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Cerebral Haemorrhage

Shu Shen, Junjie Kong, Yiwen Qiu, Shenglong Zhang, Yan Qin, Wentao Wang
OBJECTIVE: To compare the clinical outcomes of ex vivo liver resection and autotransplantation (ERAT) with allotransplantation in end-stage hepatic alveolar echinococcosis (HAE) patients. METHODS: From January 2008 to October 2017, 41 of 254 patients with end-stage HAE fulfilled the inclusion criteria (group ERAT, n=35 versus group allotransplantation, n=6). Each group was assessed for indications and short- and long-term outcomes. RESULTS: The intraoperative mortality was zero in both groups...
November 26, 2018: International Journal of Infectious Diseases: IJID
Siobhan Crilly, Alexandra Njegic, Sarah E Laurie, Elisavet Fotiou, Georgina Hudson, Jack Barrington, Kirsty Webb, Helen L Young, Andrew P Badrock, Adam Hurlstone, Jack Rivers-Auty, Adrian R Parry-Jones, Stuart M Allan, Paul R Kasher
Intracerebral haemorrhage (ICH) is a devastating condition with limited treatment options, and current understanding of pathophysiology is incomplete. Spontaneous cerebral bleeding is a characteristic of the human condition that has proven difficult to recapitulate in existing pre-clinical rodent models. Zebrafish larvae are frequently used as vertebrate disease models and are associated with several advantages, including high fecundity, optical translucency and non-protected status prior to 5 days post-fertilisation...
2018: F1000Research
Raffaella Santi, Piera Rizzolo, Michele Pietragalla, Virginia Valentini, Veronica Zelli, Francesco Maria Galassi, Laura Ottini, Gabriella Nesi
The Pathology Museum of the University of Florence houses a rich collection of anatomical specimens and over a hundred waxworks portraying pathological conditions occurring in the nineteenth century, when the museum was established. Clinical and autopsy findings of these cases can still be retrieved from the original museum catalogue, offering a rare opportunity for retrospective palaeo-pathological diagnostics. We present a historical case of severe hydrocephalus backed by modern-day anthropological, radiological and molecular analyses conducted on the skeleton of an 18-month-old male infant deceased in 1831...
November 23, 2018: Neurological Sciences
Hansen Chen, Xi Chen, Yunhao Luo, Jiangang Shen
Tissue plasminogen activator (t-PA) remains to be the only FDA-approved drug for ischaemic stroke, but it has a restrictive therapeutic window with 4.5 hours. Beyond the golden time window, thrombolytic treatment carries the risk of haemorrhagic transformation (HT). The blood-brain barrier (BBB) disruption is a critical step in the t-PA-mediated HT. Although large efforts are made to explore the mechanisms of the BBB disruption and HT, the underlying mechanisms are largely unknown. Thrombolytic treatment for recanalization could produce reactive oxygen species (ROS) and reactive nitrogen species (RNS) and mediate cerebral ischaemia-reperfusion injury...
November 23, 2018: Free Radical Research
Fenella J Kirkham, Dimitrios Zafeiriou, David Howe, Philippa Czarpran, Ashley Harris, Roxanna Gunny, Brigitte Vollmer
Fetal stroke is an important cause of cerebral palsy but is difficult to diagnose unless imaging is undertaken in pregnancies at risk because of known maternal or fetal disorders. Fetal ultrasound or magnetic resonance imaging may show haemorrhage or ischaemic lesions including multicystic encephalomalacia and focal porencephaly. Serial imaging has shown the development of malformations including schizencephaly and polymicrogyra after ischaemic and haemorrhagic stroke. Recognised causes of haemorrhagic fetal stroke include alloimmune and autoimmune thrombocytopaenia, maternal and fetal clotting disorders and trauma but these are relatively rare...
September 11, 2018: European Journal of Paediatric Neurology: EJPN
Evren Aydogmus, Sanser Gul, Burak Bahadir
We examined the protective effects of hesperidin on cerebral vasospasm by establishing an experimental rat model of subarachnoid haemorrhage and performing biochemical, pathological and histomorphometric analysis on these data. Forty albino Wistar rats were randomly divided into five groups of n = 8 in each: Group (G)1, no experimental interventions; G2, subjected to subarachnoid haemorrhage; G3, subjected to subarachnoid haemorrhage and administered saline (100 mg/kg); G4, subjected to subarachnoid haemorrhage and treated with low dose hesperidin (50 mg/kg); G5, subjected to subarachnoid haemorrhage and treated with high dose hesperidin (100 mg/kg)...
November 15, 2018: World Neurosurgery
Isabelle Mourand, Pauline Malissart, Cyril Dargazanli, Erika Nogue, Stephane Bouly, Nicolas Gaillard, Yassine Boukriche, Lucas Corti, Marie-Christine Picot, Olivier Beaufils, Mohamed Chbicheb, Denis Sablot, Alain Bonafe, Vincent Costalat, Caroline Arquizan
BACKGROUND: Mechanical thrombectomy (MT) in association with intravenous thrombolysis is recommended for treatment of acute ischemic stroke (AIS), with large vessel occlusion (LVO) in the anterior circulation. Because MT is only available in comprehensive stroke centers (CSC), the challenge of stroke organization is to ensure equitable access to the fastest endovascular suite. Our aim was to evaluate the feasibility, efficacy, and safety of MT in patients initially managed in 1 CSC (mothership), compared with patients first managed in primary stroke center (PSC), and then transferred to the CSC for MT (drip-and-ship)...
