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Cerebral AND Edema

Eriko Suzuki, Naoko Nishimura, Tetsuya Yoshikawa, Yudai Kunikiyo, Keiko Hasegawa, Keiji Hasumi
SMTP-7 ( Stachybotrys microspora triprenyl phenol-7) is a small molecule that promotes thrombolysis and suppresses inflammation possibly through plasminogen modulation and soluble epoxide hydrolase (sEH) inhibition, respectively. Here, we demonstrate an efficacy of SMTP-7 in a severe embolic stroke model in monkeys. The middle cerebral artery was embolized by an autologous blood clot. Saline, SMTP-7, or tissue-type plasminogen activator (t-PA) (n = 5 in each group) was given after 3 hours, and neurologic deficit scoring and infarct characterization were performed after 24 hours...
December 2018: Pharmacology Research & Perspectives
Alessia Felli, Keso Skhirtladze-Dworschak, Philipp Opfermann, Martin Dworschak
Regional cerebral tissue saturation monitoring is frequently used in patients on mechanical cardiac assist devices with the intention to promptly detect critical imbalances between cerebral oxygen delivery and oxygen extraction and ultimately circumvent permanent brain injury. We report a case where an intraparenchymal bleed in the supply zone of the middle cerebral artery-followed by severe hemispherical brain edema, leading to life-threatening intracranial hypertension-escaped cerebral oximetry monitoring using near-infrared spectroscopy...
December 11, 2018: A&A practice
Umit Y Malkan, Gursel Gunes, Haluk Demiroglu, Hakan Goker
Posterior reversible encephalopathy syndrome (PRES) was described in 1996. Herein, we aimed to report an immunosuppression- related PRES case. A 34-year-old woman was diagnosed as t-cell acute lymphoblastic leukemia and allogeneic hematopoietic stem cell transplantation (HSCT) was performed. Cyclosporine was given for GVHD prophylaxis in addition to the other routine medications of HSCT. She was hospitalized for acute renal failure and due to the possible contribution of acute renal failure cyclosporine was stopped...
November 6, 2018: Hematology Reports
Jian Qian, Luna Wang, Qiming Li, Dujuan Sha, Jun Wang, Jun Zhang, Peng Xu, Guofeng Fan
To investigate the role of ultrasound-targeted microbubbles in the homing effect of bone marrow-derived mesenchymal stem cells (BMSCs) and in the therapeutic efficacy of BMSCs on the ischemic stroke. A middle cerebral artery occlusion (MCAO) model was induced by plug wire preparation. Seventy-two hours after MCAO, the treatment of BMSCs with ultrasound-targeted microbubble was assessed via modified neurological severity score (mNSS), infarct volumes, and cerebral edema. In addition, immunofluorescence was performed to analyze the homing effect of BMSCs with ultrasound-targeted microbubble...
December 9, 2018: Journal of Cellular Biochemistry
Claudia Teodora Judea-Pusta, Gabriela Muţiu, Andrei Vasile Paşcalău, Camelia Liana Buhaş, Adina Nicoleta Ciursaş, Carmen Delia Nistor-Cseppento, Alina Bodea, Adrian Sorin Judea, Răzvan Marius Vicaş, Luciana Dobjanschi, Ovidiu Laurean Pop
Ethylene glycol is a toxic alcohol that is mainly introduced into an organism through the digestive pathway. Its priority toxic metabolites are glycolic acid and oxalic acid. We present the case of a young person, of the male persuasion, without any personal pathological history, found unconscious and presenting signs of violence. The patient is emergency hospitalized presenting coma, convulsive syndrome, severe metabolic acidosis and a positive result for alcoholism. Anamnestic data is extremely poor. The results of the clinical and paraclinical examinations suggest a possible poisoning with toxic alcohols...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Thomas G Liman, Eberhard Siebert, Matthias Endres
PURPOSE OF REVIEW: Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by acute cerebral endotheliopathy with consecutive disruption of the blood-brain barrier and vasogenic edema. Since its first description in 1996, PRES is increasingly recognized. However, many aspects of this syndrome with its wide spectrum of clinical and radiological features are still incompletely understood. In this review, possible pathophysiological mechanisms, approaches to diagnosis, recent study results on outcome, and future directions of research are described...
December 10, 2018: Current Opinion in Neurology
Hong-Yun He, Lu Ren, Tao Guo, Yi-Hao Deng
Ischemic stroke often induces excessive neuronal autophagy, resulting in brain damage; meanwhile, inflammatory responses stimulated by ischemia exacerbate neural injury. However, interactions between neuronal autophagy and microglial inflammation following ischemic stroke are poorly understood. CX3CL1/fractalkine, a membrane-bound chemokine expressed on neurons, can suppress microglial inflammation by binding to its receptor CX3CR1 on microglia. In the present study, to investigate whether autophagy could alter CX3CL1 expression on neurons and consequently change microglial inflammatory activity, middle cerebral artery occlusion (MCAO) was established in Sprague-Dawley rats to model ischemic stroke, and tissues from the ischemic penumbra were obtained to evaluate autophagy level and microglial inflammatory activity...
