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Cerebral Bleed

Pengfei Xia, Chang He, Lanshan Chen, Liang Zou, Shihao Sun, Pengyu Cui, Wei Wang
BACKGROUND: Prasugrel as a second generation P2Y12 adenosine diphosphate receptor antagonist which in the cerebral aneurysms with Endovascular treatment have become more emphasized. OBJECTIVE: To compare the efficacy and safety of prasugrel therapy for intracranial aneurysms with endovascular treatment. METHODS: The databases of PubMed, Embase, Cochrane Library databases and China Biology Medicine disc were retrieved with computers for collecting controlled trials about the comparison in the efficacy and safety of prasugrel and clopidogrel published from inception to September 2018...
January 8, 2019: Journal of the Neurological Sciences
Khoi D Nguyen, Vamsi Reddy, Scott Y Rahimi
OBJECT: Hemicraniectomy is a commonly performed neurosurgical procedure used in the setting of medically refractory malignant intracranial hypertension. Complications from cranioplasty following hemicraniectomy can be significant, including infection and wound issues. Difficulty with scar tissue during exposure for cranioplasty can be challenging and can lead to prolonged surgical time and increased bleeding. We describe a surgical technique, termed the "dural sandwich", that could provide a significant benefit during cranioplasty as compared to traditional single-layered dural closure...
January 11, 2019: World Neurosurgery
M Hollingworth, A A B Jamjoom, D Bulters, H C Patel
BACKGROUND: Delayed cerebral ischemia (DCI) is an independent predictor of an unfavorable outcome after aneurysmal subarachnoid hemorrhage (aSAH). Many centers, but not all, use transcranial Doppler (TCD) to screen for vasospasm to help predict DCI. We used the United Kingdom and Ireland Subarachnoid Haemorrhage (UKISAH) Registry to see if outcomes were better in centers that used TCD to identify vasospasm compared to those that did not. METHODS: TCD screening practices were ascertained by national survey in 13 participating centers of the UKISAH...
January 12, 2019: Acta Neurochirurgica
Guoqing Sun, Xiaolong Li, Xiangtao Chen, Yuhai Zhang, Zhen Xu
By comparing the intraoperative and postoperative conditions under different surgical methods, namely, keyhole endoscopy and craniotomy, we aim to provide more reasonable surgical treatment for patients with hypertensive cerebral hemorrhage.Eighty-nine patients with cerebral hemorrhage at Rizhao People's Hospital between January 2015 and December 2016 were analyzed retrospectively. Patients were assigned to the keyhole endoscopy group and the craniotomy group. The intraoperative (the duration of operation, operative blood transfusion and loss, and hematoma clearance rate) and the postoperative parameters (death rate, rebleeding rate, edema, and postoperative activity of daily living [ADL] scores) of the 2 groups were compared...
January 2019: Medicine (Baltimore)
Guntur Darmawan, Laniyati Hamijoyo, Amaylia Oehadian, Ria Bandiara, Lisda Amalia
A 38-year-old woman presented with general weakness and vaginal bleeding. One month prior, she had been diagnosed with Evans syndrome (haemolytic anemia with positive Coombs test and thrombocytopenia) and was given oral steroid as maintenance therapy. Her serology examination was negative for hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). Her obstetrical history was marked by miscarriage in second pregnancy and preeclampsia in third pregnancy. She used hormonal contraceptives until 5 months prior to admission...
October 2018: Acta Medica Indonesiana
Osamu Imataki, Shumpei Uchida, Shigeyuki Yokokura, Makiko Uemura, Norimitsu Kadowaki
Background: Lymphomatosis cerebri (LC) is a unique form of primary central nerves lymphoma (PCNSL), which presents as diffuse infiltration of lymphoma cells characteristically in the white matter rather than tumor formation. However, the involvement of central nervous system (CNS) is unclear because of the lack of contrast enhancement. Case Presentation: We treated a 53-year-old woman with LC and brain lesions resembling neuro-Behcet's disease. She had a past history of acute uveitis and current symptoms of somnolence and gait disturbances progressing for one month...
September 2018: Case Reports in Oncology
Jodi R DeGrote, Elizabeth M Olafson, Alexander Drofa, Evgueni Kouznetzov, Michael Manchak, Nathan D Leedahl, David D Leedahl
Background: Dual antiplatelet therapy with acetylsalicylic acid (ASA) and a P2Y12-receptor antagonist is often used to prevent thrombotic complications after placement of a Pipeline embolization device (PED) for cerebral aneurysm. Although clopidogrel is common in this setting, high rates of nonresponse to this drug have made ticagrelor a potentially attractive alternative. Objective: To describe safety and efficacy outcomes for ticagrelor following PED placement, including measurement of platelet function...
