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https://www.readbyqxmd.com/read/29348993/delayed-presentation-of-cerebral-air-embolism-from-a-left-atrial-esophageal-fistula-a-case-report-and-review-of-the-literature
#1
Catherine Peterson, Clay Elswick, Vicki Diaz, R Shane Tubbs, Marc Moisi
Air embolism developing from an atrial-esophageal fistula that was created as a complication from an atrial ablation procedure is a rare, yet usually fatal diagnosis. Neurologic manifestations such as meningitis, altered mental status, seizures, strokes, transient ischemic attacks (TIAs), psychiatric changes, and coma can ensue. Imaging of the brain might reveal infarcts, cerebral edema, as well as signs of pneumocephalus. This case describes a 42-year-old male with recent cardiac ablation procedure at an outside hospital for refractory atrial fibrillation (A-fib) who presented with altered mental status, dyspnea and diaphoresis...
November 15, 2017: Curēus
https://www.readbyqxmd.com/read/29348131/iodine-extravasation-quantification-on-dual-energy-ct-of-the-brain-performed-after-mechanical-thrombectomy-for-acute-ischemic-stroke-can-predict-hemorrhagic-complications
#2
M Bonatti, F Lombardo, G A Zamboni, F Vittadello, R Currò Dossi, B Bonetti, R Pozzi Mucelli, G Bonatti
BACKGROUND AND PURPOSE: Intracerebral hemorrhage represents a potentially severe complication of revascularization of acute ischemic stroke. The aim of our study was to assess the capability of iodine extravasation quantification on dual-energy CT performed immediately after mechanical thrombectomy to predict hemorrhagic complications. MATERIALS AND METHODS: Because this was a retrospective study, the need for informed consent was waived. Eighty-five consecutive patients who underwent brain dual-energy CT immediately after mechanical thrombectomy for acute ischemic stroke between August 2013 and January 2017 were included...
January 18, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29334856/stroke-after-minor-head-trauma-in-infants-and-young-children-with-basal-ganglia-calcification-a-lenticulostriate-vasculopathy
#3
Jatinder Singh Goraya, Shivankshi Berry, Kavita Saggar, Archana Ahluwalia
The authors retrospectively reviewed charts of the children with basal ganglia stroke who either had preceding minor head injury or showed basal ganglia calcification on computed tomography (CT) scan. Twenty children, 14 boys and 6 girls were identified. Eighteen were aged between 7 months to 17 months. Presentation was with hemiparesis in 17 and seizures in 3. Preceding minor head trauma was noted in 18. Family history was positive in 1 case. Bilateral basal ganglia calcification on CT scan was noted in 18...
February 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29324173/the-risk-of-deterioration-in-gcs13-15-patients-with-traumatic-brain-injury-identified-by-computed-tomography-imaging-a-systematic-review-and-meta-analysis
#4
Carl Marincowitz, Fiona E Lecky, William Townend, Aditya Borakati, Andrea Fabbri, Trevor A Sheldon
The optimal management of mild traumatic brain injury (TBI) patients with injuries identified by computed tomography (CT) brain scan is unclear. Some guidelines recommend hospital admission for an observation period of at least 24 h. Others argue that selected lower-risk patients can be discharged from the Emergency Department (ED). The objective of our review and meta-analysis was to estimate the risk of death, neurosurgical intervention, and clinical deterioration in mild TBI patients with injuries identified by CT brain scan, and assess which patient factors affect the risk of these outcomes...
