Idiopathic Intracranial Hypertension: From 1 Different Sources
(benign intracranial hypertension, pseudotumour cerebri) a syndrome of raised pressure within the skull in the absence of a clear structural cause, such as a tumour. Although the cause is not certain, proposed mechanisms include impaired reabsorption of cerebrospinal fluid or venous outflow from the brain. The symptoms include headache, vomiting, double vision, and *papilloedema. The diagnosis is made by finding a high opening pressure at *lumbar puncture in the absence of a causative structural abnormality on brain imaging. It can improve spontaneously but drug therapy or neurosurgical treatment may be required to protect the patient’s vision.
High arterial blood pressure... hypertension
No known cause.... idiopathic
Raised blood pressure in the PORTAL VEIN entering the LIVER. This results in increased pressure in the veins of the oesophagus and upper stomach and these grow in size to form varices – dilated tortuous veins. Sometimes these varices rupture, causing bleeding into the oesophagus. The raised pressure also causes ?uid to collect in the abdomen and form ASCITES. The commonest reason for portal hypertension is cirrhosis (?brosis) of the liver (see LIVER, DISEASES OF). THROMBOSIS in the portal vein may also be a cause. Treatment requires the cause to be tackled, but bleeding from ruptured vessels may be stopped by injecting a sclerosant or hardening solution into and around the veins. Sometimes a surgical shunt may be done to divert blood from the portal vein to another blood vessel.... portal hypertension
In this condition, increased resistance to the blood ?ow through the LUNGS occurs. This is usually the result of lung disease, and the consequence is an increase in pulmonary artery pressure and in the pressure in the right side of the heart and in the veins bringing blood to the heart. Chronic BRONCHITIS or EMPHYSEMA commonly constrict the small arteries in the lungs, thus causing pulmonary HYPERTENSION. (See also EISENMENGER SYNDROME.)... pulmonary hypertension
Intracranial is the term applied to structures, diseases, etc. contained in or rising within the head.... intracranial
Malignant hypertension has nothing to do with cancer; it derives its name from the fact that, if untreated, it runs a rapidly fatal course. (See HYPERTENSION.)... malignant hypertension
See HYPERTENSION.... essential (benign) hypertension
See BELL’S PALSY.... idiopathic facial nerve palsy
Sometimes described as thrombocytopenia, this is an autoimmune disorder in which blood PLATELETS are destroyed. This disturbs the blood’s coagulative properties (see COAGULATION) and spontaneous bleeding (PURPURA) occurs into the skin. The disease may be acute in children but most recover without treatment. Adults may develop a more serious, chronic variety which requires treatment with CORTICOSTEROIDS and sometimes SPLENECTOMY. Should the disease persist despite these treatments, intravenous immunoglobulin or immunosuppressive drugs (see IMMUNOSUPPRESSION) are worth trying. Should the bleeding be or become life-threatening, concentrates of platelets should be administered.... idiopathic thrombocytopenic purpura (itp)
This is the pressure that is maintained by the brain tissue, intracellular and extracellular ?uid, cerebrospinal ?uid and blood. An increase in intracranial pressure may occur as a result of in?ammation, injury, haemorrhage, or tumour in the brain tissue as well as of some congenital conditions. The pressure is measured by lumbar puncture in which a syringe attached to a mamometer (pressure-measuring device) is inserted into the cerebrospinal ?uid surrounding the lower part of the spinal cord. Where continuous pressure monitoring is necessary, an in-dwelling device can be implanted into a cerebral ventricle. Normal pressure is around 10 mm of mercury (Hg), with the acceptable upper limit being 25 mm Hg.... intracranial pressure
Previously called juvenile rheumatoid arthritis and juvenile chronic arthritis, this is a set of related conditions of unknown cause affecting children. Characteristically, the synovial membrane of a joint or joints becomes in?amed and swollen for at leat six weeks (and often very much longer – even years). About 1 in 10,000 children develop it each year, many of whom have certain HLA genetic markers, thought to be important in determining who gets the illness. In?ammatory CYTOKINES play a big part.
Clinical features There are various types. The oligoarthritic type involves 1–4 joints (usually knee or ankle) which become hot, swollen and painful. One complication is an in?ammation of the eyes – UVEITIS. The condition often ‘burns out’, but may reappear at any time, even years later.
The polyarthritic type is more like RHEUMATOID ARTHRITIS in adults, and the child may have persistent symptoms leading to major joint deformity and crippling.
The systemic type, previously called Still’s disease, presents with a high fever and rash, enlarged liver, spleen and lymph nodes, and arthritis – although the latter may be mild. In some children the illness becomes recurrent; in others it dies down only to return as polyarthritis.
Complications These include uveitis, which can lead to loss of vision; a failure to thrive; osteoporosis (see under BONE, DISORDERS OF); joint deformity; and psychosocial diffculties.
