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https://www.readbyqxmd.com/read/29779961/patient-satisfaction-with-the-consent-discussion-is-not-improved-by-showing-patients-their-computed-tomography-or-angiography-images-before-they-undergo-vascular-surgery
#1
Dominic LeBlanc, Adam H Power, Guy DeRose, Audra Duncan, Luc Dubois
OBJECTIVE: Patient-based decision aids and other multimedia tools have been developed to help enrich the preoperative discussion between surgeon and patient. Use of these tools, however, can be time-consuming and logistically challenging. We investigated whether simply showing patients their images from preoperative computed tomography (CT) or angiography would improve patients' satisfaction with the preoperative discussion. We also examined whether this improved the patient's understanding and trust and whether it contributed to increased preoperative anxiety...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29777883/atypical-presentation-of-giant-aneurysm-in-a-pediatric-patient-with-duane-syndrome
#2
Chao-Hung Kuo, Lynn B McGrath, Joseph A Carnevale, Neena I Marupudi, Jeffery G Ojemann, Richard G Ellenbogen, Anthony C Wang
BACKGROUND: Duane syndrome is a congenital eye movement disorder characterized by congenital malformation of the abducens nucleus. Thrombogenic conditions during development may lead to vascular anomalies in Duane syndrome, however, the presence of a giant aneurysm in this patient population is a rarely documented phenomenon. CASE DESCRIPTION: We reported a case of a large cerebral aneurysm in a pediatric patient with Duane syndrome, and performed a review of the literatures to identify other potential cases and associations...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29775142/aspirin-for-primary-prevention-of-stroke-in-traumatic-cerebrovascular-injury-association-with-increased-risk-of-transfusion
#3
Russell L Griffin, Stephanie R Falatko, Stella Aslibekyan, Virginia Strickland, Mark R Harrigan
OBJECTIVE Blunt traumatic extracranial carotid or vertebral artery injury (i.e., traumatic cerebrovascular injury [TCVI]) occurs in 1%-2% of all blunt trauma admissions, carries a 10% risk of thromboembolic ischemic stroke, and accounts for up to 9600 strokes annually in the US. Screening CT angiograms (CTAs) of patients with trauma has become ubiquitous in recent years, and patients with initially asymptomatic TCVI are commonly treated with antiplatelet agents to prevent stroke. Prophylaxis with antiplatelets is thought to be safer than anticoagulation, which carries a significant risk of hemorrhage in patients with trauma...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29766944/craniovertebral-junction-evaluation-by-computed-tomography-in-asymptomatic-individuals-in-the-indian-population
#4
Chinmaya Dash, Raghav Singla, Mohit Agarwal, Ambuj Kumar, Hitesh Kumar, Shashwat Mishra, Bhawani S Sharma
Background: The available literature on the anatomy and imaging of the craniovertebral junction (CVJ) focusses on the osteometric indices described for the detection of abnormal relationships between the components of CVJ. However, a knowledge of the normal osteometry of this region in the Indian population is critically important for the operating surgeon as it may influence the surgical technique as well as the choice, size and configurations of the implants. It is also important to determine whether critical differences exist between the osteometric data of Indians and the rest of the world for this part of the anatomy...
May 2018: Neurology India
https://www.readbyqxmd.com/read/29762610/comments-on-knowledge-translation-of-the-perc-rule-for-suspected-pulmonary-embolism-a-blueprint-for-reducing-the-number-of-ct-pulmonary-angiograms
#5
COMMENT
Jeffrey Dubin, Matthew Wilson, William Frohna
No abstract text is available yet for this article.
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29749664/the-role-of-neuroimaging-in-the-determination-of-brain-death
#6
Derek MacDonald, Brandie Stewart-Perrin, Jai Jai Shiva Shankar
BACKGROUND AND PURPOSE: Brain death determination (BDD) is primarily a clinical diagnosis, where death is defined as the permanent loss of brainstem function. In scenarios where clinical examinations are inaccurate, ancillary imaging tests are required. The choice of ancillary imaging test is variable, but the common denominator for all of them is to establish a lack of cerebral blood flow. The purpose of this study was to compare the diagnostic accuracy and interrater reliability of different ancillary imaging tests used for BDD...
