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https://www.readbyqxmd.com/read/28721209/recent-advances-in-preventing-stroke-recurrence
#1
REVIEW
J David Spence
Recent advances in secondary stroke prevention include new evidence in hypertension, nutrition, anticoagulation, antiplatelet therapy, intracranial stenosis, percutaneous closure of patent foramen ovale, and lipid-lowering therapy. Individualized therapy for hypertension based on phenotyping with plasma renin and aldosterone markedly improves blood pressure control in patients with resistant hypertension. A Mediterranean diet can reduce the risk of stroke by nearly half. The diagnosis and treatment of metabolic vitamin B12 deficiency, and B vitamins to lower homocysteine, can reduce the risk of stroke by approximately 30%...
2017: F1000Research
https://www.readbyqxmd.com/read/28720076/prevalence-and-risk-factors-of-intracranial-and-extracranial-artery-stenosis-in-asymptomatic-rural-residents-of-13-villages-in-china
#2
Haiqiang Jin, Qing Peng, Ding Nan, Pu Lv, Ran Liu, Wei Sun, Yuming Teng, Yuanyuan Liu, Chenghe Fan, Haiying Xing, Ke Xu, Yining Huang
BACKGROUND: The present study aimed to investigate the prevalence and risk factors for extracranial carotid artery stenosis (ECAS) and intracranial carotid artery stenosis (ICAS) simultaneously in asymptomatic Chinese pure rural population. METHODS: We analyzed 2589 asymptomatic subjects aged over 30 yr. by ultrasonography and transcranial Doppler simultaneously in 13 isolated villages by door-to-door investigation. Both ECAS and ICAS were defined as more than 50% stenosis...
July 18, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28717832/endoscopic-surgery-for-intraventricular-arachnoid-cysts-in-children-clinical-presentation-radiological-features-management-and-outcomes-over-a-12-year-period
#3
Phillip Copley, Matthew A Kirkman, Dominic Thompson, Greg James, Kristian Aquilina
PURPOSE: Less than 0.5% of arachnoid cysts are intraventricular in origin. We review our experience with endoscopic surgery for intraventricular arachnoid cysts in children. METHODS: This is a retrospective review of children with intraventricular arachnoid cysts who underwent surgery between 2005 and 2016. Clinical notes and imaging were reviewed. RESULTS: Twenty-nine patients with endoscopically treated intraventricular arachnoid cysts were identified (M/F = 17:12; median age = 1...
July 17, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28717092/cerebrospinal-fluid-rhinorrhea-and-subsequent-bacterial-meningitis-due-to-an-atypical-clival-fracture
#4
Rie Tohge, Makio Takahashi
Cases of cerebrospinal fluid (CSF) rhinorrhea due to clival fracture are rare. We present a case of bacterial meningitis with CSF rhinorrhea after a clival fracture. Heavily T2-weighted images showed a bone flap in the thinned clivus and fluid collection in the sphenoid sinus. CSF rhinorrhea developed at 1 month after mild trauma. The fracture may have been caused by the trauma and/or by the pressure gradient between the intracranial CSF space and the sphenoid sinus. A detailed history to identify trauma and an examination to detect bone defects in the skull base are necessary when patients present with bacterial meningitis and persistent rhinorrhea...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28715363/decompressive-craniectomy-vs-craniotomy-only-for-intracranial-hemorrhage-evacuation-a-propensity-matched-study
#5
Faisal Jehan, Asad Azim, Peter Rhee, Muhammad Khan, Lynn Gries, Terence OʼKeeffe, Narong Kulvatunyou, Andrew Tang, Bellal Joseph
BACKGROUND: Decompressive craniectomy (DC) is often performed in conjunction with evacuation of intracranial hemorrhage (ICH) to control intracranial pressure (ICP) in patients with a traumatic brain injury (TBI). The efficacy of DC in lowering ICP is well established, however, its effect on clinical outcomes remains controversial. The aim of our study is to assess outcomes in TBI patients undergoing decompressive craniectomy (DC) vs. craniotomy only (CO) for the evacuation of intracranial hemorrhage...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28713638/neurovascular-cell-sheet-transplantation-in-a-canine-model-of-intracranial-hemorrhage
#6
Woo-Jin Lee, Jong Young Lee, Keun-Hwa Jung, Soon-Tae Lee, Hyo Yeol Kim, Dong-Kyu Park, Jung-Suk Yu, So-Yun Kim, Daejong Jeon, Manho Kim, Sang Kun Lee, Jae-Kyu Roh, Kon Chu
Cell-based therapy for intracerebral hemorrhage (ICH) has a great therapeutic potential. However, methods to effectively induce direct regeneration of the damaged neural tissue after cell transplantation have not been established, which, if done, would improve the efficacy of cell-based therapy. In this study, we aimed to develop a cell sheet with neurovasculogenic potential and evaluate its usefulness in a canine ICH model. We designed a composite cell sheet made of neural progenitors derived from human olfactory neuroepithelium and vascular progenitors from human adipose tissue-derived stromal cells...
