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    Update on the application of optic nerve sheath fenestration.
    Restor Neurol Neurosci 2017 Mar 23. Epub 2017 Mar 23.
    Sichuan Provincial Key Laboratory for Disease Gene Study, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City, Sichuan Province, China.
    Background: With the ongoing development of surgical procedures and instruments, the safety of optic nerve sheath fenestration (ONSF) has been improved.

    Objective: Through the past three decades, progress has been made in preventing visual loss from chronic optic nerve swelling in idiopathic intracranial hypertension (IIH), secondary intracranial hypertension and local optic nerve diseases. We now review the updated application of ONSF in those diseases. Read More

    Idiopathic intracranial hypertension in a paediatric population: a retrospective observational study on epidemiology, symptoms and treatment.
    J Biol Regul Homeost Agents 2017 Jan-Mar;31(1):195-200
    General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy.
    Idiopathic intracranial hypertension (IIH) is a disorder of unknown origin, which is characterized by elevated intracranial pressure (ICP) without underlying etiological evidence of neurological disease. The purpose of the current study was to evaluate epidemiological features, clinical presentation, diagnostic findings and treatment of sixteen children (7 males and 9 females) with IIH. Medical records of the patients were obtained from the University Paediatric Hospital of Catania, Italy. Read More

    Ocular fundus photography with a smartphone device in acute hypertension.
    J Hypertens 2017 Mar 16. Epub 2017 Mar 16.
    aDepartment of Medicine bDepartment of Ophtalmology, University of Brescia cEmergency Department Gardone Val Trompia, Spedali Civili of Brescia, Brescia, Italy *M. Lorenza Muiesan and Massimo Salvetti have contributed equally to the article.
    Background: The ocular fundus examination is infrequently and poorly performed in the emergency department (ED) clinical settings, placing patients at risk for missed diagnosis of hypertensive emergencies. The aim of this study was to investigate the feasibility of the ocular fundus photography with a smartphone small optical device in an ED setting and to compare it with a traditional ocular fundus examination.

    Methods: The study included 52 consecutive patients (mean age 69 ± 16 years, 50% women) presenting to a hospital ED with an acute increase in blood pressure (SBP > 180 and/or DBP > 100 mmHg). Read More

    Idiopathic intracranial hypertension in monozygotic female twins: Intracranial pressure dynamics and treatment outcome.
    World Neurosurg 2017 Mar 11. Epub 2017 Mar 11.
    Department of Neurosurgery, Hannover Medical School, MHH, Hannover, Germany.
    Background: Familial cases of idiopathic intracranial hypertension (IIH) are exceedingly rare and its occurrence has not been reported before in monozygotic twins.

    Case Description: We describe the cases of monozygotic female twins who developed IIH at age 25 and at age 28, respectively. Continuous intracranial pressure monitoring confirmed elevated intracranial pressure (ICP) as measured initially by lumbar puncture. Read More

    POEMS Syndrome: an Enigma.
    Curr Hematol Malig Rep 2017 Mar 15. Epub 2017 Mar 15.
    Division of Hematology, Medicine and Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
    POEMS syndrome is a paraneoplastic disorder secondary to an underlying plasma cell dyscrasia. By definition, all patients with POEMS syndrome must display polyneuropathy and monoclonal plasma cell disorder. In addition, at least one major criterion (Castleman's disease, sclerotic bone lesions, or vascular endothelial growth factor elevation) and one minor criterion (organomegaly, extravascular volume overload, endocrinopathy, skin changes, papilledema, thrombocytosis, or polycythemia) are required for diagnosis. Read More

    Decision Support System for Detection of Papilledema through Fundus Retinal Images.
    J Med Syst 2017 Apr 10;41(4):66. Epub 2017 Mar 10.
    Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan.
    A condition in which the optic nerve inside the eye is swelled due to increased intracranial pressure is known as papilledema. The abnormalities due to papilledema such as opacification of Retinal Nerve Fiber Layer (RNFL), dilated optic disc capillaries, blurred disc margins, absence of venous pulsations, elevation of optic disc, obscuration of optic disc vessels, dilation of optic disc veins, optic disc splinter hemorrhages, cotton wool spots and hard exudates may result in complete vision loss. The ophthalmologists detect papilledema by means of an ophthalmoscope, Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and ultrasound. Read More