November 12, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Yu-Min Xu, Xin-Chen Wang, Shi-Jie Zhang, Ting-Ting Xu, Hong-Ying Li, Shang-Yan Hei, Ze-Huai Wen, Yun-Zhi Ma, Qi Wang, Wei-Xiong Liang
BACKGROUND: Xingnaojing injection (XNJ) sharpen the mind and induce consciousness and are widely used in acute phases of intracerebral hemorrhage (ICH). Naloxone hydrochloride injection (NX) performs equally well and replace the effects of morphine-like substances to promote conscious awareness. The applications of XNJ combined with NX for ICH show some advantages compared with NX applied individually. The aim of this systematic review is to evaluate the effectiveness and safety of XNJ combined with NX for ICH...
October 2018: Medicine (Baltimore)
Antonino Tuttolomondo, Rosario Maugeri, Elisabetta Orlando, Giulio Giannone, Francesco Ciccia, Aroldo Rizzo, Domenico Di Raimondo, Francesca Graziano, Rosaria Pecoraro, Carlo Maida, Irene Simonetta, Anna Cirrincione, Francesca Portelli, Francesca Corpora, Domenico Gerardo Iacopino, Antonio Pinto
Background: Cerebral Amyloid Angiopathy has been indicated as an important cause of spontaneous non-hypertensive intracerebral haemorrhage (ICH). Aims: to analyze the presence of β-amyloid deposit in the temporal artery of consecutive patients with ICH in comparison to control subjects and its relation to APO-E haplotype frequency. Methods: We enrolled consecutive patients admitted to Neurosurgery Ward of University Hospital "P. Giaccone" of Palermo with a diagnosis of spontaneous non hypertensive ICH and as control 12 subjects without brain haemorrhage...
October 5, 2018: Oncotarget
Suma B Hoffman, Yun-Ju Cheng, Laurence S Magder, Narendra Shet, Rose M Viscardi
OBJECTIVE: To test the hypothesis that impaired cerebral autoregulation (ICA) increases the susceptibility of premature infants to adverse outcomes, we determined the relationship of ICA and cerebral reactivity (CR) measured in the first 96 hours of life to the outcome of grade 3 or 4 intraventricular haemorrhage (IVH) and/or death within 1 month. SETTING: Single-centre level IV neonatal intensive care unit. PATIENTS: Neonates 24-29 weeks' gestation less than 12 hours old with invasive blood pressure monitoring...
November 1, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
John W P Wong, Leonid Churilov, Richard Dowling, Peter Mitchell, Steven Bush, Lasheta Kanesan, Bernard Yan
BACKGROUND/AIM: Endovascular thrombectomy may be performed in anticoagulated patients taking vitamin-K antagonists (VKA) or direct-acting oral anticoagulants (DOAC) in whom the use of intravenous tissue plasminogen activator (tPA) is contraindicated. We aimed to investigate the efficacy and safety of mechanical thrombectomy specifically in anticoagulated patients ineligible for thrombolysis. METHODS: We performed a retrospective analysis of a prospectively collected database of consecutive ischaemic stroke patients undergoing mechanical thrombectomy from January 2008 to June 2017...
November 1, 2018: Cerebrovascular Diseases
Carlotta Spagnoli, Raffaele Falsaperla, Michela Deolmi, Giovanni Corsello, Francesco Pisani
Neonatal seizures are the most common neurological event in newborns, showing higher prevalence in preterm than in full-term infants. In the majority of cases they represent acute symptomatic phenomena, the main etiologies being intraventricular haemorrhage, hypoxic-ischemic encephalopathy, central nervous system infections and transient metabolic derangements.Current definition of neonatal seizures requires detection of paroxysmal EEG-changes, and in preterm newborns the incidence of electrographic-only seizures seems to be particularly high, further stressing the crucial role of electroencephalogram monitoring in this population...
November 1, 2018: Italian Journal of Pediatrics
Kiyoshi Kikuchi, Kentaro Setoyama, Eiichiro Tanaka, Shotaro Otsuka, Takuto Terashi, Kazuki Nakanishi, Seiya Takada, Harutoshi Sakakima, Sumate Ampawong, Ko-Ichi Kawahara, Tomoka Nagasato, Kazuya Hosokawa, Yoichiro Harada, Mika Yamamoto, Chinatsu Kamikokuryo, Ryoji Kiyama, Motohiro Morioka, Takashi Ito, Ikuro Maruyama, Salunya Tancharoen
Uric acid (UA) therapy may prevent early ischemic worsening after acute stroke in thrombolysis patients. The aim of this study was to examine the influence of UA on the thrombolytic efficacy of alteplase in human blood samples by measuring thrombolysis under flow conditions using a newly developed microchip-based flow-chamber assay. Human blood samples from healthy volunteers were exposed to UA, alteplase, or a combination of UA and alteplase. Whole blood and platelet-rich plasma were perfused over a collagen- and thromboplastin-coated microchip, and capillary occlusion was monitored with a video microscope and flow-pressure sensor...
