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cerebral vasospasm diagnosis

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https://www.readbyqxmd.com/read/28320115/reversible-cerebral-vasoconstriction-syndrome-in-puerperium-a-prospective-study
#1
Gian Paolo Anzola, Renato Brighenti, Milena Cobelli, Alessia Giossi, Sara Mazzucco, Silvia Olivato, Elisa Pari, Maria Paola Piras, Alessandro Padovani, Fabrizio Rinaldi, Giulia Turri
BACKGROUND AND AIM OF THE STUDY: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe "thunderclap" headache, with or without associated neurological symptoms and neuroimaging findings of reversible vasoconstriction of cerebral arteries. Puerperium is a recognized precipitant, but the incidence of puerperal RCVS is unknown. We conducted a prospective study to assess incidence, risk factors and clinical features of RCVS. MATERIAL AND METHOD: Nine-hundred consecutive puerperae were prospectively enrolled within three days of delivery...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28257639/management-and-long-term-evolution-of-a-patient-with-3-hydroxy-3-methylglutaryl-coenzyme-a-lyase-deficiency
#2
Juan Ignacio Muñoz-Bonet, María Del Carmen Ortega-Sánchez, José Luis León Guijarro
BACKGROUND: 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) lyase deficiency is a rare inborn error of metabolism characterized by recurrent metabolic crises caused by fasting, intercurrent illness and excessive physical exercise. Non ketotic hypoglycemia is normally the cause of primary symptoms but without an immediate treatment the illness can evolve into a worsening metabolic state resembling the Reye's syndrome that may cause the patient's death. We report a case with some clinical and therapeutic features not previously described...
January 19, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28241122/numerical-investigation-of-vasospasm-detection-by-extracranial-blood-velocity-ratios
#3
Jaiyoung Ryu, Nerissa Ko, Xiao Hu, Shawn C Shadden
BACKGROUND: Early diagnosis of vasospasm following subarachnoid hemorrhage can prevent cerebral ischemia and improve neurological outcomes. This study numerically evaluates the relevance of extracranial blood velocity indices to detect vasospasm. METHODS: A numerical model of cerebral blood flow was used to evaluate the hemodynamics associated with anterior and posterior vasospasm under normal and impaired cerebral autoregulation conditions. Extracranial blood velocities at the carotid and vertebral arteries and their ratios between ipsilateral and contralateral, anterior and posterior, and downstream and upstream arteries were monitored during vasospasm progression...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28236869/intraventricular-hemorrhage-after-dural-fistula-embolization
#4
Joana Chaves Gonçalves Rodrigues de Carvalho, Francisco Javier Tercero Machin, Luis San Roman Manzanera, Jordi Blasco Andaluz, Sílvia Herrero Nogués, Núria Peix Soriano, Victor Obach Baurier, Enrique Jesus Carrero Cardenal
BACKGROUND AND OBJECTIVES: Dural arteriovenous fistulas are anomalous shunts between dural arterial and venous channels whose nidus is located between the dural leaflets. For those circumstances when invasive treatment is mandatory, endovascular techniques have grown to become the mainstay of practice, choice attributable to their reported safety and effectiveness. We describe the unique and rare case of a dural arteriovenous fistula treated by transarterial embolization and complicated by an intraventricular hemorrhage...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28217390/management-of-aneurysmal-subarachnoid-hemorrhage-state-of-the-art-and-future-perspectives
#5
REVIEW
Giovanni Grasso, Concetta Alafaci, R Loch Macdonald
BACKGROUND: Aneurysmal subarachnoid hemorrhage (SAH) accounts for 5% of strokes and carries a poor prognosis. It affects around 6 cases per 100,000 patient years occurring at a relatively young age. METHODS: Common risk factors are the same as for stroke, and only in a minority of the cases, genetic factors can be found. The overall mortality ranges from 32% to 67%, with 10-20% of patients with long-term dependence due to brain damage. An explosive headache is the most common reported symptom, although a wide spectrum of clinical disturbances can be the presenting symptoms...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28169856/postinterventional-critical-care-management-of-aneurysmal-subarachnoid-hemorrhage
#6
Sudhir Datar, Alejandro A Rabinstein
PURPOSE OF REVIEW: Subarachnoid hemorrhage from a ruptured aneurysm (aSAH) is a complex disorder with the potential to have devastating effects on the brain as well as other organ systems. After more than 3 decades of research, the underlying pathophysiologic mechanisms remain incompletely understood and important questions remain regarding the evaluation and management of these patients. The purpose of this review is to analyze the recent literature and improve our understanding of certain key clinical aspects...
