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https://www.readbyqxmd.com/read/29785667/cerebral-autoregulation-in-stroke
#1
REVIEW
Pedro Castro, Elsa Azevedo, Farzaneh Sorond
PURPOSE OF REVIEW: Cerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29726988/validation-of-noninvasive-absolute-intracranial-pressure-measurements-in-traumatic-brain-injury-and-intracranial-hemorrhage
#2
Jenny C Kienzler, Rolandas Zakelis, Sabrina Bäbler, Elke Remonda, Arminas Ragauskas, Javier Fandino
BACKGROUND: Increased intracranial pressure (ICP) causes secondary damage in traumatic brain injury (TBI), and intracranial hemorrhage (ICH). Current methods of ICP monitoring require surgery and carry risks of complications. OBJECTIVE: To validate a new instrument for noninvasive ICP measurement by comparing values obtained from noninvasive measurements to those from commercial implantable devices through this pilot study. METHODS: The ophthalmic artery (OA) served as a natural ICP sensor...
May 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29695406/a-novel-association-of-campomelic-dysplasia-with-hydrocephalus-due-to-an-unbalanced-chromosomal-translocation-upstream-of-sox9
#3
Prince Antwi, Christopher S Hong, Daniel Duran, Jin Sheng Chih, Weilai Dong, Michael DiLuna, Kristopher T Kahle
Campomelic dysplasia is a rare skeletal dysplasia characterized by Pierre-Robin sequence, craniofacial dysmorphism, shortening and angulation of long bones, tracheobronchomalacia, and occasionally sex reversal. The disease is due to mutations in SOX9 or chromosomal rearrangements involving the long arm of chromosome 17 harboring the SOX9 locus. SOX9, a transcription factor, is indispensible in establishing and maintaining neural stem cells in the CNS. We present a patient with angulation of long bones and external female genitalia on prenatal ultrasound who was subsequently found to harbor the chromosomal abnormality 46, XY, t(6;17) (p21...
April 25, 2018: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/29689584/bedside-ultrasound-guided-percutaneous-needle-aspiration-of-intra-and-extra-axial-intracranial-hemorrhage-in-neonates
#4
Mehmet N Cizmeci, Liesbeth Thewissen, Alexandra Zecic, Peter A Woerdeman, Bart de Boer, Edward Baert, Paul Govaert, Jeroen Dudink, Floris Groenendaal, Maarten Lequin, Linda S de Vries
Intracranial hemorrhage is an important cause of brain injury in the neonatal population and bedside percutaneous needle aspiration has emerged as an alternative due to the major risks that can be caused by standard neurosurgical decompression. We aimed to assess the effectiveness of this minimally invasive bedside technique and conducted a retrospective analysis of all newborn infants with a large extra-axial hemorrhage associated with a parenchymal hemorrhage causing a midline shift, managed at three academic centers over a 15-year period...
April 24, 2018: Neuropediatrics
https://www.readbyqxmd.com/read/29628552/ultrasonographic-optic-nerve-sheath-diameter-as-a-surrogate-measure-of-raised-intracranial-pressure-in-severe-pregnancy-induced-hypertension-patients
#5
Shiv Kumar Singh, Kiran Bhatia
Context: It is a well-known fact that severe pregnancy-induced hypertension (PIH) can be disastrous at times as it can cause a lot of complications to both pregnant women and her baby. Hence, it is always desirable to know the extent of severity by a real-time and easily accessible modality like ultrasound. Aims: The aim of the study was to evaluate the incidence of raised intracranial pressure (ICP) in severe preeclampsia and eclampsia patients using ocular ultrasonography with optic nerve sheath diameter (ONSD) measurement...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29610967/early-analysis-of-operative-management-of-chiari-i-malformation-in-pediatric-cystic-fibrosis-patients
#6
Derek C Samples, Dewey J Thoms, Izabela Tarasiewicz
INTRODUCTION: Chiari I malformation, defined as herniation of the cerebellar tonsils at least 5 mm below the foramen magnum, can result from congenital or acquired pathology. While the mechanism is not well understood, an association between Chiari I and cystic fibrosis has been described in the literature. The lifelong respiratory status management necessitated by cystic fibrosis creates a greater risk of Chiari symptomatology as well as post-operative CSF-related complications in the setting of duraplasty secondary to recurrent transient increases in intracranial pressure...
