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https://www.readbyqxmd.com/read/28097310/combined-intravenous-thrombolysis-and-thrombectomy-vs-thrombectomy-alone-for-acute-ischemic-stroke-a-pooled-analysis-of-the-swift-and-star-studies
#1
Jonathan M Coutinho, David S Liebeskind, Lee-Anne Slater, Raul G Nogueira, Wayne Clark, Antoni Dávalos, Alain Bonafé, Reza Jahan, Urs Fischer, Jan Gralla, Jeffrey L Saver, Vitor M Pereira
Importance: Mechanical thrombectomy (MT) improves clinical outcomes in patients with acute ischemic stroke (AIS) caused by a large vessel occlusion. However, it is not known whether intravenous thrombolysis (IVT) is of added benefit in patients undergoing MT. Objective: To examine whether treatment with IVT before MT with a stent retriever is beneficial in patients undergoing MT. Design, Setting, and Participants: This post hoc analysis used data from 291 patients treated with MT included in 2 large, multicenter, prospective clinical trials that evaluated MT for AIS (Solitaire With the Intention for Thrombectomy performed from January 1, 2010, through December 31, 2011, and Solitaire Flow Restoration Thrombectomy for Acute Revascularization from January 1, 2010, through December 31, 2012)...
January 9, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28090040/outcomes-of-brugada-syndrome-patients-with-coronary-artery-vasospasm
#2
Shingo Kujime, Harumizu Sakurada, Naoki Saito, Yoshinari Enomoto, Naoshi Ito, Keijiro Nakamura, Seiji Fukamizu, Tamotsu Tejima, Yuzuru Yambe, Mitsuhiro Nishizaki, Mahito Noro, Masayasu Hiraoka, Kaoru Sugi
Objective To evaluate the outcomes of patients with concomitant Brugada syndrome and coronary artery vasospasm. Methods Patients diagnosed with Brugada syndrome with an implantable cardiac defibrillator were retrospectively investigated, and the coexistence of vasospasm was evaluated. The clinical features and outcomes were evaluated, especially in patients with coexistent vasospasm. A provocation test using acetylcholine was performed in patients confirmed to have no organic stenosis on percutaneous coronary angiography to confirm the presence of vasospasm...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28089197/long-term-follow-up-analysis-of-microsurgical-clip-ligation-and-endovascular-coil-embolization-for-dorsal-wall-blister-aneurysms-of-the-internal-carotid-artery
#3
Mason A Brown, Cristian F Guandique, Jonathan Parish, Aubrey C McMillan, Stephen Lehnert, Nassir Mansour, Michael Tu, Bradley N Bohnstedt, Troy D Payner, Thomas J Leipzig, Andrew J DeNardo, John A Scott, Aaron A Cohen-Gadol
: Blister aneurysms at non-branching sites of the dorsal internal carotid artery (dICA) are fragile, rare, and often difficult to treat. The purpose of this study is to address the demographics, treatment modalities, and long-term outcome of patients treated for dICA blister aneurysms. A retrospective review of medical records identified all consecutive patients who presented with a blister aneurysm from 2002 to 2011 at our institution. Eighteen patients (M=7, F=11; mean age: 48.4±15...
January 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28087430/ryanodine-receptor-1-polymorphism-is-not-associated-with-aneurysmal-subarachnoid-hemorrhage-or-its-clinical-sequelae
#4
Philipp Hendrix, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
OBJECTIVE: The pathophysiological mechanisms underlying cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remain poorly understand. Ryanodine receptors (RYR) are intracellular calcium channels involved in the regulation of vascular smooth muscle cells and cerebrovascular tone and diameter. Previous work reported an association between a RYR polymorphism and cerebral vasospasm. Here, we sought to assess the impact of that RYR polymorphism on aSAH and its clinical sequelae...
