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Cerebral Haemorrhage

Antti Lindgren, Mervyn DI Vergouwen, Irene van der Schaaf, Ale Algra, Marieke Wermer, Mike J Clarke, Gabriel Je Rinkel
BACKGROUND: Around 30% of people who are admitted to hospital with aneurysmal subarachnoid haemorrhage (SAH) will rebleed in the initial month after the haemorrhage if the aneurysm is not treated. The two most commonly used methods to occlude the aneurysm for prevention of rebleeding are microsurgical clipping of the neck of the aneurysm and occlusion of the lumen of the aneurysm by means of endovascular coiling. This is an update of a systematic review that was previously published in 2005...
August 15, 2018: Cochrane Database of Systematic Reviews
Yan Liu, Zenghui Pu, Maomao Zhao
A 70-year-old woman was adimittetd with subarachnoid haemorrhage. The patient underwent cerebral aneurysm embolization. On hospital day 14, the patient underwent a lumbar subarachnoid continuous drain insertion because of fever and enlarged ventricles were showed on the head computed tomography. On hospital day 19, the patient presented with remittent fever (peak at 39.1 °C) associated with altered mental status. Cerebro-Spinal Fluid (CSF) revealed white blood cell (WBC) count of 53484/mm3 (polymorphonucleocytes,75...
August 13, 2018: Antimicrobial Agents and Chemotherapy
Gargi Banerjee, Mary Summers, Edgar Chan, Duncan Wilson, Andreas Charidimou, Lisa Cipolotti, David J Werring
Cognitive deficits after spontaneous intracerebral haemorrhage (ICH) are common and result in functional impairment, but few studies have examined deficits across cognitive domains in the subacute phase. This study aims to describe the cognitive profile following acute ICH and explore how cerebral amyloid angiopathy (CAA) may impact performance. We retrospectively reviewed 187 consecutive patients with ICH (mean age 58.9 years, 55.6% male) with available imaging and neuropsychological data (median 12 days after stroke)...
August 15, 2018: Journal of the Neurological Sciences
Mark Dzietko, Soeren Schulz, Michael Preuss, Christoph Haertel, Anja Stein, Ursula Felderhoff-Mueser, Wolfgang Goepel
AIM: Infants born preterm are at risk of intraventricular haemorrhage (IVH) but individual susceptibility related to genes is not well defined in this vulnerable population. Apolipoprotein genotypes APOE2 and APOE4 increase the hazard of cerebral haemorrhages in adults. We investigated whether APOE is associated with prevalence of IVH and is likely to have a particular genotype. METHOD: In this prospective study, 5075 infants born preterm with genotype APOE3 were compared to 965 (APOE2) and 1912 (APOE4) individuals, to analyse the association between APOE genotype and grade III and IV IVH...
August 7, 2018: Developmental Medicine and Child Neurology
E Nathal, A Serrano-Rubio, E Maciel, A Arauz
INTRODUCTION: Moyamoya disease (MD) is a progressive, occlusive disease of the arteries of the anterior cerebral circulation that may cause ischaemia or haemorrhage. Patient management aims to prevent new cerebrovascular events through surgical revascularisation and/or pharmacological treatment. METHODS: We studied a series of 17 patients with MD (n = 14) or moyamoya syndrome (n = 3), who were evaluated between January 1989 and December 2016; 11 patients were women and 6 were men...
July 31, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Umesh de Silva, Chamara Sarathchandra, Hemal Senanayake, Senaka Pilapitiya, Sisira Siribaddana, Anjana Silva
BACKGROUND: Hump-nosed pit vipers (Genus: Hypnale) are medically important snakes in Sri Lanka and South India. Merrem's Hump-nosed pit viper (Hypnale hypnale) frequently leads to potentially fatal envenomings in Sri Lanka and India. Venom-induced consumption coagulopathay (VICC), local envenoming and acute kidney injury (AKI) are the commonest effects of the envenoming by this snake. CASE PRESENTATION: We report a previously unreported presentation of H. hypnale envenoming, with an isolated urinary salt loss leading to moderate hyponatraemia resulting seizures...
August 2, 2018: Journal of Medical Case Reports
Yongcheng Ren, Yu Liu, Xi-Zhuo Sun, Bing-Yuan Wang, Yang Zhao, De-Chen Liu, Dong-Dong Zhang, Xue-Jiao Liu, Rui-Yuan Zhang, Hao-Hang Sun, Fei-Yan Liu, Xu Chen, Cheng Cheng, Lei-Lei Liu, Qiong-Gui Zhou, Ming Zhang, Dong-Sheng Hu
OBJECTIVE: Studies investigating the impact of chocolate consumption on cardiovascular disease (CVD) have reached inconsistent conclusions. As such, a quantitative assessment of the dose-response association between chocolate consumption and incident CVD has not been reported. We performed a systematic review and meta-analysis of studies assessing the risk of CVD with chocolate consumption. METHODS: PubMed and EMBASE databases were searched for articles published up to 6 June 2018...