2017: Cell Medicine
https://www.readbyqxmd.com/read/28713633/the-floating-anchored-craniotomy
#7
Matthew J Gutman, Elena How, Teresa Withers
BACKGROUND: The "floating anchored" craniotomy is a technique utilized at our tertiary neurosurgery institution in which a traditional decompressive craniectomy has been substituted for a floating craniotomy. The hypothesized advantages of this technique include adequate decompression, reduction in the intracranial pressure, obviating the need for a secondary cranioplasty, maintained bone protection, preventing the syndrome of the trephined, and a potential reduction in axonal stretching...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28713431/an-unexpected-cause-of-bradycardia-in-a-patient-with-bacterial-meningitis
#8
Petros Ioannou, Magdalini Velegraki, Stella Soundoulounaki, Achilleas Gikas, Diamantis P Kofteridis
Sinus bradycardia which is a sinus rhythm with a resting heart rate of less than 60 bpm is caused by intrinsic cardiac disorders like sick sinus syndrome or inferior myocardial infarction, metabolic and environmental causes (such as hypothyroidism and electrolyte disorders), medications (such as beta-blockers and amiodarone), infection (such as myocarditis), increased intracranial pressure, and toxic exposure, while it can sometimes be a normal phenomenon, especially during sleep, in athletes, and during pregnancy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28712906/a-comparison-of-pharmacologic-therapeutic-agents-used-for-the-reduction-of-intracranial-pressure-following-traumatic-brain-injury
#9
REVIEW
Ahmed M Alnemari, Brianna M Krafcik, Tarek R Mansour, Daniel Gaudin
OBJECTIVE: In neurotrauma care, a better understanding of treatments following traumatic brain injury (TBI) has led to a significant decrease in morbidity and mortality in this population. TBI represents a significant medical problem, and complications following TBI are associated with the initial injury and post-event intracranial processes such as elevated intracranial pressure (ICP) and brain edema. Consequently, appropriate therapeutic interventions are required to reduce brain tissue damage and improve cerebral perfusion...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28712896/prospective-evaluation-of-the-non-invasive-headsense-icp-monitor-in-tbi-patients-undergoing-invasive-icp-monitoring
#10
Martin W Herklots, Walid Moudrous, Annemarie Oldenbeuving, Gerwin Roks, Stylianos Mourtzoukos, Guus G Schoonman, Oliver Ganslandt
BACKGROUND: Currently intracranial pressure (ICP) is measured by invasive methods with a significant risk of infectious and hemorrhagic complications. Because of these high risks, there is need for a noninvasive ICP (nICP) monitor with an accuracy similar to that of an invasive ICP monitor. OBJECTIVE: To assess prospectively the accuracy and precision of a nICP monitor compared with invasive intracranial pressure (iICP) measurement in severe TBI patients. METHODS: Participants were ICP-monitored patients who had sustained TBI...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710082/accuracy-and-precision-of-venous-pressure-measurements-of-endovascular-microcatheters-in-the-setting-of-dural-venous-sinus-stenosis
#11
Michael B Avery, Sheryl Sambrano, Javed Khader Eliyas, Muneer Eesa, Alim P Mitha