January 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28078375/assessing-intra-arterial-complications-of-planning-and-treatment-angiograms-for-y-90-radioembolization
#5
Osman Ahmed, Mikin V Patel, Abdulrahman Masrani, Bradford Chong, Mohammed Osman, Jordan Tasse, Jayesh Soni, Ulku Cenk Turba, Bulent Arslan
PURPOSE: To report hepatic arterial-related complications encountered during planning and treatment angiograms for radioembolization and understand any potential-associated risk factors. MATERIALS AND METHODS: 518 mapping or treatment angiograms for 180 patients with primary or metastatic disease to the liver treated by Yttrium-90 radioembolization between 2/2010 and 12/2015 were retrospectively reviewed. Intra-procedural complications were recorded per SIR guidelines...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28074721/-capecitabine-induced-ventricular-fibrillation
#6
A V van Capelle, J de Valk, D Schakenraad, T Germans, D Ten Oever
BACKGROUND: Capecitabine is an orally-administered chemotherapeutic agent used in the treatment of colorectal, gastric and breast carcinoma. Capecitabine has relatively mild side effects. Less known are its potential severe cardiotoxic effects. CASE DESCRIPTION: We report a case of a 61-year-old man recently diagnosed with rectal cancer. Six days after starting with capecitabine, he developed a cardiac arrest due to ventricular fibrillation (VF). Extensive additional diagnostics did not explain the cardiac arrest nor VF...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28070640/erratum-to-thrombectomy-for-ischemic-stroke-meta-analyses-of-recurrent-strokes-vasospasms-and-subarachnoid-hemorrhages
#7
Robert Emprechtinger, Brigitte Piso, Peter A Ringleb
No abstract text is available yet for this article.
January 9, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28033279/the-effect-of-fenestration-of-the-lamina-terminalis-on-the-incidence-of-shunt-dependent-hydrocephalus-after-aneurysmal-subarachnoid-hemorrhage-fish-study-protocol-for-a-randomized-controlled-trial
#8
Chuanyuan Tao, Chaofeng Fan, Xin Hu, Junpeng Ma, Lu Ma, Hao Li, Yi Liu, Hong Sun, Min He, Chao You
BACKGROUND: Shunt-dependent hydrocephalus (SDH) is a well-known sequela following aneurysmal hemorrhage, adversely affecting the outcome after securing ruptured aneurysm. Fenestration of lamina terminalis (FLT) creates an anterior ventriculostomy, facilitates cerebrospinal fluid circulation and clot clearance in the basal cistern. However, controversy exists over whether microsurgical FLT during aneurysm repair can decrease the incidence of SDH. AIMS: The study is designed to determine the efficacy of lamina terminalis fenestration on the reduction of SDH after aneurysm clipping...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28004764/sheehan-syndrome
#9
Züleyha Karaca, Bashir A Laway, Hatice S Dokmetas, Hulusi Atmaca, Fahrettin Kelestimur
Sheehan syndrome or postpartum hypopituitarism is a condition characterized by hypopituitarism due to necrosis of the pituitary gland. The initial insult is caused by massive postpartum haemorrhage (PPH), leading to impaired blood supply to the pituitary gland, which has become enlarged during pregnancy. Small sella turcica size, vasospasms (caused by PPH) and/or thrombosis (associated with pregnancy or coagulation disorders) are predisposing factors; autoimmunity might be involved in the progressive worsening of pituitary functions...
December 22, 2016: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28004212/application-of-actuator-driven-pulsed-water-jet-in-aneurysmal-subarachnoid-hemorrhage-surgery-its-effectiveness-for-dissection-around-ruptured-aneurysmal-walls-and-subarachnoid-clot-removal
#10
Hidenori Endo, Toshiki Endo, Atsuhiro Nakagawa, Miki Fujimura, Teiji Tominaga
In clipping surgery for aneurysmal subarachnoid hemorrhage (aSAH), critical steps include clot removal and dissection of aneurysms without premature rupture or brain injuries. To pursue this goal, a piezo actuator-driven pulsed water jet (ADPJ) system was introduced in this study. This study included 42 patients, who suffered aSAH and underwent clipping surgery. Eleven patients underwent surgery with the assistance of the ADPJ system (ADPJ group). In the other 31 patients, surgery was performed without the ADPJ system (Control group)...
December 22, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/28004163/treatment-of-cerebral-vasospasm-following-aneurysmal-subarachnoid-haemorrhage-a-systematic-review-and-meta-analysis
#11
Grégoire Boulouis, Marc Antoine Labeyrie, Jean Raymond, Christine Rodriguez-Régent, Anne Claire Lukaszewicz, Damien Bresson, Wagih Ben Hassen, Denis Trystram, Jean Francois Meder, Catherine Oppenheim, Olivier Naggara
OBJECTIVES: To examine the clinical outcome of aneurysmal subarachnoid haemorrhage (aSAH) patients exposed to cerebral vasospasm (CVS)-targeted treatments in a meta-analysis and to evaluate the efficacy of intra-arterial (IA) approaches in patients with severe/refractory vasospasm. METHODS: Randomised controlled trials, prospective and retrospective observational studies reporting clinical outcomes of aSAH patients exposed to CVS targeted treatments, published between 2006-2016 were searched using PubMed, EMBASE and the Cochrane Library...
December 21, 2016: European Radiology
https://www.readbyqxmd.com/read/28002282/microsurgical-reconstruction-of-traumatic-lower-extremity-defects-in-the-pediatric-population
#12
Arash Momeni, Michael Lanni, L Scott Levin, Stephen J Kovach
BACKGROUND: Very few reports focus exclusively on microsurgical reconstruction of traumatic lower extremity defects in children. As such, we felt it prudent to contribute to this area of clinical research. We hypothesized that reconstructive success would be comparable to success rates reported in adults and that young age or concerns regarding vessel size or behavior do not negatively impact surgical outcome. METHODS: A retrospective review of microsurgical lower extremity reconstruction cases at two academic medical centers (University of Pennsylvania and Duke University) was performed...
December 16, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28000132/biomarkers-of-glycocalyx-injury-are-associated-with-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage-a-case-series-supporting-a-new-hypothesis
#13
Josh D Bell, Shawn G Rhind, Alex P Di Battista, R Loch Macdonald, Andrew J Baker
BACKGROUND: Delayed cerebral ischemia (DCI) contributes to morbidity following aneurysmal subarachnoid hemorrhage; however, its etiology remains poorly understood. DCI is not only a consequence of angiographic vasospasm, but also involves microthrombosis and neuroinflammation, two events with unexplained phenomenology. The vascular endothelial glycocalyx mediates platelet aggregation and endothelial cell-leukocyte interactions and may play an important role in DCI pathogenesis. METHODS: We present a case series in which we conducted multiplex and singlet enzyme-linked immunosorbent assays of endothelial, glycocalyx, inflammatory, and neuroinjury proteins in both CSF and plasma in three patients during active DCI following SAH...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27997923/the-role-of-hmgb1-in-pial-arteriole-dilating-reactivity-following-subarachnoid-hemorrhage-in-rats
#14
Haoliang Xu, Benjarat Changyaleket, Tibor Valyi-Nagy, Randal O Dull, Dale A Pelligrino, David E Schwartz, Zhao Zhong Chong
High-mobility group box 1 protein (HMGB1) has been implicated in inflammatory responses, and is also associated with cerebral vasospasm after subarachnoid hemorrhage (SAH). However, there are no direct evident links between HMGB1 and cerebral vasospasm. We therefore investigated the effects of HMGB1 on pial arteriole reactivity following SAH in rats. We initially found that SAH induced a significant decrease in pial arteriole dilating responses to sciatic nerve stimulation (SNS), hypercapnia (CO2), and the topical suffusion of acetylcholine (ACh), adenosine (ADO), and s-nitroso-N-acetylpenicillamine (SNAP) over a 7-day period after SAH...
December 21, 2016: Journal of Vascular Research
https://www.readbyqxmd.com/read/27993744/omega-3-fatty-acid-ethyl-esters-suppress-cerebral-vasospasm-and-improve-clinical-outcome-following-aneurysmal-subarachnoid-hemorrhage
#15
Ichiro Nakagawa, Shohei Yokoyama, Koji Omoto, Yasuhiro Takeshima, Ryosuke Matsuda, Fumihiko Nishimura, Shuichi Yamada, Hiroshi Yokota, Yasushi Motoyama, Young-Su Park, Hiroyuki Nakase
OBJECTIVE: The occurrence of cerebral vasospasm after onset of aneurysmal subarachnoid hemorrhage (SAH) is a critical factor determining the clinical prognosis. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), both omega-3 fatty acids (O-3FA), can suppress cerebral vasospasm and DHA can relax vessels vasoconstriction and have neuroprotective effects. In the present study, we investigated whether administration of O-3FA prevented cerebral vasospasm occurrence and improved clinical outcomes following aneurysmal SAH...
