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Intracranial hemorrhage

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https://www.readbyqxmd.com/read/28443483/aneurysm-size-and-the-windkessel-effect-an-analysis-of-contrast-intensity-in-digital-subtraction-angiography
#1
Ahmed E Hussein, Darian R Esfahani, Andreas Linninger, Fady T Charbel, Chih-Yang Hsu, Fady T Charbel, Ali Alaraj
Large cerebral aneurysms are considered more dangerous than their smaller counterparts, with higher risk of subarachnoid hemorrhage. Understanding the hemodynamics of large aneurysms has potential to predict their response to treatment. Digital subtraction angiography images for patients with intracranial aneurysms over a seven-year period were reviewed. Unruptured solitary aneurysms of the internal carotid artery (ICA) proximal to the terminus and posterior communicating artery were included. Contrast intensity over time was analyzed at the center of the M1 segment of the middle cerebral artery distal to the aneurysm and compared to the contralateral side...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28443482/subarachnoid-and-intraperitoneal-hemorrhage-secondary-to-segmental-arterial-mediolysis-a-case-report-and-review-of-the-literature
#2
Brian T Welch, Waleed Brinjikji, Andrew H Stockland, Giuseppe Lanzino
Background Segmental arterial mediolysis (SAM) is an uncommon or underdiagnosed arteriopathy that presents with life-threatening hemorrhage. SAM can affect the intracranial, spinal, and visceral arteries, with reported cases of concomitant intracranial and visceral hemorrhage. Case description We present the case of a 61-year-old male with concurrent subarachnoid and intraperitoneal hemorrhage caused by simultaneously bleeding posterior spinal artery and splenic artery pseudoaneurysms. The posterior spinal artery pseudoaneurysms were treated with selective injection of polyvinyl alcohol particles into the posterior spinal artery, while the splenic artery pseudoaneurysm was treated with Gelfoam embolization...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28439656/-management-of-paraophthalmic-aneurysms-review-of-endovascular-treatment-strategies
#3
P Bhogal, M Aguilar Pérez, G Sauder, H Bäzner, O Ganslandt, H Henkes
BACKGROUND: Aneurysms of the cerebral vessels are relatively common and aneurysms of the ophthalmic segment of the internal carotid artery (ICA) represent approximately 10% of intradural aneurysms. ANATOMICAL ASPECTS: The ophthalmic segment of the ICA extends from the origin of the ophthalmic artery to the origin of the posterior communicating artery. Aneurysms can originate from the ophthalmic artery itself or directly from the ICA at a distance from the ophthalmic artery...
April 24, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28439613/the-role-of-delayed-head-ct-in-evaluation-of-elderly-blunt-head-trauma-victims-taking-antithrombotic-therapy
#4
D Scantling, C Fischer, R Gruner, A Teichman, B McCracken, J Eakins
INTRODUCTION: Increasing active longevity has created an increasing surge of elderly trauma patients. The majority of these patients suffer blunt trauma and many are taking antithrombotic agents. The literature is mixed regarding the utility of routine repeat head CT in patients taking antithrombotic medications with a GCS of 15 and initial negative head CT. We hypothesized that scheduled delayed CT head 12 h after admission (D-CTH) in elderly blunt trauma victims would not identify clinically significant new hemorrhages or change management...
April 24, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28438894/flow-diverter-treatment-of-intracranial-vertebral-artery-dissecting-pseudoaneurysms
#5
REVIEW
Russell Cerejo, Mark Bain, Nina Moore, Julian Hardman, Andrew Bauer, M Shazam Hussain, Thomas Masaryk, Peter Rasmussen, Gabor Toth
INTRODUCTION: Intracranial vertebral dissecting pseudoaneurysms are a rare, but increasingly recognized, cause of subarachnoid hemorrhage and ischemic stroke. The risks of aneurysm re-rupture and associated morbidity are high. The use of flow diverter stents for the treatment of these aneurysms has not been well studied. OBJECTIVE: To report our data and provide a summarized review of literature using flow diverter stents for the treatment of intracranial vertebral artery dissecting pseudoaneurysms...
