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Increased Intracranial Pressure ll: Pathophysiology01:29

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Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins...
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Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
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Increased Intracranial Pressure l: Introduction01:14

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Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component...
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Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features...
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DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic...
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DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
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The pseudotumor cerebri syndrome.

Deborah I Friedman1

  • 1Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC-9036, Dallas, TX 75390-9036, USA; Department of Ophthalmology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9036, USA.

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PubMed
Summary

Pseudotumor cerebri syndrome, a condition causing increased intracranial pressure, can lead to severe vision loss. This review covers its diagnosis, evaluation, and management in both adults and children.

Keywords:
Cerebrospinal fluidIdiopathic intracranial hypertensionPapilledemaPseudotumor cerebri

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Area of Science:

  • Neurology
  • Ophthalmology

Background:

  • Pseudotumor cerebri syndrome (PTCS) is a neurological disorder characterized by increased intracranial pressure.
  • PTCS can be idiopathic or secondary to other conditions.
  • The primary morbidity associated with PTCS is visual loss, which can be profound and irreversible.

Purpose of the Study:

  • To provide a comprehensive review of the diagnosis, evaluation, and management of pseudotumor cerebri syndrome.
  • To cover PTCS in both adult and pediatric populations.

Main Methods:

  • Literature review of existing studies and clinical guidelines on PTCS.
  • Synthesis of diagnostic criteria, neuroimaging findings, and ophthalmological assessments.
  • Outline of current therapeutic strategies, including medical and surgical options.

Main Results:

  • PTCS diagnosis relies on clinical presentation, funduscopic examination, and cerebrospinal fluid pressure measurements.
  • Visual impairment is a significant complication, necessitating prompt intervention.
  • Management strategies vary based on severity and underlying causes, aiming to preserve vision and reduce intracranial pressure.

Conclusions:

  • Early diagnosis and appropriate management are crucial for preventing permanent visual loss in PTCS patients.
  • A multidisciplinary approach involving neurologists and ophthalmologists is recommended.
  • Further research is needed to optimize treatment protocols for pseudotumor cerebri syndrome.