April 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27931942/interleukin-6-in-the-cerebrospinal-fluid-as-a-biomarker-for-onset-of-vasospasm-and-ventriculitis-after-severe-subarachnoid-hemorrhage
#7
Markus Lenski, Volker Huge, Josef Briegel, Jörg-Christian Tonn, Christian Schichor, Niklas Thon
OBJECTIVE: The aim of the study was to investigate the diagnostic potential of interleukin 6 (IL-6) and other soluble biomarkers in serum and cerebrospinal fluid (CSF) for early diagnosis of cerebral vasospasm (cVSSAH) and external ventricular drain-associated ventriculitis (VCSAH) and to separate these conditions from aneurysmal subarachnoid hemorrhage (aSAH) without further complication (SAH(w/o/c)). METHODS: The concentrations of serum biomarkers and markers in the CSF were collected in 63 consecutive patients with aSAH and external ventricular drainage...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27866915/trends-in-transcranial-doppler-monitoring-in-aneurysmal-subarachnoid-hemorrhage-a-10-year-analysis-of-the-nationwide-inpatient-sample
#8
Gyanendra Kumar, Karen C Albright, John P Donnelly, Angela Hays Shapshak, Mark R Harrigan
BACKGROUND: Transcranial Doppler (TCD) is endorsed by national guidelines for use in aneurysmal subarachnoid hemorrhage (aSAH) for surveillance of cerebral vasospasm (CV). However, nationwide data on utilization of TCD for CV detection and monitoring in aSAH are lacking. METHODS: Analysis of nationwide trends in TCD prevalence was performed using Nationwide Inpatient Sample (NIS) data from 2002 to 2011. Raw counts were converted into weighted counts, which were used to generate national estimates...
November 17, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27845320/-perfusion-computed-tomography-in-the-diagnosis-of-mild-brain-injury
#9
I A Balandina, K V Shevchenko, E A Zolotovskaya
AIM: To evaluate and compare the characteristics of the regional cerebral blood flow in patients with mild cerebral concussion or injury using the results of perfusion computed tomography (CT). MATERIAL AND METHODS: Thirty-eight men, aged 18-35 years, including 21 with concussion and 17 with mild cranial/brain injury (CBI), were examined at the early stage of disease. The control group consisted of 7 age-matched men with non-confirmed CBI. RESULTS AND CONCLUSION: The results of CT-perfusion revealed generalized changes in the hemodynamics...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27740993/ultrasound-in-neurology
#10
Georgios Tsivgoulis, Andrei V Alexandrov
PURPOSE OF REVIEW: Low cost, avoidance of irradiation, and high temporal resolution are inherent advantages of ultrasound imaging that translate into multiple clinical uses in many domains of neurology. This article presents clinical uses of ultrasound examination in cerebrovascular, neurodegenerative, and peripheral nervous system diseases. RECENT FINDINGS: Modern treatment and prevention of ischemic stroke rely on prompt diagnosis. Ultrasonography has found a place as a noninvasive screening test and bedside technique that provides estimates of the degree of stenosis as well as hemodynamic and structural information about intracranial and extracranial vessels in real time...
