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Intracerebral pressure

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https://www.readbyqxmd.com/read/28642178/neurological-outcome-after-decompressive-craniectomy-predictors-of-outcome-in-different-pathologies
#1
Taco Goedemans, Dagmar Verbaan, Bert A Coert, Bertjan Kerklaan, René van den Berg, Jonathan M Coutinho, Tessa van Middelaar, Paul J Nederkoorn, W Peter Vandertop, Pepijn van den Munckhof
OBJECTIVE: Decompressive craniectomy (DC) has been proposed as lifesaving treatment in patients with elevated intracranial pressure, but its effectiveness on reaching favorable neurological outcome remains unclear. We identified predictors of outcome in a large, single-center cohort of patients undergoing DC for different pathologies. METHODS: This retrospective study included all patients undergoing DC from 2006-2014. One-year outcome, assessed using the Glasgow Outcome Scale (GOS), was dichotomized into favorable (GOS 4-5) and unfavorable (GOS 1-3) outcome...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28628707/intensive-blood-pressure-reduction-and-spot-sign-in-intracerebral-hemorrhage-a-secondary-analysis-of-a-randomized-clinical-trial
#2
Andrea Morotti, H Bart Brouwers, Javier M Romero, Michael J Jessel, Anastasia Vashkevich, Kristin Schwab, Mohammad Rauf Afzal, Christy Cassarly, Steven M Greenberg, Renee Hebert Martin, Adnan I Qureshi, Jonathan Rosand, Joshua N Goldstein
Importance: The computed tomographic angiography (CTA) spot sign is associated with intracerebral hemorrhage (ICH) expansion and may mark those patients most likely to benefit from intensive blood pressure (BP) reduction. Objective: To investigate whether the spot sign is associated with ICH expansion across a wide range of centers and whether intensive BP reduction decreases hematoma expansion and improves outcome in patients with ICH and a spot sign. Design, Setting, and Participants: SCORE-IT (Spot Sign Score in Restricting ICH Growth) is a preplanned prospective observational study nested in the Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-II) randomized clinical trial...
June 19, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28628704/can-the-spot-sign-identify-who-benefits-from-aggressive-blood-pressure-reduction-in-intracerebral-hemorrhage
#3
Jimmy V Berthaud, Bradford B Worrall
No abstract text is available yet for this article.
June 19, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28626061/intensive-blood-pressure-lowering-in-intracerebral-hemorrhage
#4
Craig S Anderson, Magdy H Selim, Carlos A Molina, Adnan I Qureshi
No abstract text is available yet for this article.
June 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28605739/satellite-sign-a-poor-outcome-predictor-in-intracerebral-hemorrhage
#5
Yoshiteru Shimoda, Satoru Ohtomo, Hiroaki Arai, Ken Okada, Teiji Tominaga
BACKGROUND: The presence of high-density starry dots around the intracerebral hemorrhage (ICH), which we termed as a satellite sign, is occasionally observed in CT. The relationship between ICH with a satellite sign and its functional outcome has not been identified. This study aimed to determine whether the presence of a satellite sign could be an independent prognostic factor for patients with ICH. METHODS: Patients with acute spontaneous ICH were retrospectively identified and their initial CT scans were reviewed...
June 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28605557/practice-patterns-for-neurosurgical-utilization-and-outcome-in-acute-intracerebral-hemorrhage-intensive-blood-pressure-reduction-in-acute-cerebral-hemorrhage-trials-1-and-2-studies
#6
Rui Guo, David J Blacker, Xia Wang, Hisatomi Arima, Pablo M Lavados, Richard I Lindley, John Chalmers, Craig S Anderson, Thompson Robinson
BACKGROUND: The prognosis in acute spontaneous intracerebral hemorrhage (ICH) is related to hematoma volume, where >30 mL is commonly used to define large ICH as a threshold for neurosurgical decompression but without clear supporting evidence. OBJECTIVES: To determine the factors associated with large ICH and neurosurgical intervention among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT). METHODS: We performed pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2839) studies of ICH patients (<6 h of onset) with elevated systolic blood pressure (SBP, 150-220 mm Hg) who were randomized to intensive (target SBP < 140 mm Hg) or contemporaneous guideline-recommended (target SBP < 180 mm Hg) management...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28598043/clinical-profile-of-hypertensive-emergencies-in-an-intensive-care-unit
#7
Shubhangi V Dhadke, Vithal N Dhadke, Dhruv S Batra
AIMS AND OBJECTIVE: To study the prevalence of hypertensive emergencies in an ICU set up and to study the clinical presentation of hypertensive emergencies related to cardiovascular, neurological and renovascular system. METHODS: Type of Study: Cross-sectional, descriptive study. DURATION OF STUDY: Two years from 1st December 2011 till 30th November 2013. SAMPLE SIZE: 50 patients of hypertensive emergencies admitted to the intensive care unit of Dr...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28595677/intensive-blood-pressure-lowering-in-patients-with-acute-cerebral-hemorrhage
#8
Sufyan Alrahbi, Rashid Alaraimi, Abdalla Alzaabi, Sophie Gosselin
Clinical question Is intensive blood pressure (BP) treatment (systolic BP target 110-139 mm Hg) better than standard antihypertensive treatment (systolic BP target 140-179 mm Hg) in reducing mortality and disability in patients with acute intracerebral hemorrhage (ICH)? Article chosen Qureshi AI, Palesch YY, Barsan WG, et al. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med 2016;375(11):1033-43. OBJECTIVE: To determine the therapeutic benefit of intensive BP treatment compared to standard BP treatment in reducing death and disability after 3 months of follow-up among patients with ICH treated within 4...
