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Cerebral Bleed

Axel Neulen, Michael Kosterhon, Tobias Pantel, Stefanie Kirschner, Hermann Goetz, Marc A Brockmann, Sven R Kantelhardt, Serge C Thal
Subarachnoid hemorrhage (SAH) is a subtype of hemorrhagic stroke. Cerebral vasospasm that occurs in the aftermath of the bleeding is an important factor determining patient outcome and is therefore frequently taken as a study endpoint. However, in small animal studies on SAH, quantification of cerebral vasospasm is a major challenge. Here, an ex vivo method is presented that allows quantification of volumes of entire vessel segments, which can be used as an objective measure to quantify cerebral vasospasm. In a first step, endovascular casting of the cerebral vasculature is performed using a radiopaque casting agent...
July 28, 2018: Journal of Visualized Experiments: JoVE
Ewa Papuć, Marek Mazurek, Konrad Rejdak
Cerebral microbleeds (CMB) are small foci of low signal which are detected in neuroimaging. They correspond to hemosiderin and other blood breakdown products from brain vessels whose structure was affected by pathological processes. Their pathogenesis is closely related to angiopathy associated with hypertension and cerebral amyloid angiopathy. Microbleeds occur in a completely healthy population as well as in numerous neurological disorders. They are often present in people afflicted with dementia, in the course of neurodegenerative diseases and due to vascular causes...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Mohamed Khalfallah, Ayman Elsheikh, Mohamed Abdalaal
BACKGROUND: The proper time for the use of percutaneous coronary intervention (PCI) following the successful fibrinolysis for ST-segment elevation myocardial infarction (STEMI) for maximum efficiency and minimum side effects has not been determined yet. The present study was designed to compare the outcome of myocardial infarction patients who received fibrinolytic therapy with successful results and underwent PCI very early (within 3-12 h) (group 1) versus early (within 12-24 h) (group 2)...
August 8, 2018: Global Heart
Ken Kinjo, Toshiyuki Matsui, Takashi Hisabe, Hiroshi Ishihara, Toshiki Kojima, Kenta Chuman, Shigeyoshi Yasukawa, Tsuyoshi Beppu, Akihiro Koga, Satoshi Ishikawa, Masahiro Kishi, Noritaka Takatsu, Fumihito Hirai, Kenshi Yao, Toshiharu Ueki, Masakazu Washio
Background/Aims: Colonic diverticular hemorrhage (DH) was a rare disease until the 1990s, and its incidence has increased rapidly since 2000 in Japan. In recent years, colonic DH has been the most frequent cause of lower gastrointestinal bleeding (LGIB). Nearly all cases of DH are mild, with the bleeding often stopping spontaneously. Some cases, however, require surgery or arterial embolization. In this study, using a cohort at Fukuoka University Chikushi Hospital, we investigated factors associated with severe colonic DH...
July 2018: Intestinal Research
Yujin Suto, Katsuhiro Nagata, Syed Ahmed, Christina Jacovides, Kevin D Browne, John Cognetti, Victoria E Johnson, Ryan Leone, Lewis J Kaplan, Douglas H Smith, Jose L Pascual
Progression of severe TBI is associated with worsening cerebral inflammation but it is unknown how a concomitant bone fracture (FX) affects this progression. Enoxaparin (ENX), a low molecular weight heparin often used for venous thromboembolic prophylaxis, decreases penumbral leukocyte (LEU) mobilization in isolated TBI and improves neurological recovery. We investigated if TBI accompanied by a FX worsens leukocyte mediated cerebral inflammation and if ENX alters this process. CD1 male mice underwent controlled cortical impact (CCI) or sham craniotomy with or without an open tibial fracture, and received either ENX (1mg/kg, 3 times/day) or saline for 2 days following injury...
August 7, 2018: Journal of Neurotrauma
Alois J Schiefecker, Verena Rass, Maxime Gaasch, Mario Kofler, Claudius Thomé, Christian Humpel, Bogdan Ianosi, Werner O Hackl, Ronny Beer, Bettina Pfausler, Erich Schmutzhard, Raimund Helbok
In patients with aneurysmal subarachnoid hemorrhage (aSAH), increased brain extracellular interleukin (IL)-6 levels measured by cerebral microdialysis (CMD) were associated with disease severity, early brain injury, delayed cerebral infarction, and axonal injury. In this study, we analyzed brain extracellular IL-6 levels of aSAH patients following parenteral diclofenac. Twenty-four mechanically ventilated poor-grade aSAH patients were included. Changes in cerebral metabolism, brain/body temperature, and CMD-IL-6 levels following intravenous diclofenac infusion (DCF; 75 mg diluted in 100 cc normal saline) were retrospectively analyzed from prospectively collected bedside data (at 1 hour before DCF = baseline; and at 2, 4, and 8 hours after DCF)...
