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https://www.readbyqxmd.com/read/29753899/co-adjuvant-treatment-of-vasospasm-in-ruptured-unsecured-cerebral-aneurysms-with-aggressive-angioplasty-intra-arterial-nimodipine-and-aneurysm-embolization
#1
Ching-Chang Chen, Alvin Yi-Chou Wang, Chun-Ting Chen, Po-Chuan Hsieh
BACKGROUND: Vasospasm is a major cause of morbidity and mortality in patients following aneurysmal subarachnoid hemorrhage (SAH). Although early treatment of ruptured aneurysms is advocated, delayed intervention complicates the treatment strategy and leading to significant vasospasm and a poor prognosis. We report our experience of endovascular protocol for occlusion of the unsecured aneurysm and angioplasty for vasospasm in a single session. METHODS: A total of 24 cases with significant vasospasm and unsecured ruptured cerebral aneurysm were reviewed among 660 aneurysmal SAH patients between January 2011 and May 2017...
May 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29706928/repetitive-neonatal-erythropoietin-and-melatonin-combinatorial-treatment-provides-sustained-repair-of-functional-deficits-in-a-rat-model-of-cerebral-palsy
#2
Lauren L Jantzie, Akosua Y Oppong, Fatu S Conteh, Tracylyn R Yellowhair, Joshua Kim, Gabrielle Fink, Adam R Wolin, Frances J Northington, Shenandoah Robinson
Cerebral palsy (CP) is the leading cause of motor impairment for children worldwide and results from perinatal brain injury (PBI). To test novel therapeutics to mitigate deficits from PBI, we developed a rat model of extreme preterm birth (<28 weeks of gestation) that mimics dual intrauterine injury from placental underperfusion and chorioamnionitis. We hypothesized that a sustained postnatal treatment regimen that combines the endogenous neuroreparative agents erythropoietin (EPO) and melatonin (MLT) would mitigate molecular, sensorimotor, and cognitive abnormalities in adults rats following prenatal injury...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29701426/is-invasive-pressure-monitoring-more-reliable-than-non-invasive-in-patients-with-cardiovascular-pathology-a-case-report
#3
Andreia Fernandes, Luísa Coimbra, Inês Delgado, José Carvalho, Carla Bentes
INTRODUCTION: Patients undergoing carotid endarterectomy (CEA) require strict arterial blood pressure (BP) control to maintain adequate cerebral perfusion. Invasive blood pressure (IBP) is the gold standard, however artifacts may lead to erroneous readings. METHODS: We report a case of CEA using IBP monitoring. RESULTS: A 64-year-old man, American Society Anaesthesiology (ASA) physical status 3 (diffuse atheromathosis, dyslipidemia and non-medicated hypertension), was presented for an elective right CEA...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701421/rapid-pacing-for-thoracic-endovascular-aortic-repair-a-case-report
#4
Hugo Silva, Andreia Fernandes, João Rodrigues, Daniel Brandão, Manuela Vieira, Catarina Celestino
INTRODUCTION: Endovascular aortic interventions are suitable alternatives to open surgery, being less invasive and having lower mortality and complications. Accurate positioning of the stent graft is a critical point because of systolic thrush. Techniques used to prevent it include pharmacological (antihypertensive drugs, nitroglycerin, adenosine) and mechanical methods (temporary caval occlusion by balloon). Rapid Right Ventricular Pacing (RRVP) is an emerging alternative with good patient tolerance and low level of complications...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29689584/bedside-ultrasound-guided-percutaneous-needle-aspiration-of-intra-and-extra-axial-intracranial-hemorrhage-in-neonates
#5
Mehmet N Cizmeci, Liesbeth Thewissen, Alexandra Zecic, Peter A Woerdeman, Bart de Boer, Edward Baert, Paul Govaert, Jeroen Dudink, Floris Groenendaal, Maarten Lequin, Linda S de Vries
Intracranial hemorrhage is an important cause of brain injury in the neonatal population and bedside percutaneous needle aspiration has emerged as an alternative due to the major risks that can be caused by standard neurosurgical decompression. We aimed to assess the effectiveness of this minimally invasive bedside technique and conducted a retrospective analysis of all newborn infants with a large extra-axial hemorrhage associated with a parenchymal hemorrhage causing a midline shift, managed at three academic centers over a 15-year period...
