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intracranial haemorrhage

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https://www.readbyqxmd.com/read/28222628/safety-and-efficiency-of-flow-diverters-for-treating-small-intracranial-aneurysms-a-systematic-review-and-meta-analysis
#1
Xiyang Yao, Junwei Ma, Haiying Li, Haitao Shen, Xiaojun Lu, Gang Chen
Background We evaluated the safety and efficiency of flow diverters (FDs) in treating small intracranial aneurysms (IAs). Materials and Methods We reviewed the literature published in PubMed and EMBASE. R for Project software was used to calculate the complete aneurysm occlusion rates, procedure-related neurologic mortality, procedure-related neurologic morbidity and procedure-related permanent morbidity. Results Ten observational studies were included in this analysis. The complete aneurysm occlusion rate was 84...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28215428/glioblastoma-presenting-as-spontaneous-intracranial-haemorrhage-case-report-and-review-of-the-literature
#2
REVIEW
Danica M Joseph, Anthea H O'Neill, Ronil V Chandra, Leon T Lai
Glioblastoma (GB) classically presents with symptoms of raised intracranial pressure and gradual progressive neurological deficits. An acute presentation, with intracerebral haemorrhage (ICH) and rapid clinical deterioration, occurs infrequently. Contemporary imaging modalities do not reliably reflect underlying mass lesions in parenchymal brain haemorrhage at first presentation. We report a delayed diagnosis of GB in a 21-year-old patient presenting with spontaneous ICH and a negative initial neurovascular workup...
February 15, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28209459/progressive-subcortical-calcifications-secondary-to-venous-hypertension-in-an-intracranial-dural-arteriovenous-fistula
#3
Heather M Pascoe, Elaine H Lui, Peter Mitchell, Frank Gaillard
Intracranial dural arteriovenous fistulas (dAVF) are acquired lesions, with the most commonly reported findings on CT haemorrhage or focal oedema. We describe a case of progressive subcortical calcification on CT secondary to venous hypertension from a high grade dAVF.
February 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28197790/surgical-treatment-of-anterior-cranial-fossa-dural-arterio-venous-fistulas-davfs-a-two-centre-experience
#4
Pietro Meneghelli, Alberto Pasqualin, Luigi Andrea Lanterna, Claudio Bernucci, Roberto Spinelli, Gianluigi Dorelli, Piergiuseppe Zampieri
BACKGROUND: Anterior cranial fossa dural arterio-venous fistulas (DAVFs) represent 6% of all intracranial DAVFs; characteristically they show an aggressive behaviour with high risk of intracranial haemorrhage. Peculiar anatomical features, such as feeding by the ethmoidal arteries and the pattern of venous drainage (frequently with varices that mimic aneurysmal dilatation), can be evaluated in detail only by digital subtraction angiography (DSA), which represents the "gold standard" in the diagnosis of such cranial fistulas...
February 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28193628/management-of-endocrine-disease-neuroendocrine-surveillance-and-management-of-neurosurgical-patients-non-pituitary
#5
Aoife Garrahy, Mark Sherlock, Chris J Thompson
Advances in the management of traumatic brain injury, subarachnoid haemorrhage and intracranial tumours have led to improved survival rates and an increased focus on quality of life of survivors. Endocrine sequelae of the acute brain insult and subsequent neurosurgery, peri-operative fluid administration and/or cranial irradiation are now well described. Unrecognized acute hypopituitarism, particularly ACTH/cortisol deficiency and diabetes insipidus, can be life-threatening. While hypopituitarism may be transient, up to 30% of survivors of TBI have chronic hypopituitarism, which can diminish quality of life and hamper rehabilitation...
