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https://www.readbyqxmd.com/read/29163750/long-acting-liposomal-bupivacaine-for-percutaneous-sympathetic-stellate-ganglion-blockade-a-technical-note
#1
Adnan I Qureshi, Muhammad A Waqas, Vikram Jadhav, Muhammad A Saleem, Jeff Campbell, Shawn S Wallery
Introduction: We describe the use of long acting liposomal bupivacaine for percutaneous stellate ganglion blockade to treat severe headaches following internal carotid artery dissection. Methods: A 43-year old woman developed right-sided refractory headache after right internal carotid artery dissection. Patient underwent percutaneous stellate ganglion block using bupivacaine hydrochloride (0.25%-20 ml) in the past with short acting relief. Liposomal bupivacaine (EXPAREL) 13...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29163742/endovascular-treatment-of-spontaneous-intracranial-internal-carotid-dissection-in-a-young-patient-affected-by-systemic-lupus-erythematosus-a-case-report
#2
Sergio Racchiusa, Marcello Longo, Gianmarco Bernava, Antonio Pitrone, Rosario Papa, Francesca Granata, Giuseppe Centorrino, Sergio Lucio Vinci
Systemic lupus erythematosus (SLE) increases the risk of cerebrovascular events due to vascular changes, resulting in the weakening of the vessel walls. Moreover, patients with SLE have more incidence of arterial lesions such as dissections. Internal carotid dissection (ICA) is an infrequent cause of ischemic stroke, representing 2% of all ischemic events. We present a case of ischemic stroke, caused by a spontaneous dissection of intracranial ICA, treated with endovascular stent implantation, in a 22-year-old woman affected by SLE, newly diagnosed...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29152739/first-bite-syndrome-following-transcervical-arterial-ligation-after-transoral-robotic-surgery
#3
Michael C Topf, Ethan Moritz, John Gleysteen, Joseph M Curry, David M Cognetti, Adam J Luginbuhl
OBJECTIVE: To assess the incidence of first bite syndrome (FBS) in transoral robotic surgical (TORS) patients undergoing transcervical arterial ligation. METHODS: Retrospective case series of all patients diagnosed with FBS following prophylactic transcervical arterial ligation of branches of the external carotid system between March 2010 and December 2016 at a single academic center. RESULTS: Six patients with FBS after TORS with transcervical arterial ligation were evaluated, representing 7% of all patients who underwent neck dissection with concomitant transcervical arterial ligation (6 of 83)...
November 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29152471/internal-carotid-artery-dissection-in-brazilian-jiu-jitsu
#4
Zeferino Demartini, Maxweyd Rodrigues Freire, Roberto Oliver Lages, Alexandre Novicki Francisco, Felipe Nanni, Luana A Maranha Gatto, Gelson Luis Koppe
Carotid artery dissection is a significant cause of stroke in young patients. It may be asymptomatic and go undiagnosed, or minimal transient manifestations may follow, commanding a higher index of suspicion than ordinarily exists to avoid misdiagnosis. Reported herein is a 27-year-old man who suffered extracranial internal carotid artery dissection while practicing a Brazilian Jiu-Jitsu submission maneuver. The patient's condition suddenly deteriorated one week later due to distal embolization and stroke. Despite endovascular treatment, with stenting of the cervical carotid artery, neurologic deficits remained...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29147634/intracranial-ischemic-infarct-due-to-blunt-force-trauma-in-a-high-school-football-player
#5
Brandon I Esianor, Ali S Haider, Margaret I Engelhardt, Tijani Osumah, Steven Vayalumkal, Richa Thakur, Dean Leonard, Jeffrey Haithcock, Kennith F Layton
Ischemic stroke is an uncommon cause of death among teenagers and young adults; however, the etiologies differ when compared to ischemic strokes in older individuals. Large-vessel atherosclerosis and small-vessel disease causing ischemic stroke are rare for the teenage population, while cervicocerebral arterial dissections account for up to 20% of ischemic strokes. Here, we present the case of a 16-year-old male who developed internal carotid artery dissection (ICAD) after a head injury and subsequently developed ischemic stroke and seizures...
