Internal Medicine

0521779407-10 CUNY1086/Karliner 0 521 77940 7 June 6, 2007 17:44

Intestinal Motor Disorders Intracranial Hypertension 853

Contraindications to Treatment

■Octreotide: not used in patients with bacterial overgrowth since it

delays small bowel transit time

follow-up

During Treatment

■Monitoring of electrolytes, hydration status and for drug side effects

Routine

■Periodic clinical and laboratory evaluations and nutritional assess-

ment are needed

complications and prognosis

Complications

■Malnutrition to be avoided by all means

Prognosis

■Variable

■Hospitalizations for rehydration and nutritional support frequently

needed

Intracranial Hypertension..............................

MICHAEL J. AMINOFF, MD, DSc

history & physical

■Headache, often worse in the morning or on straining

■Visual blurring, obscurations, sometimes diplopia

■Reduced level of consciousness w/ increasing ICP

■No other neurologic complaints unless from herniation syndrome

or from cause of increased ICP (eg, hematoma, tumor, venous sinus

thrombosis)

■Bilateral papilledema

■6th nerve palsy sometimes found

■Mild neck stiffness common

■Other neurologic deficits depend on underlying structural lesion

tests

■MRI or CT scan reveals underlying structural lesion, extent of mass

effect; in pseudotumor cerebri, ventricles are small, slitlike; MRI pro-

vides better resolution of soft tissues & of posterior fossa than CT