June 9, 2017: CJEM
https://www.readbyqxmd.com/read/28592775/blood-pressure-management-for-stroke-prevention-and-in-acute-stroke
#9
REVIEW
Keun-Sik Hong
Elevated blood pressure (BP) is the leading modifiable risk factor for stroke and the benefit of BP lowering therapy on the stroke risk reduction is well established. The optimal BP target for preventing stroke and other vascular events have been controversial, but the evidences from epidemiological studies and randomized controlled trials (RCTs) support intensive BP lowering for greater vascular protection, particularly for stroke prevention. For secondary stroke prevention, the evidence of intensive BP lowering benefit is limited since only a single RCT for patients with lacunar infarctions was conducted and most data were driven by exploratory analyses...
May 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28592739/a-case-of-idiopathic-normal-pressure-hydrocephalus-in-an-elder-diabetic-patient
#10
Kyoko Kawakami, Hiroshi Yoshino, Hiroyuki Igarashi, Yoshiyuki Chiba, Gen Yoshino, Takahisa Hirose
The clinical entity idiopathic normal pressure hydrocephalus (iNPH) is characterized by dementia, urinary incontinence, gait ataxia. An 80-year old man with a past history of Type 2 diabetes mellitus admitted to our hospital. Combination of twice Aspart and Aspart premixed30/70 insulin were used. Although, he was unable to inject insulin by himself recently. On physical examination, he walked in a mildly wide based manner. According to his family, urinary incontinence was existed. Laboratory data were as follows: Postrandial blood glucose 243 mg/dl and glycated hemoglobin 8...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/28575005/various-meteorological-conditions-exhibit-both-immediate-and-delayed-influences-on-the-risk-of-stroke-events-the-hews-stroke-study
#11
Tomoya Mukai, Naohisa Hosomi, Miwako Tsunematsu, Yoshimasa Sueda, Yutaka Shimoe, Tomohiko Ohshita, Tsuyoshi Torii, Shiro Aoki, Tomohisa Nezu, Hirofumi Maruyama, Masayuki Kakehashi, Masayasu Matsumoto
We hypothesized that meteorological conditions on the onset day and conditions on the former days may play important roles in the modulation of physical conditions. Associations of meteorological factors and their changes in former days with stroke onset are of interest. We conducted a multicenter retrospective study to evaluate the frequency of stroke events and their interaction with meteorological conditions and their daily changes. Acute stroke patients (n = 3935, 73.5±12.4 years, 1610 females) who were admitted to 7 stroke hospitals in three restricted areas were enrolled in this study...
2017: PloS One
https://www.readbyqxmd.com/read/28571544/programmed-cell-death-after-intracerebral-hemorrhage
#12
Tobias Bobinger, Petra Burkardt, Hagen B Huttner, Anatol Manaenko
Intracerebral hemorrhage (ICH) accounts for up to 15% of all strokes and is characterized by high rates of mortality and morbidity. At present, treatment of ICH patients is based on oral anticoagulant reversal and management of blood pressure and other medical complications. The primary damage is caused by the hematoma's extensive effects, which cause disruption and mechanical deformation of the cellular architecture. Damage secondary to the primary insult is induced by mitochondrial dysfunction, microglia activation and neurotransmitter and inflammatory mediator release...
June 1, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28566094/assessment-of-cerebral-blood-flow-in-adult-patients-with-aortic-coarctation
#13
Rachel Wong, Waheed Ahmad, Allan Davies, Neil Spratt, Andrew Boyle, Christopher Levi, Peter Howe, Nicholas Collins
BACKGROUND: Survival into adult life in patients with aortic coarctation is typical following surgical and catheter-based techniques to relieve obstruction. Late sequelae are recognised, including stroke, hypertension, and intracerebral aneurysm formation, with the underlying mechanisms being unclear. We hypothesised that patients with a history of aortic coarctation may have abnormalities of cerebral blood flow compared with controls. METHODS: Patients with a history of aortic coarctation underwent assessment of cerebral vascular function...