INTRODUCTION: Dural venous sinus stenosis (DVSS) may lead to increased intracranial pressure, sometimes requiring a stent if a high pressure gradient exists. Many neuroendovascular physicians use microcatheters to measure gradients, yet there are no studies comparing the accuracies and precisions of modern day microcatheters. We examined pressure recordings from five commonly used microcatheters in an experimental DVSS model. METHODS: Using a programmable pump, dynamic flow was established in a closed circuit mimicking the venous sinus waveform...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28707549/efficacy-safety-and-timing-of-5-sodium-chloride-compared-with-23-4-sodium-chloride-for-osmotic-therapy
#12
Chris Carter, Theresa Human
BACKGROUND: Bolus doses of 23.4% sodium chloride (NaCl) are commonly used for the treatment of intracranial hypertension; however, delays in administration may occur in patients without central intravenous access. At our institution, equiosmolar bolus doses of 5% NaCl have emerged as potential alternatives to 23.4% NaCl because they may be safely administered through peripheral lines. OBJECTIVES: We sought to assess the efficacy in reducing intracranial pressure (ICP), time to administration, and safety of 5% NaCl as compared with 23...
August 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28706860/targeted-temperature-management-in-neurological-intensive-care-unit
#13
REVIEW
Sombat Muengtaweepongsa, Winchana Srivilaithon
Targeted temperature management (TTM) shows the most promising neuroprotective therapy against hypoxic/ischemic encephalopathy (HIE). In addition, TTM is also useful for treatment of elevated intracranial pressure (ICP). HIE and elevated ICP are common catastrophic conditions in patients admitted in Neurologic intensive care unit (ICU). The most common cause of HIE is cardiac arrest. Randomized control trials demonstrate clinical benefits of TTM in patients with post-cardiac arrest. Although clinical benefit of ICP control by TTM in some specific critical condition, for an example in traumatic brain injury, is still controversial, efficacy of ICP control by TTM is confirmed by both in vivo and in vitro studies...
June 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/28704823/different-behavior-and-response-of-staphylococcus-epidermidis-and-streptococcus-pneumoniae-to-a-ventriculoperitoneal-shunt-an-in-vitro-study
#14
Vahid Heidari, Zohreh Habibi, Ahmadreza Hojjati Marvasti, Zahra Ebrahim Soltani, Negin Naderian, Parvin Tanzifi, Farideh Nejat
BACKGROUND: Pneumococcal shunt infection is a rare event. There is no consensus on the therapeutic management of this kind of shunt infection according to literature reviews, and it seems to be different from infection with Staphylococcus epidermidis. We studied 2 shunted patients with pneumococcal meningitis, both of whom were treated with only antibiotics. The management of these cases seems to be different from that of shunt catheter infection due to these bacteria. We conducted a laboratory study to show the different behavior of pneumococcus compared to S...
July 14, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28704038/eosinophilic-meningitis-caused-by-angiostrongylus-cantonensis
#15
Shan Lv, Xiao-Nong Zhou, Jason R Andrews
Rat lungworm, Angiostrongylus cantonensis, is one major cause of human eosinophilic meningitis. This helminth is endemic in Southeast Asia, Pacific Islands, and the Caribbean and has recently expanded to South America. The infection is characterized by an elevated eosinophil count in cerebrospinal fluid. Common symptoms and signs include headache, neck stiffness, paresthesia and nausea/vomiting. The unique history of eating freshwater and land snails or slugs within 2 weeks before onset is helpful for diagnosis...