October 26, 2018: Scientific Reports
Roger M Krzyżewski, Kornelia M Kliś, Borys M Kwinta, Małgorzata Gackowska, Krzysztof Stachura, Anna Starowicz-Filip, Ashley Thompson, Jerzy Gąsowski
BACKGROUND: Many researchers have found correlation between tortuous arteries and development of aneurysms in cerebral arteries. However, due to our knowledge, there are no studies analysing impact of tortuosity on risk of subarachnoid haemorrhage occurrence. Therefore, we decided to determine, whether tortuosity of Anterior Cerebral Artery can be related to rupture of Anterior Communicating Artery aneurysm, as well as to severity and treatment outcome of subarachnoid haemorrhage. METHODS: We retrospectively analyzed the Anterior Cerebral Artery anatomy of 121 patients with Anterior Communicating Artery aneurysms...
October 23, 2018: World Neurosurgery
Haakon Lindekleiv, Eivind Berge, Karsten Mh Bruins Slot, Joanna M Wardlaw
BACKGROUND: Most ischaemic strokes are caused by blockage of a cerebral artery by a thrombus. Intravenous administration of recombinant tissue plasminogen activator given within 4.5 hours is now standard treatment for this condition. Percutaneous vascular interventions use an intra-arterial, mechanical approach for thrombus disruption or removal (thrombectomy). Recent randomised trials indicate that percutaneous vascular interventions are superior to usual care (usual care usually included intravenous thrombolysis)...
October 26, 2018: Cochrane Database of Systematic Reviews
Andris Piebalgs, Boram Gu, Dylan Roi, Kyriakos Lobotesis, Simon Thom, Xiao Yun Xu
Ischaemic stroke can occur when an artery to the brain is blocked by a blood clot. The use of thrombolytic agents, such as tissue plasminogen activator (tPA), to dissolve the occluding clot is limited by the risk of intracerebral haemorrhage (ICH), a known side effect associated with tPA. We developed a computational thrombolysis model for a 3D patient-specific artery coupled with a compartmental model for temporal concentrations of tPA and lysis proteins during intravenous infusion of tPA, in order to evaluate the effects of tPA dose on the efficacy of thrombolytic therapy and the risk of ICH...
October 25, 2018: Scientific Reports
Jeanie L Y Cheong, Katherine J Lee, Rosemarie A Boland, Alicia J Spittle, Gillian F Opie, Alice C Burnett, Leah M Hickey, Gehan Roberts, Peter J Anderson, Lex W Doyle
BACKGROUND: Decisions regarding provision of intensive care and post-discharge follow-up for infants born extremely preterm (<28 weeks' gestation) are based on the risks of mortality and neurodevelopmental disability. We aimed to elucidate the changes in probability of three outcomes (death, survival with major disability, and survival without major disability) with postnatal age in extremely preterm infants offered intensive care, and the effect of postnatal events on the probability of survival without major disability...
December 2018: Lancet Child & Adolescent Health
Cecilia Lindgren, Lars-Owe Koskinen, Rashida Ssozi, Silvana Naredi
BACKGROUND: Increased lactate in cerebrospinal fluid (CSF) has been regarded as a marker for cerebral ischemia and damage in the central nervous system. The aim of this study was to evaluate if CSF-lactate was associated with; impaired cerebral circulation, outcome, sex, age, clinical condition or treatment after subarachnoid haemorrhage (SAH). METHODS: This study consists of 33 patients (22 females, 11 males) with aneurysmal SAH treated at Umeå university hospital 2008-2009...
October 22, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jacob Wall, Per Enblad
The aim was to review the neurointensive care (NIC) of cerebral venous sinus thrombosis patients with haemorrhage during a 15-year period. This is a severe condition with substantial mortality caused by increased intracranial pressure (ICP) and studies are lacking describing the complex picture of the NIC, which offers a large treatment arsenal for intracranial hypertension. Patients treated 2000-2015 were investigated. Data regarding patient characteristics, symptoms, imaging, ICP-treatment, NIC-treatment intensity, and outcome were collected and analysed...
October 16, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Livia E V M de Guerre, Said Sadiqi, Loek P H Leenen, Cumhur F Oner, Steven M van Gaalen
BACKGROUND: This study aims to analyze the incidence and outcomes of bicycle-related injuries in hospitalized patients in The Netherlands. METHODS: Bicycle accidents resulting in hospitalization in a level-I trauma center in The Netherlands between 2007 and 2017 were retrospectively identified. We subcategorized data of patients involved in a regular bicycle, race bike, off-road bike or e-bike accident. The primary outcomes were mortality rate and incidence of multitrauma...
October 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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