    Fully automated diagnosis of papilledema through robust extraction of vascular patterns and ocular pathology from fundus photographs.
    Biomed Opt Express 2017 Feb 23;8(2):1005-1024. Epub 2017 Jan 23.
    Department of Computer Engineering, National University of Sciences and Technology, Pakistan.
    Rapid development in the field of ophthalmology has increased the demand of computer aided diagnosis of various eye diseases. Papilledema is an eye disease in which the optic disc of the eye is swelled due to an increase in intracranial pressure. This increased pressure can cause severe encephalic complications like abscess, tumors, meningitis or encephalitis, which may lead to a patient's death. Read More

    Natural history of headache in patients with lymphocytic meningitis following lumbar puncture.
    J Clin Neurosci 2017 Mar 2. Epub 2017 Mar 2.
    Department of Neurology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    Background: Analysis of cerebrospinal fluid (CSF) obtained by lumbar puncture (LP) is essential for diagnosis of meningitis. What is the impact of the procedure upon the natural history of headache and associated signs in patients with lymphocytic meningitis and what factors can have prognostic value for the future progression of symptomatology? This study was aimed at looking into these questions.

    Methods: One hundred and one patients with clinical and laboratory diagnosis of aseptic meningitis answered a questionnaire intended at assessing the severity and nature of headache and meningeal irritation signs before and one, and twenty four hours after the LP. Read More

    Multidisciplinary Approach to Complicated Pregnancy.
    South Med J 2017 Mar;110(3):154-160
    From the Department of Pathophysiology, University of Split School of Medicine, Split, the Department of Internal Medicine, University Hospital Center Split, Split, University Psychiatric Hospital Vrapce, University of Zagreb School of Medicine, Zagreb, the Clinical Department of Diagnostic and Interventional Radiology University Hospital Center Split, Split, and the Department of Gynecology and Obstetrics, University Hospital Center Split, Split, Croatia.
    A nulliparous pregnant woman in her mid-20s and in the 32nd week of gestation presented to the emergency department with severe headache and vomiting. She had an uneventful medical history; however, the physical examination upon hospital admission revealed a hypertensive emergency, papilledema, and 2+ dipstick proteinuria. Upon establishing the diagnosis of preeclampsia, aggressive therapy with corticosteroids, antihypertensive medication, and seizure prophylaxis was initiated. Read More

    Endovascular treatment of idiopathic intracranial hypertension: retrospective analysis of immediate and long-term results in 51 patients.
    Neuroradiology 2017 Mar 2. Epub 2017 Mar 2.
    Clinic for Neuroradiology, Klinikum Stuttgart, Kriegsbergstrasse 60, D-70174, Stuttgart, Germany.
    Purpose: Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure in the absence of any known causative factor. Sinus stenosis is common in these patients. Stenting of stenotic dural sinuses has gained popularity as a treatment option, since these stenoses may contribute to an obstruction of the venous return, and, thereby may contribute to IIH via an increase in venous sinus pressure. Read More

    Retrospective analysis of translaminar, demographic, and physiologic parameters in relation to papilledema severity.
    Can J Ophthalmol 2017 Feb 17;52(1):26-29. Epub 2016 Nov 17.
    Department of Ophthalmology, University of North Carolina Hospitals, Chapel Hill, North Carolina.
    Objective: Some case reports suggest that the translaminar pressure difference is important in cases of papilledema. The purpose of this study was to determine ocular, physiologic, and demographic factors associated with papilledema severity.