August 3, 2018: Therapeutic Hypothermia and Temperature Management
Atsuhito Uneda, Koji Hirashita, Satoru Yabuno, Takahiro Kanda, Kenta Suzuki, Atsushi Matsumoto, Masatoshi Yunoki, Kimihiro Yoshino
BACKGROUND: In surgical treatment of acute subdural hematoma (ASDH), neurosurgeons frequently encounter bleeding from cortical arteries, which is usually controlled with bipolar coagulation. However, bipolar coagulation is associated with a risk of sacrificing the cortical artery, which may affect the prognosis of neurological symptoms when these cortical arteries supply critical areas. In this article, we describe microsurgical repair of damaged cortical arteries using a 10-0 nylon micro-suture in patients with arterial-origin ASDH...
July 31, 2018: Acta Neurochirurgica
Marvin Darkwah Oppong, Daniela Pierscianek, Yahya Ahmadipour, Thiemo Florin Dinger, Philipp Dammann, Karsten Henning Wrede, Neriman Özkan, Oliver Müller, Ulrich Sure, Ramazan Jabbarli
OBJECTIVES: Intraoperative aneurysm rupture (IOAR) is a common complication during intracranial aneurysm(s) (IA) surgery. In virtue of paradigm shift regarding IA selected for clipping in the post-ISAT era, we aimed to evaluate the risk factors and impact of IOAR in an institutional series of clipped ruptured (RIA) and unruptured (UIA) IA. MATERIAL AND METHODS: All IA treated by microsurgical clipping at our institution between 2003 and 2016, were eligible for this study...
July 27, 2018: World Neurosurgery
Federico di Rocco, Arnaud Gleizal, Laura Lohkamp, Alexandru Szathmari, Christian Paulus, Carmine Mottolese
INTRODUCTION: Trigonocephaly with its premature fusion of the metopic synostosis is associated with a risk of cerebral compression and several craniofacial morphological deformations. Numerous surgical techniques have been proposed to enlarge and reshape the forehead. They all carry a risk of bleeding during osteotomies, especially in the region of the superior sagittal sinus (SSS) encased in the early fused suture and of the paired metopic transosseous emissary veins superior to the glabella, which is typical of this type of synostosis...
July 27, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Marvin Darkwah Oppong, Vanessa Skowronek, Daniela Pierscianek, Oliver Gembruch, Annika Herten, Dino Vitali Saban, Philipp Dammann, Michael Forsting, Ulrich Sure, Ramazan Jabbarli
OBJECTIVES: Intracerebral hematoma (ICH) complicates the course of aneurysmal subarachnoid hemorrhage (SAH). To date, there are no unique guidelines for management of aneurysmal ICH. The aim of this study was to identify risk factors for and impact of aneurysmal ICH with special attention on treatment decisions derived from ICH volume. PATIENTS AND METHODS: All patients admitted with aneurysmal SAH between 2003 and 2016 were eligible for this study. Various demographic, clinical and radiographic characteristics of patients were correlated with the occurrence and volume of ICH in univariate and multivariate manner...
July 19, 2018: Clinical Neurology and Neurosurgery
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
Gábor Nagy, Stuart S Stokes, Loránd G Erőss, Debapriya Bhattacharyya, John Yianni, Jeremy G Rowe, Andras A Kemeny, Matthias W R Radatz
OBJECTIVE The role of radiosurgery (RS) in treating superficial cavernous malformations (CMs) is insufficiently studied in part because of the disappointing results of early experimental attempts as compared to the mostly safe and effective microsurgery. Nonetheless, because of lesion- or treatment-specific factors, a therapeutic alternative may be required. In this study, the authors aimed to assess the safety of RS in treating superficial CMs and to analyze its long-term effect on hemorrhage rates and epilepsy control...
July 27, 2018: Journal of Neurosurgery
Gábor Nagy, Wendy Burkitt, Stuart S Stokes, Debapriya Bhattacharyya, John Yianni, Jeremy G Rowe, Andras A Kemeny, Matthias W R Radatz
OBJECTIVE Long-term benefits of radiosurgery (RS) applying modern protocols to treat cavernous malformations (CMs) remain unclear as critics may consider the decrease in the rebleed rate generally observed 2 years after RS as a reflection of the lesion's natural history. The authors adopted an early intention-to-treat attitude since rehemorrhage from deep-seated CMs ultimately leads to stepwise neurological deterioration. The safety of this early policy was previously demonstrated. Here, the authors revisit their current practice in a larger population with a longer follow-up time to assess the long-term effects of RS in the context of current knowledge on the natural history of CMs...
