69 patients with hypertensive intracerebral hemorrhage (HICH) admitted within 24 hours of stroke onset. 14/69 patients (20.3%) with enlarged hematomas after the first CT was performed during 30 minutes at admission and the second within 24-36 hours of admission (33%). Multivariate analyses revealed that the following three factors were independently associated with hematoma enlargement: the time from stroke onset, prothrombin ratio, the shape of hematoma. Hematoma enlargement was an independent factor increasing the mortality rate in the HICH patients
Hematoma ; Diagnosis ; Intracranial Hemorrhage, Hypertensive ; Hypertension

In order to better understand the clinical manifestation of systemic lupus erythematosus (SLE) with intracranial hypertension syndrome (IHS), we analyzed the clinical features and treatment of a typical SLE patient with IHS. SLE is one of the most unpredictable autoimmune diseases involving multiple organ systems that is defined clinically and associated with antibodies directed against cell nuclei. IHS is an uncommon manifestation of neuropsychiatric SLE (NPSLE) and is characterized by an elevated intracranial pressure, papilledema, and headache with occasional abducens nerve paresis, absence of a space-occupying lesion or ventricular enlargement, and normal cerebrospinal fluid chemical and hematological constituents. IHS has been reported in a few sporadic cases in patients with SLE worldwide, but rarely has been reported in China. In this study, a 34-year-old female SLE patient with IHS was reported and pertinent literature reviewed. The clinical presentation, image logical features, and investigatory findings were discussed.
Diagnosis, Differential ; Intracranial Hypertension/diagnosis ; Intracranial Hypertension/*etiology ; Lupus Erythematosus, Systemic/*complications ; Lupus Erythematosus, Systemic/diagnosis

A normal-weight full-term newborn infant with a posterior fossa subdural hematoma is described. This potentially trea table condition has been previously diagnosed in only 13 reported cases. The clinical characteristics in this case were the lack of specific symptoms and signs indicating the nature and location of the lesion and the presence of signs of intracranial hypertension. Computed tomography allowed for earlier confirmation of the diagnosis and early surgical treatment resulted in excellent recovery.
Diagnosis ; Hematoma, Subdural* ; Humans ; Infant, Newborn* ; Intracranial Hypertension

Intracranial infections are one of the most common neurological diseases in children and are associated with high mortality and morbidity. Intracranial hypertension and hydrocephalus are the common, fatal complications of intracranial infections, so early diagnosis and timely treatment are the keys to saving patients' lives and reducing neurological sequelae. This paper introduces the progress in the etiology, diagnosis, and treatment of intracranial hypertension and hydrocephalus in children with intracranial infections.
Central Nervous System Infections ; complications ; Child ; Humans ; Hydrocephalus ; diagnosis ; etiology ; therapy ; Intracranial Hypertension ; diagnosis ; etiology ; therapy

We have experienced 10 cases of intracranial tuberculoma which were confirmed by CT scan in National Medical Center from Jan. '79 to Aug. '82. The analysis is based on 10 cases with intracranial tuberculoma on whom operation was performed in 7 cases and conservative treatment was done in 3 cases. Extracranial disease or a past history of tuberculosis are evident in half of patients. The common presenting features are intracranial hypertension and papilledema. These are usually located in the supratentorial region. The use of CT brain scanning can be of great help in diagnosis and follow up more than others. The current treatment consists of medical therapy such as combined antituberculous agents, but surgical exploration may be reserved for intractable seizure, suspected brain tumor and medical failure or severe intracranial hypertension.
Brain ; Brain Neoplasms ; Diagnosis ; Follow-Up Studies ; Humans ; Intracranial Hypertension ; Papilledema ; Seizures ; Tomography, X-Ray Computed ; Tuberculoma, Intracranial* ; Tuberculosis

Although the detection of intracranial pressure (ICP) is an important precondition for diagnosing intracranial diseases, yet the detection method prevalently used in clinical practice is still invasive. This study is aimed at finding a non-invasive method for effective detection of the variation of patient's ICP so as to release the patient from bodily pain and to provide the doctor with evidences for giving medicine. Based on analyzing and comparing several existing non-invasive ICP detection methods, we have found the linear relationship of flash visual evoked potential (FVEP) with intracranial medium and high pressure by using the statistics obtained from a number of clinical experiments. The FVEP can be picked up effectively by independent component analysis, while the potential latency corresponding to the wave crest of III wave in the VEP waveform picked-up is linearly related to intracranial pressure, thus obtaining ICP from the III wave of FVEP is possible.
Evoked Potentials, Visual ; physiology ; Humans ; Intracranial Hypertension ; diagnosis ; physiopathology ; Intracranial Pressure ; physiology ; Monitoring, Physiologic ; methods ; Signal Processing, Computer-Assisted

