Elevation of intracranial pressure in acute AIDS-related cryptococcal meningitis.
Clin Investig
; 72(12): 1020-6, 1994 Dec.
Article
en En
| MEDLINE
| ID: mdl-7711408
ABSTRACT
Prior to the AIDS-era, elevation of intracranial pressure was known to be a typical complication of cryptococcal meningitis associated with an increased risk of early death. In AIDS-patients, however, the prevalence and clinical significance of this complication are as yet unclear. We analysed clinical features and courses, CSF findings, serological results and neuroimaging scans in acute cryptococcal meningitis in eight patients with AIDS. Five showed symptoms and signs compatible with raised intracranial pressure, which was life-threatening in one and the most probable cause of death in another. Serial monitoring of intracranial pressure together with repeated CSF analysis revealed that severe intracranial pressure elevation in AIDS related cryptococcal meningitis can occur in spite of effective antimycotic treatment, does not depend on an increased CSF/serum osmolality ratio or CSF overproduction and can be associated with normal cranial computed tomography and magnetic resonance imaging findings. Our data support the hypothesis that CSF reabsorption failure plays the crucial role in the pathophysiological mechanism. External lumbar drainage may be of benefit in selected cases of acute AIDS related cryptococcal meningitis with persisting life threatening elevation in intracranial pressure and normal computed tomogram.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Presión Intracraneal
/
Meningitis Criptocócica
/
Infecciones Oportunistas Relacionadas con el SIDA
Tipo de estudio:
Prevalence_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Investig
Asunto de la revista:
MEDICINA
Año:
1994
Tipo del documento:
Article
País de afiliación:
Alemania