scholarly journals IDIOPATHIC INTRACRANIAL HYPERTENSION IN UNIVERSITY HOSPITAL IN SAUDI ARABIA, RETROSPECTIVE STUDY

2021 ◽  
Vol 9 (08) ◽  
pp. 300-305
Author(s):  
Faisal Al-Abass ◽  
◽  
Kawther Hadhiah ◽  
Abdullah Al-Fajri ◽  
Hanan AlHabib. ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Retrospective Study ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
University Hospital ◽  
Hormonal Contraceptives ◽  
Common Symptom ◽  
Blurred Vision ◽  
High Index Of Suspicion ◽  
The University

Background: Idiopathic intracranial hypertension (IIH) is one of headache syndromes that is female predominate and associated with increase intracranial pressure without obvious etiology, it has variable clinical presentation, and it needs high index of suspicion to reach diagnosis even with presence of well-established diagnostic criteria. Visual symptoms, which range from visual obscuration to blindness significantly,affect the outcome of this disease. Unfortunately, there is limited literature about IHH in Middle East and in Saudi Arabia in particular. In this retrospective study, we try to shed the light on pseudo-tumor cerebri in university hospital in Saudi Arabia. Methodology: This is a retrospective study conducted among 105 patients with IIH admitted to the university hospital in Saudi Arabia. Data on age, gender, as well as about symptoms, obesity, medication and surgeries, and CT/MRI results was collected. Results: The mean age of patients was 37.72 years old with standard deviation of 13.48 where 96.2 % of patients were females. Headache is the more common symptom presented by 96.2 % of patients followed with blurred vision and papilledema (85.7 %) and over weight (77.1 %). Considering medications taken by patients because of IIH, we found that main medications was Diamox which prescribed to 96.2 % with mean dose of 942.3 mg. Regarding surgical intervention, 4.8 % had a surgery of VP-shunt and 1.9 % had optic nerve fenestration Conclusion: We concluded that IIH incidence is higher among young women with higher body weight and associated with the use of hormonal contraceptives. The main symptoms of IIH are headache with papilledema and visual disturbances. Acetazolamide is the most common prescribed medication for IIH patients while 6.6 % of patients need surgical procedures.

Intracranial hypertension and papilloedema as a complication to low antiretroviral therapy adherence in a man living with chronic HIV

2021 ◽  
Vol 14 (3) ◽  
pp. e237504
Author(s):  
Rosa Maja Møhring Gynthersen ◽  
Helene Mens ◽  
Marianne Wegener ◽  
Neval Ete Wareham
Keyword(s):  
Antiretroviral Therapy ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Ventricular Volume ◽  
Art Adherence ◽  
Hiv Viral Load ◽  
Blurred Vision ◽  
Antiretroviral Therapy Adherence ◽  
Acute Retroviral Syndrome

We describe a 61-year-old man living with HIV on antiretroviral therapy (ART), who presented with headache, dizziness and blurred vision. Latest CD4+ cell count 3 months prior to admission was 570×106 cells/mL and HIV viral load <20 copies/mL. The patient was diagnosed with cerebrospinal fluid (CSF) lymphocytic pleocytosis, raised intracranial pressure and papilloedema. Neuroimaging showed normal ventricular volume and no mass lesions, suggesting (1) neuroinfection (2) idiopathic intracranial hypertension or (3) retroviral rebound syndrome (RRS) as possible causes. Neuroinfection was ruled out and idiopathic intracranial hypertension seemed unlikely. Elevated plasma HIV RNA level was detected consistent with reduced ART adherence prior to admission. RRS is a virological rebound after ART interruption, which can mimic the acute retroviral syndrome of acute primary infection. To the best of our knowledge, we describe the second case of RRS presenting as CSF lymphocytic pleocytosis and elevated intracranial pressure after low ART adherence.

