المؤلفون: D'Antona, Linda^1,2 (AUTHOR), Craven, Claudia Louise¹ (AUTHOR), Haq, Huzaifah¹ (AUTHOR), Thorne, Lewis¹ (AUTHOR), Matharu, Manjit Singh^2,3 (AUTHOR), Toma, Ahmed Kassem^1,2 (AUTHOR), Watkins, Laurence Dale¹ (AUTHOR)

المصدر: British Journal of Neurosurgery. Feb2023, Vol. 37 Issue 1, p112-115. 4p. 3 Black and White Photographs, 1 Graph.

مصطلحات موضوعية: *CEREBROSPINAL fluid shunts, *CLINICAL deterioration, *MAGNETIC resonance imaging, *AIR travel, *BRAIN imaging

مستخلص: Shunted patients often complain of headaches after flights. The effect of air travel on shunt systems is unknown. We describe the case of a patient with longstanding hydrocephalus, who suffered flight-induced clinical deterioration and shunt overdrainage in two independent occasions. The patient, clinically stable for 1.5 and 5 years before each episode, reported severe headaches starting during the descent stages of the air travel. On both occasions, brain MRI imaging demonstrated pronounced ventricular size reduction. This case suggests that flight-induced shunt overdrainage can occur and should be suspected in patients with prolonged headaches and/or clinical deterioration triggered by air travel. [ABSTRACT FROM AUTHOR]

المؤلفون: Funnell, Jonathan P.¹ jfunnell17@gmail.com, Craven, Claudia L.¹ claudia.craven@gmail.com, Thompson, Simon D.¹ simon.thompson3@nhs.net, D’Antona, Linda¹ linda.D'Antona@uclh.nhs.uk, Chari, Aswin¹ aswinchari@gmail.com, Thorne, Lewis¹ lewis.thorne@uclh.nhs.uk, Watkins, Laurence D.¹ laurence.watkins@uclh.nhs.uk, Toma, Ahmed K.¹ ahmedtoma@nhs.net

المصدر: Acta Neurochirurgica. Oct2018, Vol. 160 Issue 10, p2025-2029. 5p. 1 Chart, 2 Graphs.

مصطلحات موضوعية: *INTRACRANIAL hypertension, *PULSATILE flow, *CEREBROSPINAL fluid, *TINNITUS, *MAGNETIC resonance imaging

مستخلص: Introduction: Tinnitus is a symptom commonly associated with idiopathic intracranial hypertension (IIH) that can have a profound effect on quality of life. We aim to determine tinnitus symptom response after dural venous sinus stenting (DVSS) or CSF diversion with a shunt, in patients with both pulsatile (PT) and non-pulsatile tinnitus (NPT).Methods: Single-centre cohort of IIH patients (2006-2016) who underwent 24-h ICP monitoring (ICPM). An un-paired t test compared ICP and pulse amplitude (PA) values in IIH patients with PT vs. NPT.Results: We identified 59 patients with IIH (56 F:3 M), mean age 32.5 ± 9.49 years, 14 of whom suffered from tinnitus. Of these 14, seven reported PT and seven reported NPT. Patients with tinnitus had a mean 24-h ICP and PA of 9.09 ± 5.25 mmHg and 6.05 ± 1.07 mmHg respectively. All 7 patients with PT showed symptom improvement or resolution after DVSS (n = 4), secondary DVSS (n = 2) or shunting (n = 1). In contrast, of the 7 with NPT, only 1 improved post intervention (DVSS), despite 2 patients having shunts and 5 having DVSS.Conclusions: NPT and PT were equally as common in our group of IIH patients. DVSS appears to be an effective management option for IIH patients with a clear history of pulsatile tinnitus. However, non-pulsatile tinnitus was more persistent and did not respond well to either DVSS or CSF diversion. [ABSTRACT FROM AUTHOR]