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https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#1
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28188848/electroacupuncture-preconditioning-and-postconditioning-inhibit-apoptosis-and-neuroinflammation-induced-by-spinal-cord-ischemia-reperfusion-injury-through-enhancing-autophagy-in-rats
#2
Bo Fang, Meiman Qin, Yun Li, Xiaoqian Li, Wenfei Tan, Ying Zhang, Hong Ma
Electroacupuncture (EA) has beneficial effects on spinal cord ischemia reperfusion (I/R) injury, but the underlying mechanisms are not fully understood. This study aimed to investigate the role of autophagy in the protection of EA preconditioning and postconditioning against spinal cord I/R injury. For this, spinal cord I/R injury was induced by 14min occlusion of the aortic arch, and rats were treated with EA for 20min before or after the surgery. The expression of autophagy components, light chain 3 and Beclin 1, was assessed by Western blot...
February 7, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28169294/factors-predictive-of-survival-and-estimated-years-of-life-lost-in-the-decade-following-nontraumatic-and-traumatic-spinal-cord-injury
#3
B B Hatch, C M Wood-Wentz, T M Therneau, M G Walker, J M Payne, R K Reeves
STUDY DESIGN: Retrospective chart review. OBJECTIVES: To identify factors predictive of survival after spinal cord injury (SCI). SETTING: Tertiary care institution. METHODS: Multiple-variable Cox proportional hazards regression analysis for 759 patients with SCI (535 nontraumatic and 221 traumatic) included age, sex, completeness of injury, level of injury, functional independence measure (FIM) scores, rehabilitation length of stay and SCI cause...
February 7, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28160245/lipoprotein-a-hyperlipoproteinemia-as-cause-of-chronic-spinal-cord-ischemia-resulting-in-progressive-myelopathy-successful-treatment-with-lipoprotein-apheresis
#4
Franz Heigl, Reinhard Hettich, Erich Mauch, Reinhard Klingel, Cordula Fassbender
High concentrations of lipoprotein(a) (Lp(a)) represent an important independent and causal risk factor associated with adverse outcome in atherosclerotic cardiovascular disease (CVD). Effective Lp(a) lowering drug treatment is not available. Lipoprotein apheresis (LA) has been proven to prevent cardiovascular events in patients with Lp(a)-hyperlipoproteinemia (Lp(a)-HLP) and progressive CVD. Here we present the course of a male patient with established peripheral arterial occlusive disease (PAOD) at the early age of 41 and coronary artery disease (CAD), who during follow-up developed over 2 years a progressive syndrome of cerebellar and spinal cord deficits against the background of multifactorial cardiovascular risk including positive family history of CVD...
February 3, 2017: Clinical Research in Cardiology Supplements
https://www.readbyqxmd.com/read/28154297/outcomes-of-endovascular-repair-of-aortoiliac-aneurysms-and-analyses-of-anatomic-suitability-for-internal-iliac-artery-preserving-devices-in-japanese-patients
#5
Nathan K Itoga, Naoki Fujimura, Keita Hayashi, Hideaki Obara, Hideyuki Shimizu, Jason T Lee
BACKGROUND: Understanding that the common iliac arteries (CIA) are shorter in Asian patients, we investigated whether this anatomic difference affects the clinical outcomes of internal iliac artery (IIA) exclusion during endovascular aneurysm repair (EVAR) of aortoiliac aneurysm and thus limits the use of IIA-preserving devices in Japanese patients.Methods and Results:From 2008 to 2014, 69 Japanese patients underwent EVAR of aortoiliac aneurysms with 53 unilateral and 16 bilateral IIA exclusions...
February 2, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28134030/recovery-from-spinal-cord-infarction-associated-with-cannabis-use
#6
Tamer Akel
CONTEXT: Cerebrovascular and cardiovascular accidents have been associated with illicit drug use. The most commonly used substance worldwide is cannabis. It has been related to acute ischemic cerebral stroke in multiple reports, with different mechanisms suggested. FINDINGS: This is a case of Acute Spinal Cord Ischemia Syndrome (ASCIS) in a 25-year-old male who presented 20 minutes after smoking cannabis. Although a direct causal relationship between cannabis and cerebrovascular accidents is difficult to establish, there might be an association...
