Posterior fossa subdural hematoma of the newborn

1971 ◽  
Vol 34 (3) ◽  
pp. 423-426 ◽  
Author(s):  
L. Philip Carter ◽  
Hal W. Pittman
Keyword(s):  
Intracranial Pressure ◽  
Posterior Fossa ◽  
Newborn Infant ◽  
Subdural Hematoma ◽  
Communicating Hydrocephalus ◽  
Increased Intracranial Pressure ◽  
Content Type ◽  
Surgical Evacuation ◽  
Increased Pressure ◽  
Fine Print

✓ A newborn infant with a posterior fossa subdural hematoma is described, and nine similar cases from the literature summarized. A postnatal asymptomatic period was followed by signs of increased intracranial pressure. The diagnosis was established on the basis of negative subdural taps, bloody or xanthochromic ventricular fluid under increased pressure, and demonstration of a posterior fossa mass on the ventriculogram. Surgical evacuation with careful observation for an associated intracerebellar hematoma is the treatment of choice. Five of the 10 cases developed postoperative communicating hydrocephalus.

Conray ventriculography in the diagnosis of intraventricular and posterior fossa lesions

1971 ◽  
Vol 34 (3) ◽  
pp. 405-407 ◽  
Author(s):  
Salvador Gonzalez-Cornejo
Keyword(s):  
Intracranial Pressure ◽  
Posterior Fossa ◽  
Increased Intracranial Pressure ◽  
Content Type ◽  
Conray Ventriculography ◽  
Fine Print

✓ The author reports the safe and satisfactory use of Conray ventriculography in 26 patients with increased intracranial pressure and discusses his technique for this procedure.

Intracranial xanthogranuloma of the dura in Hand-Schüller-Christian disease

1993 ◽  
Vol 78 (2) ◽  
pp. 297-300 ◽  
Author(s):  
Zain Alabedeen B. Jamjoom ◽  
Vinita Raina ◽  
Abdulfattah Al-Jamali ◽  
Abdulhakim B. Jamjoom ◽  
Basim Yacub ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Clinical Features ◽  
Obstructive Hydrocephalus ◽  
Relevant Literature ◽  
Increased Intracranial Pressure ◽  
Falx Cerebri ◽  
Content Type ◽  
Tentorium Cerebelli ◽  
Ultrastructural Studies ◽  
Fine Print

✓ The authors describe a 37-year-old man with the classic clinical features of Hand-Schüller-Christian disease. He presented with symptoms of increased intracranial pressure due to obstructive hydrocephalus secondary to a huge xanthogranuloma involving falx cerebri and tentorium cerebelli. Immunohistochemical and ultrastructural studies failed to demonstrate Langerhans histiocytes, however. The implication of this finding is discussed in light of the recent relevant literature.

Subdural hematomas of the posterior fossa in normal-weight newborns

1984 ◽  
Vol 61 (5) ◽  
pp. 972-974 ◽  
Author(s):  
José Hernansanz ◽  
Francisco Muñoz ◽  
Daniel Rodríguez ◽  
Concepción Soler ◽  
Carlos Principe
Keyword(s):  
Surgical Treatment ◽  
Posterior Fossa ◽  
Subdural Hematoma ◽  
Newborn Infants ◽  
Normal Weight ◽  
Content Type ◽  
Specific Symptoms ◽  
Symptoms And Signs ◽  
Fine Print ◽  
Early Surgical Treatment

✓ Two cases are reported of subdural hematoma of the posterior fossa in normal-weight full-term newborn infants. The most salient factors in these cases were the lack of specific symptoms and signs indicating the nature and location of the lesion, the importance of computerized tomography for diagnosis, and the good results obtained with early surgical treatment.

