Relationship between intracranial pressure and aneurysmal subarachnoid hemorrhage grades

Wang, Xiang; Chen, Jinxiu; Mao, Qing; Liu, Yan‐Hui; You, Chao

doi:10.1016/j.jns.2014.09.011

Cited by 12 publications

(4 citation statements)

References 22 publications

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“…We also conjectured that aneurysms arising from the anterior circulation could be a more frequent cause of Terson's syndrome. The highest incidence of Terson's syndrome from aneurysms in the internal carotid territory might be associated with the highest increase of intracranial pressure among the anterior circulation aneurysms, as discussed in the study by Wang et al, 14) whereas, aneurysmal SAH from the posterior circulation only accounts for 8.7% of the whole study group, and among them, only 2 cases have been diagnosed as Terson's syndrome. Regarding the method of operation involved, currently, aneurysms of the posterior circulation are usually treated by endovascular coil embolization.…”

Section: Discussionmentioning

confidence: 87%

Practical Incidence and Risk Factors of Terson's Syndrome: A Retrospective Analysis in 322 Consecutive Patients with Aneurysmal Subarachnoid Hemorrhage

Lee

Choi

Han

et al. 2015

J Cerebrovasc Endovasc Neurosurg

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ObjectiveTerson's syndrome, a complication of visual function, has occasionally been reported in patients with aneurysmal subarachnoid hemorrhage (SAH), however the factors responsible for Terson's syndrome in aneurysmal SAH patients have not yet been fully clarified. In this study, we report on potential risk factors for prediction and diagnosis of Terson's syndrome in the earlier stage of the disease course in patients with aneurysmal SAH.Materials and MethodsThe authors retrospectively analyzed the data of 322 consecutive patients who suffered from aneurysmal SAH in a single institution between Jan. 2007 and Dec. 2013. Medical records including demographics, neurologic examination, and radiologic images were collected to clarify the risk factors of Terson's syndrome. Patients with visual problem were consulted to the Department of Ophthalmology.ResultsAmong 332 patients with aneurysmal SAH, 34 patients were diagnosed as Terson's syndrome. Four individual factors, including World Federation of Neurosurgical Societies (WFNS) grade at admission, aneurysm size, method of operation, and Glasgow outcome scale showed statistically significant association with occurrence of Terson's syndrome. Of these, WFNS grade at admission, aneurysm size, and method of operation showed strong association with Terson's syndrome in multivariate analysis. Terson's syndrome accompanied by papilledema due to increased intracranial pressure led to permanent visual complication.ConclusionIn patients with aneurysmal SAH, the patients' WFNS grade at admission, the size of the aneurysms, particularly the diameter of the aneurysm dome, and the method of operation might influence development of Terson's syndrome.

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Section: Discussionmentioning

confidence: 87%

Practical Incidence and Risk Factors of Terson's Syndrome: A Retrospective Analysis in 322 Consecutive Patients with Aneurysmal Subarachnoid Hemorrhage

Lee

Choi

Han

et al. 2015

J Cerebrovasc Endovasc Neurosurg

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“…The incidence of abducens nerve palsy was 35.5%, which was consistent with previously reported figures, but the incidence may increase further if patients in a more severe condition are included. The intracranial pressure often increases with a higher WFNS grade and H&H grade at the time of arrival, 7) and abducens nerve palsy was reported to be more likely in patients with a higher intracranial pressure. 8,9) Moreover, Zhang et al hypothesized that the abducens nerve is likely to receive mechanical pressure with changes in the intracranial pressure by his own autopsy findings, it is because the nerve has a long course and is surrounded by a lot of structures such as the cerebellar tentorium, ligaments, and microvessels.…”

Section: Discussionmentioning

confidence: 98%

Clinical Course of Abducens Nerve Palsy in Patients with Ruptured Vertebral Artery Dissecting Aneurysms

