (case report). 2049 27


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