January 11, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29303450/subcutaneous-bone-flap-storage-after-emergency-craniectomy-cost-effectiveness-and-rate-of-resorption
#5
Griffin Ernst, Fares Qeadan, Andrew P Carlson
OBJECTIVE Decompressive craniectomy is used for uncontrolled intracranial pressure in traumatic brain injury and malignant hemispheric stroke. Subcutaneous preservation of the autologous bone flap in the abdomen is a simple, portable technique but has largely been abandoned due to perceived concerns of resorption. The authors sought to characterize their experience with subcutaneous preservation of the bone flap and cranioplasty. METHODS The authors performed a retrospective single-institution review of subcutaneous preservation of the autologous bone flap after decompressive craniectomy from 2005 to 2015...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29282104/association-between-continuous-hyperosmolar-therapy-and-survival-in-patients-with-traumatic-brain-injury-a-multicentre-prospective-cohort-study-and-systematic-review
#6
Karim Asehnoune, Sigismond Lasocki, Philippe Seguin, Thomas Geeraerts, Pierre François Perrigault, Claire Dahyot-Fizelier, Catherine Paugam Burtz, Fabrice Cook, Dominique Demeure Dit Latte, Raphael Cinotti, Pierre Joachim Mahe, Camille Fortuit, Romain Pirracchio, Fanny Feuillet, Véronique Sébille, Antoine Roquilly
BACKGROUND: Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared the mortality and outcomes in patients with TBI with ICH treated or not with CHT. METHODS: We included patients with TBI (Glasgow Coma Scale ≤ 12 and trauma-associated lesion on brain computed tomography (CT) scan) from the databases of the prospective multicentre trials Corti-TC, BI-VILI and ATLANREA...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29273531/cns-aspergilloma-mimicking-tumors-review-of-cns-aspergillus-infection-imaging-characteristics-in-the-immunocompetent-population
#7
Devendra Kumar, Pankaj Nepal, Sumit Singh, Subraminayan Ramanathan, Maneesh Khanna, Rakesh Sheoran, S K Bansal, Santosh Patil
BACKGROUND AND PURPOSE: CNS Aspergillosis is very rare and difficult to diagnose clinically and on imaging. Our objective was to elucidate distinct neuroimaging pattern of CNS aspergillosis in the immunocompetent population that helps to differentiate from other differential diagnosis. METHODS: Retrospective analysis of brain imaging findings was performed in eight proven cases of central nervous system aspergillosis in immunocompetent patients. Immunocompetent status was screened with clinical and radiological information...
December 19, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29262441/imaging-in-neurocritical-care-practice
#8
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/29260037/cefepime-induced-neurotoxicity-a-case-series-and-review-of-the-literature
#9
Cigdem Isitan, Andrew Ferree, Anna DePold Hohler
Cefepime is a fourth generation cephalosporin which is bactericidal for broad spectrum of organisms. This is a case-series of three patients who presented to our hospital with confusion secondary to cefepime use to treat urinary tract infection (UTI) and health care associated pneumonia (HCAP), after excluding other common etiologies of altered mental status (AMS). Of these three patients, one had progressive expressive aphasia and the other two demonstrated asynchronous myoclonic activity of the limbs. The symptoms were seen within four to five days of initiating the treatment and resolved within three days of discontinuation of cefepime...
