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Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
These are WHO grade II tumours with characteristic imaging appearances. They are typically seen in young adults. They appear as heterogenous intraventricular masses, typically attached to the septum pellucidum with a variable enhancement pattern. Calcification is common. Patients often present with headaches related to raised cerebrospinal fluid pressure.
Spine
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
Maintaining spinal cord perfusion pressure (SCPP) depends on the mean arterial pressure and cerebrospinal fluid pressure (CSFP). Cross clamping leads to proximal hypertension and increased cerebrospinal fluid pressure. So, controlling the arterial pressure with vasopressors or decreasing CSFP via lumbar drains plays a significant role in maintaining SCPP.
Hydrocephalus
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
This is a syndrome of communicating hydrocephalus with normal intracranial pressure which often presents in the elderly, with gait ataxia, dementia and urinary incontinence. The cerebrospinal fluid pressure is normal. The majority of patients respond to ventricular shunting. The precise aetiology remains unknown.
A position- and time-dependent pressure profile to model viscoelastic mechanical behavior of the brain tissue due to tumor growth
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Fatemeh Abdolkarimzadeh, Mohammad Reza Ashory, Ahmad Ghasemi-Ghalebahman, Alireza Karimi
A custom Matlab script helped to define the load surface, equivalence the nodes, and write the final LS-Dyna *k file. A 10-core Intel® Xeon® CPU [email protected] GHz computer with 256GB RAM was used to run the simulations in explicit-dynamic LS-DYNA (Ansys/LST, Canonsburg, PA, US). The simulations were performed in one-step for 80 ms with time steps of 1 ms (80 time steps). Cerebrospinal fluid pressure (CSFP) was applied on the outer surface of the brain from 0-5 ms with the magnitude of −10 mmHg (-1.33 kPa) (Turner et al. 1996; Eklund et al. 2016) that is determined based on the human intracranial pressure in the supine body position. Thereafter, from 5-80 ms the pressure was set to +10 mmHg. The MRI images show the brain under applied CSFP, therefore, a negative CSFP would help to precondition the tissue and thereafter pressure it back to the same load boundary.
Ocular manifestations of endocrine disorders
Published in Clinical and Experimental Optometry, 2022
M Hossein Nowroozzadeh, Sarah Thornton, Alison Watson, Zeba A Syed, Reza Razeghinejad
Hypoparathyroidism can cause hypocalcaemia, which is an infrequent cause of papilledema. It is suspected that significant hypocalcaemia can alter cerebrospinal fluid dynamics, leading to elevated intracranial pressure and papilledema. However, the mechanism is not fully characterized, and in fact some reports describe a normal cerebrospinal fluid pressure in these cases. Alternatively, hypocalcaemia may cause a local effect on axonal transport at the optic nerve head, causing disc oedema. Regardless of the mechanism, hypoparathyroidism and hypocalcaemia may be considered in the differential diagnosis of papilledema. Suspicion should be increased in the presence of coexisting symptoms such as seizures or muscle cramps.75,76 Hypoparathyroidism has also been rarely reported in association with optic neuritis.77
Intracranial metastasis from prostate adenocarcinoma: a case report and literature review
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Suhu Liu, Ahmed Hassaan Qavi, Yoel Kim, Prasanta Basak, Stephen Jesmajian
Complete blood count revealed moderate normocytic anemia with Hb 7.3 g/dl. There was no leukocytosis or thrombocytopenia. Chemistry was significant for hypocalcemia (6.4 mg/dl) and elevated alkaline phosphatase (572 IU/L). A chest X-rayshowed no infiltrative pulmonary process, but extensive osteoblastic metastases with aggressive periosteal reaction was seen in multiple ribs and both scapula (Figure 1). He was empirically treated for sepsis with intravenous antibiotics. The fever, left eyelid ptosis, and swelling resolved after 2 days of intravenous piperacillin and tazobactam. Blood cultures were sterile. Due to lack of a clear source of infection, a contrast enhanced brain MRI and a lumbar puncture were performed. The lumbar tap was benign with a normal cerebrospinal fluid pressure, cell count, and chemistries. Brain MRI however showed leptomeningeal enhancement with a large area of dural and epidural hyperintensity (Figure 2), which was highly concerning for dural metastasis from disseminated prostate adenocarcinoma. The patient was subsequently discharged to short-term rehabilitation for physical therapy pending further workup and treatment. In the interim, two attempted bone marrow biopsies by hematologists and radiologists failed due to extremely sclerotic metastasis with no bone material retrieved.