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https://www.readbyqxmd.com/read/28730951/penumbra-and-re-canalization-acute-computed-tomography-in-ischemic-stroke-evaluation-practise-study-protocol
#1
Salwa El-Tawil, Joanna Wardlaw, Ian Ford, Grant Mair, Tom Robinson, Lalit Kalra, Keith W Muir
Rationale Multimodal imaging, including computed tomography angiography and computed tomography perfusion imaging, yields additional information on intracranial vessels and brain perfusion and can differentiate between ischemic core and penumbra which may affect patient selection for intravenous thrombolysis. Hypothesis The use of multimodal imaging will increase the number of patients receiving intravenous thrombolysis and lead to better treatment outcomes. Sample size 400 patients. Methods and design PRACTISE is a prospective, multicenter, randomized, controlled trial in which patients presenting within 4...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28724904/hypertonic-saline-infusion-suppresses-apoptosis-of-hippocampal-cells-in-a-rat-model-of-cardiopulmonary-resuscitation
#2
Xiang Zhou, Yong Liu, Yang Huang, ShuiBo Zhu, Jian Zhu, RongPing Wang
Hypertonic saline (HS) attenuates cerebral edema, improves microcirculation perfusion and alleviates inflammation. However, whether the beneficial effect of HS on neurological function after cardiopulmonary resuscitation (CPR) in rat model of asphyxial cardiac arrest (CA) is mediated via attenuating apoptosis of neurons is not known. We studied the neuroprotective effect of HS in rats after CA and CPR, and explored the likely underlying mechanisms. Animals were randomly assigned to 4 equal groups (n = 15 each) according to the different infusions administered during resuscitation: control (C), normal saline (NS), hypertonic saline (HS), and hydroxyethyl starch (HES) groups...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28723274/identifying-voxels-at-risk-for-progression-in-glioblastoma-based-on-dosimetry-physiologic-and-metabolic-mri
#3
Mekhail Anwar, Annette M Molinaro, Olivier Morin, Susan M Chang, Daphne A Haas-Kogan, Sarah J Nelson, Janine M Lupo
Despite the longstanding role of radiation in cancer treatment and the presence of advanced, high-resolution imaging techniques, delineation of voxels at-risk for progression remains purely a geometric expansion of anatomic images, missing subclinical disease at risk for recurrence while treating potentially uninvolved tissue and increasing toxicity. This remains despite the modern ability to precisely shape radiation fields. A striking example of this is the treatment of glioblastoma, a highly infiltrative tumor that may benefit from accurate identification of subclinical disease...
July 19, 2017: Radiation Research
https://www.readbyqxmd.com/read/28721902/permeability-of-brain-tumor-vessels-induced-by-uniform-or-spatially-microfractionated-synchrotron-radiation-therapies
#4
Audrey Bouchet, Marine Potez, Nicolas Coquery, Claire Rome, Benjamin Lemasson, Elke Bräuer-Krisch, Chantal Rémy, Jean Laissue, Emmanuel L Barbier, Valentin Djonov, Raphael Serduc
PURPOSE: To compare the blood-brain barrier permeability changes induced by synchrotron microbeam radiation therapy (MRT, which relies on spatial fractionation of the incident x-ray beam into parallel micron-wide beams) with changes induced by a spatially uniform synchrotron x-ray radiation therapy. METHODS AND MATERIALS: Male rats bearing malignant intracranial F98 gliomas were randomized into 3 groups: untreated, exposed to MRT (peak and valley dose: 241 and 10...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28721220/severe-diabetic-ketoacidosis-complicated-by-hypocapnic-seizure
#5
A Majid, B J Wheeler
In clinical practice, seizures independent of hypoglycemia are observed in patients with type 1 diabetes mellitus (T1DM) more frequently than expected by chance, suggesting a link. However, seizures during management of diabetic ketoacidosis (DKA) have generally been considered a bad prognostic factor, and usually associated with well-known biochemical or neurological complications. We present the case of a 17-year-old girl with known T1DM managed for severe DKA complicated by hypocapnic seizure. We review the literature on this rare occurrence as well as outline other possible differentials to consider when faced with the alarming combination of DKA and seizure...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28720746/-a-rare-case-of-ruptured-internal-carotid-posterior-communicating-artery-aneurysm-associated-with-contralateral-delayed-oculomotor-nerve-palsy
#6
Chika Somagawa, Yutaka Fukuda, Shota Yoshimura, Kei Satoh, Takeshi Hiu, Tomonori Ono, Ryujirou Ushijima, Keisuke Toda, Keisuke Tsutsumi
