Intracranial hypertension secondary to sigmoid sinus compression by group A streptococcal epidural abscess

Ludemann, Jeffrey P.; Poskitt, Kenneth J.; Singhal, Ash

doi:10.1017/s0022215109990764

Cited by 3 publications

(2 citation statements)

References 8 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 39 Epidural abscesses can also restrict venous outflow. 40 Of note, while lesion volume can appear small (see Figure 4(b) ), the impact on ICP may be wholly unrelated and excessive (compared to the apparent reserve space/compliance of a CT image).…”

Section: Introductionmentioning

confidence: 99%

Monro-Kellie 2.0: The dynamic vascular and venous pathophysiological components of intracranial pressure

Wilson

2016

J Cereb Blood Flow Metab

279

189

View full text Add to dashboard Cite

For 200 years, the ‘closed box’ analogy of intracranial pressure (ICP) has underpinned neurosurgery and neuro-critical care. Cushing conceptualised the Monro-Kellie doctrine stating that a change in blood, brain or CSF volume resulted in reciprocal changes in one or both of the other two. When not possible, attempts to increase a volume further increase ICP. On this doctrine’s “truth or relative untruth” depends many of the critical procedures in the surgery of the central nervous system. However, each volume component may not deserve the equal weighting this static concept implies. The slow production of CSF (0.35 ml/min) is dwarfed by the dynamic blood in and outflow (∼700 ml/min). Neuro-critical care practice focusing on arterial and ICP regulation has been questioned. Failure of venous efferent flow to precisely match arterial afferent flow will yield immediate and dramatic changes in intracranial blood volume and pressure. Interpreting ICP without interrogating its core drivers may be misleading. Multiple clinical conditions and the cerebral effects of altitude and microgravity relate to imbalances in this dynamic rather than ICP per se. This article reviews the Monro-Kellie doctrine, categorises venous outflow limitation conditions, relates physiological mechanisms to clinical conditions and suggests specific management options.

show abstract

Section: Introductionmentioning

confidence: 99%

Monro-Kellie 2.0: The dynamic vascular and venous pathophysiological components of intracranial pressure

Wilson

2016

J Cereb Blood Flow Metab

279

189

View full text Add to dashboard Cite

show abstract

“…Regarding the management of venous sinus thrombosis, a previous report has shown that tympanostomy tube insertionor myringotomy aloneis usually sufficient surgical therapy (in addition to IV antibiotics and consideration of anticoagulation therapy) [11]. In this case, a cortical mastoidectomy, or perhaps even more extensive surgery, would have been considered had there been evidence of coalescence, cholesteatoma and/or an abscess adjacent to the venous sinus thrombosis [12].…”

Section: Discussionmentioning

confidence: 99%

Luc’s Abscess: First Reported Case with Coexisting Intracranial Abscess and/or Venous Sinus Thrombosis

Akbari¹,

Strahlendorf²,

Ludemann³

et al. 2018

View full text Add to dashboard Cite

A 4-year-old male had fever for two weeks, left-sided otalgia and otorrhea for 1 week and then suddenly developed left temporal soft tissue swelling and papilledema. Computerized tomography scan revealed a 3.5 x 2.3 x 1.2cm subperiosteal temporal space (Luc's) Abscess, a 4.6 x 2.7 x 2.5 cm temporal lobe abscess, and transverse plus sigmoid sinus thrombosis. The patient was successfully treated with surgical drainage, long-term intravenous antibiotics, and anti-coagulation. Conclusion: To our knowledge, this is the first documented case of Luc's abscess with a coexisting intracranial abscess and/or venous sinus thrombosis. Although Luc's abscess is a rare and usually relatively benign complication of acute otitis media, early diagnosis and treatment remain essential in preventing potentially life-threatening disease progression.

show abstract

Cranial Epidural Abscesses

Akhaddar

2017

Atlas of Infections in Neurosurgery and Spinal Surgery

View full text Add to dashboard Cite

Intracranial hypertension secondary to sigmoid sinus compression by group A streptococcal epidural abscess

Cited by 3 publications

References 8 publications

Monro-Kellie 2.0: The dynamic vascular and venous pathophysiological components of intracranial pressure

Monro-Kellie 2.0: The dynamic vascular and venous pathophysiological components of intracranial pressure

Luc’s Abscess: First Reported Case with Coexisting Intracranial Abscess and/or Venous Sinus Thrombosis

Cranial Epidural Abscesses

Contact Info

Product

Resources

About