The Experts below are selected from a list of 156 Experts worldwide ranked by ideXlab platform
Jong-ling Fuh - One of the best experts on this subject based on the ideXlab platform.
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Spontaneous Intracranial Hypotension Presenting as Mental Deterioration
Headache, 2005Co-Authors: Ping‐huang Tsai, Shuu-jiun Wang, Jiing-feng Lirng, Jong-ling FuhAbstract:A 55-year-old woman had new onset of postural headache followed by change of Mental status 3 weeks later. Magnetic resonance imaging (MRI) of the brain and whole spine showed typical spontaneous intracranial hypotension (SIH) findings, bilateral subdural hematoma, and cerebrospinal fluid leakage over the T7-T9. Her headache and Mentality improved after epidural blood patches. Early recognition and correct diagnosis are crucial for successful treatment in patients with SIH presenting with Mental confusion.
Yung Ki Park - One of the best experts on this subject based on the ideXlab platform.
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Misdiagnosis of Spontaneous Intracranial Hypotension Presenting as Acute Mental Deterioration Caused by Unilateral Acute Subdural Hematoma: Case Report.
Korean journal of neurotrauma, 2020Co-Authors: Hyeong Kyun Shim, Yung Ki ParkAbstract:Spontaneous intracranial hypotension (SIH) is usually a benign disease which mostly present as orthostatic headache and resolves by conservative treatment or epidural blood patch. However, in severe cases large subdural hematoma or brain caudal herniation can progress to brain herniation and neurologic complications. We introduce a rare case of SIH which presented as acute Mental Deterioration with unilateral acute subdural hematoma. A 60 years old female visited to emergency room for stuporous Mental change and unilateral acute subdural hematoma. Decompressive craniectomy and hematoma removal was performed to release brain herniation and increased intracranial pressure. There was temporary improvement of consciousness, but sustained leakage of cerebrospinal fluid (CSF) and caudal brain herniation worsened patient's condition. After recognizing that CSF leakage and hypovolemia was the underlying disease, emergent epidural blood patch and early cranioplasty was performed. After treatment CSF volume was normalized and patient recovered completely without neurologic deficits. Acute Mental Deterioration with unilateral subdural hematoma is a rare presentation for SIH. Treatment strategy for subdural hematoma with concomitant SIH patients, should be planned carefully with concerns to CSF hypovolemia and intracranial pressure.
Hitoshi Takahashi - One of the best experts on this subject based on the ideXlab platform.
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Autopsy case of primary central nervous system lymphoma with subacute Mental Deterioration and progressive white matter lesions in an elderly man
Geriatrics & Gerontology International, 2003Co-Authors: Yoshiaki Kokubo, Isao Hozumi, Akie Sano, Akifumi Akai, Yoko Ikeda, Kouichirou Okamoto, Zenjiro Matsuyama, Takashi Inuzuka, Noriyoshi Yamakita, Hitoshi TakahashiAbstract:An autopsy case is reported here of a 70-year-old Japanese man with primary central nervous system lymphoma (PCNSL) manifesting subacute Mental Deterioration and progressive white matter lesions. Brain magnetic resonance imaging (MRI) revealed irregular hyperintense lesions on T2-weighted images of the white matter of the bilateral frontal lobes. The hyperintense lesions then spread to the corpus callosum, internal capsule, globus pallidus and along the pyramidal tract in the brainstem without a mass effect. The U-fibers were also involved in some regions. Neither brain swelling nor a significant atrophy was observed. The clinical manifestations and imaging findings of PCNSL are diverse. Recently, some reports have revealed atypical MR imaging of PCNSL exhibiting diffuse infiltration in the brain parenchyma without mass formation and enhancement of the lesions after the administration of a contrast medium. The authors also encountered an interesting case of PCNSL presenting as progressive white matter lesions without brain swelling. It is now possible to finely observe white matter lesions by brain MRI, particularly in T2-weighted images. Recently the number of immunocompetent elderly patients with PCNSL appears to be increasing in Japan. Autopsy of the present case revealed an intermediate lymphocytic malignant lymphoma. Because imaging and laboratory findings are not completely specific for the diagnosis of PCNSL at present, brain biopsy is more strongly recommended for the final diagnosis of PCNSL even in elderly patients, based on which appropriate treatment is administered.
Ping‐huang Tsai - One of the best experts on this subject based on the ideXlab platform.
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Spontaneous Intracranial Hypotension Presenting as Mental Deterioration
Headache, 2005Co-Authors: Ping‐huang Tsai, Shuu-jiun Wang, Jiing-feng Lirng, Jong-ling FuhAbstract:A 55-year-old woman had new onset of postural headache followed by change of Mental status 3 weeks later. Magnetic resonance imaging (MRI) of the brain and whole spine showed typical spontaneous intracranial hypotension (SIH) findings, bilateral subdural hematoma, and cerebrospinal fluid leakage over the T7-T9. Her headache and Mentality improved after epidural blood patches. Early recognition and correct diagnosis are crucial for successful treatment in patients with SIH presenting with Mental confusion.
Hyeong Kyun Shim - One of the best experts on this subject based on the ideXlab platform.
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Misdiagnosis of Spontaneous Intracranial Hypotension Presenting as Acute Mental Deterioration Caused by Unilateral Acute Subdural Hematoma: Case Report.
Korean journal of neurotrauma, 2020Co-Authors: Hyeong Kyun Shim, Yung Ki ParkAbstract:Spontaneous intracranial hypotension (SIH) is usually a benign disease which mostly present as orthostatic headache and resolves by conservative treatment or epidural blood patch. However, in severe cases large subdural hematoma or brain caudal herniation can progress to brain herniation and neurologic complications. We introduce a rare case of SIH which presented as acute Mental Deterioration with unilateral acute subdural hematoma. A 60 years old female visited to emergency room for stuporous Mental change and unilateral acute subdural hematoma. Decompressive craniectomy and hematoma removal was performed to release brain herniation and increased intracranial pressure. There was temporary improvement of consciousness, but sustained leakage of cerebrospinal fluid (CSF) and caudal brain herniation worsened patient's condition. After recognizing that CSF leakage and hypovolemia was the underlying disease, emergent epidural blood patch and early cranioplasty was performed. After treatment CSF volume was normalized and patient recovered completely without neurologic deficits. Acute Mental Deterioration with unilateral subdural hematoma is a rare presentation for SIH. Treatment strategy for subdural hematoma with concomitant SIH patients, should be planned carefully with concerns to CSF hypovolemia and intracranial pressure.