December 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27979797/feasibility-and-safety-of-repeat-instant-endovascular-interventions-in-patients-with-refractory-cerebral-vasospasms
#16
L Andereggen, J Beck, W J Z'Graggen, G Schroth, R H Andres, M Murek, M Haenggi, M Reinert, A Raabe, J Gralla
BACKGROUND AND PURPOSE: For patients with cerebral vasospasm refractory to medical and hemodynamic therapies, endovascular therapies often remain the last resort. Data from studies in large cohorts on the efficacy and safety of multiple immediate endovascular interventions are sparse. Our aim was to assess the feasibility and safety of multiple repeat instant endovascular interventions in patients with cerebral vasospasm refractory to medical, hemodynamic, and initial endovascular interventions...
December 15, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27960174/non-atherosclerotic-intracranial-arterial-diseases
#17
Jong S Kim, Louis R Caplan
Atherosclerosis is not the only cause of intracranial arterial disease. Arterial dissection, moyamoya disease, vascular inflammatory disease, vasospasm and immunologic disorders are important non-atherosclerotic intracranial arterial diseases. Identification of the correct etiology is important in establishing treatment strategies and assessing prognosis. Careful history taking and appropriate laboratory testing are essential. Although catheter angiography is the most important diagnostic tool to examine various intracranial arterial diseases, other diagnostic modalities such as CT angiography and MR angiography are nowadays widely used...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27958312/cerebral-infarction-pattern-in-tuberculous-meningitis
#18
Mei-Ling Sharon Tai, Shanthi Viswanathan, Kartini Rahmat, Hazman Mohd Nor, Khairul Azmi Abdul Kadir, Khean Jin Goh, Norlisah Ramli, Fatimah Kamila Abu Bakar, Norzaini Rose Mohd Zain, Jun Fai Yap, Beng Hooi Ong, Mohd Hanip Rafia, Chong Tin Tan
Tuberculous meningitis (TBM) causes significant morbidity and mortality. The primary objective was to re-examine the concept of "TB zone" and "ischaemic zone" in cerebral infarction in patients with tuberculous meningitis. The secondary objective was to evaluate cerebral infarction, vasculitis and vasospasm in tuberculous meningitis infections. Between 2009 and 2014, TBM patients were recruited. Neuroimaging was performed and findings of cerebral infarction, vasculitis and vasospasm were recorded. Infarcts were classified based on arterial supply and Hsieh's classification...
December 13, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27942479/posterior-fossa-syndrome-a-narrative-review
#19
REVIEW
Salima S Wahab, Samantha Hettige, Kshtij Mankad, Kristian Aquilina
Posterior fossa syndrome (PFS), or cerebellar mutism syndrome (CMS), is a collection of neurological symptoms that occur following surgical resection of a posterior fossa tumour, and is characterised by either a reduction or an absence of speech. Some authors suggest that CM is only one symptom of the CMS complex that also includes ataxia, hypotonia and irritability as well as cranial nerve deficits, neurobehavioral changes and urinary retention or incontinence. It is seen almost exclusively in children. In 1985 Rekate et al...
October 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/27936390/irap-inhibition-using-hfi419-prevents-moderate-to-severe-acetylcholine-mediated-vasoconstriction-in-a-rabbit-model
#20
Aisha El-Hawli, Tawar Qaradakhi, Alan Hayes, Emma Rybalka, Renee Smith, Martin Caprnda, Radka Opatrilova, Katarina Gazdikova, Maria Benckova, Peter Kruzliak, Anthony Zulli
Coronary artery vasospasm (constriction) caused by reduced nitric oxide bioavailability leads to myocardial infarction. Reduced endothelial release of nitric oxide by the neurotransmitter acetylcholine, leads to paradoxical vasoconstriction as it binds to smooth muscle cell M3 receptors. Thus, inhibition of coronary artery vasospasm will improve clinical outcomes. Inhibition of insulin regulated aminopeptidase has been shown to improve vessel function, thus we tested the hypothesis that HFI419, an inhibitor of insulin regulated aminopeptidase, could reduce blood vessel constriction to acetylcholine...
December 6, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
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