February 13, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28190583/fibrinogen-is-an-independent-predictor-of-mortality-in-major-trauma-patients-a-five-year-statewide-cohort-study
#6
Zoe K McQuilten, Erica M Wood, Michael Bailey, Peter A Cameron, David J Cooper
INTRODUCTION: Fibrinogen may be reduced following traumatic injury due to loss from haemorrhage, increased consumption and reduced synthesis. In the absence of clinical trials, guidelines for fibrinogen replacement are based on expert opinion and vary internationally. We aimed to determine prevalence and predictors of low fibrinogen on admission in major trauma patients and investigate association of fibrinogen levels with patient outcomes. PATIENTS AND METHODS: Data on all major trauma patients (January 2007-July 2011) identified through a prospective statewide trauma registry in Victoria, Australia were linked with laboratory and transfusion data...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/28187986/age-dependence-of-critical-pressure-in-the-segments-and-branches-of-the-circle-of-willis
#7
Adam Piechna, Leszek Lombarski, Paweł Krajewski, Bogdan Ciszek, Krzysztof Cieslicki
Spontaneous intracranial haemorrhage is one of the most dramatic neurological disasters. The source of haemorrhage is linked to the pathology of the arterial wall or is unknown. Because the risk of haemorrhagic stroke increases with age, we tried to investigate the relationship between age and rupture pressure of cerebral arteries. In the presented study, 51 segments of large cerebral arteries (at the level of the circle of Willis and its incoming and outgoing branches) were obtained from 33 cadaver brains aged 12-86 years...
January 21, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28185082/dabigatran-etexilate-a-review-in-nonvalvular-atrial-fibrillation
#8
Hannah A Blair, Gillian M Keating
Dabigatran etexilate (Pradaxa(®)) is approved in the EU for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF) and one or more risk factors. Dabigatran etexilate is a prodrug of dabigatran, a direct inhibitor of thrombin. In patients with NVAF in the phase III RE-LY trial, dabigatran etexilate dosages of 110 and 150 mg twice daily were noninferior to warfarin with regard to the risk of stroke or systemic embolism (primary efficacy endpoint). The higher dosage was associated with a significantly lower risk of stroke or systemic embolism than warfarin, with no significant between-group difference in the risk of major bleeding (primary safety endpoint)...
February 9, 2017: Drugs
https://www.readbyqxmd.com/read/28169020/description-of-stroke-mimics-after-complete-neurovascular-assessment
#9
C Avellaneda-Gómez, A Rodríguez Campello, E Giralt Steinhauer, A Gómez González, M Serra Martínez, P de Ceballos Cerrajería, A Zabalza de Torres, E Cuadrado-Godia, A Ois Santiago, J Jiménez-Conde, J Roquer
INTRODUCTION: A considerable percentage of events initially diagnosed as ischaemic stroke have non-cerebrovascular causes; these are called stroke mimics (SM). Currently available evidence about these events is heterogeneous and comes from studies with small samples. OBJECTIVE: The purpose of our study is to identify conditions that may present as SM, define their epidemiological and clinical characteristics, and determine the percentage of cases of SM treated with intravenous fibrinolysis...
February 4, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28156051/ct-of-the-head-for-acute-stroke-diagnostic-performance-of-a-tablet-computer-prior-to-intravenous-thrombolysis
#10
Patrick D McLaughlin, Fiachra Moloney, Siobhan B O'Neill, Karl James, Lee Crush, Oisin Flanagan, Michael M Maher, Gerald Wyse, Noel Fanning
INTRODUCTION: The authors propose that tablet computers could benefit patients with acute stroke in the remote care setting, where time to and accuracy of CT interpretation greatly influences patient outcome. METHODS: One hundred and fifty consecutive patients who presented to the Emergency Department of a tertiary referral neurosciences centre within a time window suitable for intravenous thrombolytic therapy were included. Images were wirelessly transmitted to a tablet computer (iPad 3rd Generation, model = A1430, Apple, Cupertino, CA) and were reviewed by radiologists with three levels of experience for signs of intracranial haemorrhage, large vessel occlusion and parenchymal infarction...
