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Hypertensive cerebral hemorrhage

Eleni Vourla, Andreas Filis, Jan F Cornelius, Richard Bostelmann, Bernd Turowski, Piyush Kalakoti, Christian Rubbert, Marian Preetham Suresh, Angelo Tortora, Hans Jakob Steiger, Athanasios K Petridis
INTRODUCTION: De novo aneurysm formation after completely occluded aneurysms via clipping or coiling is generally not well studied. Although known to occur several years following initial aneurysm management, the natural history of de novo aneurysms is obscure. The current study investigated the formation of new aneurysms in patients who were previously treated for intracranial aneurysms. METHODS: In a retrospective, single-institutional series, eligible patients that underwent management for ruptured cerebral aneurysms between 2000-2011 were included...
October 12, 2018: World Neurosurgery
Jianfeng Zheng, Rui Xu, Guojing Liu, Zongduo Guo, Xiaochuan Sun
OBJECTIVE: Hypertension is common in patients with aneurysmal subarachnoid hemorrhage (SAH). However, it is still unclear whether premorbid antihypertensive therapy can help to reduce the risk of severe aneurysmal bleeding. Therefore, this study aims to assess the effect of premorbid hypertension control on outcome of patients with aneurysmal SAH. METHODS: We retrospectively reviewed the clinical data of patients with intracranial aneurysms admitted to our institution from February 2012 to December 2017...
October 12, 2018: Acta Neurochirurgica
Alexandros Sotiradis, Stamatios Petousis, Basky Thilaganathan, Francesc Figueras, Wellington P Martins, Anthony O Odibo, Konstantinos Dinas, Jon Hyett
OBJECTIVE: The rate of maternal and perinatal complications increases after 39 weeks in both unselected and complicated pregnancies. The aim of this study was to synthesize quantitatively the evidence on the effect of elective induction of labor at term on the risk of Cesarean section, and maternal and perinatal outcome. METHODS: We searched PubMed, US Registry of Clinical Trials, SCOPUS and CENTRAL databases from inception to August 2018. We additionally searched the references of retrieved articles...
October 8, 2018: Ultrasound in Obstetrics & Gynecology
Y Liu, D C Han, Y L Hu, L M Chen, J C Li, Y W Su, C X Hu
Objective: To summarize the clinical presentations and imaging features of cerebral venous sinus thrombosis (CVST) in 5 newborns. Methods: The clinical data of 5 newborns with CVST admitted to Department of Neonatology of Maternal and Children Hospital of Hubei Province from February 2017 to April 2018 were analyzed retrospectively. The risk factors, clinical presentations, imaging manifestations and treatment of CVST were investigated. Results: Of the 5 full term neonates, 4 were males and 1 female, with 4 aged less than 7 days and 1 more than 7 days; one with the history of maternal gestational diabetes mellitus, one with maternal gestational hypertension...
October 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Zoltan Ungvari, Andriy Yabluchanskiy, Stefano Tarantini, Peter Toth, Angelia C Kirkpatrick, Anna Csiszar, Calin I Prodan
Multifocal cerebral microhemorrhages (CMHs, also known as "cerebral microbleeds"), which are associated with rupture of small intracerebral vessels, have been recognized as an important cause for cognitive decline in older adults. Although recent studies demonstrate that CMHs are highly prevalent in patients 65 and older, many aspects of the pathogenesis and clinical significance of CMHs remain obscure. In this longitudinal observational study, a case of a 77-year-old man with multifocal CMHs is described, in whom the rupture of intracerebral vessels could be linked to repeatedly performing extended Valsalva maneuvers...
October 4, 2018: GeroScience
Makoto Saito, Hajime Senjo, Minoru Kanaya, Koh Izumiyama, Akio Mori, Masanori Tanaka, Masanobu Morioka, Masahiro Ieko
A 74-years-old male who was a smoker and received treatment for hypertension, dyslipidemia, peripheral arterial disease and idiopathic interstitial pneumonia complained of subcutaneous hemorrhage of the right lower thigh. Marked anemia (hemoglobin 5.5 g/dL) and prolonged activated partial thromboplastin time (≥130 seconds) were noted. The factor VIII activity level was reduced to 1.2%, and the factor VIII inhibitor titer was 285.3 BU/mL, a diagnosis of acquired hemophilia A (AHA) was made. Then, hematomas of 5 intra-muscles were recurred...