July 13, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28701994/the-role-of-substance-p-in-secondary-pathophysiology-after-traumatic-brain-injury
#16
REVIEW
Robert Vink, Levon Gabrielian, Emma Thornton
It has recently been shown that substance P (SP) plays a major role in the secondary injury process following traumatic brain injury (TBI), particularly with respect to neuroinflammation, increased blood-brain barrier (BBB) permeability, and edema formation. Edema formation is associated with the development of increased intracranial pressure (ICP) that has been widely associated with increased mortality and morbidity after neurotrauma. However, a pharmacological intervention to specifically reduce ICP is yet to be developed, with current interventions limited to osmotic therapy rather than addressing the cause of increased ICP...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28699412/pressure-autoregulation-measurement-techniques-in-adult-tbi-part-ii-a-scoping-review-of-continuous-methods
#17
Frederick Adam Zeiler, Joseph Donnelly, Leanne Calviello, Peter Smieleweski, David Menon, Marek Czosnyka
To perform systematically a scoping review of the literature on commonly described continuous autoregulation measurement techniques in adult TBI. The goal was to provide an overview of methodology and comprehensive reference library of the available literature for each technique. Five separate small systematic reviews were conducted for each of the continuous techniques: pressure reactivity index (PRx), laser Doppler flowmetry (LDF), near infrared spectroscopy (NIRS) techniques, brain tissue oxygen tension (PbtO2), and thermal diffusion (TD) techniques...
July 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28694618/single-parietal-burr-hole-craniostomy-with-irrigation-and-drainage-for-unilateral-chronic-subdural-hematoma-in-young-adults-40-years-a-rationale-behind-the-procedure
#18
Raj S Chandran, Milesh Nagar, M S Sharmad, Rajmohan B Prabhakar, Anil K Peethambaran, Shailesh Kumar, Saurabh Sharma, Sourabh K Jain
BACKGROUND: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. It is mostly a disease of elderly population with very little data about the young patients. There is also the debate regarding treatment strategies. We decided to determine the overall efficacy of the single burr-hole craniostomy (SBHC) for unilateral CSDH in young adults <40 years. SUBJECTS AND METHODS: We performed a retrospective study of young patients undergoing SBHC for unilateral CSDH between January 2013 and June 2016 at our institution...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28693927/risk-factors-and-outcomes-of-cerebrospinal-fluid-overdrainage-in-hiv-negative-patients-with-cryptococcal-meningitis-after-the-ventriculoperitoneal-shunting-procedure
#19
Chih-Wei Hung, Wei-Che Lin, Wen-Neng Chang, Tsung-Ming Su, Chia-Te Kung, Nai-Wen Tsai, Hung-Chen Wang, Chih-Cheng Huang, Ben-Chung Cheng, Yu-Jih Su, Ya-Ting Chang, Chih-Min Su, Sheng-Yuan Hsiao, Cheng-Hsien Lu
PURPOSE: Shunt procedures used to treat cryptococcal meningitis complicated with hydrocephalus and/or increased intracranial pressure (IICP) could result in cerebrospinal fluid (CSF) overdrainage, thereby presenting therapeutic challenges. METHODS: We analyzed the clinical features and neuroimaging findings after the ventriculoperitoneal (VP) shunt procedure in 51 HIV (Human Immunodeficiency Virus)-negative patients with cryptococcal meningitis, to assess the risk factors associated with post-shunt CSF overdrainage...
June 28, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28693567/protocol-based-invasive-intracranial-pressure-monitoring-in-acute-liver-failure-feasibility-safety-and-impact-on-management
#20
Venkatakrishna Rajajee, Robert J Fontana, Anthony J Courey, Parag G Patil
BACKGROUND: Acute liver failure (ALF) may result in elevated intracranial pressure (ICP). While invasive ICP monitoring (IICPM) may have a role in ALF management, these patients are typically coagulopathic and at risk for intracranial hemorrhage (ICH). Contemporary ICP monitoring techniques and coagulopathy reversal strategies may be associated with a lower risk of hemorrhage. Our objective was to evaluate the safety, feasibility, impact on clinical management and outcomes associated with protocol-directed use of IICPM in ALF...
July 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
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