June 1, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28561152/-hypercapnic-raised-intracerebral-pressure-ecmo-therapy-despite-major-intracerebral-haemorrhage
#14
Matthias Unterberg, Hartmuth Nowak, André Gottschalk
We report a case of a 29-year-old primigravida asian woman with severe peripartal HELLP-syndrome. During delivery she developed coma. HELLP syndrome, complicated by severe intracerebral hemorrhage was detected. During course of therapy with drainage of intraventricular intracerebral hemorrhage, the patient developed pneumonia followed by severe acute respiratory distress syndrome (ARDS) with critically raised ICP. After 31 days of stabilization by extracorporeal membrane oxygenation (ECMO) and lung protective ventilation the patient was weaned of ECMO therapy...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28559965/brainstem-injury-associated-with-supratentorial-lesions-is-revealed-by-electronystagmography-of-the-cold-caloric-reflex-test
#15
Qizhi Fu, Zhiguo Qi, Ruirui Yang, Ke Cheng, Yongtao Yang, Peng Xie
To explore the brainstem injury associated with supratentorial lesions, we conducted analysis of ICP levels and detected ENG parameters by using the cold caloric reflex test and histopathological examinations of the brainstem. Rat model of intracerebral hemorrhage was well-established in the study of supratentorial lesions of varying severities (n=210). Intracerebral pressure monitoring and electronystagmography of the cold caloric reflex test were simultaneously performed in animals. Apoptotic, immunohistochemical, and histopathological changes in different segments of the brainstem were investigated at various time intervals...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28553646/protection-against-blast-induced-traumatic-brain-injury-by-increase-in-brain-volume
#16
Ming Gu, Usmah Kawoos, Richard McCarron, Mikulas Chavko
Blast-induced traumatic brain injury (bTBI) is a leading cause of injuries in recent military conflicts and it is responsible for an increased number of civilian casualties by terrorist attacks. bTBI includes a variety of neuropathological changes depending on the intensity of blast overpressure (BOP) such as brain edema, neuronal degeneration, diffuse axonal damage, and vascular dysfunction with neurological manifestations of psychological and cognitive abnormalities. Internal jugular vein (IJV) compression is known to reduce intracranial compliance by causing an increase in brain volume and was shown to reduce brain damage during closed impact-induced TBI...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28546325/reciprocal-interaction-of-24-hour-blood-pressure-variability-and-systolic-blood-pressure-on-outcome-in-stroke-thrombolysis
#17
Lars Kellert, Christian Hametner, Niaz Ahmed, Geraldine Rauch, Mary J MacLeod, Francesco Perini, Kennedy R Lees, Peter A Ringleb
BACKGROUND AND PURPOSE: Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. METHODS: From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed...
May 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28536064/analysis-of-delayed-intracerebral-hemorrhage-associated-with-deep-brain-stimulation-surgery
#18
Chang Kyu Park, Na Young Jung, Min Soo Kim, Jin Woo Chang
OBJECTIVE: Deep brain stimulation (DBS) may cause various complications, including intracerebral hemorrhage (ICH). Because ICH causes devastating neurological outcomes, various surgical techniques are attempting to reduce the chances of ICH. More importantly, early detection and proper management of postoperative ICH are indispensable. ICH may occur immediate or delayed following DBS; in this study, we analyzed the clinical features of delayed ICH after DBS. METHODS: Patients (n=272) underwent postoperative brain computed tomography (CT) immediately after and 1 day after DBS between January 2008 and November 2016...
May 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28525977/the-intracerebral-hemorrhage-acutely-decreasing-arterial-pressure-trial-ii-ich-adapt-ii-protocol
#19
Laura Gioia, Ana Klahr, Mahesh Kate, Brian Buck, Dariush Dowlatshahi, Thomas Jeerakathil, Derek Emery, Kenneth Butcher
BACKGROUND: Aggressively lowering blood pressure (BP) in acute intracerebral hemorrhage (ICH) may improve outcome. Although there is no evidence that BP reduction changes cerebral blood flow, retrospective magnetic resonance imaging (MRI) studies have demonstrated sub-acute ischemic lesions in ICH patients. The primary aim of this study is to assess ischemic lesion development in patients randomized to two different BP treatment strategies. We hypothesize aggressive BP reduction is not associated with ischemic injury after ICH...
May 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28515710/resistant-hypertension-after-hypertensive-intracerebral-hemorrhage-is-associated-with-more-medical-interventions-and-longer-hospital-stays-without-affecting-outcome
#20
Daojun Hong, Dana Stradling, Cyrus K Dastur, Yama Akbari, Leonid Groysman, Lama Al-Khoury, Jefferson Chen, Steven L Small, Wengui Yu
BACKGROUND: Hypertension (HTN) is the most common cause of spontaneous intracerebral hemorrhage (ICH). The aim of this study is to investigate the role of resistant HTN in patients with ICH. METHODS AND RESULTS: We conducted a retrospective study of all consecutive ICH admissions at our medical center from November 2013 to October 2015. The clinical features of patients with resistant HTN (requiring four or more antihypertensive agents to keep systolic blood pressure <140 mm Hg) were compared with those with responsive HTN (requiring three or fewer agents)...
2017: Frontiers in Neurology
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