May 11, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29735504/pneumonitis-a-serious-adverse-effect-of-pd-l1-inhibitors-including-pembrolizumab
#7
Frances Rickard, Catherine Hyams, Andrew T Low
A 70-year-old man presented with breathlessness, cough and fever while receiving pembrolizumab for melanoma. A CT pulmonary angiogram demonstrated small bilateral upper lobe segmental pulmonary emboli with patchy ground-glass opacities and basal perilobular consolidation, in keeping with organising pneumonia. He was treated for community-acquired pneumonia and pulmonary emboli but rapidly deteriorated, with increasing hypoxia and dyspnoea. He was admitted to the intensive care unit for support with continuous positive airway pressure and high flow nasal oxygen...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29725568/tiny-falx-meningioma-causing-massive-interhemispheric-subdural-hematoma-a-case-report
#8
Yume Suzuki, Masashi Fujimoto, Fumihiro Kawakita, Fumio Asakura, Hiroto Murata, Yoshito Morooka, Hidenori Suzuki
Bleeding from meningiomas is well known, but massive subdural hemorrhage from a very small meningioma is rare. A 61-year-old woman presented with a sudden-onset headache and slight right hemiparesis without a history of trauma. Computed tomographic scan showed bilateral acute/subacute interhemispheric subdural hematoma, but contrast-enhanced computed tomography (CT) scan, non-enhanced magnetic resonance imaging (MRI) and digital subtraction angiography failed to detect the cause. The hematoma was conservatively treated...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29724649/anatomical-variations-of-vertebral-artery-and-c2-isthmus-in-atlanto-axial-fusion-consecutive-surgical-100-cases
#9
Bong Ju Moon, Kyung Ho Choi, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Do Heum Yoon, Yoon Ha
VA anomalies in extra- and intraosseous regions of the craniovertebral junction (CVJ) is considered very carefully during the posterior screw fixation for the atlantoaxial instability (AAI). This study aims to compare the incidence and variations of VA anomalies, isthmus and pedicle size of C2 in 100 patients with AAI due to congenital skeletal anomaly (CSA) and acquired disease by using three-dimensional CT angiograms (3D CTA) before surgery. The CSA group contained 48 patients and the acquired disease group consisted of 52...
April 30, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29720096/celiac-crisis-a-rare-and-profound-presentation-of-celiac-disease-a-case-report
#10
Elizabeth Ann Forrest, Mark Wong, Srinivasa Nama, Siddharth Sharma
BACKGROUND: Celiac crisis is a life-threatening manifestation of celiac disease and is rare in adults, with only a handful of cases documented worldwide and mostly in children. CASE PRESENTATION: A profoundly emaciated 43-year-old female presented with profuse diarrhoea, shortness of breath, left leg swelling with ulceration and immobility (Body Mass Index (BMI) = 14.7 kg/m2 ). The patient had normal anion-gap metabolic acidosis (pH = 7.16) with persisting hypokalemia, hyponatremia, hypomagnesemia and hypophosphatemia...
May 2, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29699500/in-flight-angina-pectoris-an-unusual-presentation
#11
Firas Al-Janabi, Regina Mammen, Grigoris Karamasis, John Davies, Thomas Keeble
BACKGROUND: An unusual case of typical angina which occurred on a long haul flight is presented. This case is notable as this was the index presentation, with no previous symptoms prior to this. Physiological changes at altitude can be marked, and include hypoxia, tachycardia and an increase in cardiac output. These changes were enough to expose underlying angina in our patient. CASE PRESENTATION: A 68 year old man presented with typical cardiac chest pain on a long haul flight...
April 5, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29696430/subtraction-ct-angiography-improves-evaluation-of-significant-coronary-artery-disease-in-patients-with-severe-calcifications-or-stents-the-c-sub-320-multicenter-trial
#12
Andreas Fuchs, J Tobias Kühl, Marcus Y Chen, David Viladés Medel, Xavier Alomar, Sujata M Shanbhag, Steffen Helqvist, Klaus F Kofoed
OBJECTIVES: Diagnostic accuracy of conventional coronary CT angiography (CCTAconv ) may be compromised by blooming artifacts from calcifications or stents. Blooming artifacts may be reduced by subtraction coronary CT angiography (CCTAsub ) in which non-contrast and contrast CT data sets are subtracted digitally. We tested whether CCTAsub in patients with severe coronary calcification or stents reduces the number of false-positive stenosis evaluations compared with CCTAconv . METHODS: In this study, 180 symptomatic patients scheduled for invasive coronary angiography (ICA) were prospectively enrolled and CT scanned (2013-2016) at three international centers...
April 25, 2018: European Radiology
https://www.readbyqxmd.com/read/29691271/unusual-congenital-coronary-artery-anomaly-in-a-young-adult-presenting-as-sudden-cardiac-arrest
#13
Manuel Cortes, Carlos A Roldan, Stacey Clegg
A previously asymptomatic young female with no previous medical or cardiac history collapsed during indoor exercise. A portable automatic external defibrillator showed a shockable rhythm. She received multiple electrical shocks with return to normal sinus rhythm without ischaemic ECG changes. Her troponin level was mildly elevated. A transthoracic echocardiogram revealed moderately reduced left ventricular ejection fraction with global hypokinesis. During emergent coronary angiography, the left main coronary artery could not be found...
April 24, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29689403/delayed-cerebral-ischemia-and-vasospasm-after-spontaneous-angiogram-negative-subarachnoid-hemorrhage-an-updated-meta-analysis
#14
Si Un Lee, Eun Pyo Hong, Bong Jun Kim, Sung-Eun Kim, Jin Pyeong Jeon
OBJECT: To provide an update on the clinical outcomes such as delayed cerebral ischemia (DCI) and vasospasm in angiogram-negative subarachnoid hemorrhage (SAH), according to hemorrhage patterns, perimesencephalic SAH (PMH) and non-PMH. METHODS: Online databases from January 1990 to December 2017 were systematically reviewed. A fixed-effect model was used to control heterogeneity. To resolve publication bias, the trim and fill method was used to estimate the number of missing studies and adjusted odds ratio (OR)...