April 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28438735/comparative-effectiveness-and-safety-of-dabigatran-and-rivaroxaban-in-atrial-fibrillation-patients
#6
Chao-Lun Lai, Ho-Min Chen, Min-Tsun Liao, Ting-Tse Lin, K Arnold Chan
BACKGROUND: We aimed to examine the comparative effectiveness and safety between dabigatran and rivaroxaban in atrial fibrillation patients. METHODS AND RESULTS: We conducted a population-based, retrospective, new-user cohort study based on the National Health Insurance claims database in Taiwan. Adult atrial fibrillation patients who initiated dabigatran (N=10 625) or rivaroxaban (N=4609) between June 1, 2012 and May 31, 2014 were identified as the overall population...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28438515/intravenous-thrombolysis-for-acute-ischemic-stroke-in-patients-with-thrombocytopenia
#7
Ashkan Mowla, Haris Kamal, Navdeep S Lail, Caila Vaughn, Peyman Shirani, Sandhya Mehla, Hamidreza Rajabzadeh-Oghaz, Christopher Deline, Marilou Ching, Annemarie Crumlish, Robert N Sawyer
OBJECTIVE: To determine the safety of intravenous (IV) recombinant tissue plasminogen activator (rtPA) in patients with acute ischemic stroke (AIS) who had a platelet count <100,000 /mm(3). METHODS: We reviewed the charts of all patients who received IV rtPA for AIS during a 9.6-year period at our stroke center. Those with platelets <100,000/mm(3) were identified. Head computed tomography scans performed in 24-36 hours postthrombolysis were reviewed to evaluate the rate of symptomatic intracranial hemorrhage (sICH)...
April 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28437485/t-cell-function-is-dispensable-for-intracranial-aneurysm-formation-and-progression
#8
Haruka Miyata, Hirokazu Koseki, Katsumi Takizawa, Hidetoshi Kasuya, Kazuhiko Nozaki, Shuh Narumiya, Tomohiro Aoki
Given the social importance of intracranial aneurysm as a major cause of a lethal subarachnoid hemorrhage, clarification of mechanisms underlying the pathogenesis of this disease is essential for improving poor prognosis once after rupture. Previous histopathological analyses of human aneurysm walls have revealed the presence of T cells in lesions suggesting involvement of this type of cell in the pathogenesis. However, it remains unclear whether T cell actively participates in intracranial aneurysm progression...
2017: PloS One
https://www.readbyqxmd.com/read/28436714/a-hemorrhagic-complication-after-onyx-embolization-of-a-tentorial-dural-arteriovenous-fistula-a-caution-about-subdural-extension-with-pial-arterial-supply
#9
Kenichi Sato, Yasushi Matsumoto, Hidenori Endo, Teiji Tominaga
We report a case of tentorial dural arteriovenous fistula (DAVF) with a severe intracranial hemorrhage occurring after Onyx embolization. A 40-year-old man presented with an asymptomatic tentorial DAVF on angiography. Transarterial embolization with Onyx was performed via the middle meningeal artery, and the cast filled the fistula itself and its proximal draining vein. Postoperative angiography confirmed complete occlusion of the DAVF. A computed tomography scan performed immediately after the procedure demonstrated an acute subdural hematoma with the temporal hemorrhage...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28435903/non-aneurysmal-and-non-traumatic-subarachnoid-hemorrhage-after-attempted-suicide-by-incomplete-hanging
#10
Tae Hu Kim, Soo Hoon Lee, Dong Hoon Kim, Seong Chun Kim, Wonyoungyong Jin, So Yeon Kim, Sang Heon Shin, Sang Bong Lee
Hanging is a common method of suicide that is being reported more frequently in many countries. Several complications including injuries to the cervical spine, neck vessels, and brain can occur after attempted suicide by hanging. There are only a few reports of brain computed tomography and magnetic resonance imaging of hanging victims. The most common abnormality was diffuse cerebral edema. A subarachnoid hemorrhage is an atypical complication by suicidal hanging. We report a case of a female patient who presented to an emergency department with altered mental status after attempting suicide by incomplete hanging...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28433206/efficacy-and-safety-of-rivaroxaban-versus-warfarin-in-patients-from-mainland-china-with-nonvalvular-atrial-fibrillation-a-subgroup-analysis-from-the-rocket-af-trial
#11
Yihong Sun, Dayi Hu, Susanna Stevens, Yuliya Lokhnygina, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Christopher C Nessel, Jonathan P Piccini, Daniel E Singer, Keith A A Fox, Manesh R Patel
BACKGROUND: The ROCKET AF study evaluated once-daily rivaroxaban versus dose-adjusted warfarin for the prevention of stroke and systemic embolism in patients with atrial fibrillation (AF). In this analysis, we compared rivaroxaban with warfarin in patients with AF from China, East Asia, and the rest of the world (ROW). METHODS AND RESULTS: We assessed baseline demographics and interaction of treatment effects of rivaroxaban versus warfarin among patients from mainland China, other East Asian countries, and ROW...