The abnormal pupil in Cheyne-Stokes respiration

1990 ◽  
Vol 72 (5) ◽  
pp. 810-812 ◽  
Author(s):  
Edward F. Gonyea
Keyword(s):  
Subdural Hematoma ◽  
Sympathetic Nerve ◽  
Oculomotor Nerve ◽  
Nerve Compression ◽  
Nerve Paralysis ◽  
Content Type ◽  
Pupillary Dilatation ◽  
Surgical Evacuation ◽  
Fine Print

✓ Cheyne-Stokes respiration commonly induces a rhythmic pupillary dilatation during hyperpnea and constriction during apnea. Failure of a pupil to dilate during hyperventilation indicates underlying sympathetic nerve paralysis. This report deals with an instance in which one pupil failed to constrict during apnea due to oculomotor nerve compression. The periodic respirations and anisocoria disappeared following surgical evacuation of a large ipsilateral subdural hematoma.

Acute spinal subdural hematoma

1974 ◽  
Vol 41 (5) ◽  
pp. 627-630 ◽  
Author(s):  
Albert Zilkha ◽  
John M. Nicoletti
Keyword(s):  
Subdural Hematoma ◽  
Neurological Recovery ◽  
Content Type ◽  
Surgical Evacuation ◽  
Spinal Subdural Hematoma ◽  
Fine Print

✓ A case of an acute posttraumatic spinal subdural hematoma is presented. Complete neurological recovery followed surgical evacuation.

Pneumocephalus in patients with CSF shunts

1985 ◽  
Vol 63 (4) ◽  
pp. 532-536 ◽  
Author(s):  
John R. Ruge ◽  
Leonard J. Cerullo ◽  
David G. McLone
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Mental Status ◽  
Aqueductal Stenosis ◽  
Increased Intracranial Pressure ◽  
Csf Shunts ◽  
Content Type ◽  
Presenting Symptoms ◽  
Fine Print

✓ The authors present two cases of pneumocephalus occurring in patients with permanent shunts and review nine previously reported cases. Mental status changes and headache are the most common presenting symptoms. Six of the 11 cases of pneumocephalus occurred in patients with shunt placement for hydrocephalus secondary to aqueductal stenosis. In these patients, thinned cerebrospinal fluid barriers secondary to longstanding increased intracranial pressure may predispose them to pneumocephalus. Temporary extraventricular drainage is an effective method of treatment in this group of patients. Two other etiologies are identified with significance to treatment, and the role of craniotomy is discussed.

Complication of a large cranial defect

1976 ◽  
Vol 44 (4) ◽  
pp. 506-508 ◽  
Author(s):  
Kamran Tabaddor ◽  
James LaMorgese
Keyword(s):  
Intracranial Pressure ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Content Type ◽  
Cranial Defect ◽  
Early Cranioplasty ◽  
Fine Print

✓ A patient with acute subdural hematoma was successfully treated with hemicraniectomy. He developed contralateral weakness 4 months after surgery which was reversed by cranioplasty. The presumptive mechanism is a gradient between atmospheric and intracranial pressure. Early cranioplasty is suggested to prevent this phenomenon.

Vascularized temporalis muscle flap for the treatment of otorrhea

2003 ◽  
Vol 98 (5) ◽  
pp. 1128-1132 ◽  
Author(s):  
Gabriel C. Tender ◽  
Scott Kutz ◽  
Deepak Awasthi ◽  
Peter Rigby
Keyword(s):  
Intracranial Pressure ◽  
Muscle Flap ◽  
Middle Fossa ◽  
Temporalis Muscle ◽  
Increased Intracranial Pressure ◽  
Content Type ◽  
Middle Fossa Approach ◽  
Medial Side ◽  
Temporalis Muscle Flap ◽  
Fine Print

