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https://www.readbyqxmd.com/read/28179050/cerebral-amyloid-angiopathy-in-stroke-medicine
#1
Frank Block, Manuel Dafotakis
BACKGROUND: Cerebral amyloid angiopathy (CAA) is a degenerative vasculopathy that is classically associated with lobar intracerebral or sulcal hemorrhage. Its prevalence is estimated at 30% in the seventh decade and 50% in the eighth and ninth decades. In this review, we summarize the risks linked to CAA with respect to the treatment and prevention of stroke. METHODS: This review is based on pertinent publications retrieved by a selective search employing the terms "amyloid cerebral angiopathy," "stroke," "intra - cerebral bleeding," and "acute stroke therapy...
January 20, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28155701/exploring-potential-association-between-flow-instability-and-rupture-in-patients-with-matched-pairs-of-ruptured-unruptured-intracranial-aneurysms
#2
Lijian Xu, Lixu Gu, Hao Liu
BACKGROUND: Patients with multiple intracranial aneurysms present a great challenge to the neurosurgeon, particularly when presenting with subarachnoid hemorrhage. Misjudgment may result in disastrous postoperative rebleeding from the untreated but true-ruptured lesion. METHODS: In this study, computational fluid dynamic simulations of two matched-pairs of ruptured-unruptured cerebral aneurysms were performed to investigate the potential association between flow instability and aneurysm rupture...
December 28, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28117180/the-role-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-as-an-adjunct-to-acls-in-non-traumatic-cardiac-arrest-a-review-of-key-concepts-physiology-current-evidence-and-future-directions
#3
James Daley, Jonathan James Morrison, John Sather, Lisa Hile
Non-traumatic cardiac arrest is a major public health problem that carries an extremely high mortality rate. If we hope to increase the survivability of this condition, it is imperative that alternative methods of treatment are given due consideration. Balloon occlusion of the aorta can be used as a method of circulatory support in the critically ill patient. Intra-aortic balloon pumps have been used to temporize patients in cardiogenic shock for decades. More recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been utilized in the patient in hemorrhagic shock or cardiac arrest secondary to trauma...
January 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28104522/intra-arterial-use-of-abciximab-in-thromboembolic-complications-associated-with-cerebral-aneurysm-coiling-the-london-ontario-experience
#4
R Martínez-Pérez, S P Lownie, D M Pelz
BACKGROUND: and Purpose: Experience with intra-arterial infusion of abciximab for the treatment of endovascular thrombotic complications is limited to short case series. Our objective is to evaluate the safety and effectiveness of this drug for the treatment of thromboembolic complications during aneurysm coiling and determine the risk factors. METHODS: From an aneurysm coiling database, patients treated with intra-arterial abciximab after having thrombotic complications during the coiling procedure were selected for analysis...
January 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28096478/demographic-procedural-and-30-day-safety-results-from-the-web-intra-saccular-therapy-study-web-it
#5
David Fiorella, Andrew Molyneux, Alexander Coon, Istvan Szikora, Isil Saatci, Feyyaz Baltacioglu, Ali Sultan, Adam Arthur
INTRODUCTION: The Woven EndoBridge (WEB) represents a novel intrasaccular therapeutic option for the treatment of intracranial wide-necked bifurcation aneurysms (WNBAs). The WEB-IT Study is a pivotal Investigational Device Exemption (IDE) study to determine the safety and effectiveness of the WEB device for the treatment of WNBAs located in the anterior and posterior intracranial circulations. We present the patient demographics, procedural characteristics, and 30-day adverse event data for the US WEB-IT study...
January 17, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#6
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
January 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28004163/treatment-of-cerebral-vasospasm-following-aneurysmal-subarachnoid-haemorrhage-a-systematic-review-and-meta-analysis
#7
Grégoire Boulouis, Marc Antoine Labeyrie, Jean Raymond, Christine Rodriguez-Régent, Anne Claire Lukaszewicz, Damien Bresson, Wagih Ben Hassen, Denis Trystram, Jean Francois Meder, Catherine Oppenheim, Olivier Naggara
OBJECTIVES: To examine the clinical outcome of aneurysmal subarachnoid haemorrhage (aSAH) patients exposed to cerebral vasospasm (CVS)-targeted treatments in a meta-analysis and to evaluate the efficacy of intra-arterial (IA) approaches in patients with severe/refractory vasospasm. METHODS: Randomised controlled trials, prospective and retrospective observational studies reporting clinical outcomes of aSAH patients exposed to CVS targeted treatments, published between 2006-2016 were searched using PubMed, EMBASE and the Cochrane Library...