April 13, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28432712/stroke-etiology-and-collaterals-atheroembolic-strokes-have-greater-collateral-recruitment-than-cardioembolic-strokes
#12
L C Rebello, M Bouslama, D C Haussen, J A Grossberg, S Dehkharghani, A Anderson, S R Belagaje, N A Bianchi, M Grigoryan, M R Frankel, R G Nogueira
BACKGROUND AND PURPOSE: Chronic hypoperfusion from athero-stenotic lesions is thought to lead to better collateral recruitment compared to cardioembolic strokes. It was sought to compare collateral flow in stroke patients with atrial fibrillation (AF) versus stroke patients with cervical atherosclerotic steno-occlusive disease (CASOD). METHOD: This was a retrospective review of a prospectively collected endovascular database. Patients with (i) anterior circulation large vessel occlusion stroke, (ii) pre-treatment computed tomography angiography (CTA) and (iii) intracranial embolism from AF or CASOD were included...
April 21, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28432266/baseline-blood-pressure-effect-on-the-benefit-and-safety-of-intra-arterial-treatment-in-mr-clean-multicenter-randomized-clinical-trial-of-endovascular-treatment-of-acute-ischemic-stroke-in-the-netherlands
#13
Maxim J H L Mulder, Saliha Ergezen, Hester F Lingsma, Olvert A Berkhemer, Puck S S Fransen, Debbie Beumer, Lucie A van den Berg, Geert Lycklama À Nijeholt, Bart J Emmer, H Bart van der Worp, Paul J Nederkoorn, Yvo B W E M Roos, Robert J van Oostenbrugge, Wim H van Zwam, Charles B L M Majoie, Aad van der Lugt, Diederik W J Dippel
BACKGROUND AND PURPOSE: High blood pressure (BP) is associated with poor outcome and the occurrence of symptomatic intracranial hemorrhage in acute ischemic stroke. Whether BP influences the benefit or safety of intra-arterial treatment (IAT) is not known. We aimed to assess the relation of BP with functional outcome, occurrence of symptomatic intracranial hemorrhage and effect of IAT. METHODS: This is a post hoc analysis of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands)...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28431413/novel-oral-anticoagulants-and-trauma-the-results-of-a-prospective-american-association-for-the-surgery-of-trauma-multi-institutional-trial
#14
Leslie Kobayashi, Galinos Barmparas, Patrick Bosarge, Carlos V Brown, Marko Bukur, Matthew M Carrick, Richard D Catalano, Jan Holly-Nicolas, Kenji Inaba, Stephen Kaminski, Amanda L Klein, Tammy Kopelman, Eric J Ley, Ericca M Martinez, Forrest O Moore, Jason Murry, Raminder Nirula, Douglas Paul, Jacob Quick, Omar Rivera, Martin Schreiber, Raul Coimbra
BACKGROUND: The number of anticoagulated trauma patients is increasing. Trauma patients on warfarin have been found to have poor outcomes, particularly after intracranial hemorrhage (ICH). However, the effect of novel oral anticoagulants (NOAs) on trauma outcomes is unknown. We hypothesized that patients on NOAs would have higher rates of ICH, ICH progression, and death compared with patients on traditional anticoagulant and antiplatelet agents. METHODS: This was a prospective observational trial across 16 trauma centers...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28431043/male-gender-associated-with-post-treatment-seizure-risk-of-pediatric-arteriovenous-malformation-patients
#15
Wuyang Yang, Erick M Westbroek, Heather Anderson-Keightly, Justin M Caplan, Xiaoming Rong, Alice L Hung, Maria Braileanu, Joanna Y Wang, Geoffrey P Colby, Alexander L Coon, Rafael J Tamargo, Edward S Ahn, Judy Huang
BACKGROUND: Seizure risk has not been fully characterized in pediatric patients with arteriovenous malformations (AVMs). OBJECTIVE: To describe the progression and risk factors of post-treatment seizure in children with AVMs. METHODS: We retrospectively reviewed pediatric patients diagnosed with intracranial AVMs at our institution between 1990 and 2013. Clinical and angiographic variables were included in univariate and multivariate Cox proportional hazard models to explore risk factors associated with time-related seizure outcomes...
April 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28430304/pre-ecmo-coagulopathy-does-not-increase-the-occurrence-of-hemorrhage-during-extracorporeal-support
#16
Pilar Anton-Martin, Lakshmi Raman, Nikhil Thatte, Jefferson Tweed, Vinai Modem, Janna Journeycake
INTRODUCTION AND METHODS: Observational retrospective cohort study to evaluate the association between precannulation coagulopathy and the occurrence of hemorrhage during extracorporeal membrane oxygenation (ECMO) in neonatal and pediatric patients at a tertiary children's hospital. RESULTS: Of 241 patients supported with ECMO between January 2009 and December 2014, 175 (72.6%) had precannulation coagulation laboratory data and were included in the study. Of the eligible patients, 84 (48%) were identified as coagulopathic and 91 (52%) were noncoagulopathic...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28429658/sex-differences-in-utilization-and-outcomes-of-catheter-directed-thrombolysis-in-patients-with-proximal-lower-extremity-deep-venous-thrombosis-insights-from-the-nationwide-inpatient-sample
#17
Vladimir Lakhter, Chad J Zack, Yevgeniy Brailovsky, Saurav Chatterjee, Vikas Aggarwal, Koneti A Rao, Deborah Crabbe, Huaqing Zhao, Eric Choi, Raghu Kolluri, Riyaz Bashir
Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge diagnosis of proximal LE or caval DVT who underwent CDT between January 2005 and December 2011 in the United States. We evaluated the comparative safety outcomes of CDT among a propensity-matched group of 1731 men versus 1731 women...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28429604/intra-arterial-verapamil-post-thrombectomy-is-feasible-safe-and-neuroprotective-in-stroke
#18
Justin F Fraser, Michael Maniskas, Amanda Trout, Doug Lukins, Lindsey Parker, W Lane Stafford, Abdulnasser Alhajeri, Jill Roberts, Gregory J Bix
Large vessel ischemic stroke represents the most disabling subtype. While t-PA and endovascular thrombectomy can recanalize the occluded vessel, good clinical outcomes are not uniformly achieved. We propose that supplementing endovascular thrombectomy with superselective intra-arterial (IA) verapamil immediately following recanalization could be safe and effective. Verapamil, a calcium channel blocker, has been shown to be an effective IA adjunct in a pre-clinical mouse focal ischemia model. To demonstrate translational efficacy, mechanism, feasibility, and safety, we conducted a group of translational experiments...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28429356/thrombolysis-in-acute-stroke-without-angiographically-documented-occlusion
#19
M-C Shi, F-N Chu, C Li, S-C Wang
OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) using urokinase (UK) in acute stroke patients without angiographically-documented occlusion, and to define predictors of clinical outcome. PATIENTS AND METHODS: We analyzed clinical and radiological data of acute ischemic stroke patients whose angiography did not show an arterial occlusion within six hours of symptom onset and who were further treated with IAT using UK...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28429236/the-course-of-headache-in-patients-with-moderate-to-severe-headache-due-to-mild-traumatic-brain-injury-a-retrospective-cross-sectional-study
#20
Chang-Ki Hong, Jin-Yang Joo, Yu Shik Shim, Sook Young Sim, Min A Kwon, Yong Bae Kim, Joonho Chung
BACKGROUND: Little is known about the long-term course of headache in patients with moderate-to-severe headache due to traumatic brain injury (TBI). We evaluated the course of headache in patients with moderate-to-severe headache due to mild TBI. METHODS: Since September 2009, patients with TBI prospectively rated their headache using a numeric rating scale (NRS). From the database containing 935 patients with TBI between September 2009 and December 2013, 259 patients were included according to following criteria: (1) newly onset moderate-to-severe headache (NRS ≥ 4) due to head trauma; (2) age ≥ 15 years; (3) Glasgow Coma Scale ≥ 13; (4) transient loss of consciousness ≤ 30 min; and (5) radiographic evaluation, such as computed tomography or magnetic resonance image...
December 2017: Journal of Headache and Pain
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