Management of idiopathic intracranial hypertension in children utilizing venous sinus stenting

2020 ◽  
pp. 159101992097623
Author(s):  
Justin Schwarz ◽  
Ali Al Balushi ◽  
Sri Sundararajan ◽  
Marc Dinkin ◽  
Cristiano Oliveira ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Surgical Procedures ◽  
Medical Management ◽  
Idiopathic Intracranial Hypertension ◽  
Venous Sinus ◽  
Lateral Sinus ◽  
Invasive Treatment ◽  
Blurred Vision ◽  
Surgical Interventions ◽  
Persistent Symptoms

Background Venous sinus stenting (VSS) is an accepted and minimally invasive treatment for adult idiopathic intracranial hypertension (IIH) associated with lateral sinus stenosis (LSS). The efficacy and safety of venous sinus stenting (VSS) in children with IIH has not been established. Methods This is a retrospective analysis of IIH patients 18 years of age or younger with LSS treated with VSS at our institution. Included patients have fulminant disease course or are refractory or intolerant to medical management. Results Eight patients were identified; 4 males and 4 females. Mean age is 13.4 years (range 4–18). All patients had severe headaches, 5 had blurred vision, 3 had diplopia and 3 had pulsatile tinnitus. Papilledema was present in 4 patients. Three patients had prior surgical procedures. Four patients were intolerant to medical management, 3 were refractory and 1 had fulminant course. Cerebral venography demonstrated severe stenosis of the dominant sinus in 6 patients and of bilateral co-dominant sinuses in 2 patients. Six patients had intrinsic stenosis and 2 had extrinsic stenosis. Venous sinus stenting (VSS) resulted in improvement of symptoms, papilledema and normalization of CSF opening pressure in 7 patients. No immediate complications were observed. Mean follow-up period is 21 months (range 6–42). Two patients required re-stenting; one responded well and the other had persistent symptoms and underwent subsequent surgical procedures of CSF diversion, suboccipital decompression and duraplasty which were also ineffective. Conclusion VSS may provide a viable option for pediatric IIH patients who are intolerant to medication, have failed conservative management or prior surgical interventions, or present with fulminant disease.

scholarly journals 080 The incidence, diagnosis and outcomes of idiopathic intracranial hypertension in the southern tasmanian catchment

2019 ◽  
Vol 90 (e7) ◽  
pp. A25.3-A26
Author(s):  
Natasha Krishnadas ◽  
Bruce Taylor
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Incidence Rates ◽  
Regional Studies ◽  
Opening Pressure ◽  
Exclusion Criteria ◽  
Human Ethics ◽  
Regional Population ◽  
Australian Bureau Of Statistics ◽  
The University

IntroductionThis study aimed to identify the incidence of idiopathic intracranial hypertension (IIH) in Southern Tasmania, Australia. Secondary aims were to elucidate demographics, current approaches to investigation, treatment and outcomes. To our knowledge, similar regional studies have not been performed.MethodsThe study was approved by the University of Tasmania Human Ethics Committee. Patients presented between June 2016-June 2018 to Royal Hobart Hospital, the single tertiary Neurology service in Tasmania. Cases were identified by screening lumbar punctures (LP) performed by Neurology services (inpatient, outpatient, Radiologically-assisted) and by surveying all regional Neurologists. Medical records were used to corroborate LP results and determine whether patients met Modified Dandy Criteria (MDC) (used to define IIH in current literature). Regional population statistics were obtained from the Australian Bureau of Statistics (ABS). Duplicate records were excluded. Exclusion criteria included age <18 at data collection, LP opening pressure <20cm of water or secondary causes for IIH.Results45 cases identified; 30 within the Greater Hobart region, population of 229,088 (June 2016-June 2017). Cumulative incidence was 6.55/100,000 (incidence rate 0.06/1000) with classification based on Neurologist diagnosis and 5.46/100,000 (0.05/1000) with classification according to MDC. 100% of the cohort were female. Mean age was 26.7 (range 17–45) and mean weight was 105.3kg (range 78–170). Headache was the most commonly reported symptom. 8.9% (4/45) of the total cohort were medically refractory (requiring VP/LP shunting). Ophthalmology services initiated 51% (23/45) of the referrals.ConclusionsOur incidence rates are higher than rates in previous studies for population subsets of young women.

scholarly journals Adequacy of the Endometrial Samples Obtained by the Uterine Explora Device and Conventional Dilatation and Curettage: A Comparative Study

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Maria Abdulrahim Arafah ◽  
Ammar Cherkess Al-Rikabi ◽  
Rakia Aljasser ◽  
Yaser Adi
Keyword(s):  
Saudi Arabia ◽  
Retrospective Study ◽  
Comparative Study ◽  
Outpatient Clinic ◽  
Diagnostic Yield ◽  
Age Groups ◽  
University Hospital ◽  
Dilatation And Curettage ◽  
Clinical Indications ◽  
The Difference