November 2018: Canadian Journal of Hospital Pharmacy
Marie Scully, Spero R Cataland, Flora Peyvandi, Paul Coppo, Paul Knöbl, Johanna A Kremer Hovinga, Ara Metjian, Javier de la Rubia, Katerina Pavenski, Filip Callewaert, Debjit Biswas, Hilde De Winter, Robert K Zeldin
BACKGROUND: In acquired thrombotic thrombocytopenic purpura (TTP), an immune-mediated deficiency of the von Willebrand factor-cleaving protease ADAMTS13 allows unrestrained adhesion of von Willebrand factor multimers to platelets and microthrombosis, which result in thrombocytopenia, hemolytic anemia, and tissue ischemia. Caplacizumab, an anti-von Willebrand factor humanized, bivalent variable-domain-only immunoglobulin fragment, inhibits interaction between von Willebrand factor multimers and platelets...
January 9, 2019: New England Journal of Medicine
Rajalakshmi Poyuran, Anita Mahadevan, Arivazhagan Arimappamagan, B N Nandeesh, Madhu Nagappa, Jitender Saini, K V L Narasinga Rao, Yasha T Chickabasaviah
Cerebral amyloid angiopathy (CAA) is the second most common cause of non-traumatic intracerebral haemorrhage (ICH) accounting for 12-15% of lobar haemorrhages in the elderly. Definitive diagnosis of CAA requires histological evaluation. We aimed to evaluate the spectrum of cerebrovascular changes in CAA-related ICH. Between 2011 and 2015, biopsy-confirmed cases of CAA were retrieved and clinical, radiological and pathological features were reviewed. The spectrum of vascular alterations was evaluated and amyloid deposition was graded in accordance with the Greenberg and Vonsattel scale...
January 7, 2019: Virchows Archiv: An International Journal of Pathology
Sophia F Shakur, Denise Brunozzi, Ali Alaraj
Surgical resection is considered to be the treatment of choice for carotid body tumors. However, surgery can be complicated by intraoperative bleeding, injury to the internal carotid artery, and cerebral ischemia. Consequently, preoperative endovascular strategies may be used, including transarterial or percutaneous embolization or covered carotid stenting. These neuroendovascular techniques have been described infrequently in the literature. Here, we showcase transarterial glue embolization followed by covered carotid stenting of a large carotid body tumor in the same setting...
January 4, 2019: World Neurosurgery
Qing-Ling Huang, Xuan Cao, Xue Chai, Xiao Wang, Chaoyong Xiao, Juan Wang
BACKGROUND: Epithelioid glioblastoma(eGBM) as a newly revised subtype of glioblastoma which is much less frequently found in other types of glioblastomas, and mainly focused on case reports and childrens.We collect seven cases confirmed by molecular disgnosis.In the study,we review the radiological imaging features of seven adult patients with epithelioid glioblastoma(eGBM) and histopathological findings. CASE DESCRIPTION: Patients with a diagnosis of eGBM on brain tissue specimen were retrospectively confirmed by pathology...
January 3, 2019: World Neurosurgery
Thomas Kerz, Friederike D von Loewenich, Jason Roberts, Axel Neulen, Florian Ringel
BACKGROUND: Standard dosing of meropenem (2 g t.i.d.) produces CSF concentrations of only 1-2 mg/L which is inferior to the clinical breakpoint for most Gram-negative bacteria. There is therefore concern that dosing must be increased in order to achieve therapeutic CSF concentrations for bacteria with susceptibility close to clinical breakpoints. Yet, the effects of high-dose meropenem on CSF concentrations are not well described in literature. We therefore determined meropenem CSF-levels in a patient who was treated with 15 g/day of meropenem...
December 29, 2018: Annals of Clinical Microbiology and Antimicrobials
Naoki Wakuta, Hiroshi Abe, Masani Nonaka, Takashi Morishita, Toshio Higashi, Hisatomi Arima, Tooru Inoue
OBJECTIVE: Possible factors associated with bleeding from endoscopy-detected chronic subdural hematomas (CSDHs) have rarely been analyzed. We therefore evaluated intraoperative endoscopic findings to elucidate the clinical course and assess predictors of CSDH recurrence. METHODS: Altogether, 540 CSDHs were reviewed in this retrospective study. Six possible signs of bleeding were detected in the cavity: spotty bleeding on the outer membrane, hematoma clots, cerebral parenchymal suspension, stretched cortical vessels, intraluminal trabecular structures, and septa separating the cavity...
December 26, 2018: World Neurosurgery
Yueqi Zhu, Hongbo Zhang, Yiran Zhang, Huayin Wu, Liming Wei, Gen Zhou, Yuezhou Zhang, Lianfu Deng, Yingsheng Cheng, Minghua Li, Hélder A Santos, Wenguo Cui
Cerebrovascular disease involves various medical disorders that obstruct brain blood vessels or deteriorate cerebral circulation, resulting in ischemic or hemorrhagic stroke. Nowadays, platinum coils with or without biological modification have become routine embolization devices to reduce the risk of cerebral aneurysm bleeding. Additionally, many intracranial stents, flow diverters, and stent retrievers have been invented with uniquely designed structures. To accelerate the translation of these devices into clinical usage, an in-depth understanding of the mechanical and material performance of these metal-based devices is critical...