Treatment This includes ANTIPYRETICS and ANALGESICS, including NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS), intra-articular steroid injections, anti-tumour necrosis factor drugs and steroids.
Physiotherapy is vital, and children may need to wear splints or other orthotic devices to alleviate deformity and pain. Orthopaedic operative procedures may be necessary.... juvenile idiopathic arthritis (jia)
(ITP) An autoimmune disorder in which platelets are destroyed, leading to bleeding beneath the skin (see purpura).... idiopathic thrombocytopaenic purpura
see idiopathic intracranial hypertension.... benign intracranial hypertension
see persistent idiopathic facial pain.... chronic idiopathic facial pain
(ITP) an *autoimmune disease in which platelets are destroyed, leading to spontaneous bruising (see purpura). Acute ITP is a relatively mild disease of children, who usually recover without treatment. A chronic form of the disease, typically affecting adults, is more serious, requiring treatment with corticosteroids or, if there is no response, with splenectomy. If both fail, immunosuppressant drugs may be effective. Platelet concentrates are used for life-threatening bleeding.... idiopathic thrombocytopenic purpura
(IPF) a serious interstitial lung disease, formerly called cryptogenic fibrosing alveolitis (see alveolitis). It is characterized by progressive fibrous scarring of the lung and increased numbers of inflammatory cells in the alveoli and surrounding tissues. The disease is usually diagnosed on clinical grounds on a basis of worsening breathlessness, inspiratory crackles at the lung bases on auscultation, clubbing of the fingers or toes, bilateral radiographic shadowing predominantly in the lower zones of the chest X-ray, subpleural *honeycomb change on CT scanning of the chest, and restrictive lung function on spirometry. It is also called usual interstitial pneumonia (UIP; see interstitial pneumonia), a term used by lung pathologists for the most common cellular pattern seen on biopsy. Treatment includes *pirfenidone, corticosteroids, and immunosuppressants.... idiopathic pulmonary fibrosis
an increasingly recognized type of persistent headache in a patient with no history of headaches. Features include headache that is worse on standing and resolves on lying flat. It may be associated with other symptoms, such as dizziness, tinnitus, and (rarely) *diplopia. The commonest cause is a complication of lumbar puncture, but it may occur spontaneously (spontaneous intracranial hypotension) after a dural tear resulting in a leak of cerebrospinal fluid. Treatment is with bed rest and increased intake of fluids; caffeine orally or intravenously is also used. In cases that do not resolve, an epidural blood patch procedure is performed, in which a small quantity of the patient’s blood is slowly injected into the *epidural space to seal the leak.... intracranial hypotension headache
(JIA, Still’s disease) any one of a group of conditions characterized by inflammation of the joints lasting longer than 6 weeks and occurring before the age of 16. The causes are unknown but immunological and infective mechanisms are suspected. JIA can affect either four or fewer joints (pauciarticular JIA) or more than four (polyarticular JIA). There are two recognized types of pauciarticular JIA: type 1, which generally affects girls below the age of four; and type 2 (juvenile-onset spondylarthropathy), which generally affects boys over the age of nine. There are also two types of polyarticular JIA, depending on the presence or absence of a particular antibody in the blood. There is a great range of severity of these diseases. Treatment consists of pain management and prevention of subsequent deformity or limitation of movement (e.g. contractures). Long-term joint damage is prevented by use of medications similar to those used in rheumatoid arthritis.... juvenile idiopathic arthritis
(OHT) a constantly raised intraocular pressure (greater than 21 mmHg by Goldmann applanation *tonometry) registered on two or more occasions in one or both eyes with the absence of evidence of optic nerve damage or visual field defect. Intraocular pressure increases slowly with age and OHT can increase the risk of developing glaucoma. It is treated with eye drops and surgery if indicated.... ocular hypertension
(atypical facial pain, chronic idiopathic facial pain) a chronic pain in the face that has no known cause and does not fit the classic presentation of other cranial neuralgias. It may be stress-related, and in some cases appears to be associated with defective metabolism of *tyramine. Treatment may involve the use of antidepressants.... persistent idiopathic facial pain
(PIH) raised blood pressure (>140/90 mmHg) developing in a woman during the second half of pregnancy. It usually resolves within six weeks of delivery and is associated with a better prognosis than *pre-eclampsia.... pregnancy-induced hypertension
disease affecting the arterial supply to the kidneys, leading to ischaemia and resultant stimulation of the renin-*angiotensin-aldosterone axis. In the major vessels, the most common cause is atheromatous plaque disease. Other causes are fibromuscular dysplasia and *Takayasu’s disease.... renovascular hypertension
see intracranial hypotension headache.... spontaneous intracranial hypotension
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