    Design: Retrospective, blinded study. Read More

    Neuron-specific enolase levels as a marker for possible neuronal damage in idiopathic intracranial hypertension.
    Acta Neurol Belg 2017 Feb 20. Epub 2017 Feb 20.
    Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
    Although formerly considered as a "benign" disease, the presence of some important problems such as vision loss, resistance to appropriate medical treatment and relapses suggests that neuronal damage might play a role in the pathophysiology of IIH. In order to demonstrate possible neuronal damage/dysfunction participating in IIH pathophysiology, we aimed to investigate the relationship between serum neuron-specific enolase (NSE) levels and clinical features in patients with idiopathic intracranial hypertension (IIH). Thirty-six patients with IIH, diagnosed according to the revised criteria, and 40 age, gender and body mass index-matched healthy controls were enrolled in this study after their consent. Read More

    Severe skull base osteomyelitis caused by Pseudomonas aeruginosa with successful outcome after prolonged outpatient therapy with continuous infusion of ceftazidime and oral ciprofloxacin: a case report.
    J Med Case Rep 2017 Feb 21;11(1):48. Epub 2017 Feb 21.
    Infectious Diseases Unit, Hospital General Universitario de Elche, Camino de la Almazara, 11, 03203, Elche, Alicante, Spain.
    Background: Skull base osteomyelitis is an uncommon disease that usually complicates a malignant external otitis with temporal bone involvement. It affects predominantly diabetic and immunocompromised males and has a high mortality rate. Pseudomonas aeruginosa is the most common causative organism. Read More

    Leptomeningeal metastases presenting exclusively with ocular disturbance in 34 patients: A tertiary care cancer hospital experience.
    J Clin Neurosci 2017 Feb 16. Epub 2017 Feb 16.
    Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA; Department of Neurosurgery, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA. Electronic address:
    Leptomeningeal disease (LMD) represents disseminated intracranial metastatic disease that requires early detection and initiation of therapy. Patients with LMD typically present with a variety of neurologic problems, including ocular disturbances. However, little is reported on LMD presenting exclusively with ocular-related disturbances in the absence of any other central nervous system (CNS) dysfunction. Read More

    Afebrile Seizures as Initial Symptom of Hypocalcemia Secondary to Hypoparathyroidism.
    J Neurosci Rural Pract 2016 Dec;7(Suppl 1):S117-S119
    Department of Pediatric, General Hospital of Veroia, Pediatric Clinic, Veroia, Greece.
    Hypocalcemia is rare in childhood and caused, among other conditions, by hypoparathyroidism. DiGeorge syndrome is the most common cause of hypoparathyroidism in childhood. Presentation of a rare cause of hypocalcemia in childhood and the necessity of measuring serum electrolyte levels in patients presenting with afebrile seizures. Read More

    Occipital Falcine Anaplastic Hemangiopericytoma Mimicking Meningioma.
    J Neurosci Rural Pract 2016 Dec;7(Suppl 1):S95-S98
    Department of Neuroscience, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
    The rarity of hemangiopericytoma (HPC) and its controversial histological classification result in its frequent misdiagnosis and thus make the treatment quite challenging. It is often difficult to distinguish these tumors from meningiomas based on clinical features and radiological findings. This is a case report of a man, diagnosed clinically and radiologically as meningioma, which turned out to be anaplastic HPC on histological examination. Read More

    [Clinical experience of 302 cases with brain abscess].
    Zhonghua Wai Ke Za Zhi 2017 Feb;55(2):151-155
    Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China.
    Objective: To compare the diagnosis and treatment experience of brain abscesses and improve prognosis. Methods: The data of 302 patients of brain abscess at Department of Neurosurgery in Tianjin Medical University General Hospital from 1980 to 2014 was analyzed retrospectively. There were 215 male and 87 female patients aged from 11 to 82 years with mean age of (30±8) years. Read More

    Retinal haemorrhages in a university hospital: not always abusive head injury.
    Acta Neurol Belg 2017 Feb 3. Epub 2017 Feb 3.
    Department of Neurology - Paediatric Neurology, Antwerp University Hospital, University of Antwerp, Wijlrijkstraat 10, 2610, Edegem, Belgium.
    Retinal haemorrhages (RH) and subdural haematomas (SDH) are frequently seen in abusive head trauma (AHT). The aim of our study is to show that they are suggestive, but not pathognomonic for AHT. We performed an observational retrospective study on children, aged 1-18 months old, admitted to the Antwerp University Hospital with RH. Read More

    [Papillary oedema revealing Arnold Chiari malformation type 1: about a case].
    Pan Afr Med J 2016 3;24:293. Epub 2016 Aug 3.
    Service d'Ophtalmologie, CHU Mohammed VI, Oujda, Maroc.
    Arnold Chiari malformation type 1 is defined as a herniation of the cerebellar tonsils into the foramen magnum of more than 5 mm. Symptoms are most commonly dominated by occipital headache, torticollis and sometimes swallowing disorders. Ophthalmologically abnormal convergences, oculomotor palsy and diplopia are the main clinical signs. Read More

    Current concepts and strategies in the diagnosis and management of idiopathic intracranial hypertension in adults.
    J Neurol 2017 Jan 31. Epub 2017 Jan 31.
    Departments of Neurology and Ophthalmology, University of Arizona College of Medicine, Phoenix, AZ, USA.
    Since obesity has become an epidemic in industrialized nations, idiopathic intracranial hypertension (IIH) is now a more common neuro-ophthalmic disorder that causes visual loss and headaches. This review highlights the new diagnostic criteria for IIH and the new insights into the pathophysiologic mechanisms of IIH. Key diagnostic and monitoring techniques for papilledema include not only neuroimaging and the measurement of cerebrospinal fluid (CSF) pressure, but also perimetry, optical coherence tomography, and ocular sonography. Read More

    Lhermitte-Duclos disease associated to Cowden syndrome: de novo diagnosis and management of these extremely rare syndromes in a patient.
    BMJ Case Rep 2017 Jan 30;2017. Epub 2017 Jan 30.
    Ophthalmology Department, University Hospital Santa Maria, North Lisbon Hospital Center, Lisbon, Portugal.
    A 36-year-old woman, with history of cutaneous papilomatosis and thyroid carcinoma presented with headache, transitory visual blurring and nausea. Funduscopy showed papilloedema. MRI showed a tumour of the right cerebellar hemisphere with a striated, tigroid pattern, typical of Lhermitte-Duclos disease (LDD). Read More

    P027. Idiopathic intracranial hypertension without papilledema in refractory chronic daily headache.
    J Headache Pain 2015 Dec;16(Suppl 1):A108
    Department of Biomedical and NeuroMotor Sciences (DIBINEM) Alma Mater Studiorum-University of Bologna, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.

    Optic disc haemorrhages at baseline as a risk factor for poor outcome in the Idiopathic Intracranial Hypertension Treatment Trial.
    Br J Ophthalmol 2017 Jan 27. Epub 2017 Jan 27.
    Department of Ophthalmology, University of Iowa College of Medicine, Iowa City, Iowa, USA.
    Background: The risk of optic disc haemorrhages on visual outcome in idiopathic intracranial hypertension (IIH) is unknown. We report the type and frequency of optic disc haemorrhages and other funduscopic abnormalities at baseline in the study eye of the 133 subjects enrolled in the Idiopathic Intracranial Hypertension Treatment Trial completing 6 months of follow-up.

    Methods: We reviewed optic disc photographs to tabulate the frequency and type of optic disc haemorrhages, other funduscopic abnormalities and papilloedema grades of the study eye at baseline and analyse if their presence is associated with a poor visual outcome. Read More

    [A HaNDL case with papilledema mimicking transient ischemic attack].
    Agri 2016 Oct;28(4):199-202
    Department of Neurology, Istanbul Faculty of Medicine, Istanbul, Turkey.
    The syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL), is a rare, benign, self-limiting syndrome that is not well known. Cerebrospinal fluid examination (CSF) on clinical suspicion has diagnostic value for this syndrome, which has a rich neurological symptomatology that can mimic many diseases causing mortality and morbidity. Although the ethiopathogenesis of this syndrome is not fully known, autoimmunity is thought to be in the foreground. Read More

    Steroid treatment in ocular tuberculosis: A double-edged sword?
    J Fr Ophtalmol 2017 Feb 18;40(2):126-132. Epub 2017 Jan 18.
    Service d'ophtalmologie, CHU de Pointe-à-Pitre-Abymes, route de Chauvel, 97159 Pointe-à-Pitre cedex, Guadeloupe.
    Introduction: We report the case of a Caribbean patient with an atypical presentation of bilateral tuberculous chorioretinopathy.

