Focus on therapy of the Chapter IV headaches provoked by exertional factors: primary cough headache, primary exertional headache and primary headache associated with sexual activity.
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A case of pseudotumor cerebri following glucocorticoid therapy in which warfarin prevented recurrence.
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A patient with nephrotic syndrome developed pseudotumor cerebri following glucocorticoid therapy. Diagnosis of pseudotumor cerebri was based on satisfaction of four criteria proposed by Ahlskog and O'Neill. The symptoms of pseudotumor cerebri disappeared within 10 days. After a three-week interval of remission, relapse occurred. Glycerol and urokinase produced rapid resolution of the symptoms and warfarin prevented further recurrence of pseudotumor cerebri for one year. These results suggest that the pathogenesis of pseudotumor cerebri might be associated with the hypercoagulable state which was induced by glucocorticoid therapy and nephrotic syndrome. (+info)
An update on idiopathic intracranial hypertension.
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Idiopathic intracranial hypertension (IIH) is a condition of unknown etiology often encountered in neurologic practice. It produces nonlocalizing symptoms and signs of raised intracranial pressure and, when left untreated, can result in severe irreversible visual loss. It most commonly occurs in obese women of childbearing age, but it can also occur in children, men, nonobese adults, and older adults. Although it is frequently associated with obesity, it can be associated with other conditions, such as obstructive sleep apnea and transverse cerebral venous sinus stenoses. Recent identification of subgroups at high risk for irreversible visual loss, including black patients, men, and patients with fulminant forms of IIH, help guide the optimal management and follow-up. Ongoing studies of venous anatomy and physiology in IIH patients, as well as a recently begun randomized clinical treatment trial, should provide further insight into this common yet poorly understood syndrome. (+info)
Intracerebral hematoma following lumboperitoneal shunt insertion: a rare case report.
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Lumboperitoneal shunting is widely used for the surgical management of pseudotumor cerebri and other pathologies such as communicating hydrocephalus. Although it is a safe method, it could be associated with complications including subarachnoid hemorrhage, subdural and rarely intracerebral hematoma. A 44-year-old female applied to our clinic with complaints of severe headache, retroorbital pain and blurred vision. Lumbar puncture demonstrated cerebrospinal fluid opening pressure of cmH2O. A non-programmable lumboperitoneal shunt with two distal slit valves was inserted due to pseudotumor cerebri. She deteriorated shortly after surgery. Immediate cranial computed tomography scan revealed a right parietal intracerebral hematoma. Development of intracerebral hematoma following lumboperitoneal shunt is a rare complication. We discuss this rare event accompanied by the literature. (+info)