February 3, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28133987/ruptured-intracranial-vertebral-artery-dissecting-aneurysms-an-evaluation-of-prognostic-factors-of-treatment-outcome
#11
K Urasyanandana, P Withayasuk, D Songsaeng, T Aurboonyawat, E Chankaew, A Churojana
Objective Intracranial spontaneous vertebral artery dissecting aneurysms commonly occur in the third to fifth decades of life, and are mostly associated with hypertension. Patients present with intracranial haemorrhage or thromboembolic events. Patients who present with intracranial haemorrhage carry about a 70% risk of recurrent bleeding. Patients with a posterior-inferior cerebellar artery (PICA) or ipsilateral dominant vertebral artery involve selecting which parent vessel could not be sacrificed. Recent reconstructive techniques such as stent-assisted coiling embolisation and flow-diverting stents are effective treatments of choice...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28130349/optic-disc-haemorrhages-at-baseline-as-a-risk-factor-for-poor-outcome-in-the-idiopathic-intracranial-hypertension-treatment-trial
#12
Michael Wall, Matthew J Thurtell
BACKGROUND: The risk of optic disc haemorrhages on visual outcome in idiopathic intracranial hypertension (IIH) is unknown. We report the type and frequency of optic disc haemorrhages and other funduscopic abnormalities at baseline in the study eye of the 133 subjects enrolled in the Idiopathic Intracranial Hypertension Treatment Trial completing 6 months of follow-up. METHODS: We reviewed optic disc photographs to tabulate the frequency and type of optic disc haemorrhages, other funduscopic abnormalities and papilloedema grades of the study eye at baseline and analyse if their presence is associated with a poor visual outcome...
January 27, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28118993/soft-tissue-evidence-of-head-injury-in-infants-and-young-children-is-ct-head-examination-justified
#13
S Zaman, P H Logan, C Landes, S Harave
AIM: To determine whether it is justified to undertake a computed tomography (CT) examination of the head in children under 1 year of age who present with a bruise, swelling, or laceration of >5 cm following head injury in children presenting to a paediatric accident and emergency (A&E) department in the northwest of England. Further aims were to determine whether there was any justification for performing a CT head examination for children with soft-tissue injuries measuring <5 cm, or for children >1 year with evidence of soft-tissue injury, but without any other concerning feature...
January 21, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28108577/the-efficacy-and-risk-of-cerebrospinal-fluid-drainage-for-thoracoabdominal-aortic-aneurysm-repair-a-retrospective-observational-comparison-between-drainage-and-non-drainage%C3%A2
#14
Junya Sugiura, Hideki Oshima, Tomonobu Abe, Yuji Narita, Yoshimori Araki, Kazuro Fujimoto, Masato Mutsuga, Akihiko Usui
OBJECTIVES: We reviewed our experiences with thoracoabdominal aortic aneurysm (TAAA) repair to assess the efficacy of cerebrospinal fluid drainage (CSFD) to prevent the neurological deficits and complications associated with CSFD. METHODS: Between 2002 and 2015, 118 patients underwent TAAA repair. Seventy-eight patients underwent CSFD for 2.7 ± 1.1 days after surgery. CSFD was not performed for the other 40 patients due to an urgent situation, chronic disseminated intravascular coagulation or anatomical difficulties...
January 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28106331/a-randomized-controlled-trial-of-fresh-frozen-plasma-for-coagulopathy-in-russell-s-viper-daboia-russelii-envenoming
#15
G K Isbister, S Jayamanne, F Mohamed, A H Dawson, K Maduwage, I Gawarammana, D G Lalloo, H J de Silva, F E Scorgie, L F Lincz, N A Buckley
: Essentials Russell's viper envenoming is a major health issue in South Asia and causes coagulopathy. We studied the effect of fresh frozen plasma and two antivenom doses on correcting coagulopathy. Fresh frozen plasma did not hasten recovery of coagulopathy. Low-dose antivenom did not worsen coagulopathy. SUMMARY: Background Russell's viper (Daboia russelii) envenoming is a major health issue in South Asia and causes venom-induced consumption coagulopathy (VICC)...
January 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28104729/neurologic-outcomes-after-early-surgery-for-infective-endocarditis-in-patients-with-combined-cerebral-septic-embolism
#16
Do Yeon Kim, Hwan Wook Kim, Keon Hyon Jo
OBJECTIVES: This study followed the results of any development of neurologic outcomes according to the presence or absence of cerebral stroke in infective endocarditis patients after early cardiac surgery. We also analysed the neurologic outcomes regardless of cerebral microbleeds in cerebral embolic patients after cardiac surgery. METHODS: We retrospectively studied 55 patients with left-sided infective endocarditis who underwent early surgery and hospitalization between May 2010 and May 2015...