September 7, 2017: Curēus
https://www.readbyqxmd.com/read/29147596/carotidynia-a-rare-diagnosis-for-unilateral-neck-pain-revealed-by-cross-sectional-imaging
#6
Corrado Santarosa, Salvatore Stefanelli, Roman Sztajzel, Pravin Mundada, Minerva Becker
Idiopathic carotidynia (IC) is a rare and poorly understood syndrome consisting of unilateral neck pain, tenderness, and increased pulsations over the affected carotid bifurcation. A growing body of evidence supports the hypothesis that IC is a distinct clinicopathologic entity with characteristic imaging features. We report the case of a 34-year-old Caucasian male presenting with intense unilateral neck pain in the emergency setting. Computed tomography and ultrasonography revealed fusiform eccentric thickening of the ipsilateral carotid bifurcation without vessel narrowing...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/29147475/an-extensive-chronic-aortic-dissection-presenting-with-acute-embolic-stroke
#7
Sijan Basnet, Naba Raj Mainali, Biswaraj Tharu, Rashmi Dhital, Dilli Ram Poudel
Herein, we present a rare case of extensive chronic aortic dissection with extension to bilateral subclavian arteries, bilateral common carotid arteries, right internal carotid artery, bilateral proximal external iliac arteries and simultaneous presentation of acute embolic stroke and seizure. The rarity of this case presentation and the presence of neurological features necessitated a high index of clinical suspicion to reach the definitive diagnosis. This study also demonstrates a unique situation requiring correlation between chronic aortic dissection and multi-organ system dysfunction from chronic ischemia...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29145656/refining-operative-strategies-for-optic-nerve-decompression-a-morphometric-analysis-of-transcranial-and-endoscopic-endonasal-techniques-using-clinical-parameters
#8
Steven L Gogela, Lee A Zimmer, Jeffrey T Keller, Norberto Andaluz
BACKGROUND: Various approaches can be considered for decompression of the intracanalicular optic nerve. Although clinical experience has been reported, no quantitative study has yet compared the extent of decompression achieved by an endoscopic endonasal versus transcranial approach. OBJECTIVE: Toward this aim, our morphometric analysis compared both approaches by quantifying the circumferential degree of optic canal decompression that is possible before any meningeal violation, which would result in cerebrospinal fluid (CSF) leak...
May 3, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29142493/cervical-arterial-fibromuscular-dysplasia-in-a-biethnic-population-a-retrospective-study-in-the-u-s-mexican-border
#9
Ihtesham A Qureshi, Gustavo J Rodriguez, Tatiana Chacon-Quesada, Gavito-Higuera Jose, Salvador Cruz-Flores, Alberto Maud
Background  There have been studies trying to characterize Fibromuscular Dysplasia (FMD); however, most of them are based in mainly non-Hispanic sample. The objective of this study is to better understand the epidemiology and clinical characteristics of craniocervical FMD in the Hispanic population. Methods  We retrospectively reviewed the cerebral angiograms performed in our center in a period of 3.5 years under any indication looking for angiographic patterns of FMD. Exclusion criteria consisted of cases in which the first angiogram was done when the patients were younger than 18 years...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29123849/a-case-report-of-systemic-embolic-events-associated-with-atrial-fibrillation
#10
Hidehiko Nakano, Hiroshi Yamagami, Hisashi Ofuchi
Case: An 82-year-old woman who had atrial fibrillation was found unconscious and was brought to the emergency department by ambulance. Her Glasgow Coma Scale score was 3, and an electrocardiogram showed ST segment elevation in V3 and V4. Cardiac ultrasonography showed left ventricular asynergy in the anterior wall, septum, and apex. Although dissection of the aorta was suspected, contrast computed tomography showed multiple arterial thromboses, including bilateral common carotid arteries and poor contrast in the left ventricle...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29118792/anchoring-pipeline-flow-diverter-construct-in-the-treatment-of-traumatic-distal-cervical-carotid-artery-injury
#11
Krishna Amuluru, Fawaz Al-Mufti, William Roth, Charles J Prestigiacomo, Chirag D Gandhi
Background: Traumatic extracranial internal carotid artery (ICA) dissections are uncommon and can be difficult to treat. Thinning of adventitia and dilatation may occur following arterial dissection, thus resulting in a fusiform pseudoaneurysm, which can subsequently cause bleeding, expanding, or pulsatile hematoma. Currently, medical management with anticoagulation remains the first line of treatment and yields good outcomes in 75% of cases with a mortality rate of 3-4%. Endovascular intervention is indicated with failure of medical therapy, progressive enlargement of a traumatic pseudoaneurysm, acute flow-related infarcts due to vessel occlusion, or when anticoagulation is contraindicated due to risk of pseudoaneurysm rupture and hemorrhage...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#12
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29114939/three-dimensional-endoscopy-for-endoscopic-salvage-nasopharyngectomy-preliminary-report-of-experience
#13
Jimmy Yu Wai Chan, William Ignace Wei
BACKGROUND: Prospective, observational study to assess the efficacy of salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma (NPC) via the endoscopic endonasal approach using a three-dimensional (3D) high-definition endoscopic system. METHODS: Between 2016 and 2017, 30 patients with recurrent NPC were recruited. Patient demographics, tumor characteristics, and perioperative data were recorded. Instrument ergonomics and perceived advantages were assessed by the operating, assisting, and observing surgeons...
November 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29114928/a-new-substitute-for-formalin-application-to-embalming-cadavers
#14
Yoshinori Haizuka, Miki Nagase, Satoshi Takashino, Yasushi Kobayashi, Yoshihisa Fujikura, George Matsumura
The development of formalin-free fixatives is an urgent issue in gross anatomy because of the health hazard and the tissue-hardening actions of formalin. We recently identified the fixative, antimicrobial, and preservative effects of N-vinyl-2-pyrrolidone (NVP), a precursor of the water-soluble macromolecular polymer polyvinylpyrrolidone, in animal experiments. The aim of the present study is to investigate whether NVP solution can be used as an alternative to formalin in human cadaveric dissection. Twelve donated cadavers were infused with NVP via the femoral and common carotid arteries using a peristaltic pump...