January 30, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28131733/spinal-cord-ischemia-in-scheuermann-disease-a-report-of-three-cases
#7
Léa Chiche, Robert-Yves Carlier, Dan Siahou, Arnaud Nataf, Caroline Hugeron, Clémence Palazzo
BACKGROUND: Neurological complications in Scheuermann's disease are rare but serious. CASE REPORTS: We report three cases of severe neurological deficit due to medullar ischemia attributable to the compression of a radiculomedullar artery by thoracic (two cases) and lumbar (one case) disc herniations associated with Scheuermann's disease. They were not treated surgically because of the absence of direct spinal cord compression or definitive spinal cord ischemia...
January 25, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28123428/key-genes-expressed-in-different-stages-of-spinal-cord-ischemia-reperfusion-injury
#8
Jian-An Li, Chun-Fang Zan, Peng Xia, Chang-Jun Zheng, Zhi-Ping Qi, Chun-Xu Li, Zhi-Gang Liu, Ting-Ting Hou, Xiao-Yu Yang
The temporal expression of microRNA after spinal cord ischemia/reperfusion injury is not yet fully understood. In the present study, we established a model of spinal cord ischemia in Sprague-Dawley rats by clamping the abdominal aorta for 90 minutes, before allowing reperfusion for 24 or 48 hours. A sham-operated group underwent surgery but the aorta was not clamped. The damaged spinal cord was removed for hematoxylin-eosin staining and RNA extraction. Neuronal degeneration and tissue edema were the most severe in the 24-hour reperfusion group, and milder in the 48-hour reperfusion group...
November 2016: Neural Regeneration Research
https://www.readbyqxmd.com/read/28120049/update-on-mechanism-and-therapeutic-implications-of-spinal-cord-stimulation-and-cerebral-hemodynamics-a-narrative-review
#9
Elisabetta Peppucci, Rina Di Bonaventura, Vincenzo Esposito, Jun Zhong, Gerardo Iacopino, Giuseppe Barbagallo, Massimiliano Visocchi
Spinal cord stimulation (SCS) is well known for its early role in the management of chronic pain, mainly failed back surgery syndrome (FBSS), spasticity, and bowel and bladder dysfunction. In more recent years, SCS has been proposed for patients suffering from refractory angina or peripheral vasculopathies in order to gain symptom relief, thus indicating some hemodynamic effect on the peripheral circulation. Taking into account this scientific observation, since the late1980s, researchers have started to investigate the potential effect of SCS on cerebral blood flow (CBF) regulation and its possible application in certain pathological settings dealing with vascular pattern dysfunction, such as ischemia, subarachnoid hemorrhage, head trauma, and brain tumors...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28112018/reversed-frozen-elephant-trunk-technique-to-treat-a-type-ii-thoracoabdominal-aortic-aneurysm
#10
E Sebastian Debus, Tilo Kölbel, Sabine Wipper, Holger Diener, Beate Reiter, Christian Detter, Nikolaos Tsilimparis
PURPOSE: To describe a hybrid technique of reversed frozen elephant trunk to treat thoracoabdominal aortic aneurysms (TAAA) through an abdominal only approach. TECHNIQUE: The technique is demonstrated in a 29-year-old Marfan patient with a chronic type B aortic dissection previously treated with a thoracic stent-graft who presented with a thoracoabdominal false lumen aneurysm. Through an open distal retroperitoneal approach to the abdominal aorta, a frozen elephant trunk graft was implanted over a super-stiff wire upside down with the stent-graft component in the thoracic aorta...
