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https://www.readbyqxmd.com/read/29653270/decompressive-craniotomy-for-malignant-middle-cerebral-artery-infarction-optimal-timing-and-literature-review
#1
Ahmed Elsawaf, Ayman Galhom
OBJECT: To compare the results of early or delayed decompressive craniotomy (DC) for cases of malignant middle cerebral artery (MCA) infarction. STUDY DESIGN: Prospective comparative study METHODS: Prospective randomized study on consecutive series of a 46 patients with malignant MCA territory infarction. Patients were divided randomly into two groups: Group I; 27 patients who were followed till obvious deterioration of conscious level happened, Group II; 19 patients who were operated prophylactically in 6 hours of presentation even with no clear deterioration of conscious level or radiology's findings...
April 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29650786/association-of-quantified-location-specific-blood-volumes-with-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#2
W E van der Steen, I A Zijlstra, D Verbaan, A M M Boers, C S Gathier, R van den Berg, G J E Rinkel, B A Coert, Y B W E M Roos, C B L M Majoie, H A Marquering
BACKGROUND AND PURPOSE: Delayed cerebral ischemia is a severe complication of aneurysmal SAH and is associated with a high case morbidity and fatality. The total blood volume and the presence of intraventricular blood on CT after aneurysmal SAH are associated with delayed cerebral ischemia. Whether quantified location-specific (cisternal, intraventricular, parenchymal, and subdural) blood volumes are associated with delayed cerebral ischemia has been infrequently researched. This study aimed to associate quantified location-specific blood volumes with delayed cerebral ischemia...
April 12, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29644406/the-wessex-modified-richmond-sedation-scale-as-a-novel-tool-for-monitoring-patients-at-risk-of-malignant-mca-syndrome
#3
Tayyib T A Hayat, Matthew A Myers, John Hell, Matthew Cordingly, Diederik O Bulters, Nicolas Weir, George Pengas
BACKGROUND: The Wessex Modified Richmond Sedation Scale (WMRSS) has been developed with the aim of improving the early identification of patients requiring decompressive hemicraniectomy for malignant middle cerebral artery syndrome (MMS). The objective of this study was to evaluate the WMRSS against the Glasgow Coma Scale (GCS). METHODS: A retrospective study was conducted of patients admitted to our unit for observation of MMS. Data were obtained on WMRSS and GCS recordings from admission up to 120-h post-ictus...
April 11, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29609704/role-of-positive-airway-pressure-therapy-for-obstructive-sleep-apnea-in-patients-with-stroke-a-randomized-controlled-trial
#4
Anupama Gupta, Garima Shukla, Mohammed Afsar, Shivani Poornima, Ravindra M Pandey, Vinay Goyal, Achal Srivastava, Deepti Vibha, Madhuri Behari
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is an independent risk factor for stroke. The objective of this study was to assess the effect of continuous positive airway pressure (CPAP) treatment on prevention of new vascular events among patients with stroke and OSA. METHODS: Consecutive conscious patients presenting with first imaging-confirmed arterial stroke were included, 6 weeks or more after ictus. All patients underwent clinical and polysomnography (PSG) testing...
March 30, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29599633/the-factors-associated-with-outcomes-in-surgically-managed-ruptured-cerebral-aneurysm
#5
Lai Chuang Chee, Johari Adnan Siregar, Abdul Rahman Izani Ghani, Zamzuri Idris, Noor Azman A Rahman Mohd
Background: Ruptured cerebral aneurysm is a life-threatening condition that requires urgent medical attention. In Malaysia, a prospective study by the Umum Sarawak Hospital, Neurosurgical Center, in the year 2000-2002 revealed an average of two cases of intracranial aneurysms per month with an operative mortality of 20% and management mortality of 25%. Failure to diagnose, delay in admission to a neurosurgical centre, and lack of facilities could have led to the poor surgical outcome in these patients...
