Subdural Hematoma Presenting as Recurrent Syncope

Bruner, David I.; Jamros, Christine; Cogar, William

doi:10.1016/j.jemermed.2015.01.037

Cited by 3 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The proposed mechanism is a temporary impeding of cerebral blood flow by a sudden increase in intracranial pressure. 34 , 35 The high frequency of episodic collapse in our study and the response to treatment should increase awareness for increased intracranial pressure with valsalva‐type maneuvers as a possible cause of syncope in dogs and cats in the absence of cardiovascular disease.…”

Section: Discussionmentioning

confidence: 79%

Solitary intraventricular tumors in dogs and cats treated with radiotherapy alone or combined with ventriculoperitoneal shunts: A retrospective descriptive case series

Beckmann

Kowalska

Meier

2022

Veterinary Internal Medicne

View full text Add to dashboard Cite

Background Intraventricular tumors are rare, optimal treatment is not defined. Symptomatic patients often exhibit life‐threatening hydrocephalus. With several months time‐to‐effect after radiotherapy (RT), increased intracranial pressure is concerning. This increase in pressure can be overcome by ventriculoperitoneal shunting (VPS). Objectives Retrospective evaluation of outcome and complications in dogs and cats with intracranial tumors treated with either RT or VPS/RT. Animals Twelve client‐owned cats and dogs. Methods Dogs and cats with symptomatic intraventricular tumors treated with definitive‐intent RT or VPS/RT were included in a retrospective, descriptive case series. Complications, tumor volume evolution, time‐to‐progression, and survival time were determined. Results Twelve animals were included: 1 cat and 5 dogs treated with single‐modality RT and 4 cats and 2 dogs treated with VPS/RT. Neurological worsening seen in 4/6 animals during single‐modality RT and 2/6 died during RT (suspected brain herniation). All dogs with VPS normalized clinically by the end of RT or earlier. Complications occurred in 4/6 animals, all but 1 were successfully managed surgically. Imaging follow‐up in 8 animals surviving RT showed a marked decrease in tumor volume. Median survival time was 162 days (95% confidence interval [CI]: 16; infinity) for animals treated with RT and 1103 days (95%CI: 752; infinity) for animals treated with VPS/RT. Median time‐to‐progression was 71 days (95%CI: 7; infinity) and 895 days (95%CI: 704; infinity) for each group, respectively. Two dogs died because of intraventricular metastasis 427 and 461 days after single‐modality RT. Conclusions and Clinical Importance Ventriculoperitoneal shunting led to rapid normalization of neurological signs and RT had a measurable effect on tumor volume. Combination of VPS/RT seems to be beneficial.

show abstract

Section: Discussionmentioning

confidence: 79%

Solitary intraventricular tumors in dogs and cats treated with radiotherapy alone or combined with ventriculoperitoneal shunts: A retrospective descriptive case series

Beckmann

Kowalska

Meier

2022

Veterinary Internal Medicne

View full text Add to dashboard Cite

show abstract

“…The mental status of patients with transtentorial downward brain herniation is generally severely altered, and patients may present with coma and respiratory failure 24. The severity and specific combination of symptoms in each patient presenting with ONP reflect the underlying cause of injury, location of damage, and degree of disruption to the nerve 14.…”

Section: Discussionmentioning

confidence: 99%

Isolated oculomotor nerve palsy resulting from acute traumatic tentorial subdural hematoma

Cui

Kouliev

2016

OAEM

View full text Add to dashboard Cite

Acute subdural hematoma (SDH) resulting from head trauma is a potentially life-threatening condition that requires expedient diagnosis and intervention to ensure optimal patient outcomes. Rapidly expanding or large hematomas, elevated intracranial pressure, and associated complications of brain herniation are associated with high mortality rates and poor recovery of neurological function. However, smaller bleeds (clot thickness <10 mm) or hematomas occurring in infrequent locations, such as the tentorium cerebelli, may be difficult to recognize and patients may present with unusual or subtle signs and symptoms, including isolated cranial nerve palsies. Knowledge of neuroanatomy supported by modern neuroimaging can greatly aid in recognition and diagnosis of such lesions. In this report, we present a case of isolated oculomotor nerve palsy resulting from compressive tentorial SDH following blunt head trauma, review the literature concerning similar cases, and make recommendations regarding the diagnosis of SDH in patients presenting with isolated cranial nerve palsies.

show abstract

Section: Head Trauma and Increased Intracranial Pressurementioning

confidence: 99%

“…There have been case reports of disorders causing increased intracranial pressure (ICP) resulting in recurrent syncope (22). In one case report, the recurrent syncopal events in a 36-year-old female were associated with ICP spikes to > 60 mm Hg in the setting of cerebral venous sinus thrombosis, and in the case of a 75-year-old male with recurrent syncope during coughing episodes, evaluation revealed an atraumatic subdural hematoma that was causing transient transtentorial herniation leading to the recurrent syncope (22,23). Similar to the previously described condition of temporal lobe epilepsy causing syncope from ictal bradycardia or asystole, syncope from increased ICP does technically fall under the diagnostic umbrella of transient LOC due to global cerebral hypoperfusion (recalling that cerebral blood flow is directly proportional to cerebral perfusion pressure, and cerebral perfusion pressure is the difference between mean arterial pressure and ICP).…”

Section: Head Trauma and Increased Intracranial Pressurementioning

confidence: 99%