Yamaoka

Fujita

Fujii

et al. 2022

JNET

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Objective: There are few detailed reports on abducens nerve palsy due to a ruptured vertebral artery dissecting aneurysm (VADA). We investigated the clinical characteristics and long-term course of abducens nerve palsy in ruptured VADA patients treated by endovascular surgery.Methods: Of the 51 cases of ruptured VADA treated by endovascular intervention from 2011 to 2019, 31 with a good/fair outcome, in which ocular motility disorder was able to be followed, were included and investigated.Results: In all, 11 patients (35.5%) had abducens nerve palsy, and the World Federation of Neurological Surgeons (WFNS) grade and Hunt & Hess (H&H) grade at the time of arrival of patients with abducens nerve palsy were significantly higher than those of patients without abducens nerve palsy. Of the 10 patients who were able to be followed, abducens nerve palsy in 3 completely recovered in 7-180 days. Abducens nerve palsy improved in five patients and remained in two patients. Conclusion:More severe neurological findings on admission reflect a higher rate of abducens nerve palsy. Diplopia induced by abducens nerve palsy is one of the most important sequelae of ruptured VADA, which impairs the daily activities of the patients. Some cases of abducens nerve palsy improve over a long period. Therefore, appropriate diagnosis and follow-up should be concerned.

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“…Xiang et al, in their study also concluded that volume of SAH does not correlate with the increase in ICP. 8 They however concluded that ICP positively correlates with H and H and WFNS which are predictor of consciousness.…”

Section: Correlation Between Eicp and Modified Fishermentioning

confidence: 97%

The correlation between the preoperative measurement of estimated cerebral perfusion pressure and estimated intracranial pressure as obtained by trans cranial doppler with modified fisher grade as seen in computed tomography scan head in patients with acute sub arachnoid hemorrahage undergoing surgical clipping

2019

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Background: In Aneurysmal Sub Arachnoid haemorrhage, precise Cerebral Perfusion Pressure (CPP) and Intracranial Pressure (ICP) measurement can only be achieved by an invasive monitoring device. The study aimed at non-invasively estimating the preoperative values of CPP and ICP by use of validated formulae. These estimated flow velocities (estimated CPP or eCPP and estimated ICP or eICP) of the Middle Cerebral Artery were obtained by Trans Cranial Doppler ultrasound and comparing it with the preoperative CT Head Fisher Scale. In the Institute Rimed Digi-Lite Trans Cranial Doppler machine was used for research and Siemens (Somatom) 64 CT Scanner from GE (Signa) was used to perform CT scan of patients.Methods: It is a prospective, observational study which was studied between July 2017 and December 2018 in Post Graduate Institute of Medical Education and Research, Chandigarh, India. This study is a secondary analysis of a prospective observational study which was primarily designed to evaluate the neurological outcome related to the effect of estimated Intracranial Pressure and estimated Cerebral Perfusion Pressure as measured by Trans Cranial Doppler in patients with a SAH. A total of 100 patients were recruited in this study.Results: There was significant correlation between estimated CPP and Fisher Grading. There was no strong correlation between the modified Fisher Grade and estimated ICP.Conclusions: This study was able to give a statistically significant correlation between eCPP and Fisher Grading (p value- 0.047), as the Modified Fisher grading increased, so did the eCPP, this observation was unique, and it went against the hypothesis. However, no statistically significant co-relation was seen during comparison of eICP and Fisher Grading (p value- 0.069).

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Relationship between intracranial pressure and aneurysmal subarachnoid hemorrhage grades

Cited by 12 publications

References 22 publications

Practical Incidence and Risk Factors of Terson's Syndrome: A Retrospective Analysis in 322 Consecutive Patients with Aneurysmal Subarachnoid Hemorrhage

Practical Incidence and Risk Factors of Terson's Syndrome: A Retrospective Analysis in 322 Consecutive Patients with Aneurysmal Subarachnoid Hemorrhage

Clinical Course of Abducens Nerve Palsy in Patients with Ruptured Vertebral Artery Dissecting Aneurysms

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