February 2018: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29566766/a-customized-home-based-computerized-cognitive-rehabilitation-platform-for-patients-with-chronic-stage-stroke-study-protocol-for-a-randomized-controlled-trial
#6
Macarena Gil-Pagés, Javier Solana, Rocío Sánchez-Carrión, Jose M Tormos, Antonia Enseñat-Cantallops, Alberto García-Molina
BACKGROUND: Stroke patients usually suffer primary cognitive impairment related to attention, memory, and executive functions. This impairment causes a negative impact on the quality of life of patients and their families, and may be long term. Cognitive rehabilitation has been shown to be an effective way to treat cognitive impairment and should be continued after hospital discharge. Computerized cognitive rehabilitation can be performed at home using exercise programs that advance with predetermined course content, interval, and pace...
March 22, 2018: Trials
https://www.readbyqxmd.com/read/29545253/randomized-assessment-of-the-safety-and-efficacy-of-intra-arterial-infusion-of-autologous-stem-cells-in-subacute-ischemic-stroke
#7
V Bhatia, V Gupta, D Khurana, R R Sharma, N Khandelwal
BACKGROUND AND PURPOSE: Stroke is a debilitating illness for which treatment window is limited. Most patients present to the healthcare facility beyond that window. Autologous stem cells have shown some promise for this group of patients. This study was performed to evaluate the safety and the efficacy of intra-arterial infusion of bone marrow-derived mononuclear cells in patients with middle cerebral artery ischemic stroke. MATERIALS AND METHODS: A prospective, randomized, open-label, blinded-end point study was performed from July 2015 to June 2016...
March 15, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29539612/mortality-and-stroke-recurrence-in-a-rehabilitation-cohort-of-patients-with-cerebral-infarcts-and-chagas-disease
#8
Vinícius Viana Abreu Montanaro, Thiago Falcão Hora, Creuza Maria da Silva, Carla Verônica de Viana Santos, Maria Inacia Ruas Lima, Edson Marcio Negrão, Daniele Sebestyan Martins Ribeiro, Eleonora Maria de Jesus Oliveira, Gabriel R de Freitas
BACKGROUND: Chagas disease is related to ischemic stroke (IS), although few epidemiological studies have evaluated the associated mortality and recurrence. Our objective is to determine factors associated with mortality and recurrence of IS in patients with IS and Chagas disease. METHODS: We retrospectively studied data obtained from electronic medical records of patients admitted at SARAH Hospitals across Brazil between 2009 and 2013. Using Cox regression analysis for mortality and logistic regression for recurrence, we assessed primary population characteristics and statistical associations between risk factors and outcomes...
March 14, 2018: European Neurology
https://www.readbyqxmd.com/read/29526861/clinical-features-of-patients-who-might-benefit-more-from-walking-robotic-training
#9
Giovanni Morone, Stefano Masiero, Paola Coiro, Domenico De Angelis, Vincenzo Venturiero, Stefano Paolucci, Marco Iosa
BACKGROUND: Robotic walking training improves probability to reach an autonomous walking in non-ambulant patients affected by subacute stroke. However, little information is available regarding the prognostic factors for identifying best responder patients. The purpose of the present study is therefore to investigate the clinical features of patients with subacute stroke that might benefit more from robotic walking therapy. METHODS: One hundred subacute inpatients randomized in robotic or conventional gait training were assessed at baseline and after 4 weeks of training performed 5 times per week...
2018: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/29519285/-use-of-somatosensory-evoked-potentials-for-preoperative-assessment-in-patients-with-severe-aneurysmal-subarachnoid-hemorrhage-before-surgical-or-interventional-treatment-a-prospective-observational-cohort-study
#10
Jingwei Zhao, Xuying Luo, Zheng Zhang, Kai Chen, Guangzhi Shi, Jianxin Zhou
OBJECTIVE: To explore the application value of short latency somatosensory evoked potentials (SLSEP) as a tool for preoperative assessment of surgical or interventional treatment in patients with severe aneurysmal subarachnoid hemorrhage (aSAH). METHODS: A prospective observational cohort study was conducted. The patients with severe aSAH with a WFNS grade of IV or V admitted to intensive care unit (ICU) of Beijing Tiantan Hospital of Capital Medical University from November 2016 to April 2017 were enrolled...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29509490/management-of-ruptured-blister-aneurysm-with-pipeline-device-after-prasugrel-loading
#11
Rajsrinivas Parthasarathy, Vipul Gupta, Aditya Gupta
OBJECTIVES: Blister like aneurysm (BLA) is extremely challenging to treat; endoluminal reconstruction has emerged as the most promising treatment method. When to treat after the ictus, the timing of administration of antiplatelet and causal relationship between platelet function testing results and thromboembolism is unclear. We theorized that Prasugrel with a lower incidence of resistance may be a safe suitable alternative to clopidogrel in patients treated with a flow diverter. METHODS: Prospectively collected data from consecutive patients treated for a ruptured blister with a flow diverter was reviewed...