July 30, 2018: Heart: Official Journal of the British Cardiac Society
Jonghoon Kim, Chulhoon Chang, Youngjin Jung
We report a case of a ruptured fusiform aneurysm of the distal internal carotid artery (ICA) involving the anterior choroidal artery and posterior communicating artery, treated with selective coil embolization. An 86-year-old woman was admitted with subarachnoid haemorrhage (SAH). Computed tomography (CT) and CT angiography showed diffuse SAH with a fusiform aneurysm, as well as severe atherosclerotic change in the distal ICA. A transfemoral cerebral angiogram showed a fusiform aneurysm in the supraclinoid segment of the ICA with a daughter sac...
July 24, 2018: World Neurosurgery
Josefina López-Aguilar, Gianluigi Li Bassi, María Elisa Quilez, Joan Daniel Martí, Otavio Ranzani Tavares, Eli Aguilera Xiol, Montserrat Rigol, Nestor Luque, Raquel Guillamat, Isidre Ferrer, Antoni Torres, Lluís Blanch
We previously corroborated benefits of the Trendelenburg position in the prevention of ventilator-associated pneumonia (VAP). We now investigate its potential effects on the brain versus the semirecumbent position. We studied seventeen anesthetized pigs and randomized to be ventilated and positioned as follows: duty cycle (TI/TTOT) of 0.33, without positive end-expiratory pressure (PEEP), placed with the bed oriented 30° in anti-Trendelenburg (control group); positioned as in the control group, with TI/TTOT adjusted to achieve an expiratory flow bias, PEEP of 5 cm H2O (IRV-PEEP); positioned in 5° TP and ventilated as in the control group (TP)...
July 25, 2018: Shock
Manuel Navarro-Oviedo, Carmen Roncal, Agustina Salicio, Miriam Belzunce, Obdulia Rabal, Estefanía Toledo, Beatriz Zandio, Jose A Rodríguez, Jose A Páramo, Roberto Muñoz, Josune Orbe
Diabetes is an important risk factor for ischemic stroke (IS). Tissue-type plasminogen activator (tPA) has been associated with less successful revascularization and poor functional outcome in diabetes. We assessed whether a new thrombolytic strategy based on MMP10 was more effective than tPA in a murine IS model of streptozotocin (STZ)-induced diabetes. Wild-type mice were administered a single dose of streptozotocin (STZ) (180 mg/kg) to develop STZ-induced diabetes mellitus. Two weeks later, IS was induced by thrombin injection into the middle cerebral artery and the effect of recombinant MMP10 (6...
July 27, 2018: Translational Stroke Research
Anna Purna Basu, Janice Pearse, Rose Watson, Pat Dulson, Jessica Baggaley, Blythe Wright, Denise Howel, Luke Vale, Dipayan Mitra, Nick Embleton, Tim Rapley
BACKGROUND: Perinatal stroke (PS) affects up to 1/2300 infants and frequently leads to unilateral cerebral palsy (UCP). Preterm-born infants affected by unilateral haemorrhagic parenchymal infarction (HPI) are also at risk of UCP. To date no standardised early therapy approach exists, yet early intervention could be highly effective, by positively influencing processes of activity-dependent plasticity within the developing nervous system including the corticospinal tract. Our aim was to test feasibility and acceptability of an "early Therapy In Perinatal Stroke" (eTIPS) intervention, aiming ultimately to improve motor outcome...
July 23, 2018: BMC Neurology
Steffan Edward Octávio Oliveira, Filipe Antonio Dalla Costa, Troy John Gibson, Osmar Antonio Dalla Costa, Arlei Coldebella, Neville George Gregory
Brain damage resulting from penetrating and non-penetrating stunning of Nelore cattle using pneumatically powered captive bolt guns was evaluated. Heads were shot using penetrating captive bolt gun with 160 psi (P1; n = 10), 175 psi (P2; n = 10), 190 psi (P3; n = 12), and non-penetrating operating with 220 psi (NP; n = 10). Skin and bone thickness, bolt penetration angle, bolt penetration depth, haemorrhage over the cerebral hemispheres and laceration were assessed. Only P1 had shots that failed to perforate the skull (n = 2; 20%)...
November 2018: Meat Science
Jinju Guk, Dongwoo Chae, Hankil Son, Joonsang Yoo, Ji Hoe Heo, Kyungsoo Park
AIMS: Recombinant tissue plasminogen activator (rt-PA) is the only first-line agent approved by the Food and Drug Administration to treat acute ischaemic stroke. However, it often causes the serious adverse event (AE) of haemorrhagic transformation. This study developed a pharmacometric model for rt-PA treatment effect and AE and, using the developed model, proposed a benefit-to-risk ratio assessment scheme as a supportive tool to optimize treatment outcome. METHODS: Data of 336 acute ischaemic stroke patients were used...
July 13, 2018: British Journal of Clinical Pharmacology
Alessandro Palleschi, Lorenzo Rosso, Marco Schiavon, Alessandro Rebusso, Paolo Mendogni, Federico Rea, Luigi Santambrogio, Mario Nosotti, Franco Valenza
Ex vivo lung perfusion (EVLP) has become a reality as a technique to evaluate and recondition lungs from marginal donors. We report the first case on the use of EVLP followed by separate transplantation in two different centres. The local organ procurement organization proposed the lungs of a 53-year-old non-smoker donor who died for cerebral haemorrhage. P/F ratio was 294 after lung recruitment manoeuvres. Oto score was 10. Two centres accepted the grafts for two single transplantations under the condition of EVLP evaluation...
May 2018: Journal of Thoracic Disease
Kohki Nakamura, Shigeto Naito, Takehito Sasaki, Yutaka Take, Kentaro Minami, Yoshiyuki Kitagawa, Hiroyuki Motoda, Mitsuho Inoue, Yoshimitsu Otsuka, Katsura Niijima, Eiji Yamashita, Yoshinao Sugai, Koji Kumagai, Keiko Koyama, Nobusada Funabashi, Shigeru Oshima
Aims: This prospective, randomized, single-centre study aimed to directly compare the safety and efficacy of uninterrupted and interrupted periprocedural anticoagulation protocols with direct oral anticoagulants (DOACs) in patients undergoing catheter ablation of non-valvular atrial fibrillation (NVAF). Methods and results: We randomly assigned 846 NVAF patients receiving DOACs prior to ablation to uninterruption (n = 422) or interruption (n = 424) of the DOACs on the day of the procedure...
June 29, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Wenbo Zhao, Jing Zhang, Mordechai G Sadowsky, Ran Meng, Yuchuan Ding, Xunming Ji
BACKGROUND: Remote ischaemic conditioning (RIC) has been developed as a neuroprotective strategy to prevent and treat ischaemic stroke. It usually involves restricting blood flow to limbs and then releasing the ischaemic blood to promote a neuroprotective effect. Preclinical studies have suggested that RIC may have beneficial effects in ischaemic stroke patients and those at risk of ischaemic stroke. However, existing evidence is insufficient to demonstrate the efficacy and safety of RIC in preventing and treating ischaemic stroke...
July 5, 2018: Cochrane Database of Systematic Reviews
Björn Alexander Hummel, Sebastian Senger, Christian Schleicher, Hermann Eichler
HISTORY AND CLINICAL FINDINGS:  82-year old male patient suspected of having cerebral hemorrhage under anticoagulation therapy with Dabigatran due to atrial fibrillation. INVESTIGATIONS:  CT scan showed bilateral chronic subdural hematomas with fresh blood in left-subdural hematoma and midline shift. Laboratory analysis shows only a moderately high Dabigatran level but thrombin time was high out of range. DIAGNOSIS:  Fall-related intracerebral haemorrhage and subdural hematoma under anticoagulation therapy...
July 2018: Deutsche Medizinische Wochenschrift
Réka Gál, Rodica Bălaşa, Zoltán Bajkó, Smaranda Maier, Iunius Simu, Adrian Bălaşa
Giant cell arteritis is a systemic inflammatory vasculitis, typically involving the superficial temporal arteries, but with possible ischemic and hemorrhagic cerebrovascular complications. The case is reported of a patient with a clinical picture of giant cell arteritis, who had multiple occupational exposures to various infectious agents. His initial favourable progress was followed by an atypical outcome. Despite immunosuppressive treatment, he developed fatal subarachnoid and intracerebral haemorrhages, possibly due to rupture of a microaneurysm of the posterior cerebral artery...
October 2017: Journal of Critical Care Medicine
Jendé L Zijlmans, Bert A Coert, René van den Berg, Marieke E S Sprengers, Charles B L M Majoie, W Peter Vandertop, Dagmar Verbaan
BACKGROUND: Patients with an aneurysmal subarachnoid hemorrhage (aSAH) and World Federation of Neurosurgical Societies (WFNS) grade I on admission are generally considered to have a good clinical outcome. OBJECTIVE: The objective of this study was to assess the actual clinical outcome of WFNS grade I aSAH patients, and to determine which factors are associated with unfavourable outcome. METHODS: For this prospective cohort study, 132 consecutive patients (age 18 years or older) with a WFNS grade I aSAH admitted to our hospital between December 2011 and January 2016 were eligible...
June 30, 2018: World Neurosurgery
Dougal A S Buchanan, David Owen, Richard Angliss, David N McClure
Subclavian artery injury is a rare consequence of clavicle fracture. It most often results from penetrating trauma but can result from blunt trauma with adjacent bone fragments causing rupture, pseudoaneurysm, dissection or thrombosis of the artery. If flow through the subclavian artery is compromised there is a risk of ipsilateral upper limb ischaemia. Life-threatening haemorrhage may result in cases of laceration, and cerebral infarction may result from dissection. Vascular injury in association with clavicle fracture is typically regarded as an indication for internal fixation of the fracture...
June 28, 2018: BMJ Case Reports
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