February 2019: Neural Regeneration Research
Reza Jahan, J Pablo Villablanca, Robert J Harris, Sandra Duarte-Vogel, Christopher K Williams, Harry V Vinters, Neal Rao, Dieter R Enzmann, Benjamin M Ellingson
BACKGROUND: A reliable animal model of ischemic stroke is vital for pre-clinical evaluation of stroke therapies. We describe a reproducible middle cerebral artery (MCA) embolic occlusion in the French Lop rabbit characterized with multimodal MRI and histopathologic tissue analysis. NEW METHOD: Fluoroscopic-guided microcatheter placement was performed in five consecutive subjects with angiographic confirmation of MCA occlusion with autologous clot. Multimodal MRI was obtained prior to occlusion and up to six hours post after which repeat angiography confirmed sustained occlusion...
December 7, 2018: Journal of Neuroscience Methods
Jennifer N Brudno, James N Kochenderfer
Chimeric antigen receptor (CAR) T-cell therapy is an effective new treatment for hematologic malignancies. Two CAR T-cell products are now approved for clinical use by the U.S. FDA: tisagenlecleucel for pediatric acute lymphoblastic leukemia (ALL) and adult diffuse large B-cell lymphoma subtypes (DLBCL), and axicabtagene ciloleucel for DLBCL. CAR T-cell therapies are being developed for multiple myeloma, and clear evidence of clinical activity has been generated. A barrier to widespread use of CAR T-cell therapy is toxicity, primarily cytokine release syndrome (CRS) and neurologic toxicity...
November 14, 2018: Blood Reviews
Qiang Lu, Lu Wen, Feiping Li, Xiaoping Yu
To investigate the magnetic resonance imaging (MRI) features for primary brain lymphoma and improve its diagnosis and differential diagnosis.
 Methods: The clinical and MRI data from 14 patients with primary brain lymphoma were retrospectively reviewed.
 Results: Fourteen patients, including 5 males and 9 females, were (55±8) years old. There were 9 patients with single lesion and 5 patients with multiple lesions (2-6 lesions). A total of 26 lesions were identified. All lesions located in supratentorium, such as the cerebral hemisphere, the basal ganglia, and the corpus callosum...
October 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Cihan Gündoğan, Aytül Hande Yardimci, Burçak Yilmaz Güneş, Tevfik Fikret Çermik
A 68-year-old woman with colon carcinoma was referred to F-FDG PET/CT imaging for staging. In addition to primary tumor involvement, PET/CT demonstrated focal FDG uptake in the right temporal lobe suggestive of primary brain tumor or metastasis. To delineate the lesion, a brain MRI scan showed sigmoid sinus thrombosis and vasogenic edema in the right temporal lobe. The patient presented a history of right-sided headache that began 1 week before the PET/CT. Neurological examination and MRI findings were concluded as subacute venous infarct due to sigmoid sinus thrombosis and that is a potential cause for false-positive FDG uptake on PET/CT...
December 3, 2018: Clinical Nuclear Medicine
Matthew A Koenig
PURPOSE OF REVIEW: This article reviews the management of cerebral edema, elevated intracranial pressure (ICP), and cerebral herniation syndromes in neurocritical care. RECENT FINDINGS: While corticosteroids may be effective in reducing vasogenic edema around brain tumors, they are contraindicated in traumatic cerebral edema. Mannitol and hypertonic saline use should be tailored to patient characteristics including intravascular volume status. In patients with traumatic brain injury who are comatose, elevated ICP should be managed with an algorithmic, multitiered treatment protocol to maintain an ICP of 22 mm Hg or less...
December 2018: Continuum: Lifelong Learning in Neurology
Masaki Mino, Miki Fujimura, Masahiro Yoshida, Shinya Sonobe, Teiji Tominaga
BACKGROUND: The optimal management strategy for cerebral contusion remains controversial, especially when standard craniotomy could not be used. We performed neuro-endoscopic target lesionectomy for the delayed progression of cerebral contusion in order to aspirate the necrotic core, which is the primal source of contusional edema. METHODS: The present study included 10 consecutive patients (2 women and 8 men, with a mean age of 67 years old) with traumatic brain injury presenting with delayed deterioration of cerebral contusion where standard craniotomy could not be used...
