Some diagnostic difficulties

Gaisford, Wilfrid

doi:10.1016/s0022-3476(60)80125-4

Cited by 5 publications

(1 citation statement)

References 10 publications

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“…Any corticosteroid or ACTH preparation may be involved but triamcinolone has been reported surprisingly often (17). Many different diseases treated with steroids or ACTH and complicated by abnormally raised intracranial pressure have been reported (8, 9,14,27,33,45,73,75). Children receiving long-term steroids for asthma, rheumatoid arthritis or blood dyscrasias are characteristic victims (78).…”

Section: Etiologymentioning

confidence: 99%

BENIGN INTRACRANIAL HYPERTENSION (PSEUDOTUMOR CEREBRI): Review and Report of 18 Cases

Hagberg

Sillanpää

1970

Acta Paediatrica

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Section: Etiologymentioning

confidence: 99%

BENIGN INTRACRANIAL HYPERTENSION (PSEUDOTUMOR CEREBRI): Review and Report of 18 Cases

Hagberg

Sillanpää

1970

Acta Paediatrica

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Pseudotumor Cerebri in Congenital Adrenal Hyperplasia

Gordon¹,

Kelsey²

1967

Arch Pediatr Adolesc Med

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BENIGN INTRACRANIAL hypertension has been reported as a complication of prolonged steroid therapy by a number of authors. The following case report describes the occurrence of the syndrome in a child with congenital adrenal hyperplasia who had been treated with steroids for nine years before she manifested the syndrome of pseudotumor cerebri. From this report and a review of the literature, it would appear that patients with the syndrome of pseudotumor cerebri following steroid therapy should be treated in a conservative fashion. Report of a CaseA 10-year-old white girl (NCBH 23 47 60) was diagnosed at 10 days of age as having congenital adrenal hyperplasia of the salt-losing type. She was admitted to the North Carolina Baptist Hospital with a history of intermittent vomiting of five days' duration. One sibling with enlarged genitalia died at 14 days of age.Physical examination revealed a female infant with an enlarged clitoris. Laboratory studies were diagnostic of congenital adrenal hyperplasia. She responded to treatment and was dis¬ charged on a regimen of 25 mg cortisone ace¬ tate (Cortone) intramuscularly (IM) weekly, 25 mg desoxycorticosterone trimethylacetate (Doca) IM monthly, and a daily addition of 1 gm NaCl to the formula. Because of the NC 27103 (Dr. Kelsey). difficulty in regulation of her serum electro¬ lytes, changes were made in the therapeutic program; pertinent data concerning her subse¬ quent course are summarized in the Table. Severe generalized headaches and four days of vomiting resulted in her most recent admis¬ sion to the North Carolina Baptist Hospital when she was 9 years old. Physical examina¬ tion revealed a moderately obese female with a temperature of 101 F (38.3 C), pulse rate of 90 beats per minute, respirations, 16, and blood pressure, 110/50. Pertinent findings were an enlarged clitoris, bilateral papilledema and bi¬ lateral Babinski responses. X-ray films of the chest were normal, and those of the skull re¬ vealed prominent saggital and coronal sutures. The serum electrolytes, serum urea nitrogen, blood sugar and hemogram were all normal. Urinary 17-ketosteroids (KS) were 17.5 mg/24 hr. The morning after admission the child de¬ veloped a left abducens palsy. The cortisone acetate dose was increased to 75 mg per day. A brain scan using Technetium was normal. The electroencephalogram showed bilateral diffuse slow-wave activity. A ventriculogram revealed a fluctuating pressure of 90 to 120 mm and a nor¬ mal ventricular system except for the fourth ventricle, which was not well visualized. The ventricular fluid protein was 19 mg/100 ce. A right subtemporal decompression was per¬ formed and at surgery the dura was tight and nonpulsatile. She tolerated this procedure well. During surgery and postoperatively she was given 100 mg hydrocortisone (Solu-Cortef) in saline intravenously. Her dosage of oral corti¬ sone was gradually tapered over the next four days and she was discharged on cortisone, 12.5 mg every 12 hours, fludrocortisone (Florinef), 0.1 mg every 12 hours, and salt tablets...

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Coarctation Of the Aorta

Margileth¹

1964

Arch Surg

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Some diagnostic difficulties

Cited by 5 publications

References 10 publications

BENIGN INTRACRANIAL HYPERTENSION (PSEUDOTUMOR CEREBRI): Review and Report of 18 Cases

BENIGN INTRACRANIAL HYPERTENSION (PSEUDOTUMOR CEREBRI): Review and Report of 18 Cases

Pseudotumor Cerebri in Congenital Adrenal Hyperplasia

Coarctation Of the Aorta

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