TITLE

Orthostatic mesodiencephalic dysfunction after decompressive craniectomy

AUTHOR(S)
Bijlenga, Philippe; Zumofen, Daniel; Yilmaz, Hasan; Creisson, Eric; de Tribolet, Nicolas
PUB. DATE
April 2007
SOURCE
Journal of Neurology, Neurosurgery & Psychiatry;Apr2007, Vol. 78 Issue 4, p430
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
An extreme syndrome of the trephined after decompressive craniectomy is reported here. The most extensive clinical syndrome observed was established over 4 weeks and consisted of bradypsychia, dysartria, and limb rigidity with equine varus feet predominating on the right. The syndrome was aggravated when the patient was sitting with the sequential appereance over minutes of a typical parkinsonian levodopa-resistant tremor starting on the right side, extending to all four limbs, followed by diplopia resulting from a left abducens nerve palsy followed by a left-sided mydriasis. All signs recovered within 1–2 h after horizontalisation. It was correlated with an orthostatic progressive sinking of the skin flap, MRI and CT scan mesodiencephalic distortion without evidence of parenchymal lesion. Brain stem auditory evoked potential wave III latency increases were observed on the right side on verticalisation of the patient. EEG exploration excluded any epileptic activity. Symptoms were fully recovered within 2 days after cranioplasty was performed. The cranioplasty had to be removed twice due to infection. Bradypsychia, speech fluency, limb rigidity and tremor reappeared within a week after removal of the prosthesis. While waiting for sterilisation of the operative site, the symptoms were successfully prevented by a custom-made transparent suction-cup helmet before completion of cranioplasty.
ACCESSION #
24777699

 

Related Articles

  • Current Opinions on Epidemiology, Treatment and Outcome After Traumatic Brain Injury. Urbanek, Florian; Frink, Michael; Grün, Orna; Lohse, Ralf; Hildebrand, Frank; Andruszkow, Hagen // Journal of Trauma & Treatment;Special2012, Vol. 1 Issue S, p1 

    Objective: The objective of this article is to provide an overview on current incidences of traumatic brain injury (TBI) with special focus on current surgical and non-surgical treatment options as well as outcome. Method: A Medline database search was performed using various combinations of the...

  • ICP monitoring in children: why are we not adhering to guidelines? Roumeliotis, Nadia; Pettersen, Géraldine; Crevier, Louis; Émeriaud, Guillaume // Child's Nervous System;Nov2015, Vol. 31 Issue 11, p2011 

    Background: Despite pediatric guidelines, variability exists in the management of severe traumatic brain injury (TBI), as somewhere between 7 and 60 % of children undergo intracranial pressure (ICP) monitoring. Reasons for this low adherence to TBI management guidelines remain unclear. The...

  • Does size matter? Decompressive surgery under review. Kurzbuch, Arthur // Neurosurgical Review;Oct2015, Vol. 38 Issue 4, p629 

    In patients with traumatic brain injury (TBI) and ischemic hemispheric stroke (IHS), supratentorial decompressive craniectomy (DC) is performed when intracranial pressure (ICP) is unresponsive to medical treatment. There are numerous publications about the indications of supratentorial DC, the...

  • AIRWAY MANAGEMENT IN PATIENTS WITH BRAIN INJURY. Meier, Curtis // Emergency Nurse;Dec2013, Vol. 21 Issue 8, p18 

    Research has highlighted potential for changes in the technique and implementation of the bag-valve-mask system, a common piece of equipment used during resuscitation attempts to ventilate patients' lungs and deliver oxygen. This article analyses a critical incident involving a patient who...

  • Hypertonic saline in paediatric traumatic brain injury: a review of nine years' experience with 23.4% hypertonic saline as standard hyperosmolar therapy. Piper, B. J.; Harrigan, P. W. // Anaesthesia & Intensive Care;Mar2015, Vol. 43 Issue 2, p204 

    We describe the protocolised use of 23.4% hypertonic saline solution (HTS) for intracranial hypertension in the context of traumatic brain injury in the paediatric population. This study represents the largest published data on the use of 23.4% HTS in the paediatric population. In this...

  • Ernährungstherapie bei Schädel-Hirn-Trauma. Marcus, H.E.; Spöhr, F.A.; Böttiger, B.W.; Grau, S.; Padosch, S.A. // Anaesthesist;Aug2012, Vol. 61 Issue 8, p696 

    Severe traumatic brain injury ranks among the most common causes of death in young adults in western countries. Severe traumatic brain injury is typically followed by a pronounced pathophysiological cascade that accounts for many deaths. The aim of intensive care medicine after traumatic brain...

  • The use of Hypertonic Saline in the Treatment of Post-Traumatic Cerebral Edema: A Review. Catrambone, Jeffrey E.; Wenzhuan He; Prestigiacomo, Charles J.; McIntosh, Tracy K.; Carmel, Peter W.; Maniker, Allen // European Journal of Trauma & Emergency Surgery;Aug2008, Vol. 34 Issue 4, p397 

    Effective methods for treating cerebral edema have recently become a matter of both extensive research and significant debate within the neurosurgery and trauma surgery communities. The pathophysiologic progression and outcome of different forms of cerebral edema associated with traumatic brain...

  • Substance P Antagonists as a Therapeutic Approach to Improving Outcome Following Traumatic Brain Injury Vink, Robert; van den Heuvel, Corinna // Neurotherapeutics;Jan2010, Vol. 7 Issue 1, p74 

    Summary: Although a number of secondary injury factors are known to contribute to the development of morphological injury and functional deficits following traumatic brain injury, accumulating evidence has suggested that neuropeptides, and in particular substance P, may play a critical role....

  • Propofol Administration Modulates AQP-4 Expression and Brain Edema After Traumatic Brain Injury. Ding, Zhongyang; Zhang, Jiaming; Xu, Jinyu; Sheng, Guangjie; Huang, Guorong // Cell Biochemistry & Biophysics;Nov2013, Vol. 67 Issue 2, p615 

    The increased intracranial pressure caused by brain edema following traumatic brain injury (TBI) always leads to poor patient prognosis. Aquaporin-4 (AQP-4) plays an important role in edema formation and resolution, which may provide a novel therapeutic target for edema treatment. In this...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics