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Intracranial hemorrhage

Davide Croci, Edin Nevzati, Hiroki Danura, Salome Schöpf, Javier Fandino, Serge Marbacher, Carl Muroi
BACKGROUND: In subarachnoid hemorrhage (SAH), occurrence of cerebral vasospasm (CVS) mediated by endothelin (ET)-1 might be a result of a compartmental inflammatory response with interleukin (IL)-6 release. We aim to investigate the relationship between ET-1 and IL-6 in association of CVS. METHODS: A total of 24 New Zealand white rabbits where randomly allocated into 3 groups: SAH (n=10), IL-6 (n=10), and sham (n=4). SAH was induced by a closed cranium extracranial-intracranial shunt model...
October 19, 2016: Journal of Neurosurgical Sciences
Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
BACKGROUND AND IMPORTANCE: As the use of flow-diverting stents (FDSs) for intracranial aneurysms expands, a small number of case reports have described the successful treatment of blister aneurysms of the internal carotid artery with flow diversion. Blister aneurysms are uncommon and fragile lesions that historically have high rates of morbidity and mortality despite multiple treatment strategies. We report a case of rebleeding after treatment of a ruptured blister aneurysm with deployment of a single FDS...
November 2016: Neurosurgery
Rui Guo, Lu Ma, Bal Krishna Shrestha, Zhiyuan Yu, Hao Li, Chao You
The aim of the study is to define the clinical features, risk factors, treatment and prognosis of idiopathic primary intraventricular hemorrhage (IPIVH).We retrospectively collected the data of consecutively admitted patients who were diagnosed and treated for IPIVH in our hospital from January 2010 to December 2014. The clinical information, treatment, and prognosis at the 6-month follow-up were analyzed.Among the 3798 cases of spontaneous intracranial hemorrhage (ICH), 98 IPIVH (2.58%) patients were recruited for the study...
October 2016: Medicine (Baltimore)
Hao Li, Jizong Zhao, Wen Wang, Lu Zhang, Qing Lan, Jiangfei Wang, Yong Cao, Jizong Zhao
BACKGROUND: Intracranial aneurysm (IA) is a cerebrovascular disorder characterized by an abnormally bulged artery in the brain and subarachnoid hemorrhage caused by IA rupture with a high ratio of fatality and morbidity. However, the genetic etiology of IA remains largely unknown. MATERIALS AND METHODS: A dysregulated lncRNA-associated competing endogenous RNA (ceRNA) network was constructed by utilizing sample-matched microRNA (miRNA), long non-coding RNA (lncRNA) and mRNA expression profiles in 12 saccular IA samples and paired control arteries...
October 14, 2016: World Neurosurgery
Matthias Eckert, Philipp Gölitz, Hannes Lücking, Tobias Struffert, Frauke Knossalla, Arnd Doerfler
BACKGROUND: Using flat-detector CT (FD-CT) for stroke imaging has the advantage that both diagnostic imaging and endovascular therapy can be performed directly within the Angio Suite without any patient transfer and time delay. Thus, stroke management could be speeded up significantly, and patient outcome might be improved. But as precondition for using FD-CT as primary imaging modality, a reliable exclusion of intracranial hemorrhage (ICH) has to be possible. This study aimed to investigate whether optimized native FD-CT, using a newly implemented reconstruction algorithm, may reliably detect ICH in stroke patients...
October 18, 2016: Cerebrovascular Diseases
Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Feyi Kunle-Hassan, Minaxi Dattani, Martin Snead, Mala Subash
PURPOSE: To report a case of bilateral intraocular hemorrhage secondary to cerebral venous sinus thrombosis with no associated intracranial hemorrhage. METHODS: Case report. RESULTS: A 32-year-old Asian gentleman presented with left reduced vision as a result of a left subhyaloid macular hemorrhage associated with severe headache. Right retinal hemorrhages were also present. Magnetic resonance imaging and computed tomography brain imaging demonstrated cerebral transverse venous sinus thrombosis...
October 5, 2016: Retinal Cases & Brief Reports
Tanja Radovanovic, Slobodan Spasojevic, Vesna Stojanovic, Aleksandra Doronjski
INTRODUCTION: An apparent life-threatening event (ALTE) is defined as "an episode that is frightening to the observer and is characterized by some combination of apnea, color change, marked change of muscle tone, choking, or gagging." OBJECTIVE: The aims of this study were to determine etiology and outcome of severe ALTE (requiring resuscitation measures) and to review diagnostic approaches in infants hospitalized after such an episode of ALTE. METHODS: Retrospective analysis included patients hospitalized at the Intensive Care Unit, Institute of Child and Youth Healthcare of Vojvodina, after an episode of severe ALTE over a 4-year period...
September 30, 2016: Pediatric Emergency Care
Navid Elmi Sadr, Bijan Samavat, Payam Mehrian, Alireza Hedayatfar
Introduction. Terson syndrome is described as intraocular hemorrhage in association with any type of intracranial hemorrhage and is associated with higher mortality rate and vision loss. Intraocular hemorrhage in Terson syndrome may be diagnosed using computed tomography but there are false positive results. Silicone oil which is widely used for internal tamponade of complicated retinal detachments has high attenuation on computed tomography and hyperintensity on T1-weighted magnetic resonance imaging that can mimic intraocular hemorrhage...
2016: Case Reports in Ophthalmological Medicine
Xavier Freixa, Laura Llull, Sameer Gafoor, Ignacio Cruz-Gonzalez, Samera Shakir, Heyder Omran, Sergio Berti, Gennaro Santoro, Joelle Kefer, Ulf Landmesser, Jens Erik Nielsen-Kudsk, Prapa Kanagaratnam, Fabian Nietlispach, Steffen Gloekler, Adel Aminian, Paolo Danna, Marco Rezzaghi, Friederike Stock, Miroslava Stolcova, Luis Paiva, Marco Costa, Xavier Millán, Reda Ibrahim, Tobias Tichelbäcker, Wolfgang Schillinger, Jai-Wun Park, Horst Sievert, Bernhard Meier, Apostolos Tzikas
Cardioembolic strokes are generally more lethal and disabling than other source of strokes. Data from PROTECT AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in Patients With Atrial Fibrillation) suggest that strokes after left atrial appendage occlusion (LAAO) with the Watchman device are less disabling than those in the warfarin group. No data assessing the severity of strokes after LAAO with the AMPLATZER Cardiac Plug (ACP) are available. The objective of the study was to evaluate the severity of cerebrovascular events after LAAO with the ACP in a population mostly characterized by an absolute or relative contraindication to oral anticoagulation...
September 15, 2016: American Journal of Cardiology
Rustum Karanjia, Alfredo A Sadun, Angelos A Konstas
Severe visual loss may occur in patients with pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension. Transverse sinus stenosis is 1 cause of PTC syndrome. Although the role of transverse sinus stenosis in the pathogenesis of the disease remains controversial, recent case series of transverse sinus stenting have reported very high rates of symptom response and resolution of papilledema with improvement or at least stabilization of the visual fields and visual acuity (Ahmed et al., 2011)...
October 12, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
P Pardes-Chavanes, M Afanetti, C Boyer, M Poirée
Intracerebral hemorrhage (ICH) remains a cause of death in hematologic malignancies. Asparaginase represents a key agent in the treatment of acute lymphoblastic leukemia (ALL). The toxicity of asparaginase includes coagulopathy such as thrombotic or bleeding tendency. We report a case of fatal cerebral hemorrhage in a 12-year-old girl treated for ALL. Cerebral hemorrhage occurred after three injections of L-asparaginase. The patient presented with hypofibrinogenemia (0.36g/L), associated with thrombocytopenia (24,000/mm(3))...
October 12, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Robert T Granata, Edward M Castillo, Gary M Vilke
BACKGROUND: Patients presenting to the emergency department (ED) with altered mental status and alcohol intoxication can clinically resemble patients with an intracranial hemorrhage. Although intracranial hemorrhage is quickly excluded with a head computed tomographic (CT) scan, it is common practice to defer imaging and allow the patient to metabolize to spare ED resources and minimize radiation exposure to the patient. Although this reduces unnecessary scans, it may delay treatment in patients with occult intracranial hemorrhage, which some fear may increase morbidity and mortality...
September 30, 2016: American Journal of Emergency Medicine
Junkoh Yamamoto, Shohei Shimajiri, Daisuke Akiba, Yoshiteru Nakano, Shigeru Nishizawa
BACKGROUND: An intracranial neurenteric cyst (NC) is a rare congenital benign lesion that usually has a well-demarcated cystic appearance without contrast enhancement on magnetic resonance imaging (MRI). In particular, an intracranial NC with an enhanced mural nodule is extremely rare. CASE DESCRIPTION: A 20-year-old man presented with left-sided hearing disturbance and headache. On MRI, a cystic mass was seen in the prepontine cistern that significantly compressed the brain stem...
October 11, 2016: World Neurosurgery
Andrea Morotti, Joshua N Goldstein
Intracerebral hemorrhage (ICH) is the deadliest type of stroke and up to half of patients die in hospital. Blood pressure management, coagulopathy reversal, and intracranial pressure control are the mainstays of acute ICH treatment. Prevention of hematoma expansion and minimally invasive hematoma evacuation are promising therapeutic strategies under investigation. This article provides an updated review on ICH diagnosis and management in the emergency department.
November 2016: Emergency Medicine Clinics of North America
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
Ryan Hakimi, Ankur Garg
PURPOSE OF REVIEW: Hemorrhagic stroke comprises approximately 15% to 20% of all strokes. This article provides readers with an understanding of the indications and significance of various neuroimaging techniques available for patients presenting with hemorrhagic strokes of distinct causes. RECENT FINDINGS: The most common initial neuroimaging study is a noncontrast head CT, which allows for the identification of hemorrhage. Once an intracranial hemorrhage has been identified, the pattern of blood and the patient's medical history, neurologic examination, and laboratory studies lead the practitioner to pursue further neuroimaging studies to guide the medical, surgical, and interventional management...
October 2016: Continuum: Lifelong Learning in Neurology
Tibor Becske, Matthew B Potts, Maksim Shapiro, David F Kallmes, Waleed Brinjikji, Isil Saatci, Cameron G McDougall, István Szikora, Giuseppe Lanzino, Christopher J Moran, Henry H Woo, Demetrius K Lopes, Aaron L Berez, Daniel J Cher, Adnan H Siddiqui, Elad I Levy, Felipe C Albuquerque, David J Fiorella, Zsolt Berentei, Miklós Marosföi, Saruhan H Cekirge, Peter K Nelson
OBJECTIVE The long-term effectiveness of endovascular treatment of large and giant wide-neck aneurysms using traditional endovascular techniques has been disappointing, with high recanalization and re-treatment rates. Flow diversion with the Pipeline Embolization Device (PED) has been recently used as a stand-alone therapy for complex aneurysms, showing significant improvement in effectiveness while demonstrating a similar safety profile to stent-supported coil treatment. However, relatively little is known about its long-term safety and effectiveness...
October 14, 2016: Journal of Neurosurgery
Anne C Ritter, Amy K Wagner, Anthony Fabio, Mary Jo Pugh, William C Walker, Jerzy P Szaflarski, Ross D Zafonte, Allen W Brown, Flora M Hammond, Tamara Bushnik, Douglas Johnson-Greene, Timothy Shea, Jason W Krellman, Joseph A Rosenthal, Laura E Dreer
OBJECTIVE: Determine incidence of posttraumatic seizure (PTS) following traumatic brain injury (TBI) among individuals with moderate-to-severe TBI requiring rehabilitation and surviving at least 5 years. METHODS: Using the prospective TBI Model Systems National Database, we calculated PTS incidence during acute hospitalization, and at years 1, 2, and 5 postinjury in a continuously followed cohort enrolled from 1989 to 2000 (n = 795). Incidence rates were stratified by risk factors, and adjusted relative risk (RR) was calculated...
October 14, 2016: Epilepsia
Anton M Kolomeyer, Ken K Nischal, Ellen Mitchell
PURPOSE: To report a case of bilateral cavernous sinus thrombosis (CST) in a patient with tacrolimus-associated posttransplant thrombotic microangiopathy. METHODS: Case report. RESULTS: An 8-year-old boy with a medical history of orthotopic heart transplant, posttransplant lymphoproliferative disease, and recurrent infections was hospitalized for nausea, vomiting, and diarrhea. His ocular history included accommodative esotropia, hyperopia with astigmatism, Molluscum contagiosum lid lesions, and idiopathic intracranial hypertension...
October 13, 2016: European Journal of Ophthalmology
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