September 5, 2018: Hematology Reports
Donghuan Zhang, Honglei Wang, Tianyi Liu, Yingli Feng, Yuan Qi, Ning Xu
BACKGROUND: It was known that a small number of patients could have intracranial aneurysm recurrences after either surgical clipping or endovascular embolization treatment. However, early recurrence within one month after the treatment and re-recurrence was rarely reported before. CASE PRESENTATION: We reported a 46-year-old male patient with a medical history of smoking and hypertension who was non-compliant with the treatments. He presented to the hospital due to right extremity paralysis and aphasia, and was found to have a ruptured middle cerebral artery aneurysm...
September 24, 2018: World Neurosurgery
Matthew D Howe, Liang Zhu, Lauren H Sansing, Nicole R Gonzales, Louise D McCullough, Nancy J Edwards
Background: Intracerebral hemorrhage (ICH) is a stroke subtype associated with high disability and mortality. There is a clinical need for blood-based biomarkers that can aid in diagnosis, risk stratification, and prognostication. Given their role in the pathophysiology of ICH, we hypothesized markers of blood-brain barrier disruption and fibrosis would associate with neurologic deterioration and/or long-term functional outcomes. We also hypothesized these markers may be unique in patients with ICH due to cerebral amyloid angiopathy (CAA) vs...
2018: Frontiers in Neurology
Masaraf Hussain, Shri Ram Sharma, M D Jamil
Introduction: A study of stroke among young adults and children has recently become a subject of interest. This is because it has a major impact on the individual and society. Studies of stroke in young can lead to therapeutical results affecting both short- and long-term outcomes. Methods: This paper is based on a hospital-based retrospective study, of stroke in young, for a duration of 1 year. Results: The study revealed stroke in young in 31...
July 2018: Annals of Indian Academy of Neurology
Joshua A Ronen, Aileen Nguyen, Jerrica N Mueller, Hyonju Lee
Primary angiitis of the central nervous system (PACNS) is a rare disease with various clinical presentations. It is the preferred name for vasculitis that is confined to the central nervous system (CNS) and is often considered a diagnosis of exclusion in vascular or inflammatory CNS diseases. This case describes a 46-year-old right-handed female with a past medical history of hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus type two (DM2), obesity, and hemorrhagic stroke who was transferred from an outside facility after a one-month hospitalization to be evaluated for CNS vasculitis...
July 23, 2018: Curēus
Sang Hun Lee, Keun-Sik Hong, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu, Sun U Kwon
OBJECTIVES: To investigate the predictors of hemorrhagic transformation (HT) in patients with mild atrial fibrillation-related stroke who were treated with early anticoagulation. We conducted a post-hoc subgroup analysis from Acute Cerebral Infarction Patients with Non-valvular Atrial Fibrillation (Triple AXEL) study. PATIENTS AND METHODS: The Triple AXEL study was a randomized, multicenter, open-label, blinded end-point evaluation, comparative phase 2 trial. To identify the relationship between the type of HT and risk factors...
September 9, 2018: Clinical Neurology and Neurosurgery
V Šćepanović, G Tasić, N Repac, I Nikolić, A Janićijević, D Todorović, M Stojanović, R Šćepanović, D Mitrović, T Šćepanović, S Borozan, Lj Šćepanović
Cerebral aneurysm affects 2-5% of the population and posterior inferior cerebellar artery (PICA) aneurysms account for 1-3% of all intracranial aneurysms. Oxidative stress is known to contribute to the progression of cerebrovascular disease and it may be increased by inflammation, a key contributor to cerebral aneurysm development and rupture. The aim of this study was to examine the role of overall oxidative stress as a risk factor for rupture of PICA aneurysms. This study included 29 patients with PICA aneurysms: 18 ruptured and 11 unruptured...
September 20, 2018: Molecular Biology Reports
Eleni Georgianou, Panagiotis I Georgianos, Konstantinos Petidis, Vasilios G Athyros, Pantelis A Sarafidis, Asterios Karagiannis
Despite the proven benefits of strict blood pressure (BP) control on primary and secondary prevention of stroke, management of acute hypertensive response in the early post-stroke period is surrounded by substantial controversy. Observational studies showed that raised BP on ischemic stroke onset is prognostically associated with excess risk for early adverse events and mortality. By contrast, randomized controlled trials and recent meta-analyses showed that although antihypertensive therapy effectively controls elevated BP in the acute stage of ischemic stroke, this BP-lowering effect is not translated into improvement in the risk of death or dependency...