Aims. Our aim is to compare the adequacy and diagnostic yield of samples obtained by the endometrial Explora Sampler I-MX120 with endometrial specimens obtained by conventional dilatation and curettage (D&C).Methods. A total of 1270 endometrial samples were received in the histopathology laboratories at the King Khalid University Hospital, Riyadh, Saudi Arabia, between 2007 and 2010. In the outpatient clinic, the Uterine Explora Model I was used to obtain 996 samples. The remaining 274 samples were obtained by conventional D&C. Sample adequacy and the clustering of inadequate specimens according to age groups by the two different techniques were compared and statistically analyzed.Results. Out of 1270 endometrial samples, 253 (19.9%) were inadequate. The Uterine Explora was used in 88.5% of these inadequate samples (253 samples), and the remaining 11.5% were obtained by D&C. The insufficient tissue incidence was higher with the Explora (17.6%) than with the D&C (2.2%) and the difference was statistically significant(P<0.0001). The ages of the patients, as well as the clinical indications for the procedures, were recorded.Conclusion. This retrospective study demonstrated better specimen adequacy when D&C was used compared to the higher rate of sample insufficiency obtained with the Explora.

scholarly journals Two Episodes of Ventriculoperitoneal Shunt Migration in a Patient with Idiopathic Intracranial Hypertension

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
V. Balakrishnan ◽  
R. Jeanmonod
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Symptom Control ◽  
Subsequent Development ◽  
Distal Portion ◽  
Obese Patients ◽  
Medical Provider ◽  
And Migration ◽  
High Index Of Suspicion ◽  
Shunt Migration

Introduction. Ventriculoperitoneal shunts are often placed as treatment for refractory idiopathic intracranial hypertension. Dislodgement and migration of the distal portion of the shunt are more common in obese patients and can be difficult to detect. We report the case of a woman with two separate episodes of shunt migration into her abdominal wall.Case Presentation. We report a case of a 37-year-old female with history of obesity eventually diagnosed with idiopathic intracranial hypertension (IIH) as the cause. She failed outpatient therapy and, through neurosurgery, had a VP shunt placed for symptom control. She had subsequent development of worsened symptoms that were found to be due to shunt migration. This happened not once but twice to the same patient.Conclusion. Shunt dislodgement, migration, and subsequent failure are common in obese patients who have shunts placed for IIH. The medical provider should maintain a high index of suspicion for shunt malfunction in these patients, particularly because clinical evaluation may be challenging due to habitus.

scholarly journals A Clinical and Pathological Study of Kikuchi–Fujimoto Disease in A University Hospital in Saudi Arabia

2018 ◽  
Vol 25 (1) ◽  
pp. 23-29
Author(s):  
Fahad A. Alghamdi ◽  
Mohammed S. Abdelwahed ◽  
Abdulaziz Alghamdi ◽  
Hani z. Marzouki ◽  
Ghadeer A. Mokhtar ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Retrospective Study ◽  
Histopathological Examination ◽  
Complete Recovery ◽  
Benign Disease ◽  
University Hospital ◽  
Pathological Features ◽  
Pathological Study ◽  
King Abdulaziz University ◽  
Clinical And Pathological Features

Kikuchi–Fujimoto disease is a benign disease of self-limiting course characterized by lymphadenopathy that is often mistaken clinically as lymphoma or infectious lymphadenitis. To prevent such a mistake, a clinical and pathological correlation is recommended. In this retrospective study, we are documenting the clinical and pathological features of this disease through the last 15 years (2001-2016) in King Abdulaziz University Hospital; and comparing results with that of international findings. From a total number of 1805 lymph nodes sent for histopathological examination during that period, only 9 cases had been diagnosed as Kikuchi–Fujimoto disease. Three (33%) cases were 20 years old and under; five (56%) cases were in the ages between 20 to 40 years old and only one (11%) was above 40 years old. Eight (89%) cases were females. Regarding the outcome, all cases showed complete recovery and there was no recurrence. Only two histological phases were seen, namely proliferative and necrotizing phases.  

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