Marc de Perrot, MD Division of Thoracic Surgery, University Health Network University of Toronto Toronto, ON Patients with pulmonary hypertension that progress to acute decompensation present high mortality rates. The main mechanism of death in this population is right ventricular failure. Once this scenario becomes refractory to optimized medical therapies, mechanical support is increasingly c...

Uncontrolled hypertension is a significant problem in children with end stage kidney disease. We studied 10 children on chronic hemodialysis who received the endothelin-1 receptor antagonist, bosentan as adjunctive therapy in refractory systemic hypertension. Data were retrospectively analyzed on systolic (SBP) and diastolic blood pressure (DBP), antihypertensive medications and hospitalization...

CLINICAL CASE Craneal sinuses stenosis can appear in patients with idiopathic intracranial hypertension. Neuroimaging techniques revealed a right transverse sinus stenosis. As the pressure gradient between both sides of the stenosis was small and response to conservative treatment good, angioplasty was not indicated. DISCUSSION Lateral sinus stenosis in patients with idiopathic intracranial h...

A 67-year-old woman with drug-refractory essential hypertension was admitted for renal sympathetic denervation (RDN). The secondary causes of hypertension were fully investigated in this patient. A 24-h ambulatory blood pressure (BP) monitor documented a mean daytime BP of 172/101 mmHg, a mean nighttime BP of 151/84 mmHg, and an overall mean BP of 167/97 mmHg despite compliance with metoprolol ...

1. The effects of prazosin administered alone or in combination were studied in thirty patients between August 1974 and March 1975. 2. All patients had previously received treatment for hypertension with other agents, for from 2 months to 10 years. All thirty patients had refractory hypertension which had not responded satisfactorily to other treatment. 3. Patients were treated initially with p...

The treatment of patients with large hemispheric ischaemic stroke accompanied by massive space-occupying oedema represents one of the major unsolved problems in neurocritical care medicine. Despite maximum intensive care, the prognosis of these patients is poor, with case fatality rates as high as 80%. Therefore, the term 'malignant brain infarction' was coined. Because conservative treatment s...