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Andre Y Denault - One of the best experts on this subject based on the ideXlab platform.

  • point of care handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and terson syndrome a description of two cases
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2020
    Co-Authors: Jennifer Palermo, Michel W Bojanowski, Stephan Langevin, Andre Y Denault
    Abstract:

    Ultrasound (US) examination of the eye can be used to detect and monitor elevated intracranial pressure (ICP) and its consequences. Elevated ICP is transmitted to the contiguous optic nerve and its sheath (dura mater), thus underlying the development of papilledema and a widened sheath diameter. The US measurement of the optic nerve sheath diameter (ONSD) has previously been validated to diagnose and monitor raised ICP. The occurrence of vitreous hemorrhage in association with subarachnoid hemorrhage (SAH)—i.e., Terson syndrome—can also be easily diagnosed using ophthalmic US. Because of its relevance in anesthesia and critical care, we describe how to perform the technique illustrated by two cases. A 72-yr-old man with Hydrocephalus secondary to a SAH developed raised ICP following the removal of an external ventricular drainage (EVD) system. Daily ONSD measurements using handheld US allowed us to diagnose and monitor the progression and resolution of the intracranial hypertension following the placement of a second EVD system. We also describe the steps used to obtain ONSD measurements during the ophthalmic US examination of a 53-yr-old woman who presented with a stage IV SAH with concomitant bilateral vitreous hemorrhages or Terson syndrome. Ophthalmic US using a handheld device to measure and monitor ONSD at the bedside is useful in diagnosing and monitoring the progression of intracranial hypertension following EVD removal in a Patient with Hydrocephalus secondary to SAH. Ophthalmic US can also be used to identify concomitant vitreous hemorrhage that is associated with a worse prognosis.

  • point of care handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and terson syndrome a description of two cases
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2020
    Co-Authors: Jennifer Palermo, Michel W Bojanowski, Stephan Langevin, Andre Y Denault
    Abstract:

    BACKGROUND: Ultrasound (US) examination of the eye can be used to detect and monitor elevated intracranial pressure (ICP) and its consequences. Elevated ICP is transmitted to the contiguous optic nerve and its sheath (dura mater), thus underlying the development of papilledema and a widened sheath diameter. The US measurement of the optic nerve sheath diameter (ONSD) has previously been validated to diagnose and monitor raised ICP. The occurrence of vitreous hemorrhage in association with subarachnoid hemorrhage (SAH)-i.e., Terson syndrome-can also be easily diagnosed using ophthalmic US. Because of its relevance in anesthesia and critical care, we describe how to perform the technique illustrated by two cases. CASE PRESENTATIONS: A 72-yr-old man with Hydrocephalus secondary to a SAH developed raised ICP following the removal of an external ventricular drainage (EVD) system. Daily ONSD measurements using handheld US allowed us to diagnose and monitor the progression and resolution of the intracranial hypertension following the placement of a second EVD system. We also describe the steps used to obtain ONSD measurements during the ophthalmic US examination of a 53-yr-old woman who presented with a stage IV SAH with concomitant bilateral vitreous hemorrhages or Terson syndrome. CONCLUSION: Ophthalmic US using a handheld device to measure and monitor ONSD at the bedside is useful in diagnosing and monitoring the progression of intracranial hypertension following EVD removal in a Patient with Hydrocephalus secondary to SAH. Ophthalmic US can also be used to identify concomitant vitreous hemorrhage that is associated with a worse prognosis.

  • bedside transcranial sonography monitoring in a Patient with Hydrocephalus post subarachnoid hemorrhage
    Critical Ultrasound Journal, 2017
    Co-Authors: Ahmed Najjar, Andre Y Denault, Michel W Bojanowski
    Abstract:

    Development of Hydrocephalus can occur after subarachnoid hemorrhage (SAH). Typically, it is diagnosed with computed tomography, CT, scan. However, transcranial sonography (TCS) can be used particularly in Patients with craniotomy which removes the acoustic interference of the skull and allows a closer up visualization of brain structures through the skin. We report a 73-year-old woman who was hospitalized for SAH and developed acute Hydrocephalus requiring an external ventricular drain (EVD). In this Patient, detection and monitoring of Hydrocephalus was done and monitored with a small pocket-sized TCS device. Nine days after surgery, weaning of the EVD was attempted. Prior to EVD closure and removal, TCS showed a measurement of the 3rd ventricle at around 1.16 cm. On the third day, the Patient deteriorated clinically and the TCS showed a dilated 3rd ventricle measuring 1.37 cm which correlated well with computed tomography and with clinical signs of active Hydrocephalus as both her sensorium and communication were affected. Subsequently following EVD re-installation, on the next day, TCS showed that the 3rd ventricle dimension was reduced to 0.99 cm and the following day it went down to 0.69 cm. Patients with SAH and in particular those with a craniotomy can be monitored easily at the bedside with hand-held TCS for the development and monitoring of Hydrocephalus.

