Cerebral
A. Sahib El-Radhi in Paediatric Symptom and Sign Sorter, 2019
Headache is a common symptom in children, occurring in about 50% of children aged 7 years and 80% of children aged 15 years. It may be acute, acute recurrent, chronic recurrent or progressive, caused by minor viral infections or severe underlying disease such as CNS infection or increased intracranial pressure (ICP). Therefore, careful evaluation of a child with headache is essential. Infants or toddlers with headache present with irritability, unwillingness to play, crying while holding the head or vomiting. The most common causes of headache are acute viral infection, migraine and tension headache. Migraine without aura is the most common type, defined as a headache lasting 1–72 hours, plus two of the following: bilateral or unilateral, pulsating, aggravated by routine physical activities, plus at least one of the following: nausea and/or vomiting, photophobia or phonophobia. Tension headache is diagnosed as headache lasting from 30 minutes to 7 days, in addition to two of the following: pressing/tightening, non-pulsating, mild–moderate intensity, bilateral with no nausea or vomiting.
Cerebral
A Sahib El-Radhi, James Carroll in Paediatric Symptom Sorter, 2017
This is a very common problem, occurring in about 50% of children aged 7 years and 80% of children aged 15 years. It may be acute, acute recurrent, chronic recurrent or progressive, caused by minor viral infection or severe underlying disease such as central nervous system (CNS) infection or increased intracranial pressure (ICP). Therefore, careful evaluation of a child with headaches is essential. Infants or toddlers may present with irritability, unwillingness to play, crying while holding the head or vomiting. The most common cause of headache is an acute viral infection, migraine and tension headache. Migraine without aura is the most common type, defined as a headache lasting 1–72 hours, plus two of the following: bilateral or unilateral, pulsating, aggravated by routine physical activities plus at least one of the following: nausea and/or vomiting, photophobia or phonophobia. Tension headache is diagnosed with these criteria: headache lasting from 30 minutes to 7 days, in addition to two of the following: pressing/tightening, non-pulsating, mild-moderate intensity, bilateral location with no nausea or vomiting.
Subarachnoid hemorrhage
Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor in Essentials of Anesthesia for Neurotrauma, 2018
Management of traumatic SAH goes along with the overall treatment for TBI. In this respect, patients with severe TBI, defined as Glasgow Coma Scale (GCS) score ≤8 on admission, should be monitored and treated aggressively. These patients, often with multiple intracranial lesions in addition to isolated traumatic SAH, should be managed in specialized ICUs with dedicated neurosurgical services.29 Monitoring of the conscious state closely, arterial and cerebral hemodynamics (the mechanism involved with circulation) should be performed to detect and prevent secondary injury.30 Intracranial pressure (ICP) monitoring should be considered.31,32 Repeated brain imaging (CT or, less commonly, MRI) should also be performed to monitor the progression of intracranial lesions.
The Effects of Acute Intracranial Pressure Changes on the Episcleral Venous Pressure, Retinal Vein Diameter and Intraocular Pressure in a Pig Model
Published in Current Eye Research, 2021
Deepta Ghate, Sachin Kedar, Shane Havens, Shan Fan, William Thorell, Carl Nelson, Linxia Gu, Junfei Tong, Vikas Gulati
Intracranial pressure (ICP) measurement is critical to the management of several neurological conditions such as traumatic brain injury, intracranial hemorrhage and cerebral edema. Early recognition and management of elevated ICP reduce mortality and long-term morbidity from decreased cerebral perfusion, brain herniation and death.1–5 The current gold standard for ICP measurement involves cannulation of a manometer into the cerebrospinal fluid (CSF) space through lumbar puncture, intraventricular device or intra-parenchymal probe. These techniques are invasive, painful, require a high degree of technical expertise and have the potential for serious complications.6 There is a critical societal need to develop a non-invasive, easy and accurate quantitative biomarker to estimate acute ICP elevations. This can aid triage and evacuation decisions in civilian and military non-clinical facilities.
Effects of Acute Intracranial Pressure Changes on Optic Nerve Head Morphology in Humans and Pig Model
Published in Current Eye Research, 2022
Sachin Kedar, Junfei Tong, John Bader, Shane Havens, Shan Fan, William Thorell, Carl Nelson, Linxia Gu, Robin High, Vikas Gulati, Deepta Ghate
Intracranial pressure (ICP) measurement is important in the management of catastrophic neurological conditions (traumatic brain injury and intracranial hemorrhage), as well as chronic diseases, such as idiopathic intracranial hypertension and normal pressure hydrocephalus.1 Current methods for ICP measurement, such as external ventricular drainage, parenchymal monitoring or lumbar puncture (LP), are invasive, require trained personnel and clinical settings, such as hospitals or clinics, and have increased risks for serious complications, such as chronic pain, infections, and neurological deficits.2 Thus, there is a critical need to develop noninvasive clinical methods for ICP estimation. The optic nerve head (ONH) may be an ideal site to explore biomarkers for such clinical methods.
Intracranial Hypertension Associated With Testosterone Therapy In Female-To-Male Transgender Patients: A Case Report And Literature Review
Published in Seminars in Ophthalmology, 2023
Alisha Kamboj, Meghan M. Brown, Anne S. Abel
Idiopathic intracranial hypertension (IIH) is a rare disorder affecting 1 to 2 per 100,000 people in the United States.1,2 It is most prevalent in women of child-bearing age and is often associated with weight gain. Patients frequently present with symptoms of increased intracranial pressure (ICP), including headache, transient visual obscurations, diplopia, and pulsatile tinnitus.1 The disorder is a diagnosis of exclusion and must fulfill the Modified Dandy Criteria: signs or symptoms of elevated ICP; absence of localizing or focal neurologic signs, with the exception of abducens nerve palsy or impaired consciousness; increased cerebrospinal fluid (CSF) pressure with normal CSF composition; and absence of an alternative etiology on examination and neuro-imaging.3 While rare, IIH may lead to optic neuropathy and precipitate permanent vision loss. The substantial morbidity associated with IIH highlights the importance of timely and appropriate evaluation and management.1