April 24, 2018: Neuropediatrics
https://www.readbyqxmd.com/read/29682071/intraoperative-rupture-cerebral-aneurysm-and-computational-flow-dynamics
#6
Ilya Senko, Anton Shatokhin, Ishu Bishnoi, Yasuhiro Yamada, Riki Tanaka, Daisuke Suyama, Tukasa Kawase, Yoko Kato
Intraoperative aneurysmal rupture (IAR) is the most fearsome complication of aneurysm surgery. IAR associates with high morbidity and mortality. In recent years, we have many studies regarding using computational fluid dynamics (CFD) in aneurysm surgery. CFD helps in calculating the velocity of blood flowing in the aneurysm sac, the pressure in the aneurysm sac, and wall shear stress (WSS). CFD also helps in predicting nature of aneurysm wall and thus may warn about different intraoperative microscopy findings in aneurysms...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682009/the-effect-of-stents-in-cerebral-aneurysms-a-review
#7
REVIEW
Kenan Alkhalili, Jack Hannallah, Mary Cobb, Nohra Chalouhi, Jessica L Philips, Angela B Echeverria, Pascal Jabbour, M Haithem Babiker, David H Frakes, L Fernando Gonzalez
The etiology of up to 95% of cerebral aneurysms may be accounted for by hemodynamically-induced factors that create vascular injury. The purpose of this review is to describe key physical properties that stents have and how they affect cerebral aneurysms. We performed a two-step screening process. First, a structured search was performed using the PubMed database. The following search terms and keywords were used: "Hemodynamics," "wall shear stress (WSS)," "velocity," "viscosity," "cerebral aneurysm," "intracranial aneurysm," "stent," "flow diverter," "stent porosity," "stent geometry," "stent configuration," and "stent design...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29616518/coronary-artery-bypass-surgery-in-patients-with-chronic-brain-hypoperfusion
#8
Hajime Imura, Yuji Maruyama, Kenichiro Takahashi, Dai Nishina, Takashi Nitta
BACKGROUND: Cerebrovascular disease (CVD) is a risk factor of stroke and cerebral hypoperfusion is one of the underlying mechanisms. We hypothesized that coronary artery bypass grafting (CABG) can be performed at an acceptable risk for such patients without concomitant surgery for CVD. METHODS: Carotid echo was carried out for 538 consecutive patients undergoing isolated CABG between 2005 and 2016. Magnetic resonance image/angiography (MRI/A) for neck and brain was performed for 288 patients (stenosis≥50% in echo were basically included)...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29578465/fluid-structure-interaction-of-patient-specific-circle-of-willis-with-aneurysm-investigation-of-hemodynamic-parameters
#9
Mahsa Jahed, Farzan Ghalichi, Mehdi Farhoudi
BACKGROUND: Circle of Willis (COW) is a network of cerebral artery which continually supplies the brain with blood. Any disturbance in this supply will result in trauma or even death. One of these damages is known as brain Aneurysm. Clinical methods for diagnosing aneurysm can only measure blood velocity; while, in order to understand the causes of these occurrences it is necessary to have information about the amount of pressure and wall shear stress, which is possible through computational models...
2018: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/29497965/pressure-and-flow-rate-changes-during-contrast-injections-in-cerebral-angiography-correlation-to-reflux-length
#10
Brandon Kovarovic, Henry H Woo, David Fiorella, Baruch B Lieber, Chander Sadasivan
Cerebral angiography involves the antegrade injection of contrast media through a catheter into the vasculature to visualize the region of interest under X-ray imaging. Depending on the injection and blood flow parameters, the bolus of contrast can propagate in the upstream direction and proximal to the catheter tip, at which point contrast is said to have refluxed. In this in vitro study, we investigate the relationship of fundamental hemodynamic variables to this phenomenon. Contrast injections were carried out under steady and pulsatile flow using various vessel diameters, catheter sizes, working fluid flow rates, and injection rates...