    Patient And Methods: A 57-year-old woman, with hypertension and non-insulin dependent diabetes, was referred to our center for a sudden loss of vision in the right eye to hand motions. Ophthalmic examination revealed only right papilledema. Read More

    The Longitudinal Idiopathic Intracranial Hypertension Trial: Outcomes from Months 6 - 12.
    Am J Ophthalmol 2017 Jan 16. Epub 2017 Jan 16.
    Purpose: To determine whether the beneficial effects of acetazolamide (ACZ) in improving vision at 6 months continues to month 12 in participants of the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT).

    Design: non-randomized clinical study METHODS: In the IIHTT, subjects were randomly assigned to placebo-plus-diet or maximally tolerated dosage of acetazolamide-plus-diet. At 6 months subjects transitioned from study drug to ACZ. Read More

    Idiopathic intracranial hypertension in children: Diagnostic and management approach.
    Sudan J Paediatr 2016 ;16(2):67-76
    Division of Neurology, Departments of Pediatrics, King Khalid University Hospital, College of Medicine, King Saud University , Riyadh , Saudi Arabia.
    Idiopathic intracranial hypertension (IIH) is a rare neurological disorder in children. It is characterized by raised intracranial pressure (ICP) in the absence of brain parenchymal lesion, vascular malformations, hydrocephalus, or central nervous system (CNS) infection. The diagnosis is usually confirmed by high opening pressure of cerebrospinal fluid (CSF) with exclusion of secondary causes of intracranial hypertension. Read More

    Pseudotumour cerebri in children: Aetiology, clinical features, and progression.
    Neurologia 2017 Jan 9. Epub 2017 Jan 9.
    Unidad de Neuropediatría, Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
    Introduction: The definition, associated aetiologies, diagnosis, and treatment of idiopathic intracranial hypertension, or pseudotumour cerebri (PTC), are constantly being revised in the paediatric population.

    Objectives And Methods: Our study included children younger than 15 years old with PTC and attended at a reference hospital in the past 12 years. We analysed the clinical and epidemiological features of our sample and the diagnostic and treatment approaches. Read More

    The Effect of Treatment of Idiopathic Intracranial Hypertension on Prevalence of Retinal and Choroidal Folds.
    Am J Ophthalmol 2016 Dec 28. Epub 2016 Dec 28.
    Department of Ophthalmology and Vision Sciences, Iowa City VA Health Care System, Iowa City, IA.
    Purpose: We described 3 types of folds in the retina and a crease in the outer retina associated with papilledema due to idiopathic intracranial hypertension (IIH) at presentation. We report the change in folds relative to treatment of IIH over the six months. Design/Study Subjects: Substudy of a randomized clinical trial. Read More

    Role of vitamin A metabolism in IIH: Results from the idiopathic intracranial hypertension treatment trial.
    J Neurol Sci 2017 Jan 10;372:78-84. Epub 2016 Nov 10.
    Neurology, University of Iowa School of Medicine, Iowa City, IA, United States.
    Introduction: Vitamin A and its metabolites (called retinoids) have been thought to play a role in the development of idiopathic intracranial hypertension (IIH). The IIH Treatment Trial (IIHTT) showed the efficacy of acetazolamide (ACZ) in improving visual field function, papilledema grade, quality of life and cerebrospinal fluid (CSF) pressure. We postulated that IIH patients would demonstrate elevated measures of vitamin A metabolites in the serum and CSF. Read More

    Intracranial hypertension secondary to high dose cytosine arabinoside - A case study.
    J Infect Chemother 2016 Dec 20. Epub 2016 Dec 20.
    King Faisal Specialist Hospital and Research Centre, Section of Adult Hematology/HSCT, PO Box 3354, Riyadh, 11211, Saudi Arabia.
    We report a rare case of intracranial hypertension following high dose cytosine arabinoside (HiDAC) in a 20-year-old man, with precursor B-cell acute lymphoblastic leukemia (ALL). A five drug induction protocol for ALL was initiated; post induction consolidation was with HiDAC (3 g/m(2) IV every 12 h on days 1, 3 and 5). Post consolidation, cytogenetic remission was attained and he received an intensification and maintenance regimen for ALL, for a period of approximately 24 months. Read More

    Fulminant idiopathic intracranial hypertension and venous stasis retinopathy resulting in severe bilateral visual impairment.
    Eur J Ophthalmol 2017 Mar 10;27(2):e25-e27. Epub 2017 Mar 10.
    West Virginia University Eye Institute, Morgantown, West Virginia - USA.
    Purpose: To report a complicated case of fulminant idiopathic intracranial hypertension and concomitant venous stasis retinopathy leading to postpapilledema optic atrophy.