December 4, 2018: Acta Neurochirurgica
Hsing-Hsien Wu, Ko-Chi Niu, Cheng-Hsien Lin, Hung-Jung Lin, Ching-Ping Chang, Chia-Ti Wang
High-mountain sickness is characterized by brain and pulmonary edema and cognitive deficits. The definition can be fulfilled by a rat model of high-altitude exposure (HAE) used in the present study. This study aimed to investigate the protective effect of hyperbaric oxygen therapy (HBO2 T) and to determine the underlying mechanisms. Rats were subjected to an HAE (9.7% O2 at 0.47 absolute atmosphere of 6,000 m for 3 days). Immediately after termination of HAE, rats were treated with HBO2 T (100% O2 at 2.0 absolute atmosphere for 1 hour per day for 5 consecutive days) or non-HBO2 T (21% O2 at 1...
2018: BioMed Research International
Nissar Shaikh, Zia Mahmood, Syed Imran Ghuori, Arshad Chanda, Adel Ganaw, Qazi Zeeshan, Moad Ehfeda, Ali O Mohamed Belkhair, Muhammad Zubair, Sayed Tarique Kazi, Umaiz Momin
BACKGROUND: Fat embolism syndrome (FES) is a multi-organ dysfunction caused by the fat emboli. The diagnostic of FES remains a challenge for clinicians. The clinical criteria including those of Gurd's and Wilson's although universally used for its diagnosis are not specific. Different methods of imaging are increasingly performed in the patients with presumed FES. The objective of this study is to determine whether there is a correlation between the clinical parameters and the imaging findings in confirming the FES diagnosis...
2018: International Journal of Burns and Trauma
Brittany A Riggle, Sanhita Sinharay, William Schreiber-Stainthorp, Jeeva P Munasinghe, Dragan Maric, Eva Prchalova, Barbara S Slusher, Jonathan D Powell, Louis H Miller, Susan K Pierce, Dima A Hammoud
The deadliest complication of Plasmodium falciparum infection is cerebral malaria (CM), with a case fatality rate of 15 to 25% in African children despite effective antimalarial chemotherapy. No adjunctive treatments are yet available for this devastating disease. We previously reported that the glutamine antagonist 6-diazo-5-oxo-l-norleucine (DON) rescued mice from experimental CM (ECM) when administered late in the infection, a time by which mice had already suffered blood-brain barrier (BBB) dysfunction, brain swelling, and hemorrhaging...
December 4, 2018: Proceedings of the National Academy of Sciences of the United States of America
Haydn Hoffman, Brendon Verhave, Lawrence S Chin
BACKGROUND: Hypernatremia is one of the most common electrolyte disturbances following aneurysmal subarachnoid hemorrhage (aSAH) and has been correlated with increased mortality in single institution studies. We investigated this association using a large nationwide healthcare database. METHODS: We performed a retrospective analysis of adults between 2002 and 2011 with a primary diagnosis of aSAH using the Nationwide Inpatient Sample (NIS). Patients were grouped according to whether or not an inpatient diagnosis of hypernatremia was present...
December 5, 2018: Journal of Neurosurgical Sciences
Abha Sahni, Hema P Narra, Jignesh Patel, Sanjeev K Sahni
Microvascular endothelial cells (ECs) represent the primary target cells during human rickettsioses and respond to infection via the activation of immediate⁻early signaling cascades and the resultant induction of gene expression. As small noncoding RNAs dispersed throughout the genome, microRNAs (miRNAs) regulate gene expression post-transcriptionally to govern a wide range of biological processes. Based on our recent findings demonstrating the involvement of fibroblast growth factor receptor 1 (FGFR1) in facilitating rickettsial invasion into host cells and published reports suggesting miR-424 and miR-503 as regulators of FGF2/FGFR1, we measured the expression of miR-424 and miR-503 during R...
December 1, 2018: Cells
Hong-Mei Zhang, Wei Chen, Rui-Ning Liu, Yan Zhao
Introduction: Secondary brain injury is a major factor that affects the prognosis and outcome of traumatic brain injury (TBI) patients. Secondary brain edema is considered to be an initiating factor in secondary brain injury after TBI. A previous study has indicated that Notch signaling activation contributes to neuron death in mice affected by stroke; however, its role in neuronal oxidation stress for brain edema after TBI is not well established. Apparent diffusion coefficient (ADC) values can represent the brain edema after TBI...
2018: Drug Design, Development and Therapy
Yunhong Li, Yujing Zhang, Ying Zhang
After ascent to high altitude (≥2500 m), the inability of the human body to adapt to the hypobaric and hypoxia environment can induce tissue hypoxia, then a series of high altitude illnesses including acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE) would develop. Symptoms of AMS include headache, dizziness, nausea, and vomiting; HAPE is characterized by orthopnea, breathlessness at rest, cough, pink frothy sputum, and results in obvious pulmonary edema that poses significant harm to people; HACE is characterized by ataxia and decreased consciousness, leading to coma and brain herniation which would be fatal if not treated promptly...
December 2018: Respiratory Medicine
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