July 27, 2018: Journal of Neurosurgery
Weigang Dai, Yujie Yuan, Jidong Zuo, Jinfu Tan, Weidong Feng, Kaitao Yuan, Qiongyun Zhao, Min Tan
OBJECTIVE: To observe the safety and efficacy of biological patch (Biodesign Surgisis mesh, SIS) in hybrid technique for incisional herniorrhaphy. METHODS: Clinical and follow-up data of 14 incisional hernia patients who underwent incisional herniorrhaphy with hybrid technique, using porcine small intestinal submucosa acellular matrix patch, at the First Affiliated Hospital of Sun Yat-sen University from January 1, 2012 to June 31, 2016 were analyzed retrospectively...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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
S Hatzl, B Uhl, M Hinterramskogler, S Leber, F Eisner, M Haring, P Jud
We report a case of severe central nervous system bleeding in a patient with acute monocytic leukemia. The patient was admitted to our emergency department because of massive back pain and positive meningeal signs. MR imaging yielded a spontaneous epidural hematoma of the thoracic vertebral column. Coagulation studies revealed fibrinogen levels below the linear measuring range and blood smears showed myeloid blast cells in the peripheral blood. The diagnosis of acute monocytic leukemia was confirmed by flow cytometric analysis...
July 2018: EJIFCC
Zixia Wu, Zhiyong Liu, Wei Zhang, Wenzheng Zhang, En Mu
OBJECTIVE: To explore the correlation between thromboelastography (TEG) parameters and the risk of venous thromboembolism (VTE) and bleeding in patients receiving anticoagulant therapy in surgical intensive care unit (SICU). METHODS: 205 patients received low molecular weight heparin (LMWH) anticoagulant therapy admitted to SICU of Tianjin Hospital from December 2016 to December 2017 were consecutively enrolled. TEG detection was performed in all patients at 1 day after anticoagulation therapy, and coagulation reaction time (R value), blood clot generation time (K value), blood clot generation rate (α angle) and maximum width value (MA value) were recorded...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Laura P B Elbers, Alessandro Squizzato, Victor E A Gerdes
Lower levels of free thyroxine (whether this is endogenous or exogenous) lead to a hypocoagulable state, and higher levels of free thyroxine lead to a hypercoagulable state. In this narrative review, the effects of different levels of thyroid hormones on clinical end points are described. Hypothyroidism is associated with an increased bleeding risk, whereas hyperthyroidism leads to an increased risk of venous thrombosis. Besides, effects of thyroid hormone on the heart may indirectly influence hemostasis. Hyperthyroidism leads to a higher incidence of atrial fibrillation and atrial flutter, and, at least partly by that mechanism, a higher risk of cerebral arterial thrombosis...
July 25, 2018: Seminars in Thrombosis and Hemostasis
Gülseren Büyükşerbetçi, Esen Saka, Kader Karli Oğuz, Rahşan Göçmen, Ethem Murat Arsava, Mehmet Akif Topçuoğlu
Introduction: Contribution of cerebral microbleeds (CMBs) on cognitive dysfunctions in elderly patients with otherwise asymptomatic white matter lesions (WMLs) is not well-documented. Methods: MRI parameters of cerebral atrophy, CMBs and WMLs were herein analyzed in relation to global and main domains (attention, executive, memory, visuospatial, language) of cognitive function. Eighty-five patients older than 50, without neurodegenerative/cerebrovascular disease, but had CMBs were recruited from 2562 with T2*-gradient-echo MR imaging during one-year period...
March 2018: Noro Psikiyatri Arsivi
Stefan Schopf, Thomas von Ahnen, Martin von Ahnen, Hans Martin Schardey, Ulrich Wirth
BACKGROUND: Postoperative cervical hemorrhage is a rare but life-threatening complication that can cause severe morbidity. Different mechanisms leading to asphyxia have been described based only on clinical observation. METHODS: We performed a series of in vivo animal studies simulating post-thyroidectomy hemorrhage and its effect on respiratory drive. Three series of tests were carried out in 12 German domestic pigs under general anesthesia. The pigs were breathing spontaneously with secured airways...
July 17, 2018: Surgery
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