    Methods: Case report.

    Results: A 34-year-old morbidly obese woman with a history of idiopathic intracranial hypertension (IIH) presented with a 1-month history of bilateral vision loss, diplopia, and left eye pain after being lost to follow-up for 6 years. Read More

    Venous sinus stenting for reduction of intracranial pressure in IIH: a prospective pilot study.
    J Neurosurg 2016 Dec 23:1-8. Epub 2016 Dec 23.
    Departments of 1 Neurological Surgery.
    OBJECTIVE Idiopathic intracranial hypertension (IIH) may cause blindness due to elevated intracranial pressure (ICP). Venous sinus stenosis has been identified in select patients, leading to stenting as a potential treatment, but its effects on global ICP have not been completely defined. The purpose of this pilot study was to assess the effects of venous sinus stenting on ICP in a small group of patients with IIH. Read More

    SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF THE OPTIC DISK IN OPTIC NEUROPATHY.
    Retina 2016 Dec;36 Suppl 1:S168-S177
    *Department of Ophthalmology, Doheny Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California; and †Eye Research Center and Eye Department, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
    Purpose: To evaluate the optic nerve head microvasculature in eyes with acute and chronic optic neuropathies using swept-source optical coherence tomography angiography.

    Methods: In this cross-sectional, observational study, optical coherence tomography angiography images were obtained from the optic nerve heads of 21 eyes of 12 patients with optic disk edema, pseudoedema and atrophy, and 12 eyes of 6 healthy subjects using a 1,050-nm optical coherence tomography angiography (Topcon DRI OCT; Triton). Peripapillary vasculature was assessed within five horizontal slabs consisting of the nerve fiber layer (NFL), ganglion cell layer, inner nuclear layer, choroidal layer, and full-thickness retinal layer. Read More

    [Treatment of idiopathic intracranial hypertension].
    Zhonghua Yan Ke Za Zhi 2016 Dec;52(12):948-951
    Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Medicate Sciences & Peking Union Medical College, Beijing 100730, China.
    Idiopathic intracranial hypertension(IIH) is a kind of diffuse brain swelling disease. Several causes could lead to IIH. Intracranial venous circulatory disturbance is more common. Read More

    Bariatric Surgery or Non-surgical Weight Loss for Idiopathic Intracranial Hypertension? A Systematic Review and Comparison of Meta-analyses.
    Obes Surg 2017 Feb;27(2):513-521
    Department of Bariatric Surgery, Chelsea and Westminster Hospital, London, UK.
    Background: Idiopathic intracranial hypertension (IIH) is associated with obesity and weight loss by any means is considered beneficial in this condition.

    Objectives: This study aims to appraise bariatric surgery vs. non-surgical weight-loss (medical, behavioural and lifestyle) interventions in IIH management. Read More

    Fulminant bilateral papilloedema during low-dose steroid taper in a child with systemic idiopathic arthritis treated with tocilizumab.
    Clin Exp Rheumatol 2017 Jan-Feb;35(1):149-151. Epub 2016 Dec 14.
    University of Western Ontario, London; Department of Paediatrics; and Paediatric Rheumatology, London Health Sciences Center, London, ON, Canada.
    Systemic juvenile idiopathic arthritis (SJIA) is one of the most severe forms of arthritis that affects children younger than 16 years of age at onset. SJIA often requires corticosteroids to control the inflammation. However, long-term corticosteroid use may have adverse effects, including intracranial hypertension (IH). Read More

    Dural sinus stenting for idiopathic intracranial hypertension: factors associated with hemodynamic failure and management with extended stenting.
    J Neurointerv Surg 2016 Nov 8. Epub 2016 Nov 8.
    Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
    Background: Some patients undergoing dural sinus stenting for idiopathic intracranial hypertension (IIH) develop clinical and hemodynamic failure (recurrence of the pressure gradient) owing to stent-adjacent stenosis.