November 7, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/29103427/neuroinflammation-in-ischemic-pediatric-stroke
#15
Maja Steinlin
Over the last decades, the importance of inflammatory processes in pediatric stroke have become increasingly evident. Ischemia launches a cascade of events: activation and inhibition of inflammation by a large network of cytokines, adhesion and small molecules, protease, and chemokines. There are major differences in the neonatal brain compared to adult brain, but developmental trajectories of the process during childhood are not yet well known. In neonatal stroke ischemia is the leading pathophysiology, but infectious and inflammatory processes have a significant input into the course and degree of tissue damage...
August 2017: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/29101840/ex%C3%A2-vivo-culture-of-human-atherosclerotic-plaques-a-model-to-study-immune-cells-in-atherogenesis
#16
Anna Lebedeva, Daria Vorobyeva, Murad Vagida, Oxana Ivanova, Eugeny Felker, Wendy Fitzgerald, Natalya Danilova, Vladimir Gontarenko, Alexander Shpektor, Elena Vasilieva, Leonid Margolis
BACKGROUND AND AIMS: The mechanisms that drive atherosclerotic plaque progression and destabilization in humans remain largely unknown. Laboratory models are needed to study these mechanisms under controlled conditions. The aim of this study was to establish a new ex vivo model of human atherosclerotic plaques that preserves the main cell types in plaques and the extracellular components in the context of native cytoarchitecture. METHODS: Atherosclerotic plaques from carotid arteries of 28 patients undergoing carotid endarterectomy were dissected and cultured...
October 7, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29101462/the-validity-of-arterial-measurements-in-a-south-african-embalmed-body-population
#17
Marelize Schoeman, Albert van Schoor, Farhana Suleman, Liebie Louw, Peet du Toit
INTRODUCTION: Knowledge of the normal arterial diameter at a given anatomical point is the first step toward quantifying the severity of cardiovascular diseases. According to several studies, parameters such as weight, height, age and sex can explain morphometric variations in arterial anatomy that are observed in a population. Before the development of a reference database against which to compare the diameters of arteries in a variety of pathological conditions, the compatibility between embalmed body measurements and computed tomography (CT) measurements must first be established...
November 3, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29100856/recanalization-after-extracranial-dissection-effect-of-antiplatelet-compared-with-anticoagulant-therapy
#18
Preethi Ramchand, Michael T Mullen, Aaron Bress, Robert Hurst, Scott E Kasner, Brett L Cucchiara, Steven R Messé
BACKGROUND: Cervical arterial dissection is a leading cause of stroke in young patients, yet optimal management remains controversial. Existing studies focusing on recurrent stroke were underpowered to demonstrate differences between antithrombotic strategies. Vessel recanalization is a more prevalent outcome and is potentially clinically important. We aimed to assess recanalization rates with anticoagulation compared with antiplatelet therapy. METHODS: We studied a single-center retrospective cohort of patients with extracranial carotid or vertebral artery dissection...
October 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29099499/carotid-cavernous-fistula-current-concepts-in-aetiology-investigation-and-management
#19
A D Henderson, N R Miller
A carotid-cavernous fistula (CCF) is an abnormal communication between arteries and veins within the cavernous sinus and may be classified as either direct or dural. Direct CCFs are characterized by a direct connection between the internal carotid artery (ICA) and the cavernous sinus, whereas dural CCFs result from an indirect connection involving cavernous arterial branches and the cavernous sinus. Direct CCFs frequently are traumatic in origin and also may be caused by rupture of an ICA aneurysm within the cavernous sinus, Ehlers-Danlos syndrome type IV, or iatrogenic intervention...
November 3, 2017: Eye
https://www.readbyqxmd.com/read/29098320/iatrogenic-vessel-dissection-in-endovascular-treatment-of-acute-ischemic-stroke
#20
Barbara Goeggel Simonetti, Justine Hulliger, Etienne Mathier, Simon Jung, Urs Fischer, Hakan Sarikaya, Johannes Slotboom, Gerhard Schroth, Pasquale Mordasini, Jan Gralla, Marcel Arnold
PURPOSE: Knowledge about the localization and outcome of iatrogenic dissection (ID) during endovascular treatment of acute ischemic stroke (AIS) is limited. We aimed to determine the frequency, clinical aspects and morphology of ID in endovascular AIS treatment and to identify predictors of this complication. METHODS: Digital subtraction angiography (DSA) of ID carried out during endovascular treatment between January 2000 and March 2012 have been re-evaluated. The ID localization and morphology were analyzed and related to the interventional techniques...
November 2, 2017: Clinical Neuroradiology
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