A 55-year-old man presented with difficulty breathing, chest pain, and disturbance of consciousness, and was transferred to our hospital. Initial whole body CT revealed a diffuse subarachnoid hemorrhage(SAH)with severe pulmonary edema that was considered neurogenic in origin. He received controlled ventilation under sedation and conservative care for the SAH. One day after the onset of the SAH, his left pupil suddenly became dilated to 6mm, with no reaction to light. Head CT showed no new bleeding. Subsequent CT angiogram revealed a right internal carotid-posterior communicating artery aneurysm(IC-PC AN)with a posterior-lateral projection; however, no vessel abnormality was observed in the left anterior or posterior circulations...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28716233/-23-na-mri-reveals-persistent-sodium-accumulation-in-tumefactive-ms-lesions
#7
Konstantin Huhn, Angelika Mennecke, Peter Linz, Franz Tschunko, Nicola Kästle, Armin M Nagel, Michael Uder, Arnd Dörfler, Ralf A Linker, Tobias Engelhorn
BACKGROUND: Chronic inflammatory demyelinating diseases of the CNS typically show a limited lesion size. However, extended lesions may appear with an atypical configuration. Large lesions with a diameter>2cm accompanied by tumor-like edema are entitled "tumefactive" and may occur in multiple sclerosis (MS) and other demyelinating diseases. Historically, differential diagnosis often requires histological analysis. Therefore, advanced imaging techniques are warranted to allow for a precise non-invasive diagnosis...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28714410/management-of-blood-pressure-and-heart-rate-in-patients-with-acute-stroke
#8
Carlo Maida, Antonino Tuttolomondo, Domenico Di Raimondo, Antonio Pinto
BACKGROUND: Stroke represent one of the most devastating of all neurological diseases, affecting about 15 million people per year and is an important cause of morbidity and mortality worldwide and currently the leading cause of adult disability in developed countries. Blood pressure and heart rate may undergo several modifications in patients with both ischemic and hemorrhagic stroke in fact raised blood pressure levels may lead to cerebral edema, hematoma expansion or hemorrhagic transformation and in contrast low blood pressure can lead to increased cerebral infarction or perihematomal ischemia...
July 14, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28713633/the-floating-anchored-craniotomy
#9
Matthew J Gutman, Elena How, Teresa Withers
BACKGROUND: The "floating anchored" craniotomy is a technique utilized at our tertiary neurosurgery institution in which a traditional decompressive craniectomy has been substituted for a floating craniotomy. The hypothesized advantages of this technique include adequate decompression, reduction in the intracranial pressure, obviating the need for a secondary cranioplasty, maintained bone protection, preventing the syndrome of the trephined, and a potential reduction in axonal stretching...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28712906/a-comparison-of-pharmacologic-therapeutic-agents-used-for-the-reduction-of-intracranial-pressure-following-traumatic-brain-injury
#10
REVIEW
Ahmed M Alnemari, Brianna M Krafcik, Tarek R Mansour, Daniel Gaudin
OBJECTIVE: In neurotrauma care, a better understanding of treatments following traumatic brain injury (TBI) has led to a significant decrease in morbidity and mortality in this population. TBI represents a significant medical problem, and complications following TBI are associated with the initial injury and post-event intracranial processes such as elevated intracranial pressure (ICP) and brain edema. Consequently, appropriate therapeutic interventions are required to reduce brain tissue damage and improve cerebral perfusion...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710023/transient-brain-hypothermia-reduces-the-reperfusion-injury-of-delayed-tissue-plasminogen-activator-and-extends-its-therapeutic-time-window-in-a-focal-embolic-stroke-model
#11
Mohammadreza Zarisfi, Fatemeh Allahtavakoli, Mahsa Hassanipour, Mohammad Khaksari, Hossain Rezazadeh, Mohammad Allahtavakoli, Mohammad Mohsen Taghavi
It has been reported that restriction of reperfusion after thrombolytic therapy in ischemic stroke may reduce tissue plasminogen activator (tPA) adverse effects and extend its time window. We examined whether shortIt has been reported that restriction of reperfusion after thrombolytic therapy in ischemic stroke may reduce tissue plasminogen activator (tPA) adverse effects and extend its time window. We examined whether short-term and mild local brain cooling can prevent hyperemia and/or adverse effects of delayed tPA in rat embolic stroke model...