    Objective: To characterize factors associated with hemodynamic failure, and to describe outcomes of patients after repeat stenting.

    Materials And Methods: We reviewed the initial and follow-up clinical, venographic, and hemodynamic data in 39 patients with IIH treated over 17 years with stenting. Read More

    Intracranial Pressure Influences the Behavior of the Optic Nerve Head.
    J Biomech Eng 2017 Mar;139(3)
    Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588-0656;Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, NE 68198-6245;Nebraska Center for Materials and Nanoscience, Lincoln, NE 68588-0656 e-mail:
    In this work, the biomechanical responses of the optic nerve head (ONH) to acute elevations in intracranial pressure (ICP) were systematically investigated through numerical modeling. An orthogonal experimental design was developed to quantify the influence of ten input factors that govern the anatomy and material properties of the ONH on the peak maximum principal strain (MPS) in the lamina cribrosa (LC) and postlaminar neural tissue (PLNT). Results showed that the sensitivity of ONH responses to various input factors was region-specific. Read More

    [Idiopathic intracranial hypertension as a cause of headache].
    Tidsskr Nor Laegeforen 2016 Dec 6;136(22):1895-1898. Epub 2016 Dec 6.
    Nevrologisk avdeling Oslo universitetssykehus, Rikshospitalet og Universitetet i Oslo.
    Idiopathic intracranial hypertension (IIH) is characterised by increased intracranial pressure with normal cerebrospinal fluid, and no evidence of space occupying process, meningeal pathology or venous thrombosis. The condition is associated with obesity, especially in women of childbearing age. IIH is a rare but serious cause of headache, and constitutes a differential diagnosis for sudden-onset headache, particularly if the patient has visual disturbances not related to migraine and reports pulsatile tinnitus, cranial nerve palsy or radiculopathy. Read More

    Asymmetrical Intraocular Pressures and Asymmetrical Papilloedema in Pseudotumor Cerebri Syndrome.
    Neuroophthalmology 2016 Dec 5;40(6):292-296. Epub 2016 Oct 5.
    Moorfields Eye Hospital, City Road, London, United Kingdom; The National Hospital for Neurology and Neurosurgery, London, United Kingdom; St Thomas' Hospital, London, United Kingdom.
    This report is of two cases of asymmetrical papilloedema in patients with asymmetrical intraocular pressures (IOPs). The first patient presented with headaches, transient visual obscurations (TVOs), and elevated IOPs, and was found to have increased intracranial pressure caused by a torcula meningioma. He developed papilloedema after his IOPs were pharmacologically lowered; the papilloedema resolved after the IOP became elevated again after stopping his glaucoma drops, and then again returned as the IOP reduced when the drops were restarted. Read More

    Advanced Vestibular Schwannoma: A Case of Optic Disc Oedema without Hydrocephalus.
    Neuroophthalmology 2016 Oct 27;40(5):222-224. Epub 2016 May 27.
    Department of Ophthalmology, Centro Hospitalar Médio Tejo , Tomar, Portugal.
    A wide range of pathologies can cause papilloedema. Vestibular schwannoma is a benign and slow-growing tumour that causes symptoms and findings on ophthalmic examination when the diagnostic is delayed. The authors report a case of a 64-year-old male who presented with bilateral disc oedema secondary to a vestibular schwannoma grade 4. Read More

    Increased Prevalence of Optic Disc Drusen after Papilloedema from Idiopathic Intracranial Hypertension: On the Possible Formation of Optic Disc Drusen.
    Neuroophthalmology 2016 Aug 1;40(4):171-180. Epub 2016 Jul 1.
    Lifespan Biostatistics Core, Departments of Orthopaedics and Surgery, Alpert Medical School of Brown University/Lifespan/Rhode Island Hospital , Providence, Rhode Island, USA.
    This is a 25-year observational retrospective review of 372 consecutive participants with optic disc drusen or resolved papilloedema from idiopathic intracranial hypertension. The prevalence of optic disc drusen at 19% among eyes with resolved papilloedema was approximately 10 times higher and significantly increased (p < 0.001) as compared with the occurrence in the general population. Read More

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