November 1, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28104107/erythropoietin-and-nonhematopoietic-effects
#11
REVIEW
Alireza Nekoui, Gilbert Blaise
Erythropoietin (EPO) is the main regulator of red blood cell production. Since the 1990s, EPO has been used for the treatment of anemia associated with end-stage renal failure and chemotherapy. The erythropoietin receptors were found on other organs such as the brain, spinal cord, heart and skin. In addition, it has been shown that many tissues produce and locally release EPO in response to hypoxic, biochemical and physical stress. In cellular, animal and clinical studies, EPO protects tissues from ischemia and reperfusion injury, has antiapoptotic effects and improves regeneration after injury...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28100154/one-year-follow-up-after-hybrid-thoracoabdominal-aortic-repair
#12
Rob A van de Graaf, Frank Grüne, Sanne E Hoeks, Sander Ten Raa, Robert Jan Stolker, Hence J M Verhagen, Felix van Lier
BACKGROUND: Compared to open thoracoabdominal aortic aneurysm (TAAA) repair, hybrid repair is thought to be less invasive with better perioperative outcomes. Due to the extent of the operation and long recovery period, studying perioperative results may not be sufficient for evaluation of the true treatment effect. The aim of this study is to evaluate 1-year mortality and morbidity in patients with TAAA undergoing hybrid repair. METHODS: In a retrospective cohort study, all medical records of patients undergoing hybrid repair for TAAA at the Erasmus University Medical Center between January 2007 and January 2015 were studied...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28089662/electroacupuncture-pretreatment-attenuates-spinal-cord-ischemia-reperfusion-injury-via-inhibition-of-high-mobility-group-box-1-production-in-a-lxa4-receptor-dependent-manner
#13
Xiao-Ling Zhu, Xin Chen, Wei Wang, Xu Li, Jia Huo, Yu Wang, Yu-Yuan Min, Bin-Xiao Su, Jian-Ming Pei
Paraplegia caused by spinal cord ischemia is a severe complication following surgeries in the thoracic aneurysm. HMGB1 has been recognized as a key mediator in spinal inflammatory response after spinal cord injury. Electroacupuncture (EA) pretreatment could provide neuroprotection against cerebral ischemic injury through inhibition of HMGB1 release. Therefore, the present study aims to test the hypothesis that EA pretreatment protects against spinal cord ischemia-reperfusion (I/R) injury via inhibition of HMGB1 release...
January 12, 2017: Brain Research
https://www.readbyqxmd.com/read/28089563/diagnostic-and-prognostic-relevance-of-magnetic-resonance-imaging-and-electrophysiological-findings-in-acute-spinal-ischemia
#14
Dimitrios Artemis, Marc Wolf, Christian Blahak, Kristina Szabo, Michael G Hennerici, Marc Fatar
OBJECTIVE: Our purpose was to classify the rare entity of spontaneous spinal ischemia with clinical, magnetic resonance-tomographic, and electrophysiological parameters to determine criteria for outcome prediction. METHODS: We analyzed the stroke registry database of the University Hospital Mannheim, Germany, from 2004 to 2010 for patients with a diagnosis of vascular spinal cord ischemia. RESULTS: Ten patients were identified (mean age 65 years [range 50-83], 5 women)...
January 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28043422/extent-ii-thoracoabdominal-aortic-aneurysm-repair-how-i-do-it
#15
Joseph S Coselli, Kim I de la Cruz, Ourania Preventza, Scott A LeMaire, Scott A Weldon
The primary risks associated with thoracoabdominal aortic aneurysm (TAAA) repair-namely operative death, paraplegia, and renal failure necessitating dialysis-are commonly related to the distal ischemia that occurs during aortic clamping and the disruption of vital branching arteries. Our technique for open TAAA repair has evolved over the course of 3 decades, from the unheparinized, simple "clamp-and-sew" approach learned directly from E. Stanley Crawford himself to a contemporary, multimodal strategy that uses an array of surgical adjuncts...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28007572/methane-ameliorates-spinal-cord-ischemia-reperfusion-injury-in-rats-antioxidant-anti-inflammatory-and-anti-apoptotic-activity-mediated-by-nrf2-activation
#16
Liping Wang, Ying Yao, Rong He, Yan Meng, Na Li, Dan Zhang, Jiajun Xu, Ouyang Chen, Jin Cui, Jinjun Bian, Yan Zhang, Guozhong Chen, Xiaoming Deng
Methane is reported to have antioxidant, anti-inflammatory and anti-apoptotic properties. We investigated the potential neuroprotective effects of methane-rich saline (MS) on spinal cord ischemia-reperfusion injury and determined that its therapeutic benefits are associated with the activation of nuclear factor erythroid 2-related factor 2 (Nrf2). Rats received 9min of spinal cord ischemia induced by occlusion of the descending thoracic aorta plus systemic hypotension followed by a single MS treatment (10ml/kg, ip) and 72h reperfusion...