  • Bedside transcranial sonography monitoring in a Patient with Hydrocephalus post subarachnoid hemorrhage
    SpringerOpen, 2017
    Co-Authors: Ahmed Najjar, Andre Y Denault, Michel W Bojanowski
    Abstract:

    Abstract Background Development of Hydrocephalus can occur after subarachnoid hemorrhage (SAH). Typically, it is diagnosed with computed tomography, CT, scan. However, transcranial sonography (TCS) can be used particularly in Patients with craniotomy which removes the acoustic interference of the skull and allows a closer up visualization of brain structures through the skin. Case presentation We report a 73-year-old woman who was hospitalized for SAH and developed acute Hydrocephalus requiring an external ventricular drain (EVD). In this Patient, detection and monitoring of Hydrocephalus was done and monitored with a small pocket-sized TCS device. Nine days after surgery, weaning of the EVD was attempted. Prior to EVD closure and removal, TCS showed a measurement of the 3rd ventricle at around 1.16 cm. On the third day, the Patient deteriorated clinically and the TCS showed a dilated 3rd ventricle measuring 1.37 cm which correlated well with computed tomography and with clinical signs of active Hydrocephalus as both her sensorium and communication were affected. Subsequently following EVD re-installation, on the next day, TCS showed that the 3rd ventricle dimension was reduced to 0.99 cm and the following day it went down to 0.69 cm. Conclusions Patients with SAH and in particular those with a craniotomy can be monitored easily at the bedside with hand-held TCS for the development and monitoring of Hydrocephalus

Michel W Bojanowski - One of the best experts on this subject based on the ideXlab platform.

  • point of care handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and terson syndrome a description of two cases
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2020
    Co-Authors: Jennifer Palermo, Michel W Bojanowski, Stephan Langevin, Andre Y Denault
    Abstract:

    Ultrasound (US) examination of the eye can be used to detect and monitor elevated intracranial pressure (ICP) and its consequences. Elevated ICP is transmitted to the contiguous optic nerve and its sheath (dura mater), thus underlying the development of papilledema and a widened sheath diameter. The US measurement of the optic nerve sheath diameter (ONSD) has previously been validated to diagnose and monitor raised ICP. The occurrence of vitreous hemorrhage in association with subarachnoid hemorrhage (SAH)—i.e., Terson syndrome—can also be easily diagnosed using ophthalmic US. Because of its relevance in anesthesia and critical care, we describe how to perform the technique illustrated by two cases. A 72-yr-old man with Hydrocephalus secondary to a SAH developed raised ICP following the removal of an external ventricular drainage (EVD) system. Daily ONSD measurements using handheld US allowed us to diagnose and monitor the progression and resolution of the intracranial hypertension following the placement of a second EVD system. We also describe the steps used to obtain ONSD measurements during the ophthalmic US examination of a 53-yr-old woman who presented with a stage IV SAH with concomitant bilateral vitreous hemorrhages or Terson syndrome. Ophthalmic US using a handheld device to measure and monitor ONSD at the bedside is useful in diagnosing and monitoring the progression of intracranial hypertension following EVD removal in a Patient with Hydrocephalus secondary to SAH. Ophthalmic US can also be used to identify concomitant vitreous hemorrhage that is associated with a worse prognosis.

  • point of care handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and terson syndrome a description of two cases
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2020
    Co-Authors: Jennifer Palermo, Michel W Bojanowski, Stephan Langevin, Andre Y Denault
    Abstract:

