[Plateau wave, unexpected cause of anoxo-ischemic syncope. Reflections on the pathogenesis of the plateau wave apropos of a case].
The case of a 56 year old female suffering from a carcinomatous meningitis with recurrent attacks of unconciousness is presented. The ischemic nature of the attacks was substantiated through a simultaneous recording of ICP, systemic arterial blood pressure, and EEG. Every syncope was clearly accompanied by 1) a typical ICP plateau-wave, 2) a systemic blood pressure wave of lower amplitude, 3) a considerable correlative diminution of the cerebral perfusion pressure and 4) a slowing down of the EEG. These phenomenons could be provoked by intraventricular injections of a few milliliters of artificial CSF, whereas a ventriculo-peritoneal shunting made them disappeared. The role played by the disturbances of the CSF flow in the production of the plateau waves is discussed.
D001794:Blood Pressure; D002545:Brain Ischemia / Q000503:physiopathology*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000503:physiopathology*; D007427:Intracranial Pressure; D008581:Meningitis / Q000150:complications; D008875:Middle Aged; D011559:Pseudotumor Cerebri / Q000209:etiology / Q000503:physiopathology; D013575:Syncope / Q000209:etiology / Q000503:physiopathology*
L'onde en plateau, cause inattendue de syncopes anoxo-ischémiques. Réflexions sur la pathogénie de l'onde en plateau à propos d'une observation.