October 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27721780/the-need-for-a-rational-approach-to-vasoconstrictive-syndromes-transcranial-doppler-and-calcium-channel-blockade-in-reversible-cerebral-vasoconstriction-syndrome
#11
Elisabeth B Marsh, Wendy C Ziai, Rafael H Llinas
INTRODUCTION: Reversible cerebral vasoconstriction syndrome (RCVS) typically affects young patients and left untreated can result in hemorrhage or ischemic stroke. Though the disorder has been well characterized in the literature, the most appropriate way to diagnose, treat, and evaluate therapeutic response remains unclear. In previous studies, transcranial Doppler ultrasound (TCD) has shown elevated velocities indicative of vasospasm. This imaging modality is noninvasive and inexpensive; an attractive option for diagnosis and therapeutic monitoring if it is sensitive enough to detect changes in the acute setting given that RCVS often affects the distal vessels early in the course of disease...
May 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/27682826/predictors-of-acute-vertebrobasilar-vasospasm-following-tumor-resection-in-the-foramen-magnum-region
#12
Chuanyuan Tao, Jiajing Wang, Yuekang Zhang, Shirong Qi, Fan Liu, Chao You
OBJECTIVE: Cerebral vasospasm can occur after skull base tumor removal. Few studies concentrated on the posterior circulation vasospasm after tumor resection in the posterior fossa. We aimed to identify the risk factors associated with postoperative vertebrobasilar vasospasm after tumor resection in the foramen magnum. METHODS: We retrospectively reviewed the data of 62 patients with tumors in the foramen magnum at our institution from January 2010 to January 2015...
2016: PloS One
https://www.readbyqxmd.com/read/27677690/-intraventricular-hemorrhage-after-dural-fistula-embolization
#13
Joana Chaves Gonçalves Rodrigues de Carvalho, Francisco Javier Tercero Machin, Luis San Roman Manzanera, Jordi Blasco Andaluz, Sílvia Herrero Nogués, Núria Peix Soriano, Victor Obach Baurier, Enrique Jesus Carrero Cardenal
BACKGROUND AND OBJECTIVES: Dural arteriovenous fistulas are anomalous shunts between dural arterial and venous channels whose nidus is located between the dural leaflets. For those circumstances when invasive treatment is mandatory, endovascular techniques have grown to become the mainstay of practice, choice attributable to their reported safety and effectiveness. We describe the unique and rare case of a dural arteriovenous fistula treated by transarterial embolization and complicated by an intraventricular hemorrhage...
March 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27639512/-reversible-cerebral-vasoconstriction-syndrome-a-rare-pediatric-cause-of-thunderclap-headaches
#14
M Trolliet, A Sevely, J-F Albucher, N Nasr, C Hachon Lecamus, K Deiva, E Cheuret
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by thunderclap headaches with diffuse segmental constriction of cerebral arteries that resolves spontaneously within 3 months. We report on a case of a 13-year-old boy presenting with acute severe headaches, triggered by physical exertion. His past medical history was uneventful. Moderate headache persisted between exacerbations for 4 weeks. He secondarily presented with signs of intracranial hypertension. Brain magnetic resonance angiography (MRA) revealed multifocal narrowing of the cerebral arteries...
December 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27597383/cerebral-vasospasm-and-delayed-ischaemic-deficit-following-elective-aneurysm-clipping
#15
REVIEW
Anastasia Tsyben, Iddo Paldor, John Laidlaw
Although common after subarachnoid haemorrhage, cerebral vasospasm (CVS) and delayed ischaemic neurological deficit (DIND) rarely occur following elective clipping of unruptured aneurysms. The onset of this complication is variable and its pathophysiology is poorly understood. We report two patients with CVS associated with DIND following unruptured aneurysmal clipping. The literature is reviewed and the potential mechanisms in the context of patient presentations are discussed. A woman aged 53 and a man aged 70 were treated with elective clipping of unruptured middle cerebral artery aneurysms, the older patient also having an anterior communicating artery aneurysm clipped...