✓ The surgical treatment for cerebral spinal fluid (CSF) fistulas provides closure of the bone and dural defects and prevents the recurrence of brain herniation and CSF fistula. The two main approaches used are the transmastoid and middle fossa ones. The authors review the results of performing a modified middle fossa approach with a vascularized temporalis muscle flap to create a barrier between the repaired dural and bone defects. Fifteen consecutive cases of CSF fistulas treated at the authors' institution were retrospectively reviewed. All patients presented with otorrhea. Eleven patients had previously undergone ear surgery. A middle fossa approach was followed in all cases. The authors used a thin but watertight and vascularly preserved temporalis muscle flap that had been dissected from the medial side of the temporalis muscle and was laid intracranially on the floor of the middle fossa, between the repaired dura mater and petrous bone. The median follow-up period was 2.5 years. None of the patients experienced recurrence of otorrhea or meningitis. There was no complication related to the intracranial temporalis muscle flap (for example, seizures or increased intracranial pressure caused by muscle swelling). One patient developed hydrocephalus, which resolved after the placement of a ventriculoperitoneal shunt 2 months later. The thin, vascularized muscle flap created an excellent barrier against the recurrence of CSF fistulas and also avoided the risk of increased intracranial pressure caused by muscle swelling. This technique is particularly useful in refractory cases.

Intracranial pressure in patients with dementia and communicating hydrocephalus

1974 ◽  
Vol 40 (3) ◽  
pp. 376-380 ◽  
Author(s):  
Jagdish C. Chawla ◽  
A. Hulme ◽  
R. Cooper
Keyword(s):  
Intracranial Pressure ◽  
Continuous Monitoring ◽  
Communicating Hydrocephalus ◽  
Content Type ◽  
Fine Print

✓ Intracranial pressure (ICP) was monitored continuously for 48 to 72 hours in 12 patients with dementia and communicating hydrocephalus, to see if this would help determine which patients might benefit from surgical shunting of CSF, since not all such patients respond to treatment. Patients who showed variability of ICP improved following surgery, while patients with consistently flat ICP tracings did not. It is suggested that continuous monitoring of ICP may help identify cases suitable for surgery.

Intracranial pressure monitoring in the posterior fossa: a preliminary report

1989 ◽  
Vol 71 (4) ◽  
pp. 503-505 ◽  
Author(s):  
Robert H. Rosenwasser ◽  
Laurence I. Kleiner ◽  
Joseph P. Krzeminski ◽  
William A. Buchheit
Keyword(s):  
Intracranial Pressure ◽  
Posterior Fossa ◽  
Cerebrospinal Fluid Leak ◽  
Early Postoperative Period ◽  
Intracranial Pressure Monitoring ◽  
Posterior Fossa Surgery ◽  
Pressure Monitoring ◽  
Content Type ◽  
Cranial Nerve Palsies ◽  
Fine Print

✓ Direct therapeutic drainage and intracranial pressure monitoring from the posterior fossa has never been accepted in neurosurgical practice. Potential complications including cerebrospinal fluid leak, cranial nerve palsies, and brain-stem irritation have been a major deterrent. The authors placed a catheter for pressure monitoring in the posterior fossa of 20 patients in the course of posterior fossa surgery: 14 patients with acoustic schwannomas, four with posterior fossa meningiomas, one with cerebellar hemangioblastoma, and one with a solitary cerebellar metastatic lesion. A Richmond bolt was also placed in the frontal area. Continuous monitoring of the supratentorial and infratentorial compartments was performed for 48 hours. During the first 12 hours the posterior fossa pressure was 50% greater than that of the supratentorial space in all patients (p < 0.01). Over the next 12 hours the supratentorial pressure was 10% to 15% higher than the posterior fossa pressures in all patients, and by 48 hours of monitoring the pressures had equilibrated. There was no mortality or morbidity referable to insertion of the posterior fossa catheter. The conclusions drawn from this study are that: 1) direct monitoring and drainage of the posterior fossa is safe and effective; and 2) within the early postoperative period, the supratentorial pressures failed to reflect what is taking place within the posterior fossa. The implications and advantages of direct posterior fossa monitoring in the postoperative patient are discussed.

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