March 1, 2018: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29492555/icp-from-correlation-to-causation
#11
Eric A Schmidt, Olivier Maarek, Jérôme Despres, Manon Verdier, Laurent Risser
Intracranial pressure (ICP) is a complex modality in the sense that it largely interconnects various systemic and intra-cranial variables such as cerebral blood flow and volume, cerebrospinal fluid flow and absoption, craniospinal container. In this context, although empirical correlation is an interesting tool for establishing relations between pairs of observed variables, it may be limited to establishing causation relations. For instance, if variables X and Y are mainly influenced by variable Z, their correlation is strong, but does not mean that X has a causation relation with Y or vice versa...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29492141/management-of-obstructive-hydrocephalus-in-pregnant-patient
#12
Murat Şakir Ekşi, Ahmet Öğrenci, Osman Ersegun Batçık, Orkun Koban
De novo obstructive hydrocephalus is a rare event during pregnancy. There are only case reports presented in literature. We aimed to discuss the pathophysiological basis and management options with an exemplary case presentation and review of the current literature. A 28-year-old G2P1 patient presented to our clinic with headache, vomiting, and deteriorated vision at the 8th week of gestation. She had no history of central nervous system infection or trauma. A brain magnetic resonance imaging was obtained. There was hydrocephalus due to cerebral aqueduct stenosis (Evan's index of 58%)...
January 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29477456/incidence-risk-factors-and-clinical-implications-of-post-operative-delirium-in-lung-transplant-recipients
#13
Brian J Anderson, Christopher F Chesley, Miranda Theodore, Colin Christie, Ryan Tino, Alex Wysoczanski, Kristy Ramphal, Michelle Oyster, Laurel Kalman, Mary K Porteous, Christian A Bermudez, Edward Cantu, Dennis L Kolson, Jason D Christie, Joshua M Diamond
BACKGROUND: Delirium significantly affects post-operative outcomes, but the incidence, risk factors, and long-term impact of delirium in lung transplant recipients have not been well studied. METHODS: We analyzed 155 lung transplant recipients enrolled in the Lung Transplant Outcomes Group (LTOG) cohort at a single center. We determined delirium incidence by structured chart review, identified risk factors for delirium, determined whether plasma concentrations of 2 cerebral injury markers (neuron-specific enolase [NSE] and glial fibrillary acidic protein [GFAP]) were associated with delirium, and determined the association of post-operative delirium with 1-year survival...
February 2, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29472865/intracranial-pressure-is-a-determinant-of-sympathetic-activity
#14
Eric A Schmidt, Fabien Despas, Anne Pavy-Le Traon, Zofia Czosnyka, John D Pickard, Kamal Rahmouni, Atul Pathak, Jean M Senard
Intracranial pressure (ICP) is the pressure within the cranium . ICP rise compresses brain vessels and reduces cerebral blood delivery. Massive ICP rise leads to cerebral ischemia, but it is also known to produce hypertension, bradycardia and respiratory irregularities due to a sympatho-adrenal mechanism termed Cushing response. One still unresolved question is whether the Cushing response is a non-synaptic acute brainstem ischemic mechanism or part of a larger physiological reflex for arterial blood pressure control and homeostasis regulation...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29432378/low-perfusion-pressure-is-associated-with-renal-tubular-injury-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-secondary-analysis-of-an-observational-study
#15
Mirela Bojan, Maria C Basto Duarte, Vanessa Lopez, Laurent Tourneur, Stephanie Vicca, Marc Froissart
BACKGROUND: Earlier work on adults undergoing surgery with cardiopulmonary bypass suggests that there is a close relationship between the lower limit of the cerebral and renal autoregulation pressures. Although cerebral autoregulation during bypass in infants has been extensively investigated, the impact of bypass on kidney function is not well known. It is, nevertheless, acknowledged that the main pathophysiological process involved in cardiac surgery-related kidney damage is tubular injury, and that urine neutrophil gelatinase-associated lipocaline (uNGAL) is a reliable biomarker of injury...