March 6, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29492563/pressure-reactivity-based-optimal-cerebral-perfusion-pressure-in-a-traumatic-brain-injury-cohort
#12
J Donnelly, M Czosnyka, H Adams, C Robba, L A Steiner, D Cardim, B Cabella, X Liu, A Ercole, P J Hutchinson, D K Menon, M J H Aries, P Smielewski
OBJECTIVES: Retrospective data from patients with severe traumatic brain injury (TBI) indicate that deviation from the continuously calculated pressure reactivity-based "optimal" cerebral perfusion pressure (CPPopt) is associated with worse patient outcome. The objective of this study was to assess the relationship between prospectively collected CPPopt data and patient outcome after TBI. METHODS: We prospectively collected intracranial pressure (ICP) monitoring data from 231 patients with severe TBI at Addenbrooke's Hospital, UK...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29463452/-asymmetries-in-the-hospital-treatment-of-acute-ischemic-stroke
#13
Á Estella, F Aranda Aguilar, R Alonso Avilés, M Liñán López, B Gros Bañeres
OBJECTIVE: To analyze the degree of implementation of the protocolized care for acute stroke in the Spanish emergency departments and to discuss the territorial differences in the treatment of stroke. MATERIAL AND METHODS: Multicenter national survey conducted to evaluate the current treatment of ischemic stroke in emergency departments. The main variables analyzed were focused at evaluating the participation of ERs in the performance of thrombolysis, interventional treatment and destination of patients with stroke...
February 17, 2018: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/29444172/motor-and-psychosocial-impact-of-robot-assisted-gait-training-in-a-real-world-rehabilitation-setting-a-pilot-study
#14
Cira Fundarò, Anna Giardini, Roberto Maestri, Silvia Traversoni, Michelangelo Bartolo, Roberto Casale
In the last decade robotic devices have been applied in rehabilitation to overcome walking disability in neurologic diseases with promising results. Robot assisted gait training (RAGT) using the Lokomat seems not only to improve gait parameters but also the perception of well-being. Data on the psychosocial patient-robot impact are limited, in particular in the real-world of RAGT, in the rehabilitation setting. During rehabilitation training, the Lokomat can be considered an "assistive device for movement"...
2018: PloS One
https://www.readbyqxmd.com/read/29428269/comparison-of-craniotomy-and-decompressive-craniectomy-in-large-supratentorial-intracerebral-hemorrhage
#15
Dong Bin Kim, Sang Kyu Park, Byeong Hoo Moon, Byeong Rae Cho, Dong Kyu Jang, Kyeong Sool Jang
Intracerebral hemorrhage (ICH) is devastating disease with high mortality and morbidity rates. Most ICH is evacuated by either craniotomy (CR) or decompressive craniectomy (DC) although optimal treatment has not been established yet. The objective of this study was to compare clinical outcomes of spontaneous ICH patients between CR and DC groups and determine clinical factors affecting clinical prognosis. We retrospectively analyzed our single-center experience with large supratentorial ICH. From January 2011 to December 2016, 286 consecutive supratentorial large ICH patients underwent surgery in our institute...
