Hot Topics: High and Low CSF Pressure Headaches

(MedPage Today) -- How do you diagnose and treat high and low cerebrospinal fluid pressure headaches? Three clinicians provide a primer: lumbar puncture is key to diagnosing both conditions but treatment strategies differ considerably.
Source: MedPage Today Pain Management - Category: Anesthesiology Source Type: news

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This study suggests that while further research is warranted, cosyntropin is a potential alternative to epidural blood patch for pediatric patients with postdural puncture headache who fail conservative management.
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
AbstractPurpose of ReviewPseudotumor cerebri syndrome (PTCS) may affect both children and adults; however, the risk factors and clinical presentation vary greatly between these populations. This review aims to highlight the entity of PTCS in children and the unique considerations in this population; review the epidemiology and demographics; discuss the clinical presentation, revised diagnostic criteria, and approach to evaluation; review management strategies; and discuss the prognosis and long-term outcomes in children with PTCS.Recent FindingsClinical presentation can be variable in children and may be less obvious than ...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
ConclusionsThe decision of how to manage LM-associated hydrocephalus is complex and requires close collaboration amongst the physician, patient, and/or patient ’s family/friends/community leaders. Ultimately, the decision should be rooted in the patients’ values and should aim to optimize a patient’s quality-of-life.
Source: Journal of Neuro-Oncology - Category: Cancer & Oncology Source Type: research
Conclusion: Symptomatic epidural CSF collections rarely occur in adults following LPs. Nevertheless, the management remains the same as for pediatric patients; bed rest for 72 h results typically in full resolution of symptoms/signs and regression of the collection on MR studies. PMID: 30210902 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs
Conclusions: Ineffectiveness of conservative measures and epidural blood patches performed posteriorly to resolve PDPH should lead the physician both to question the diagnosis of PDPH by pursuing radiographic confirmation of a cerebral spinal fluid leak and, furthermore, identification of its location to best direct further therapy.
Source: Regional Anesthesia and Pain Medicine - Category: Anesthesiology Tags: Pediatric Analgesia: Case Report Source Type: research
CONCLUSIONS: Ineffectiveness of conservative measures and epidural blood patches performed posteriorly to resolve PDPH should lead the physician both to question the diagnosis of PDPH by pursuing radiographic confirmation of a cerebral spinal fluid leak and, furthermore, identification of its location to best direct further therapy. PMID: 28178090 [PubMed - as supplied by publisher]
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Reg Anesth Pain Med Source Type: research
Management of Idiopathic Intracranial Hypertension (IIH) is not standardised. A multidisciplinary Special Interest Group (SIG) was established to develop a uniform investigation and treatment strategy according to disease severity based on current literature and expert consensus. Methods A systematic literature review of "IIH";"Benign IH" and "pseudotumour cerebri" was followed by a SIG meeting, to identify the population, interventions, controls and outcomes (PICO) questions. Discrepant views were reflected in a questionnaire disseminated though a modified Delphi approach to district general ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - Category: Neurosurgery Authors: Tags: Cranial nerves, Headache (including migraine), Pain (neurology), Hypertension, Ophthalmology, Radiology, Radiology (diagnostics) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research
Objective To ensure good outcomes in the management of subarachnoid haemorrhage (SAH), accurate prediction is crucial for initial assessment of patients presenting with acute headache. We conducted this study to develop a new clinical decision rule using only objectively measurable predictors to exclude SAH, offering higher specificity than the previous Ottawa SAH Rule while maintaining comparable sensitivity. Design Multicentre prospective cohort study. Setting Tertiary-care emergency departments of five general hospitals in Japan from April 2011 to March 2014. Participants Eligible patients comprised 1781 patients age...
Source: BMJ Open - Category: Journals (General) Authors: Tags: Open access, Emergency medicine, Neurology Research Source Type: research
Conclusions CT with no follow-up was shown to be the best strategy when the pre-test probability of SAH is low (99.6%). Otherwise, LP should be the preferred strategy for follow-up.
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: Headache (including migraine), Pain (neurology), Radiology, Clinical diagnostic tests, Radiology (diagnostics) Original article Source Type: research
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