Refractory Intracranial Hypertension due to Fentanyl Administration Following Closed Head Injury
BackgroundAlthough the effects of opioids on intracranial pressure have long been a subject of controversy, they are frequently administered to patients with severe head trauma. We present a patient with an uncommon paradoxical response to opioids.Case ReportA patient with refractory intracranial hy...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2013-01-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fneur.2013.00003/full |
| _version_ | 1818180612269277184 |
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| author | Sara E Hocker Jeremy L Fogelson Alejandro eRabinstein |
| author_facet | Sara E Hocker Jeremy L Fogelson Alejandro eRabinstein |
| author_sort | Sara E Hocker |
| collection | DOAJ |
| description | BackgroundAlthough the effects of opioids on intracranial pressure have long been a subject of controversy, they are frequently administered to patients with severe head trauma. We present a patient with an uncommon paradoxical response to opioids.Case ReportA patient with refractory intracranial hypertension after closed head injury was managed with standard medical therapy with only transient decreases in the intracranial pressure. Only after discontinuation of opiates did the intracranial pressure become manageable without metabolic suppression and rescue osmotic therapy, implicating opiates as the etiology of refractory intracranial hypertension in this patient. ConclusionsClinicians should consider opioids as a contributing factor in malignant intracranial hypertension when findings on neuroimaging do not explain persistent and refractory intracranial hypertension. |
| first_indexed | 2024-12-11T21:22:32Z |
| format | Article |
| id | doaj.art-59f133dfb9854c299e881e368ddc7a78 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T21:22:32Z |
| publishDate | 2013-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-59f133dfb9854c299e881e368ddc7a782022-12-22T00:50:25ZengFrontiers Media S.A.Frontiers in Neurology1664-22952013-01-01410.3389/fneur.2013.0000341842Refractory Intracranial Hypertension due to Fentanyl Administration Following Closed Head InjurySara E Hocker0Jeremy L Fogelson1Alejandro eRabinstein2Mayo ClinicMayo ClinicMayo ClinicBackgroundAlthough the effects of opioids on intracranial pressure have long been a subject of controversy, they are frequently administered to patients with severe head trauma. We present a patient with an uncommon paradoxical response to opioids.Case ReportA patient with refractory intracranial hypertension after closed head injury was managed with standard medical therapy with only transient decreases in the intracranial pressure. Only after discontinuation of opiates did the intracranial pressure become manageable without metabolic suppression and rescue osmotic therapy, implicating opiates as the etiology of refractory intracranial hypertension in this patient. ConclusionsClinicians should consider opioids as a contributing factor in malignant intracranial hypertension when findings on neuroimaging do not explain persistent and refractory intracranial hypertension.http://journal.frontiersin.org/Journal/10.3389/fneur.2013.00003/fullFentanylIntracranial HypertensionMorphineOpioidsTraumatic brain injury (TBI)Closed head injury |
| spellingShingle | Sara E Hocker Jeremy L Fogelson Alejandro eRabinstein Refractory Intracranial Hypertension due to Fentanyl Administration Following Closed Head Injury Frontiers in Neurology Fentanyl Intracranial Hypertension Morphine Opioids Traumatic brain injury (TBI) Closed head injury |
| title | Refractory Intracranial Hypertension due to Fentanyl Administration Following Closed Head Injury |
| title_full | Refractory Intracranial Hypertension due to Fentanyl Administration Following Closed Head Injury |
| title_fullStr | Refractory Intracranial Hypertension due to Fentanyl Administration Following Closed Head Injury |
| title_full_unstemmed | Refractory Intracranial Hypertension due to Fentanyl Administration Following Closed Head Injury |
| title_short | Refractory Intracranial Hypertension due to Fentanyl Administration Following Closed Head Injury |
| title_sort | refractory intracranial hypertension due to fentanyl administration following closed head injury |
| topic | Fentanyl Intracranial Hypertension Morphine Opioids Traumatic brain injury (TBI) Closed head injury |
| url | http://journal.frontiersin.org/Journal/10.3389/fneur.2013.00003/full |
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