April 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29412162/diagnostic-performance-of-different-perfusion-algorithms-for-the-detection-of-angiographical-spasm
#16
Saif Afat, Carolin Brockmann, Omid Nikoubashman, Marguerite Muller, Kolja M Thierfelder, Wolfgang G Kunz, Ulrike Haberland, Marc A Brockmann, Konstantin Nikolaou, Martin Wiesmann, Ahmed E Othman
PURPOSE: To assess the diagnostic utility of different perfusion algorithms for the detection of angiographical arterial spasm. METHOD: During a 2-year period, 45 datasets from 29 patients (54.2±10,75y,20F) with suspected cerebral vasospasm after aneurysmal subarachnoid hemorrhage were included. Volume Perfusion CT (VPCT), Non-enhanced CT (NCT) and angiography were performed within 6hours post-ictus. Perfusion maps were generated using a maximum slope (MS) and a deconvolution-based approach (DC)...
February 2, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29410100/association-between-neurological-outcomes-related-to-aneurysmal-subarachnoid-haemorrhage-and-onsite-access-to-neurointerventional-radiology
#17
Jorge Pena Mogollon, Nicolas Roydon Smoll, Rakshit Panwar
OBJECTIVE: An onsite access to neurointerventional radiology (NIR) may be useful for managing patients with aneurysmal subarachnoid haemorrhage (aSAH) after the aneurysm-securing procedure. We aimed to assess the association between neurological outcomes related to aSAH and onsite access to NIR service. METHODS: This was a sequential period study of 47 patients with aSAH admitted consecutively during the pre-NIR period (Jan 2010 to Jun 2012) compared with 81 patients with aSAH admitted consecutively during the post-NIR period (Jan 2013 to Jun 2015) at an academic tertiary referral ICU...
February 1, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29409775/atmospheric-pressure-variation-is-a-delayed-trigger-for-aneurysmal-subarachnoid-hemorrhage
#18
Carlina E van Donkelaar, Adriaan R E Potgieser, Henk Groen, Mahrouz Foumani, Herrer Abdulrahman, Rob Sluijter, J Marc C van Dijk, Rob J M Groen
OBJECTIVE: There is an ongoing search for conditions that induce spontaneous subarachnoid hemorrhage (SAH). The seasonal pattern of SAH is demonstrated in a large meta-analysis of the literature, but its explanation remains undecided. As such, there is a clear need for sound meteorological data to further elucidate the seasonal influence on SAH. Because of the stable and densely monitored atmospheric situation in the North of the Netherlands, we reviewed our unique cohort on the seasonal incidence of SAH and the association between SAH and local atmospheric changes...
February 1, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29380719/impact-of-diabetes-on-caregiver-stress-in-patients-with-alzheimer-s-disease-data-from-the-ictus-study
#19
Jun Li, Matteo Cesari, Natalia Del Campo, Sandrine Andrieu, Birong Dong, Wee Shiong Lim, Bruno Vellas
BACKGROUND: To estimate the impact of comorbid diabetes on caregiver stress in Alzheimer's disease (AD) patients from the Impact of Cholinergic Treatment Use (ICTUS) study. METHODS: Using the Data from the ICTUS study, diabetes mellitus (DM) was recorded at baseline and caregiver burden was assessed twice per year using the Zarit Burden Interview (ZBI) scale. The three-factorial model of ZBI (the effect on the social and personal life of caregivers, the psychological burden and the feelings of guilt) was adopted...
January 30, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29354887/delayed-recanalization-promotes-functional-recovery-in-rats-following-permanent-middle-cerebral-artery-occlusion
#20
Devin William McBride, Guangyong Wu, Derek Nowrangi, Jerry J Flores, Liang Hui, Paul R Krafft, John H Zhang
Most large vessel stroke patients have permanent occlusion, for which there are no current treatment options. Recent case studies have indicated delayed recanalization, that is recanalization outside of the 6-h treatment window, may lead to improved outcome. We hypothesized that delayed recanalization will restore cerebral blood flow, leading to improved function in rats. Male SD rats were subjected to pMCAO or sham surgery. Delayed recanalization was performed on either day 3, 7, or 14 after pMCAO in a subset of animals...
April 2018: Translational Stroke Research
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