    BACKGROUND: Ultrasound (US) examination of the eye can be used to detect and monitor elevated intracranial pressure (ICP) and its consequences. Elevated ICP is transmitted to the contiguous optic nerve and its sheath (dura mater), thus underlying the development of papilledema and a widened sheath diameter. The US measurement of the optic nerve sheath diameter (ONSD) has previously been validated to diagnose and monitor raised ICP. The occurrence of vitreous hemorrhage in association with subarachnoid hemorrhage (SAH)-i.e., Terson syndrome-can also be easily diagnosed using ophthalmic US. Because of its relevance in anesthesia and critical care, we describe how to perform the technique illustrated by two cases. CASE PRESENTATIONS: A 72-yr-old man with Hydrocephalus secondary to a SAH developed raised ICP following the removal of an external ventricular drainage (EVD) system. Daily ONSD measurements using handheld US allowed us to diagnose and monitor the progression and resolution of the intracranial hypertension following the placement of a second EVD system. We also describe the steps used to obtain ONSD measurements during the ophthalmic US examination of a 53-yr-old woman who presented with a stage IV SAH with concomitant bilateral vitreous hemorrhages or Terson syndrome. CONCLUSION: Ophthalmic US using a handheld device to measure and monitor ONSD at the bedside is useful in diagnosing and monitoring the progression of intracranial hypertension following EVD removal in a Patient with Hydrocephalus secondary to SAH. Ophthalmic US can also be used to identify concomitant vitreous hemorrhage that is associated with a worse prognosis.

  • bedside transcranial sonography monitoring in a Patient with Hydrocephalus post subarachnoid hemorrhage
    Critical Ultrasound Journal, 2017
    Co-Authors: Ahmed Najjar, Andre Y Denault, Michel W Bojanowski
    Abstract:

    Development of Hydrocephalus can occur after subarachnoid hemorrhage (SAH). Typically, it is diagnosed with computed tomography, CT, scan. However, transcranial sonography (TCS) can be used particularly in Patients with craniotomy which removes the acoustic interference of the skull and allows a closer up visualization of brain structures through the skin. We report a 73-year-old woman who was hospitalized for SAH and developed acute Hydrocephalus requiring an external ventricular drain (EVD). In this Patient, detection and monitoring of Hydrocephalus was done and monitored with a small pocket-sized TCS device. Nine days after surgery, weaning of the EVD was attempted. Prior to EVD closure and removal, TCS showed a measurement of the 3rd ventricle at around 1.16 cm. On the third day, the Patient deteriorated clinically and the TCS showed a dilated 3rd ventricle measuring 1.37 cm which correlated well with computed tomography and with clinical signs of active Hydrocephalus as both her sensorium and communication were affected. Subsequently following EVD re-installation, on the next day, TCS showed that the 3rd ventricle dimension was reduced to 0.99 cm and the following day it went down to 0.69 cm. Patients with SAH and in particular those with a craniotomy can be monitored easily at the bedside with hand-held TCS for the development and monitoring of Hydrocephalus.

  • Bedside transcranial sonography monitoring in a Patient with Hydrocephalus post subarachnoid hemorrhage
    SpringerOpen, 2017
    Co-Authors: Ahmed Najjar, Andre Y Denault, Michel W Bojanowski
    Abstract:

    Abstract Background Development of Hydrocephalus can occur after subarachnoid hemorrhage (SAH). Typically, it is diagnosed with computed tomography, CT, scan. However, transcranial sonography (TCS) can be used particularly in Patients with craniotomy which removes the acoustic interference of the skull and allows a closer up visualization of brain structures through the skin. Case presentation We report a 73-year-old woman who was hospitalized for SAH and developed acute Hydrocephalus requiring an external ventricular drain (EVD). In this Patient, detection and monitoring of Hydrocephalus was done and monitored with a small pocket-sized TCS device. Nine days after surgery, weaning of the EVD was attempted. Prior to EVD closure and removal, TCS showed a measurement of the 3rd ventricle at around 1.16 cm. On the third day, the Patient deteriorated clinically and the TCS showed a dilated 3rd ventricle measuring 1.37 cm which correlated well with computed tomography and with clinical signs of active Hydrocephalus as both her sensorium and communication were affected. Subsequently following EVD re-installation, on the next day, TCS showed that the 3rd ventricle dimension was reduced to 0.99 cm and the following day it went down to 0.69 cm. Conclusions Patients with SAH and in particular those with a craniotomy can be monitored easily at the bedside with hand-held TCS for the development and monitoring of Hydrocephalus

Gregorioboto Rodriguez - One of the best experts on this subject based on the ideXlab platform.