July 11, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28704229/treatment-of-hyponatremic-encephalopathy-in-the-critically-ill
#12
Steven G Achinger, Juan Carlos Ayus
OBJECTIVES: Hyponatremic encephalopathy, symptomatic cerebral edema due to a low osmolar state, is a medical emergency and often encountered in the ICU setting. This article provides a critical appraisal and review of the literature on identification of high-risk patients and the treatment of this life-threatening disorder. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: Online search of the PubMed database and manual review of articles involving risk factors for hyponatremic encephalopathy and treatment of hyponatremic encephalopathy in critical illness...
July 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28700732/tissue-plasminogen-activator-mediates-deleterious-complement-cascade-activation-in-stroke
#13
Xue-Jun Zhao, Timothy M Larkin, Molly A Lauver, Saif Ahmad, Andrew F Ducruet
The use of intravenous tissue plasminogen activator (tPA) in the treatment of ischemic stroke is limited by its propensity to exacerbate brain edema and hemorrhage. The mechanisms underlying these deleterious effects of tPA remain incompletely understood. The purpose of this study was to delineate a pathway of tPA-mediated complement cascade activation in stroke and to determine whether complement inhibition ameliorates the adverse effects of post-ischemic tPA administration. We found that tPA promotes C3 cleavage both in vitro and in ischemic brain through a plasmin-mediated extrinsic pathway...
2017: PloS One
https://www.readbyqxmd.com/read/28700481/a-multiparameter-model-predicting-in-hospital-mortality-in-malignant-cerebral-infarction
#14
Chien-Fu Chen, Ruey-Tay Lin, Hsiu-Fen Lin, A-Ching Chao
The early identification of patients with large hemisphere infarctions (LHIs) at risk of fatal brain edema may result in better outcomes. A quantitative model using parameters obtained at admission may be a predictor of in-hospital mortality from LHI.This prospective study enrolled all patients with LHI involving >50% of the middle cerebral artery (MCA) admitted to our neurological intensive care unit within 48 hours of symptom onset. Early clinical and radiographic parameters and the baseline CHADS2 score (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke [double weight]) were analyzed regarding their ability to predict patient outcomes...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28699288/different-characteristics-of-cell-volume-and-intracellular-calcium-ion-concentration-dynamics-between-the-hippocampal-ca1-and-lateral-cerebral-cortex-of-male-mouse-brain-slices-during-exposure-to-hypotonic-stress
#15
Nanae Takahashi, Akibumi Omi, Hiroyuki Uchino, Yoshihisa Kudo
The mechanism of brain edema is complex and still remains unclear. Our aim was to investigate the regional differences of cell volume and intracellular Ca(2+) concentration ([Ca(2+) ]i ) dynamics during hypotonic stress in male mouse hemi-brain slices. Brain slices were loaded with the fluorescence Ca(2+) indicator fura-2, and cell volume and [Ca(2+) ]i in the lateral cerebral cortex (LCC) and hippocampal CA1 (CA1) region were measured simultaneously during exposure to hypotonic stress using Ca(2+) insensitive (F360) and Ca(2+) sensitive fluorescence (F380), respectively...