December 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27579950/transcranial-doppler-ultrasonography-as-a-non-invasive-tool-for-diagnosis-and-monitoring-of-reversible-cerebral-vasoconstriction-syndrome
#16
Jay H Levin, Jorge Benavides, Claudine Caddick, Kathleen Laurie, Janet Wilterdink, Shadi Yaghi, Brian Silver, Muhib Khan
BACKGROUND AND PURPOSE: Reversible cerebral vasoconstriction syndrome (RCVS) is a vascular headache disorder characterized by severe headaches with vasospasm of cerebral arteries. Transcranial Doppler ultrasonography (TCD) has been widely applied and validated in studying vasospasm of intracranial vessels, but the role of TCD in the diagnosis and monitoring of RCVS is less well established. We sought to determine the reliability of TCD for diagnosis and monitoring of RCVS. METHODS: Patients admitted to an inpatient neurology service between 2011 and 2014 with a discharge diagnosis of RCVS were retrospectively analyzed for demographics, neuroimaging, and functional outcomes...
September 1, 2016: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/27515947/cerebral-vasospasm-and-wernicke-encephalopathy-secondary-to-adult-cyclic-vomiting-syndrome-the-role-of-magnesium
#17
Álvaro Sánchez-Larsen, Tomás Segura, Susana García-Muñozguren, Javier Peinado-Ródenas, Joaquín Zamarro, Francisco Hernández-Fernández
BACKGROUND: Magnesium has a regulatory role in the excitability of cell membranes, and is also a cofactor in the phosphorylation of thiamine. Hypomagnesemia has been associated with coronary vasospasm, but its role in cerebrovascular pathology is controversial, and cerebral vasospasm exclusively attributable to hypomagnesemia has not been reported in humans. CASE PRESENTATION: We report the case of a 51-year-old man in whom uncontrollable vomiting, treatment with omeprazole and thiazide, and renal impairment lead to a severe hypomagnesemia (magnesium below the level of detection in blood tests), which secondarily caused Wernicke's encephalopathy and vasospasm in multiple cerebral arteries (seen with cerebral angiography and CT angiography) that presented with a complete right hemisphere neurological deficit...
August 11, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27446600/standards-in-neurosonology-part-iii
#18
REVIEW
Joanna Wojczal, Tomasz Tomczyk, Piotr Luchowski, Grzegorz Kozera, Radosław Kaźmierski, Zbigniew Stelmasiak
The paper presents standards related to ultrasound imaging of the cerebral vasculature and structures. The aim of this paper is to standardize both the performance and description of ultrasound imaging of the extracranial and intracranial cerebral arteries as well as a study of a specific brain structure, i.e. substantia nigra hyperechogenicity. The following aspects are included in the description of standards for each ultrasonographic method: equipment requirements, patient preparation, study technique and documentation as well as the required elements of ultrasound description...
June 2016: Journal of Ultrasonography
https://www.readbyqxmd.com/read/27364895/subarachnoid-haemorrhage-secondary-to-traumatic-intracranial-aneurysm-of-the-posterior-cerebral-circulation-case-series-and-literature-review
#19
REVIEW
Ruth-Mary deSouza, Munirih Shah, Panayiotis Koumellis, Mansoor Foroughi
BACKGROUND: To identify the clinical features, rebleed risk, timing and method of diagnosis, complications and outcome for subarachnoid haemorrhage (SAH) from traumatic intracranial aneurysm (TICA) of the posterior circulation. Subjects included 26 patients aged 3-54 (mean 24.8). METHODS: Case series and literature search to identify all reported cases. RESULTS: In our series, two of three cases were fatal as a result of rebleed, and one case had a good outcome with no deficit, following prompt diagnosis and embolisation...
September 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27333759/-japanese-guidelines-for-the-management-of-stroke-2015-overview-of-the-chapter-on-subarachnoid-hemorrhage
#20
REVIEW
Hideyuki Ishihara, Michiyasu Suzuki
After an interval of 6 years, the Japanese Guidelines for the Management of Stroke were revised in 2015 in accordance with recent advances in clinical knowledge. The chapter on subarachnoid hemorrhage includes new and revised recommendations for diagnosis, treatment selection, and management of vasospasm. The chapter on diagnosis recommends re-examination of vascular images at regular intervals in cases in which cerebral aneurysm was not detected on the first examination. The section dealing with treatment selection for cerebral aneurysmal emphasizes that the method for aneurysm obliteration should be selected based on consultation with both surgical and endovascular specialists...
April 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
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