April 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29686924/anomalous-right-subclavian-artery-esophageal-fistulae
#15
Courtney Brooke Shires, Michael J Rohrer
An aberrant right subclavian artery (ARSA) is the most common aortic arch anomaly, but only 19 previous cases of ARSA-esophageal fistula have been reported. Six patients have survived their bleeding episode. We describe the case of a 44-year-old woman who developed massive hemoptysis. Laryngoscopy, bronchoscopy, head and neck angiogram, and median sternotomy did not reveal what was presumed initially to be a tracheoinnominate fistula. Contrasted CT showed an anomalous subclavian artery posterior to the esophagus...
2018: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/29685360/incidental-lad-stenosis-identified-on-non-gated-chest-cta
#16
Nicholas Chan, Brian M Yuen, Ji Yang, Stuart L Cohen, Loukas Boutis, John N Makaryus
A 57-year-old male former smoker presented to the Emergency Department (ED) with blurry vision, headache, and generalized weakness. He was hypoxic on room air and ECG showed sinus tachycardia. A CT pulmonary angiogram was ordered in the ED and revealed no pulmonary embolism but incidentally noted a likely significant stenosis in the proximal LAD. Subsequent cardiac catheterization revealed a 90% stenotic lesion with percutaneous coronary intervention leading to symptom resolution. Unlike coronary CTA, CTPA is performed with non-ECG gated helical scanning and generates motion artifacts associated with myocardial contraction...
April 14, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29685020/ability-of-computed-tomography-to-predict-right-heart-strain-on-an-echocardiogram-in-patients-with-acute-pulmonary-embolus
#17
A Shams, J Hung, A Bahl
Patients with submassive pulmonary embolism (PE) resulting in right heart strain (RHS) have an increased risk of mortality compared to those with a preserved right ventricular function. This study aimed to investigate the predictive value of computed tomography pulmonary angiogram (CTPA) findings of right heart strain in patients with computed tomography (CT)-proven PE for the diagnosis of right heart strain by echocardiogram (ECHO). The institutional review board (IRB) approved retrospective chart review of the adult emergency department patients diagnosed with an acute PE between 2012 and 2016...
March 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29678783/safety-and-efficacy-of-stereotactic-radioablation-targeting-pulmonary-vein-tissues-in-an-experimental-model
#18
Paul C Zei, Doug Wong, Edward Gardner, Thomas Fogarty, Patrick Maguire
BACKGROUND: Stereotactic radioablation (SR), a commonly used therapy to treat malignancies, has been utilized to treat refractory ventricular tachycardia, but the feasibility of treating atrial fibrillation (AF) with SR is unknown. OBJECTIVE: We evaluated the safety and efficacy of SR targeting pulmonary vein (PV) antral tissues as potential therapy for AF. METHODS: Seventeen adult canines and two adult swine underwent surgical fiducial marker placement, 3D anatomic rendering CT angiogram of the left atrium (LA), and creation of a treatment plan targeting the right superior pulmonary veins (RSPVs)...
April 17, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29678310/grossly-abnormal-ventilation-perfusion-spect-study-in-idiopathic-pulmonary-arterial-hypertension-without-thromboembolism
#19
Kenneth Chan, John G Coghlan, Margaret Hall, Jamanda Haddock, Alan Bates, Benjamin E Schreiber
Pulmonary hypertension is a serious condition with multiple underlying aetiologies which require different treatment strategies. We present a case of severe idiopathic pulmonary arterial hypertension in a 20-year-old patient with ongoing breathlessness. She was initially diagnosed with asthma and panic attacks in community care. As the symptoms became progressively worse, she was referred for pulmonary hypertension clinic assessment. Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) showed grossly abnormal perfusion defects which were mismatched to the ventilation scan, suggestive of chronic thromboembolic disease...
January 31, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29674397/massive-haemoptysis-secondary-to-mycotic-pulmonary-artery-aneurysm-in-subacute-invasive-aspergillosis
#20
Shahbaz Piracha, Asad Mahmood, Noman Qayyum, Muhammad Badar Ganaie
A 68-year-old man, presented with 3 week history of infective symptoms and mild haemoptysis. Past medical history included severe emphysema and a chronic right upper lobe (RUL) cavity. He was discharged from follow-up a year ago in view of clinical and radiological stability; previous bronchoscopic examinations yielded no specific diagnosis. CT scan on admission confirmed complex cavitary consolidation of RUL. He developed massive haemoptysis requiring intubation and ventilation. CT pulmonary angiogram (CTPA) revealed 16 mm RUL pulmonary artery (PA) aneurysm which was successfully embolized...
April 19, 2018: BMJ Case Reports
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