September 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/29251702/safety-and-efficacy-of-brain-injury-guidelines-at-a-level-iii-trauma-center
#10
Grace E Martin, Christopher P Carroll, Zach J Plummer, D A Millar, Timothy A Pritts, Amy T Makley, Bellal A Joseph, Laura B Ngwenya, Michael D Goodman
BACKGROUND: Patients with mild-to-moderate traumatic brain injury (TBI) are often primarily managed by emergency medicine and trauma/acute care physicians. The Brain Injury Guidelines (BIG) were developed at an ACS-accredited level 1 trauma center to triage mild-to-moderate TBI patients and help identify patients who warrant neurosurgical consultation. The BIG have not been validated at a level III trauma center. We hypothesized that BIG criteria can be safely adapted to an ACS-accredited level III trauma center to guide transfers to a higher echelon of care...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29250028/the-structural-imaging-characteristics-and-its-clinical-relevance-in-patients-with-cerebral-venous-thrombosis-a-retrospective-analysis-from-one-single-center-in-china
#11
Li-Xin Zhou, Ming Yao, Li-Ying Cui, Ming-Li Li, Yi-Cheng Zhu, Jun Ni, Bin Peng
Background: Few studies have investigated structural imaging findings of cerebral venous thrombosis (CVT) in China. The structural imaging [head computed tomography (CT) and routine brain magnetic resonance imaging (MRI)] can assess any parenchymal lesion secondary to the venous thrombosis and reveal direct signs of intraluminal thrombus. In recent years, many patients can be diagnosed with CVT more rapidly and directly by structural imaging. The aim of the present study is to determine the performance of structural imaging in the diagnosis and outcome of CVT in a large cohort single center of Chinese patients...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29250024/clinical-predictors-of-progressive-hemorrhagic-injury-in-children-with-mild-traumatic-brain-injury
#12
Guangfu Di, Hua Liu, Xiaochun Jiang, Yi Dai, Sansong Chen, Zhichun Wang, Hongyi Liu
Objective: Traumatic brain injury (TBI) occurs commonly in children. Repeat computed tomography (CT) follow up of TBI patients is often scheduled to identify progressive hemorrhagic injury (PHI). However, the utility of repeated CT scans, especially in children with mild TBI [Glasgow Coma Scale (GCS) scores of 13-15], has been debated. The purposes of the present study were to identify clinical predictors of PHI in children with mild TBI and to clarify relevant clinical factors via radiological examination...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29248834/cerebellar-metastasis-of-gastrointestinal-stromal-tumor-a-case-report-and-review-of-the-literature
#13
Mohamed Badri, Mohamed Chabaane, Ghassen Gader, Kamel Bahri, Ihsen Zammel
INTRODUCTION: Intracranial metastases of gastro intestinal tumors are very rare. To the best of our knowledge only few cases were reported on the literature. CASE DESCRIPTION: We describe the case of 66-year-old male that presented with headache and vomiting. Physical examination found a kinetic cerebellar syndrome. Brain CT scan and MRI showed a right cerebellar tumor. Sub-occipital craniotomy was performed and the tumor was completely resected. Surgical outcomes were marked by the occurrence of an abdominal pain two days after brain surgery...
December 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29246619/symptomatic-non-infectious-non-hemorrhagic-edema-after-subthalamic-nucleus-deep-brain-stimulation-surgery-for-parkinson-s-disease
#14
Jules M Nazzaro, Rajesh Pahwa, Kelly E Lyons
OBJECT: We review our experience with Parkinson's disease (PD) patients who underwent subthalamic nucleus (STN) deep brain stimulation (DBS) and then developed noninfectious, non-hemorrhagic, delayed, symptomatic brain edema associated with a DBS lead. METHODS: All PD patients who underwent STN DBS lead implantation from 2007 to 2015 were included. The same neurosurgeon performed all surgeries, typically in staged fashion, utilizing single pass microelectrode recordings (MER) within a stereotactic frame...
December 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29245306/unusual-synchronous-liver-and-brain-abscesses-infected-by-rare-aerococcus-viridians-in-a-patient-with-pulmonary-arteriovenous-malformations-on-fdg-pet-ct-a-case-report-and-literature-review
#15
Donghe Chen, Mengjie Dong, Kui Zhao, Fang Sun, Huatao Wang, Zhengfeng Liu
RATIONALE: Pulmonary arteriovenous malformations (PAVMs) complicated with multiple organ abscesses is an uncommon manifestation. Because of the low incidence of the disease, F-18 fluorodeoxyglucose positron emission tomography with computed tomography (F-FDG PET/CT) imaging studies for PAVMs complicated with multiple organ abscesses are scarce. PATIENT CONCERNS: We report a case of a 54-year-old man presenting with PAVMs complicated with synchronous multiple organ abscesses founded by F-FDG PET/CT...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29243534/eight-and-a-half-syndrome-caused-by-a-pontine-hemorrhage-a-case-report-and-review-of-the-literature
#16
Nian-Ge Xia, Yan-Yan Chen, Jia Li, Xi Chen, Zu-Sen Ye, Si-Yan Chen, Zhen-Guo Zhu
BACKGROUND: Eight-and-a-half syndrome is caused by a lesion in the dorsal tegmentum of the caudal pons involving parapontine reticular formation (PPRF) and the median longitudinal fasciculus (MLF), as well as the nucleus and/or the fasciculus of the facial nerve. It is characterized by one-and-a-half syndrome and an ipsilateral cranial nerve VII palsy. There are also many variants of eight-and-a-half syndrome has been described, including nine syndrome, thirteen-and-a-half syndrome, and fifteen-and-a-half syndrome...
