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Re-written by: Daniel Habashi Seminar by: Dr.

Re-written by: Daniel Habashi Seminar by: Dr. Intracranial hypertension. Symptoms General Headache nausea, vomiting papillar edema (stages) EPI Blindness (intermittent) Nose touching Vegetative Bradycardia BP rise Breathing disturbances Psychic

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Re-written by: Daniel Habashi Seminar by: Dr.

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  1. Re-written by: Daniel Habashi Seminar by: Dr.

  2. Intracranial hypertension • Symptoms • General • Headache nausea, vomiting • papillar edema (stages) • EPI • Blindness (intermittent) • Nose touching • Vegetative • Bradycardia • BP rise • Breathing disturbances • Psychic • Consciousness (quantitative) disturbances • Fully conscious – coma depasse

  3. Focal Symptoms • 1. Deficits • 2. Excitations • Epileptic seizures (small focal) • Paraesthesias

  4. Radiology • Morphology and topography • Oedema • Temporal horns in a normal CT are not visible. If they are visible then it means that they’re enlarged. – hydrocephalus or cerebral atrophy etc.

  5. Management

  6. In-Hospital Management • Complementary diagnostics: • Extra-imagery • Biopsy • General “suitability” • Specific tumor diagnostic

  7. Surgical Maneuvers • Biopsy • Cytoreduction, subtotal • Total • Palliative (Rickham, Shunt, External Decompression) • Rickham – small tube that we put into the cyst (catheter?), used to diminish the quantity of the fluid in a cyst, just like a shunt I suppose.

  8. Out-Patient Management • Steroids: Diminishing protocol • Anti-Epileptics: Tegretol 3 x 200mg • (blood level, EEG) • General examination • Karnofsky • 1. I ° -II ° Kernohan: (not-malignant) • CT 6 months • 2. III ° -IV ° Kernohan (malignant) • CT 2 months

  9. Karnofsky Scale (modified)

  10. Neuronavigation Assisted Transphenoid Pituitary Surgery

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