BACKGROUND AND PURPOSE: Cerebral venous flow obstruction (CVFO) is a fatal complication of traumatic brain injury. To compare the outcomes of patients with CVFO secondary to traumatic-brain-injury-induced transsinus fracture who were diagnosed early versus those diagnosed late in the therapeutic course. METHODS: In total, 403 patients with transsinus fracture were reviewed retrospectively. The patients were divided into an early-diagnosis group (n=338) and a delayed-diagnosis group (n=65). The patients submitted to 2D time-of-flight magnetic resonance venography (2D-TOF MRV) and/or CT venography (CTV), depending upon the findings of intracranial pressure monitoring, in order to identify potentially complicated CVFO. These examinations took place within 3 days of the onset of malignant intracranial hypertension symptoms in the early-diagnosis group, and after an average of 7 days in the delayed-diagnosis group. Once diagnosed, patients received intravenous thrombolytic therapy with low-dose urokinase. Patients with massive transsinus epidural hematoma, depressed fracture, or cerebral hernia were treated surgically to relieve the compression and repair any damage to the venous sinuses. RESULTS: Cerebral venous flow obstruction was much more severe in the delayed-diagnosis group than in the early-diagnosis group (p<0.001), and hence patients in the former group were given a higher dose of urokinase (p<0.001) for thrombolytic therapy. They were also significantly more likely to need surgery (48.1% vs. 20.6%, p=0.003) and had a higher mortality rate (37.0% vs. 4.1%, p<0.001). However, patients in both groups experienced a similarly favorable prognosis, not only with regard to functional outcome but also with respect to neuroradiological improvement, as evaluated by 2D-TOF MRV/CTV at the final follow-up (p=0.218). CONCLUSIONS: Delayed diagnosis can result in increased risk of surgery and death in the acute phase. Thrombolytic therapy with low-dose urokinase resulted in promising improvements in both functional and neuroradiological outcomes in all of the patients in this study, regardless of the time to diagnosis.
Brain Injuries* ; Delayed Diagnosis ; Early Diagnosis* ; Encephalocele ; Follow-Up Studies ; Hematoma ; Humans ; Intracranial Hypertension ; Intracranial Pressure ; Magnetics ; Magnets ; Phlebography ; Prognosis ; Retrospective Studies ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator

The CT classification of diffuse head injury permits the early identification of patients at high risk from intracranial hypertension and allows the neurosurgeon the option of early intervention. With the CT classification it is feasible to identify the patients who would appear to be at low risk based on a clinical examination, but who are known from the CT scan diagnosis to be at high risk. The CT classification was based on the status of the mesencephalic cisterns and the degree of midline shift. Diffuse head injury was divided into four subgroups(I, II, III, IV). We analyzed 276 patients with diffuse head injury from January 1995 to september 1996 for identification of likelihood of early raised intracranial pressure in emergency room and decision about early management in patients with diffuse injury. There was close relationship between these diffuse injury type of CT scan and the prognosis. Patients suffering with no pathology(diffuse injury I) and without compression of mesencephalic cistern and midline shift (diffuse injury II) had the lowest mortality rate(1.3%,4.1%), while the mortality rate in patients suffering diffuse injury with a obliteration of mesencephalic cistern(diffuse injury IIIB) and midline shift(diffuse injury IV) was greater than 50%(84.2%,50.0%). The CT diagnosis was a highly significant independent predictor of mortality in diffuse injury I and IIIB but there was an interdependence between the degree of consciousness level and pupil change and the finding on CT scan in diffuse injury II, IIIA and IV.
Classification* ; Consciousness ; Craniocerebral Trauma* ; Diagnosis ; Early Intervention (Education) ; Emergency Service, Hospital ; Head* ; Humans ; Intracranial Hypertension ; Intracranial Pressure ; Mortality ; Prognosis* ; Pupil ; Tomography, X-Ray Computed

The management of patients with severe head injury continues to present neurosurgeons with a major challenge. Despite of early diagnosis and aggressive treatment, it has showed still high mortality and morbidity. We analyzed the results of treatment of 50 cases with severly head injured-children who were treated during past 2 years for detection of predicting factors of outcome. Our conclusions are as follows ; 1) The Glasgow coma scale(GCS) on admission was an important predicting factor for outcome of severe head injury. In patients with 3, 4 of GCS, outcome was poor. In cases above 5 of GCS, outcome was better than the former. 2) The clinical features on admission(i. e., light reflex of pupils, oculocephalic responses and abnormal motor responses) were also important predicting factor of outcome. 3) There was no significant relation between outcome of severe head injury and age distribution in children. 4) The mass lesion occupied relatively small proportion in the types of lesion which was proved by CT scan(26%). 5) Overall outcome showed 28% of good recovery, 26% of moderately disabled, 12% of severly disabled, 12% of vegetative state and 22% of dead.
Age Distribution ; Child* ; Coma ; Craniocerebral Trauma* ; Early Diagnosis ; Head* ; Humans ; Intracranial Hypertension ; Mortality ; Persistent Vegetative State ; Pupil ; Reflex

The signal of flash visual evoked potential (FVEP) is very weak, and often submerges into strong noise environment, like spontaneous electroencephalogram (EEG) signal, so effective de-noising methods should be taken to extract FVEP waveform exactly. In this paper, based upon the frequency feature of FVEP, we use average technology and multi-resolution wavelet transform to filter spontaneous EEG signals, and FVEP can be extracted effectively as a result. While the potential latency corresponding to the N2 wave in the FVEP waveform picked-up is related to intracranial pressure (ICP), the Non-invasive detection of ICP can be realized.
Electroencephalography ; Evoked Potentials, Visual ; physiology ; Humans ; Intracranial Hypertension ; diagnosis ; physiopathology ; Monitoring, Physiologic ; instrumentation ; methods ; Signal Processing, Computer-Assisted ; Wavelet Analysis