December 15, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29236167/evaluation-of-the-yield-of-24-h-close-observation-in-patients-with-mild-traumatic-brain-injury-on-anticoagulation-therapy-a-retrospective-multicenter-study-and-meta-analysis
#17
Merelijne A Verschoof, Charlotte C M Zuurbier, Frank de Beer, Jonathan M Coutinho, Evert A Eggink, Björn M van Geel
BACKGROUND/AIMS: Patients with mild traumatic brain injury (mTBI) on anticoagulants have an increased risk of intracranial hemorrhage (ICH). However, consensus is lacking on whether to admit them after normal initial cranial CT. We evaluated the yield of 24-h neurological observation. METHODS: Retrospective multicenter study including adult patients admitted over a 5-year period with mTBI on anticoagulation [therapeutic dose heparin, direct oral anticoagulant, or vitamin K antagonist (VKA) with international normalized ratio (INR) ≥ 1...
December 13, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29227053/quantifying-the-funding-gap-for-management-of-traumatic-brain-injury-at-a-major-trauma-centre-in-south-africa
#18
V Y Kong, J J Odendaal, J L Bruce, G L Laing, E Jerome, B Sartorius, P Brysiewicz, D L Clarke
BACKGROUND: Trauma is an eminently preventable disease. However, prevention programs divert resources away from other priorities. Costing trauma related diseases helps policy makers to make decisions on re-source allocation. We used data from a prospective digital trauma registry to cost Traumatic Brain Injury (TBI) at our institution over a two-year period and to estimate the funding gap that exists in the care of TBI. METHOD: All patients who were admitted to the Pietermaritzburg Metropolitan Trauma Service (PMTS) with TBI were identified from the Hybrid Electronic Medical Registry (HMER)...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29222716/childhood-acute-disseminated-encephalomyelitis-an-egyptian-pilot-study
#19
Hamed Ahmed Elkhayat, Omnia Fathy El-Rashidy, Iman Ali Elagouza, Raghda Zaitoun, Yasser Abdel Azeem Abbas
Describing the variable clinical features, laboratory findings, neuroimaging findings, and treatments given to children who presented with ADEM and following them up both clinically and radiologically. 21 patients were recruited: 14 new cases, and 7 old ones presenting over the preceding 5 years (retrospective review of existing data). 11 males and 10 females, with a mean age of 4.4 years ± 2.7 SD, were included. All new patients were subject to full history, examination and a panel of investigations including MRI of the brain...
December 8, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29210924/intraventricular-hemorrhage-in-moderate-to-severe-congenital-heart-disease
#20
Cynthia M Ortinau, Jagruti S Anadkat, Christopher D Smyser, Pirooz Eghtesady
OBJECTIVES: Determine the prevalence of intraventricular hemorrhage in infants with moderate to severe congenital heart disease, investigate the impact of gestational age, cardiac diagnosis, and cardiac intervention on intraventricular hemorrhage, and compare intraventricular hemorrhage rates in preterm infants with and without congenital heart disease. DESIGN: A single-center retrospective review. SETTING: A tertiary care children's hospital...
January 2018: Pediatric Critical Care Medicine
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