April 2, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29534259/sonographic-diagnosis-of-meningoencephalitis-in-newborns-and-infants
#7
Karl-Heinz Deeg
Prenatal, neonatal meningoencephalitis and infections of the brain in older infants are often associated with serious complications which can be diagnosed by sonography through the open fontanelles. Most frequently postmeningitic hydrocephalus and subdural effusions occur. Rarer complications are brain abscesses and ventriculitis which are caused by gram negative bacteria such as E. coli, Serratia marcescens, Proteus and Enterobacter. A serious complication after ventriculitis is the development of compartment hydrocephalus...
April 2018: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/29528889/new-directions-in-point-of-care-ultrasound-at-the-crossroads-of-paediatric-emergency-and-critical-care
#8
William Bortcosh, Ashkon Shaahinfar, Sakina Sojar, Jean E Klig
PURPOSE OF REVIEW: The diagnostic capability, efficiency and versatility of point-of-care ultrasound (POCUS) have enabled its use in paediatric emergency medicine (PEM) and paediatric critical care (PICU). This review highlights the current applications of POCUS for the critically ill child across PEM and PICU to identify areas of progress and standardized practice and to elucidate areas for future research. RECENT FINDINGS: POCUS technology continues to evolve and advance bedside clinical care for critically ill children, with ongoing research extending its use for an array of clinical scenarios, including respiratory distress, trauma and dehydration...
June 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29492541/volumetric-ophthalmic-ultrasound-for-inflight-monitoring-of-visual-impairment-and-intracranial-pressure
#9
Aaron Dentinger, Michael MacDonald, Douglas Ebert, Kathleen Garcia, Ashot Sargsyan
OBJECTIVE:  The objective is enhanced ophthalmic ultrasound imaging to monitor ocular structure and intracranial dynamics changes related to visual impairment and intracranial pressure (ICP) induced by microgravity. The goals are to improve the ease of use and reduce operator variability by automatically rendering improved views of the anatomy and deriving new metrics of the morphology and dynamics. MATERIALS AND METHODS:  A prototype three-dimensional (3-D) probe was integrated onto a portable ultrasound scanner...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29367448/posthemorrhagic-ventricular-dilatation-in-preterm-infants-when-best-to-intervene
#10
Lara M Leijser, Steven P Miller, Gerda van Wezel-Meijler, Annemieke J Brouwer, Jeffrey Traubici, Ingrid C van Haastert, Hilary E Whyte, Floris Groenendaal, Abhaya V Kulkarni, Kuo S Han, Peter A Woerdeman, Paige T Church, Edmond N Kelly, Henrica L M van Straaten, Linh G Ly, Linda S de Vries
OBJECTIVE: To compare neurodevelopmental outcomes of preterm infants with and without intervention for posthemorrhagic ventricular dilatation (PHVD) managed with an "early approach" (EA), based on ventricular measurements exceeding normal (ventricular index [VI] <+2 SD/anterior horn width <6 mm) with initial temporizing procedures, followed, if needed, by permanent shunt placement, and a "late approach" (LA), based on signs of increased intracranial pressure with mostly immediate permanent intervention...