February 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29430730/cerebral-ischemia-during-hemodialysis-finding-the-signal-in-the-noise
#16
EDITORIAL
Clare MacEwen, Peter Watkinson, Lionel Tarassenko, Christopher Pugh
Hemodialysis patients have multiple risk factors for small vessel cerebrovascular disease and cognitive dysfunction. Hemodialysis itself may cause clinically significant neurological injury through repetitive cerebral ischemia. However, supporting evidence to date consists of epidemiological associations, expert opinion, and small, single-centre studies of variable methodological quality. Isolating the impact of intra-dialytic hemodynamic instability from underlying renal and vascular disease on clinically relevant functional outcomes would require very large, controlled studies, given the heterogeneity and confounding comorbidities of the population, and the complex relationship between blood pressure and cerebral oxygen delivery...
February 11, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29412114/caveolin-1-in-stroke-neuropathology-and-neuroprotection-a-novel-molecular-therapeutic-target-for-ischemic-related-injury
#17
Shanshan Wang, Brian P Head
Cardiovascular disease and associated cerebral stroke are a global epidemic attributed to genetic and epigenetic factors, such as diet, life style and an increasingly sedentary existence due to technological advances in both the developing and developed world. There are approximately 5.9 million stroke-related deaths worldwide annually. Current epidemiological data indicate that nearly 16.9 million people worldwide suffer a new or recurrent stroke yearly. In 2014 alone, 2.4% of adults in the United States (U...
February 5, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29322480/intra-operative-video-characterization-of-carotid-artery-pulsation-patterns-in-case-series-with-post-endarterectomy-hypertension-and-hyperperfusion-syndrome
#18
Yiming Xiao, Hassan Rivaz, Hidetoshi Kasuya, Suguru Yokosako, Cristina Mindru, Jeanne Teitelbaum, Denis Sirhan, David Sinclair, Mark Angle, Benjamin W Y Lo
Cerebral hyperperfusion syndrome (CHS) is a complication that can occur after carotid endarterectomy (CEA), the treatment of choice to decrease the subsequent risk of fatal or disabling stroke for patients with symptomatic severe stenosis of the carotid artery. Because of its rarity and complexity, the mechanism of the condition is still unclear, making its prevention via prediction and monitoring challenging. This is especially true during surgery, when multiple factors can induce physiological changes, including blood pressure and baroreceptor functions, which are crucial factors for post-CEA hypertension and CHS...
January 10, 2018: Translational Stroke Research
https://www.readbyqxmd.com/read/29287672/-impact-of-hypotension-and-global-hypoperfusion-in-postoperative-delirium-a-pilot-study-in-older-adults-undergoing-open-colon-surgery
#19
Eduardo Tobar, Mario A Abedrapo, Jaime A Godoy, Jose L Llanos, Mauricio J Díaz, Rodrigo Azolas, Gunther R Bocic, Jaime A Escobar, Rodrigo A Cornejo, Carlos M Romero
BACKGROUND: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the association between perfusion and hemodynamics peri-operative with the appearance of post-operative delirium. METHODS: Prospective cohort study of adults 60 years or older undergoing elective open colon surgery...
March 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29262429/blood-pressure-management-for-acute-ischemic-and-hemorrhagic-stroke-the-evidence
#20
Sang-Bae Ko, Byung-Woo Yoon
Hypertension is the most common modifiable risk factor for stroke (both ischemic and hemorrhagic types). In the hyperacute phase, a majority of patients shows an elevated blood pressure (BP) at the time of presentation because of sympathetic hyperactivity or a physiological response to tissue ischemia. Therefore, BP may decrease spontaneously in a few hours and may drop further when complete recanalization is achieved. In stroke guidelines, an elevated BP is usually left untreated up to a systolic BP (SBP) of 220 mm Hg and a diastolic BP of 120 mm Hg...
December 2017: Seminars in Respiratory and Critical Care Medicine
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