December 27, 2018: Advanced Materials
Vanessa Helena Brait, Francesc Miro-Mur, Isabel Pérez de Puig, Laura Notario, Begoña Hurtado, Jordi Pedragosa, Mattia Gallizioli, Francesc Jimenez-Altayo, Maria Arbaizar-Rovirosa, Amaia Otxoa-de-Amezaga, Juan Monteagudo, Maura Ferrer-Ferrer, Xavier de la Rosa, Ester Bonfill-Teixidor, Angelica Salas-Perdomo, Alba Hernandez-Vidal, Pablo García de Frutos, Pilar Lauzurica, Anna M Planas
RATIONALE: CD69 is an immunomodulatory molecule induced during lymphocyte activation. Following stroke, T lymphocytes upregulate CD69 but its function is unknown. OBJECTIVE: We investigated whether CD69 was involved in brain damage following ischemic stroke. METHODS AND RESULTS: We used adult male mice on the C57BL/6 or BALB/c backgrounds, including wild type mice and CD69-/- mice, and CD69+/+ and CD69-/- lymphocyte-deficient Rag2-/- mice, and generated chimeric mice...
December 3, 2018: Circulation Research
Takehiro Kimura, Shin Kashimura, Takahiko Nishiyama, Yoshinori Katsumata, Kohei Inagawa, Yukinori Ikegami, Nobuhiro Nishiyama, Kotaro Fukumoto, Yoko Tanimoto, Yoshiyasu Aizawa, Kojiro Tanimoto, Keiichi Fukuda, Seiji Takatsuki
OBJECTIVES: This randomized study compared uninterrupted rivaroxaban therapy with warfarin therapy as prophylaxis against catheter ablation (CA)-induced asymptomatic cerebral infarction (ACI) and identified the risk factors of rivaroxaban. BACKGROUND: The reported incidence of ACI during CA for atrial fibrillation (AF) remains at 10% to 30%, and periprocedural oral anticoagulation could affect this incidence. METHODS: Patients with nonvalvular AF undergoing radiofrequency CA were randomly assigned to receive either uninterrupted rivaroxaban or warfarin as periprocedural anticoagulation therapy...
December 2018: JACC. Clinical Electrophysiology
Tomohiro Kawano, Munehisa Shimamura, Hironori Nakagami, Tatsuya Iso, Hiroshi Koriyama, Shuko Takeda, Kosuke Baba, Tsutomu Sasaki, Manabu Sakaguchi, Ryuichi Morishita, Hideki Mochizuki
Decreased adherence to daily ingestion of antiplatelet drugs is a critical issue, increasing mortality and morbidity in poststroke patients. As vaccination could be a promising approach to solving this, we designed an antiplatelet vaccine that inhibited S100A9 (S100 calcium-binding protein A9)/CD36 (cluster of differentiation 36) signaling in platelets, which was reported to be a key signal in arterial thrombosis, but not hemostasis. Immunization with this vaccine induced a sustainable increase in the anti-S100A9 antibody titer for >2 months and an additional booster immunization enhanced the antibody production further...
December 2018: Hypertension
Masahiro Sugawara, Yoshio Goto, Tsutomu Yamazaki, Tamio Teramoto, Shinichi Oikawa, Kazuyuki Shimada, Shinichiro Uchiyama, Katsuyuki Ando, Naoki Ishizuka, Mitsuru Murata, Kenji Yokoyama, Yukari Uemura, Yasuo Ikeda
INTRODUCTION: This post hoc subanalysis of the randomized Japanese Primary Prevention Project investigated whether once-daily low-dose aspirin versus no aspirin reduced the risk of cardiovascular events (CVEs) in patients aged ≥ 70 years with atherosclerotic risk factors. METHODS: Patients aged < 70 years (young-old) or ≥ 70 years (old) with hypertension, dyslipidemia, or diabetes participated between 2005 and 2007. Patients were randomized 1:1 to receive 100 mg enteric-coated aspirin once daily or no aspirin plus standard of care...
December 18, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
I Aydin, A Algin, M K Poyraz, O Yumrutas
Background: Glial fibrillary acidic protein (GFAP) is a brain-specific astroglial protein that is released into the blood soon after traumatic brain injury by mature astrocytes. S100B is rapidly released into the cerebrospinal fluid and bloodstream after brain damage. We compared the serum concentrations of these proteins in patients with severe head trauma (bleeding and/or fracture) or nontraumatic intracerebral hemorrhage and healthy individuals. Materials and Methods: The study included 63 patients (33 males and 30 females) with traumatic cerebral hemorrhage and/or cranial bone fractures or nontraumatic cerebral hemorrhage and 30 healthy control subjects...
December 2018: Nigerian Journal of Clinical Practice
Morteza Qaribi, Arash Yazdanbakhsh, Koorosh Ahmadi, Mohammad Reza Maghsoudi, Vagefe Farshin, Ali Ahmadi, Abolfazl Jokar
BACKGROUND: Filgrastim, a neopogen brand, is a blood-forming agent and a natural protein in the body that plays a role in stimulating the growth of white blood cells and protecting them against infectious agents. To the best of knowledge, human and animal specimens have shown the effect of Filgrastim on treating brain injuries regarding bone marrow transfusion into the blood, neuroprotection, stimulation of neurons for forming new neural networks and reducing the risk of bacterial infections...
November 25, 2018: Open Access Macedonian Journal of Medical Sciences
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