December 20, 2016: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/27993707/p53-participates-in-the-protective-effects-of-ischemic-post-conditioning-against-ogd-reperfusion-injury-in-primary-cultured-spinal-cord-neurons
#17
Jinquan Li, Gong Chen, Xinjie Gao, Chao Shen, Ping Zhou, Xing Wu, Xiaoming Che, Rong Xie
Spinal cord ischemia-reperfusion (I/R) injury is a severe clinical condition, while the mechanism is still not clarified and the therapeutic approach is limited. Ischemia post-conditioning (PC) has been found to have the protective effects against I/R injury in brain. Recently p53 has been reported to take part in the regulation and protection of I/R injury. We hypothesize that PC has the protective effects in primary cultured spinal cord neurons against ischemia-reperfusion injury, and MDM2-p53 signaling pathway may involve in its protective mechanism...
December 16, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27990305/a-66-year-old-woman-with-a-progressive-longitudinally-extensive-tract-specific-myelopathy
#18
Elizabeth O'Keefe, Katherine E Schwetye, John Nazarian, Richard Perrin, Robert E Schmidt, Robert Bucelli
A 66-year-old woman presented with progressive lancinating pain and sensory deficits attributable to a myelopathy of unclear etiology. Spinal cord magnetic resonance imaging showed a longitudinally extensive T2-hyperintense lesion of the dorsal columns. Comprehensive serum, urine, and cerebrospinal fluid analyses failed to identify an etiology. Empiric intravenous methylprednisolone and intravenous immunoglobulin were of no benefit and serial screens for an occult malignancy were negative. She developed dysesthesias and allodynia affecting her entire body and lost the use of her arms and legs due to severe sensory ataxia that was steadily progressive from onset...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27932767/-mid-and-long-term-result-of-celiac-artery-coverage-in-tevar-treatment-for-aortic-dissection
#19
Ming Li, Chang Shu, Quanming Li, Tun Wang, Kun Fang
To observe the mid- and long-term result of intentional coverage of celiac artery in thoracic endovascular aortic repair (TEVAR) surgery for aortic dissection.
 Methods: We retrospectively analyzed 21 cases who received TEVAR with celiac artery coverage during the operation. The existence of collaterals between celiac artery (CA) and superior mesenteric artery (SMA) was confirmed by preoperative CT angiography (CTA) or digital substract angiography (DSA) for each patient. We used the stent-graft precisely above the orifice of SMA...
November 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/27932511/ascending-and-descending-thoracic-vertebral-arteries
#20
P Gailloud, L Gregg, M S Pearl, D San Millan
Thoracic vertebral arteries are anastomotic chains similar to cervical vertebral arteries but found at the thoracic level. Descending thoracic vertebral arteries originate from the pretransverse segment of the cervical vertebral artery and curve caudally to pass into the last transverse foramen or the first costotransverse space. Ascending thoracic vertebral arteries originate from the aorta, pass through at least 1 costotransverse space, and continue cranially as the cervical vertebral artery. This report describes the angiographic anatomy and clinical significance of 9 cases of descending and 2 cases of ascending thoracic vertebral arteries...
December 8, 2016: AJNR. American Journal of Neuroradiology
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