Arteriovenous malformations (AVMs) are abnormal connections of arteries and veins without intermediate capillary components. As such, AVMs can remain asymptomatic or have a variety of clinical presentations ranging from mild headaches to severe symptoms like seizures, hemorrhage, and subsequent coma. Papilledema and increased intracranial pressure without hydrocephalus or hemorrhage are rare forms of presentations of cerebral AVM. The mechanism of intracranial hypertension accompanying brain AVMs is not entirely understood, and the right treatment strategy is controversial. Here, we present the treatment and outcomes of four patients with unruptured AVMs who presented with intracranial hypertension accompanied by visual symptoms, papilledema, and without evidence of hydrocephalus. In cases of AVMs accompanied by intracranial hypertension, AVM treatment should be considered the main target of management.
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http://dx.doi.org/10.1177/19714009241303068 | DOI Listing |
ASIDE Intern Med
December 2024
Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Introduction: Managing idiopathic intracranial hypertension (IIH) is challenging due to limited treatment options. This study evaluates metformin as a potential therapy for IIH, examining its impact on disease outcomes and safety.
Methods: We performed a retrospective cohort study using the TriNetX database, covering data from 2009 to August 2024.
Neurosurg Rev
January 2025
Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA.
Awake craniotomy (AC) facilitates real-time brain mapping, maximizing tumor resection while preserving critical neurological functions. This study systematically reviews the efficacy of several anesthetic protocols under Monitored Anesthesia Care (MAC) during AC, focusing on clinical outcomes. A systematic review and meta-analysis were conducted using data from observational studies and randomized trials involving AC under MAC.
View Article and Find Full Text PDFJ Neurol
January 2025
Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, Australia.
Background: Idiopathic intracranial hypertension (IIH) is increasingly prevalent, yet longitudinal outcome data are scarce. This study aimed to characterise demographic and longitudinal clinical changes in a cohort of patients with IIH.
Methods: Retrospective cohort analysis on adult patients diagnosed with IIH (Friedman criteria) enrolled in the neuro-ophthalmology database (NODE) across two tertiary centres.
Croat Med J
December 2024
Marijan Klarica, Department of Pharmacology and Croatian Institute for Brain Research, University of Zagreb School of Medicine, Šalata 3b, 10000 Zagreb, Croatia,
It is generally accepted that intraocular pressure (IOP) depends on the rate of aqueous humor production, system outflow resistance, and episcleral venous pressure. Therefore, control IOP values are expected to be within the strict and predictable limits in specific animal species, and there should be no vast differences between species. However, in the literature the control IOP values significantly vary (from potentially "hypotensive" to "hypertensive") within the same species, and especially between species depending on the measurement technique, head position in relation to the rest of the body, circadian rhythm, age, and topical and systemic drugs (anesthetics) applied.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Surgery, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Objective: Increased intracranial pressure (ICP) can worsen the clinical condition of traumatic brain injury (TBI) patients. One non-invasive and easily bedside-performed technique to estimate ICP is ultrasonographic measurement of optic nerve sheath diameter (ONSD). This study aimed to analyze ONSD and correlate it with ICP values obtained by intraparenchymal monitoring to establish the ONSD threshold value for elevated ICP and reference range of ONSD in severe TBI patients.
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