September 19, 2018: Journal of Human Hypertension
Satoru Hayashi, Koji Hosoda, Yo Nishimoto, Motonobu Nonaka, Shinya Higuchi, Toshifumi Miki, Masatoshi Negishi
Background: Segmental arterial mediolysis (SAM) is an uncommon vascular disease, which manifests as catastrophic intraabdominal hemorrhage caused by rupture of visceral dissecting aneurysms in most cases. The etiology of SAM is still unclear, but SAM may be a vasospastic disorder and the responsible pressor agent is norepinephrine. Recently, abdominal SAM coexisting with intracranial dissecting aneurysms has been reported, but the relationship between intraabdominal and intracranial aneurysms in SAM remains unclear, as no cases of concomitant abdominal SAM and ruptured intracranial saccular aneurysm have been reported...
2018: Surgical Neurology International
Amanda Kahn, Gurmeen Kaur, Laura Stein, Stanley Tuhrim, Mandip S Dhamoon
BACKGROUND: International trials suggest benefit of revascularization surgery (RS) for moyamoya disease (MMD). However, nationally representative US data on demographics and outcomes after RS in MMD are lacking. AIMS: To estimate causes and rates of readmission after RS for MMD. METHODS: In the Nationwide Readmissions Database, index admissions for ECICB for MMD and readmissions for ischemic stroke (IS), subarachnoid hemorrhage (SAH), and intracerebral hemorrhage (ICH) were identified using validated International Classification of Diseases, Ninth Revision, Clinical Modification codes...
November 2018: Journal of Neurology
S Rasras, H Safari, M Zeinali, M Jahangiri
OBJECTIVE: Decompressive craniectomy (DC) lowers intracranial pressure and improves outcomes in patients with malignant middle cerebral artery stroke; yet, its usefulness in intracerebral hemorrhage (ICH) is unclear. The authors sought to assess the preliminary utility of decompressive hemicraniectomy (DHC) without clot evacuation in patients with deep-seated supratentorial ICH. PATIENTS AND METHODS: Patients with deep seated spontaneous ICH who were admitted to the Golestan Hospital, of Ahvaz, from November 2014 to February 2016, were prospectively enrolled in this study...
August 23, 2018: Clinical Neurology and Neurosurgery
Stefano Spina, Vittorio Scaravilli, Giovanni Cavenaghi, Dario Manzolini, Chiara Marzorati, Enrico Colombo, Davide Savo, Alessia Vargiolu, Giuseppe Citerio
BACKGROUND: Brain-injured patients frequently require tracheostomy, but no technique has been shown to be the gold standard for these patients. We developed and introduced into standard clinical practice an innovative bedside translaryngeal tracheostomy (TLT) technique aided by suspension laryngoscopy (modified TLT). During this procedure, the endotracheal tube is left in place until the airway is secured with the new tracheostomy. This study assessed the clinical impact of this technique in brain-injured patients...
August 29, 2018: Journal of Neurosurgical Anesthesiology
José M Ceresetto
The use of fibrinolytics in lung thromboembolism (PTE) is a subject under debate since its first description in the 1960s. This therapy, which can rapidly resolve the mechanical obstruction in the pulmonary artery, has the limiting of a high hemorrhagic risk. Precisely because of the prohibitive incidence of major and cerebral bleeding and the lack of benefit in survival, the use of systemic thrombolytics is only indicated in the small number of patients with severe PE and hemodynamic instability. In moderate-risk PE, even with right ventricular (RV) dysfunction, they are not indicated...
2018: Medicina
Alexander Hammer, Anahi Steiner, Gholamreza Ranaie, Eduard Yakubov, Frank Erbguth, Christian M Hammer, Monika Killer-Oberpfalzer, Hans Steiner, Hendrik Janssen
The intention of this observational study is to show the significant impact of comorbidities and smoking on the outcome in aneurysmal subarachnoid hemorrhage (SAH). During this observational study 203 cases of treatment of ruptured intracranial aneurysms were analyzed. We examined and classified prospectively the 12 month outcome according to the modified Rankin Scale (mRS) considering retrospectively a history of smoking and investigated prospectively the occurrence of early and delayed cerebral ischemia between 2012 and 2017...
August 17, 2018: Scientific Reports
Ruchira M Jha, Jonathan Elmer, Benjamin E Zusman, Shashvat Desai, Ava M Puccio, David O Okonkwo, Seo Young Park, Lori A Shutter, Jessica S Wallisch, Yvette P Conley, Patrick M Kochanek
OBJECTIVES: Intracranial pressure in traumatic brain injury is dynamic and influenced by factors like injury patterns, treatments, and genetics. Existing studies use time invariant summary intracranial pressure measures thus potentially losing critical information about temporal trends. We identified longitudinal intracranial pressure trajectories in severe traumatic brain injury and evaluated whether they predicted outcome. We further interrogated the model to explore whether ABCC8 polymorphisms (a known cerebraledema regulator) differed across trajectory groups...
November 2018: Critical Care Medicine
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