January 24, 2018: Neurology
https://www.readbyqxmd.com/read/29356623/effect-of-history-of-mild-traumatic-brain-injury-on-optic-nerve-sheath-diameter-changes-after-valsalva-maneuver
#11
Matthew Lyon, Parth Agrawal, Kyle Friez, Richard Gordon, Ivan Morales, Li Fang Zhang, Hongyan Xu, Ian Heger, Robert W Gibson
Optic nerve sheath diameter (ONSD) measured by transocular ultrasound is a marker of real-time intracranial pressure (ICP). The objective of this study was to evaluate the association between optic nerve sheath (ONS) dilation after a Valsalva maneuver and a prior history of mild to moderate traumatic brain injury (mTBI) in a heterogeneous sample of participants. Participants were excluded if they had had a recent brain injury, were symptomatic from a prior brain injury, had a history consistent with severe TBI and/or had undergone intracranial surgery...
February 15, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29262441/imaging-in-neurocritical-care-practice
#12
Craig Williamson, Larry Morgan, Joshua P Klein
The use of neuroimaging in conjunction with serial neurological examinations is a core component of modern neurocritical care practice. Although there is a growing role for other neuromonitoring techniques, the ability to quickly and accurately interpret images in the context of a patient's clinical status arguably remains the indispensable skill for neurocritical care practitioners. Due to its rapid acquisition time and excellent ability to detect intracerebral hemorrhage (ICH), cerebral edema, and signs of elevated intracranial pressure, computed tomography (CT) remains the most useful neuroimaging technique for intensive care unit (ICU) patients...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29212156/effects-of-cerebral-perfusion-pressure-on-regional-cerebral-blood-flow-in-dogs-with-acute-epidural-hematoma-quantitative-evaluation-with-contrast-enhanced-ultrasound
#13
Hongwei Cheng, Xiang Mao, Zonggang Hou, Jian Xu, Shuyu Hao, Huan Li, Baiyun Liu
To discuss the relationship between the regional cerebral blood flow (rCBF) and cerebral perfusion pressure (CPP) and the effect of CPP on rCBF in different spaces in an experimental animal model. As the ICP increased, the CPP and rCBF (A × β value measured by CEU) decreased to varying degrees. The rCBF1 and rCBF2 were well correlated with the CPP. At the same CPP, rCBF1 decreased significantly than the level of rCBF2 (p < 0.01). Six healthy cross-breed dogs, both males and females, weighing 18.3 ± 1...
November 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/29207924/speckle-tracking-in-transcranial-ultrasound-allows-noninvasive-analysis-of-pulsation-patterns-of-the-third-ventricle
#14
Benjamin Würzer, Cristina Laza, Jörn Pons-Kühnemann, Manfred Kaps, Bernd Junge, Florian C Roessler
Cerebrospinal fluid (CSF) flow is sensitive to many cerebral disorders. We aimed to develop a noninvasive bedside method to detect physiological and pathological CSF phenomena by measuring pulsation patterns of the third ventricle. By transcranial B-mode ultrasound, electrocardiography (ECG)-gated video loops of the third ventricle were acquired. "Speckle tracking" software was used to quantify the relative change of its width. We conducted measurements of nine cardiac cycles in 11 healthy subjects in sitting and in supine position during Valsalva maneuver to investigate the influence of an increased intracranial pressure on the relative deformation of the third ventricle...
March 2018: Ultrasonic Imaging
https://www.readbyqxmd.com/read/28865838/placement-of-a-cervical-collar-increases-the-optic-nerve-sheath-diameter-in-healthy-adults
#15
Casey M Woster, Michael D Zwank, Joseph R Pasquarella, Sandi S Wewerka, Jeffrey P Anderson, Jessica T Greupner, Sakib Motalib
INTRODUCTION: Blunt head trauma is a common cause of increased intracranial pressure (ICP). Ultrasound measurement of the optic nerve sheath diameter (OSND) is an accurate and non-invasive way to detect increased ICP. Blunt trauma patients are often immobilized in a rigid cervical spine collar. Our objective was to describe the changes in ONSD following the placement of a c-collar and determine if any changes were time-dependent. METHODS: We performed a prospective cohort study measuring the ONSD of healthy volunteers before and after placement of a c-collar...