  • intraventricular cryptococcoma mimicking a neoplastic lesion in an immunocompetent Patient with Hydrocephalus a case report
    Surgical Neurology International, 2019
    Co-Authors: Xavier A Santander, Carlos Cotua, Eva Tejerina, Raquel Gutierrezgonzalez, Gregorioboto Rodriguez
    Abstract:

    Background: The aim of this study is to highlight the importance of cryptococcosis as one of the most common fungal infections of the central nervous system, stressing the consideration of a cryptococcoma within the list of differential diagnosis of intraventricular masses in immunocompetent hosts. Case Description: We present the case of an immunocompetent 41-year-old female from Philippines with an intraventricular cryptococcoma due to Cryptococcus neoformans, mimicking an intraventricular primary brain tumor, who had Hydrocephalus. She was approached as having a neoplastic lesion and underwent surgical resection plus third ventriculostomy through endoscopy. Later in her evolution, we realized the infectious nature of the lesion, and antifungal systemic therapy was initiated. In the end, she needed the placement of a ventriculoperitoneal shunt to maintain a good neurologic status. Despite all our efforts, she had a fatal outcome due to various complications. Conclusion: Our case is the first intraventricular cryptococcoma due to C. neoformans, as far as we know, to be reported in English, German, or Spanish literature. Our report stresses the importance to consider this kind of infection in immunocompetent Patients, to raise the level of suspicion of this diagnosis, and to know the complications and management options.

  • intraventricular cryptococcoma mimicking a neoplastic lesion in an immunocompetent Patient with Hydrocephalus a case report
    Surgical Neurology International, 2019
    Co-Authors: Xavier A Santander, Carlos Cotua, Eva Tejerina, Raquel Gutierrezgonzalez, Gregorioboto Rodriguez
    Abstract:

    Background: The aim of this study is to highlight the importance of cryptococcosis as one of the most common fungal infections of the central nervous system, stressing the consideration of a cryptococcoma within the list of differential diagnosis of intraventricular masses in immunocompetent hosts. Case Description: We present the case of an immunocompetent 41-year-old female from Philippines with an intraventricular cryptococcoma due to Cryptococcus neoformans, mimicking an intraventricular primary brain tumor, who had Hydrocephalus. She was approached as having a neoplastic lesion and underwent surgical resection plus third ventriculostomy through endoscopy. Later in her evolution, we realized the infectious nature of the lesion, and antifungal systemic therapy was initiated. In the end, she needed the placement of a ventriculoperitoneal shunt to maintain a good neurologic status. Despite all our efforts, she had a fatal outcome due to various complications. Conclusion: Our case is the first intraventricular cryptococcoma due to C. neoformans, as far as we know, to be reported in English, German, or Spanish literature. Our report stresses the importance to consider this kind of infection in immunocompetent Patients, to raise the level of suspicion of this diagnosis, and to know the complications and management options.

Xavier A Santander - One of the best experts on this subject based on the ideXlab platform.

  • intraventricular cryptococcoma mimicking a neoplastic lesion in an immunocompetent Patient with Hydrocephalus a case report
    Surgical Neurology International, 2019
    Co-Authors: Xavier A Santander, Carlos Cotua, Eva Tejerina, Raquel Gutierrezgonzalez, Gregorioboto Rodriguez
    Abstract:

    Background: The aim of this study is to highlight the importance of cryptococcosis as one of the most common fungal infections of the central nervous system, stressing the consideration of a cryptococcoma within the list of differential diagnosis of intraventricular masses in immunocompetent hosts. Case Description: We present the case of an immunocompetent 41-year-old female from Philippines with an intraventricular cryptococcoma due to Cryptococcus neoformans, mimicking an intraventricular primary brain tumor, who had Hydrocephalus. She was approached as having a neoplastic lesion and underwent surgical resection plus third ventriculostomy through endoscopy. Later in her evolution, we realized the infectious nature of the lesion, and antifungal systemic therapy was initiated. In the end, she needed the placement of a ventriculoperitoneal shunt to maintain a good neurologic status. Despite all our efforts, she had a fatal outcome due to various complications. Conclusion: Our case is the first intraventricular cryptococcoma due to C. neoformans, as far as we know, to be reported in English, German, or Spanish literature. Our report stresses the importance to consider this kind of infection in immunocompetent Patients, to raise the level of suspicion of this diagnosis, and to know the complications and management options.