July 12, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28694213/a-general-protocol-of-ultra-high-resolution-mr-angiography-to-image-the-cerebro-vasculature-in-6-different-rats-strains-at-high-field
#16
Géraldine Pastor, María Jiménez-González, Sandra Plaza-García, Marta Beraza, Daniel Padro, Pedro Ramos-Cabrer, Torsten Reese
BACKGROUND: Differences in the cerebro-vasculature among strains as well as individual animals might explain variability in animal models and thus, a non-invasive method tailored to image cerebral vessel of interest with high signal to noise ratio is required. NEW METHOD: Experimentally, we describe a new general protocol of three-dimensional time-of-flight magnetic resonance angiography to visualize non-invasively the cerebral vasculature in 6 different rat strains...
July 8, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28674364/diffuse-cerebral-vasoconstriction-in-a-intravascular-lymphoma-patient-with-a-high-serum-mpo-anca-level
#17
Atsuhiko Sugiyama, Makoto Kobayashi, Ayaka Daizo, Miyako Suzuki, Hirotoshi Kawashima, Shin-Ichiro Kagami, Hiroaki Tanaka, Yoshio Suzuki, Takashi Matsunaga, Satoshi Kuwabara
An 87-year-old woman presented with a 3-month history of fever, edema of the lower legs, and gait disturbance. A laboratory examination revealed high serum levels of myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA). Although microscopic polyangiitis was initially suspected and treated, the patient subsequently developed transient hemiparesis and disturbed consciousness. Brain magnetic resonance imaging/angiography revealed infarct-like lesions, pachymeningeal involvement, and diffuse cerebral vasoconstriction...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28673669/cerebral-venous-sinus-thrombosis-complicated-with-acute-development-of-dural-arteriovenous-fistula-a-case-report
#18
Ji-Gang Chen, Zhen-Xing Li, Dan-Feng Zhang, Jun-Yu Wang, Li-Jun Hou
Development of dural arteriovenous fistula (dAVF) after cerebral venous sinus thrombosis (CVST) was very uncommon and for all these reported cases, the dAVF was a chronic complication. We present a case of acute development of dAVF after CVST. A 40-year-old female was admitted into our department with 2day's headache and vomiting for 9h. Head computed tomography (CT) scan showed only scattered minor hematomas over the right frontal lobe. Blood test indicated an elevated D-dimer. The patient experienced transient paralysis (Todd's paralysis) after intermittent focal epilepsy from day 3, which progressed into sustained epilepsy on day 6...
June 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28673564/demyelinating-diseases-as-a-result-of-cerebral-edema
#19
Helmut Barz, Almut Schreiber, Ulrich Barz
Due to the elastic properties of the human organs, tissue edema causes an increased tissue pressure. This phenomenon leads to a reduction of blood circulation or ischemia, and thus leads to the hypothesis that tissue edema can be the cause of demyelinating lesions. Even though brain edema occurs in the whole brain, the authors assume that the characteristically focal appearance of demyelinated lesions, for instance of multiple sclerosis plaques, are attributable to anatomical and structural characteristics of the brain...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28672801/microrna-210-suppresses-junction-proteins-and-disrupts-blood-brain-barrier-integrity-in-neonatal-rat-hypoxic-ischemic-brain-injury
#20
Qingyi Ma, Chiranjib Dasgupta, Yong Li, Lei Huang, Lubo Zhang
Cerebral edema, primarily caused by disruption of the blood-brain barrier (BBB), is one of the serious complications associated with brain injury in neonatal hypoxic-ischemic encephalopathy (HIE). Our recent study demonstrated that the hypoxic-ischemic (HI) treatment significantly increased microRNA-210 (miR-210) in the neonatal rat brain and inhibition of miR-210 provided neuroprotection in neonatal HI brain injury. The present study aims to determine the role of miR-210 in the regulation of BBB integrity in the developing brain...
June 24, 2017: International Journal of Molecular Sciences
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