January 18, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28087725/neurodevelopmental-outcomes-of-extremely-low-birthweight-infants-randomised-to-different-pco2-targets-the-phelbi-follow-up-study
#17
Ulrich H Thome, Orsolya Genzel-Boroviczeny, Bettina Bohnhorst, Manuel Schmid, Hans Fuchs, Oliver Rohde, Stefan Avenarius, Hans-Georg Topf, Andrea Zimmermann, Dirk Faas, Katharina Timme, Barbara Kleinlein, Horst Buxmann, Wilfried Schenk, Hugo Segerer, Norbert Teig, Annett Bläser, Roland Hentschel, Matthias Heckmann, Rolf Schlösser, Jochen Peters, Rainer Rossi, Wolfgang Rascher, Ralf Böttger, Jürgen Seidenberg, Gesine Hansen, Maria Zernickel, Harald Bode, Jens Dreyhaupt, Rainer Muche, Helmut D Hummler
BACKGROUND: Tolerating higher partial pressures of carbon dioxide (PCO2) in mechanically ventilated extremely low birthweight infants to reduce ventilator-induced lung injury may have long-term neurodevelopmental side effects. This study analyses the results of neurodevelopmental follow-up of infants enrolled in a randomised multicentre trial. METHODS: Infants (n=359) between 400 and 1000 g birth weight and 23 0/7-28 6/7 weeks gestational age who required endotracheal intubation and mechanical ventilation within 24 hours of birth were randomly assigned to high PCO2 or to a control group with mildly elevated PCO2 targets...
January 13, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28071818/safety-profile-of-the-direct-oral-anticoagulants-an-analysis-of-the-who-database-of-adverse-drug-reactions
#18
Luca Monaco, Chiara Biagi, Valentino Conti, Mauro Melis, Monia Donati, Mauro Venegoni, Alberto Vaccheri, Domenico Motola
AIM: Direct oral anticoagulants (DOACs) have shown non-inferiority to warfarin for stroke prevention in non-valvular atrial fibrillation (AF) and a more promising safety profile. Unanswered safety aspects remain to addressed and available evidence on the risk associated with these drugs are conflicting. In order to contribute to the debate on their safety profile, we conducted a comparative analysis of the reports of suspected adverse drug reactions (ADRs) associated with DOACs in VigiBase...
January 10, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28058856/effective-treatment-with-a-new-protocol-using-tissue-type-plasminogen-activator-thrombolysis-for-pump-thrombosis-with-the-hvad-device
#19
Benedikt Schrage, Hanno Grahn, Florian M Wagner, Alexander Bernhardt, Meike Rybczynski, Stefan Blankenberg, Hermann Reichenspurner, Markus J Barten
BACKGROUND: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis. METHODS: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28049738/when-the-heart-rules-the-head-ischaemic-stroke-and-intracerebral-haemorrhage-complicating-infective-endocarditis
#20
REVIEW
Estabrak Jiad, Sumanjit K Gill, Maria Krutikov, David Turner, Michael H Parkinson, Carmel Curtis, David J Werring
Sir William Osler meticulously described the clinical manifestations of infective endocarditis in 1885, concluding that: 'few diseases present greater difficulties in the way of diagnosis … which in many cases are practically insurmountable'. Even with modern investigation techniques, diagnosing infective endocarditis can be hugely challenging, yet is critically important in patients presenting with stroke (both cerebral infarction and intracranial haemorrhage), its commonest neurological complication. In ischaemic stroke, intravenous thrombolysis carries an unacceptably high risk of intracranial haemorrhage, while in intracerebral haemorrhage, mycotic aneurysms require urgent treatment to avoid rebleeding, and in all cases, prompt treatment with antibiotics and valve surgery may be life-saving...
January 2017: Practical Neurology
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