Brief Answer:
In the future, question must be DIRECTED to Dr. XXXXXXX XXXXXXX

Detailed Answer:
Good evening. Please accept my apologies but in the method you've entered your question into the system there is no guarantee that Dr. XXXXXXX would receive or be able to answer this question. For future reference if you wish to direct questions to specific physicians you must enter the question in what is known as a DIRECT QUERY format. For example, if you would like to send me questions and be sure that I and only I answered them you would need to go to bit.ly/drdariushsaghafi and then, once you arrived there you would see how to specifically direct a question to my attention. The same applies to Dr. XXXXXXX and every other physician on this network.

Having said that the goal is to answer your question regarding your son. My name is Dr. Saghafi I am an adult neurologist and headache/facial pain subspecialist and am quite familiar with this sort of problem.

I don't know if there is more history that I should know of his problem but from what I've read your son now is being subjected to increased pressure within the ventricular system over the past 5 days from a point where apparently he had close to normal pressures (23- slightly elevated). Now, his pressures have risen into the high 40's and apparently his physicians are not finding the exact reason. Is this correct?

You say he was placed on medication but you've not specified which. Was it something that reduced his pressure? One of the most common classes of drug to use for this purpose would be the CARBONIC ANHYDRASE INHIBITORS such as ACETAZOLAMIDE, TOPIRAMATE, and METHOZOLAMIDE represent examples of drugs that can reduce pressure in fairly short order. Many other medications are available.

But to your question as to the cause. There are many reasons why relatively normal pressures such as what your son demonstrated several days ago with a 23 would suddenly rise to 43. The first step is to determine whether this pressure increase is because of an actual rise in FLUID PRESSURE because of increased production, obstruction of flow, or is the fluid pressure increased because pressure IN THE BRAIN is increased and exerting its force against the fluid that is circulating?

The former cause could be as a result of sudden INCREASE IN PRODUCTION OF FLUID as could happen with a tumor of the choroid plexus in the 3rd ventricular. An example cause of increased brain pressure resulting in fluid pressure increases would be the presence of a mass lesion within the brain such as a tumor or large cyst which is displacing brain contents into the fluid which bathes the brain which obviously causes the fluid pressure to elevate since we are working in a CLOSED BOX type of situation with the skull having very little flexibility to expand under these circumstances.

These are but 2 examples of a plethora of other diagnostic examples of what could elevate fluid pressure in an acute fashion. The trick would be to go about the diagnostic conundrum by looking at his clinical condition (no significant headaches apparently) and make a list of MOST likely to LEAST likely candidates.

And if you're interested in a simple list which is not in any particular order (EXCEPT ALPHABETIZED) nor suggestive that your son should have any one of these things since I am somewhat in the dark as to his clinical status or the history that led to all this then, here it is for your edification:

Aneurysm rupture and subarachnoid hemorrhage
Brain tumor
Encephalitis
Head injury
Hydrocephalus (CAUSE UNKNOWN- referred to as Idiopathic Intracranial
Hypertension)
Hypertensive brain hemorrhage
Intraventricular hemorrhage
Meningitis
Subdural hematoma
Status epilepticus
Stroke

Discovering if any of the above are relevant to your son or not will require imaging studies, blood work, spinal fluid analysis, and clinical prowess by the treating physicians.

Hopefully, you were not inconvenienced too much by my answering your question as opposed to my colleague Dr. XXXXXXX however, perhaps you will be able to look him up specifically and discover his webpage that you can land on the next time so that your directed questions will make it exactly and exclusively to his attention as opposed to being distributed to the general physician populus as happened in this case.

I hope this answer satisfactorily addresses your question. If so, may I ask for your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?

Please direct more comments or inquiries to me in the future at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.
All the best.

The query has required a total of 37 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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