March 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28853610/white-matter-hyperintensities-in-migraine-clinical-significance-and-central-pulsatile-hemodynamic-correlates
#16
Chun-Yu Cheng, Hao-Min Cheng, Shih-Pin Chen, Chih-Ping Chung, Yung-Yang Lin, Han-Hwa Hu, Chen-Huan Chen, Shuu-Jiun Wang
Background The role of central pulsatile hemodynamics in the pathogenesis of white matter hyperintensities in migraine patients has not been clarified. Methods Sixty patients with migraine (20-50 years old; women, 68%) without overt vascular risk factors and 30 demographically-matched healthy controls were recruited prospectively. Cerebral white matter hyperintensities volume was determined by T1-weighted magnetic resonance imaging with CUBE-fluid-attenuated-inversion-recovery sequences. Central systolic blood pressure, carotid-femoral pulse wave velocity, and carotid augmentation index were measured by applanation tonometry...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28634578/neonatal-venous-thromboembolism
#17
REVIEW
Kristina M Haley
Neonates are the pediatric population at highest risk for development of venous thromboembolism (VTE), and the incidence of VTE in the neonatal population is increasing. This is especially true in the critically ill population. Several large studies indicate that the incidence of neonatal VTE is up almost threefold in the last two decades. Central lines, fluid fluctuations, sepsis, liver dysfunction, and inflammation contribute to the risk profile for VTE development in ill neonates. In addition, the neonatal hemostatic system is different from that of older children and adults...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28611153/effects-of-short-term-mild-hypercapnia-during-head-down-tilt-on-intracranial-pressure-and-ocular-structures-in-healthy-human-subjects
#18
Steven S Laurie, Gianmarco Vizzeri, Giovanni Taibbi, Connor R Ferguson, Xiao Hu, Stuart M C Lee, Robert Ploutz-Snyder, Scott M Smith, Sara R Zwart, Michael B Stenger
Many astronauts experience ocular structural and functional changes during long-duration spaceflight, including choroidal folds, optic disc edema, globe flattening, optic nerve sheath diameter (ONSD) distension, retinal nerve fiber layer thickening, and decreased visual acuity. The leading hypothesis suggests that weightlessness-induced cephalad fluid shifts increase intracranial pressure (ICP), which contributes to the ocular structural changes, but elevated ambient CO2 levels on the International Space Station may also be a factor...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28577164/internal-jugular-vein-blood-flow-in-the-upright-position-during-external-compression-and-increased-central-venous-pressure-an-ultrasound-study-in-healthy-volunteers
#19
Tze Yeng Yeoh, Lashmi Venkatraghavan, Joseph A Fisher, Massimiliano Meineri
BACKGROUND: External compression of the jugular veins is an effective method to increase intracranial blood volume and brain stiffness in rats and healthy volunteers. It has been reported that, on assuming an upright posture, cerebral venous drainage is distributed away from the internal jugular veins (IJVs) to the cervical venous plexus, causing complete collapse of the IJV. If so, it is not clear why external IJV compression would increase intracranial blood volume, but the latter is frequently observed in neurosurgery in the sitting position...
August 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28495841/lower-body-negative-pressure-decreases-noninvasively-measured-intracranial-pressure-and-internal-jugular-vein-cross-sectional-area-during-head-down-tilt
#20
William Watkins, Alan R Hargens, Shannon Seidl, Erika Marie Clary, Brandon R Macias
Long-term spaceflight induces a near visual acuity change in ~50% of astronauts. In some crew members, postflight cerebrospinal fluid (CSF) opening pressures by lumbar puncture are as high as 20.9 mmHg; these members demonstrated optic disc edema. CSF communicates through the cochlear aqueduct to affect perilymphatic pressure and tympanic membrane motion. We hypothesized that 50 mmHg of lower-body negative pressure (LBNP) during 15° head-down tilt (HDT) would mitigate elevations in internal jugular vein cross-sectional area (IJV CSA) and intracranial pressure (ICP)...
July 1, 2017: Journal of Applied Physiology
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