  • intraventricular cryptococcoma mimicking a neoplastic lesion in an immunocompetent Patient with Hydrocephalus a case report
    Surgical Neurology International, 2019
    Co-Authors: Xavier A Santander, Carlos Cotua, Eva Tejerina, Raquel Gutierrezgonzalez, Gregorioboto Rodriguez
    Abstract:

    Background: The aim of this study is to highlight the importance of cryptococcosis as one of the most common fungal infections of the central nervous system, stressing the consideration of a cryptococcoma within the list of differential diagnosis of intraventricular masses in immunocompetent hosts. Case Description: We present the case of an immunocompetent 41-year-old female from Philippines with an intraventricular cryptococcoma due to Cryptococcus neoformans, mimicking an intraventricular primary brain tumor, who had Hydrocephalus. She was approached as having a neoplastic lesion and underwent surgical resection plus third ventriculostomy through endoscopy. Later in her evolution, we realized the infectious nature of the lesion, and antifungal systemic therapy was initiated. In the end, she needed the placement of a ventriculoperitoneal shunt to maintain a good neurologic status. Despite all our efforts, she had a fatal outcome due to various complications. Conclusion: Our case is the first intraventricular cryptococcoma due to C. neoformans, as far as we know, to be reported in English, German, or Spanish literature. Our report stresses the importance to consider this kind of infection in immunocompetent Patients, to raise the level of suspicion of this diagnosis, and to know the complications and management options.

Jennifer Palermo - One of the best experts on this subject based on the ideXlab platform.

  • point of care handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and terson syndrome a description of two cases
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2020
    Co-Authors: Jennifer Palermo, Michel W Bojanowski, Stephan Langevin, Andre Y Denault
    Abstract:

    BACKGROUND: Ultrasound (US) examination of the eye can be used to detect and monitor elevated intracranial pressure (ICP) and its consequences. Elevated ICP is transmitted to the contiguous optic nerve and its sheath (dura mater), thus underlying the development of papilledema and a widened sheath diameter. The US measurement of the optic nerve sheath diameter (ONSD) has previously been validated to diagnose and monitor raised ICP. The occurrence of vitreous hemorrhage in association with subarachnoid hemorrhage (SAH)-i.e., Terson syndrome-can also be easily diagnosed using ophthalmic US. Because of its relevance in anesthesia and critical care, we describe how to perform the technique illustrated by two cases. CASE PRESENTATIONS: A 72-yr-old man with Hydrocephalus secondary to a SAH developed raised ICP following the removal of an external ventricular drainage (EVD) system. Daily ONSD measurements using handheld US allowed us to diagnose and monitor the progression and resolution of the intracranial hypertension following the placement of a second EVD system. We also describe the steps used to obtain ONSD measurements during the ophthalmic US examination of a 53-yr-old woman who presented with a stage IV SAH with concomitant bilateral vitreous hemorrhages or Terson syndrome. CONCLUSION: Ophthalmic US using a handheld device to measure and monitor ONSD at the bedside is useful in diagnosing and monitoring the progression of intracranial hypertension following EVD removal in a Patient with Hydrocephalus secondary to SAH. Ophthalmic US can also be used to identify concomitant vitreous hemorrhage that is associated with a worse prognosis.

  • point of care handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and terson syndrome a description of two cases
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2020
    Co-Authors: Jennifer Palermo, Michel W Bojanowski, Stephan Langevin, Andre Y Denault
    Abstract:

    Ultrasound (US) examination of the eye can be used to detect and monitor elevated intracranial pressure (ICP) and its consequences. Elevated ICP is transmitted to the contiguous optic nerve and its sheath (dura mater), thus underlying the development of papilledema and a widened sheath diameter. The US measurement of the optic nerve sheath diameter (ONSD) has previously been validated to diagnose and monitor raised ICP. The occurrence of vitreous hemorrhage in association with subarachnoid hemorrhage (SAH)—i.e., Terson syndrome—can also be easily diagnosed using ophthalmic US. Because of its relevance in anesthesia and critical care, we describe how to perform the technique illustrated by two cases. A 72-yr-old man with Hydrocephalus secondary to a SAH developed raised ICP following the removal of an external ventricular drainage (EVD) system. Daily ONSD measurements using handheld US allowed us to diagnose and monitor the progression and resolution of the intracranial hypertension following the placement of a second EVD system. We also describe the steps used to obtain ONSD measurements during the ophthalmic US examination of a 53-yr-old woman who presented with a stage IV SAH with concomitant bilateral vitreous hemorrhages or Terson syndrome. Ophthalmic US using a handheld device to measure and monitor ONSD at the bedside is useful in diagnosing and monitoring the progression of intracranial hypertension following EVD removal in a Patient with Hydrocephalus secondary to SAH. Ophthalmic US can also be used to identify concomitant vitreous hemorrhage that is associated with a worse prognosis.