December 21, 2016: European Radiology
https://www.readbyqxmd.com/read/27896904/contrast-induced-encephalopathy-following-cardiac-catheterization
#8
Roberto Spina, Neil Simon, Romesh Markus, David Wm Muller, Krishna Kathir
OBJECTIVES: To describe the epidemiology, pathophysiology, clinical presentation, and management of contrast-induced encephalopathy (CIE) following cardiac catheterization. BACKGROUND: CIE is an acute, reversible neurological disturbance directly attributable to the intra-arterial administration of iodinated contrast medium. METHODS: The PubMed database was searched and all cases in the literature were retrieved and reviewed. RESULTS: 52 reports of CIE following cardiac catheterization were found...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27865203/minocycline-prevents-cerebral-malaria-confers-neuroprotection-and-increases-survivability-of-mice-during-plasmodium-berghei-anka-infection
#9
Thittayil Suresh Apoorv, Phanithi Prakash Babu
Cerebral malaria (CM) is a neurological complication arising due to Plasmodium falciparum or Plasmodium vivax infection. Minocycline, a semi-synthetic tetracycline, has been earlier reported to have a neuroprotective role in several neurodegenerative diseases. In this study, we investigated the effect of minocycline treatment on the survivability of mice during experimental cerebral malaria (ECM). The currently accepted mouse model, C57BL/6 mice infected with Plasmodium berghei ANKA, was used for the study...
November 16, 2016: Cytokine
https://www.readbyqxmd.com/read/27812447/continuous-intra-arterial-nimodipine-infusion-in-refractory-symptomatic-vasospasm-after-subarachnoid-hemorrhage
#10
Raimund Helbok, Alexandra Zangerle, Andreas Chemelli, Ronny Beer, Thomas Benke, Rainer Ehling, Marlene Fischer, Martin Sojer, Bettina Pfausler, Claudius Thome, Erich Schmutzhard
INTRODUCTION: Vasospasm still is a major cause of morbidity after aneurysmal subarachnoid hemorrhage. The purpose of this report is to describe the successful management of severe refractory vasospasm with continuous intra-arterial nimodipine (IAN) treatment. CASE DESCRIPTION: A 72-year old right handed woman was admitted with non-traumatic SAH WFNS grade 1. Cerebral computed tomography demonstrated thick blood filling of the basal cisterns, and intraventricular hemorrhage...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27789150/a-case-of-contrast-leakage-mimicking-intraventricular-hemorrhage-in-a-patient-with-intravenous-thrombolysis
#11
Min-Gyu Park, Min-Kyeung Kim, Baik-Kyun Kim, Seung Kug Baik, Kyung-Pil Park
Contrast leakage on non-enhanced brain computed tomography (CT) is a common phenomenon after diagnostic or interventional cerebral angiography in patients with acute ischemic stroke. Contrast leakage is known to be related to the loosening of the blood-brain barrier. Sometimes, the contrast leakage on non-enhanced brain CT has been mistaken for intracranial hemorrhage. Differentiating the contrast leakage from the intracranial hemorrhage on non-enhanced brain CT is a very important issue, because subsequent treatment after intravenous thrombolysis (IVT) or intra-arterial thrombolysis would depend on the result of brain CT after thrombolysis...
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27781037/rescue-thrombectomy-in-large-vessel-occlusion-strokes-leads-to-better-outcomes-than-intravenous-thrombolysis-alone-a-real-world-applicability-of-the-recent-trials
#12
Raul G Nogueira, Osama O Zaidat, Alicia C Castonguay, Diogo C Haussen, Coleman O Martin, William E Holloway, Nils Mueller-Kronast, Joey English, Italo Linfante, Guilherme Dabus, Tim W Malisch, Franklin A Marden, Hormozd Bozorgchami, Andrew Xavier, Ansaar T Rai, Michael T Froehler, Aamir Badruddin, Thanh N Nguyen, M Asif Taqi, Michael G Abraham, Vallabh Janardhan, Albert J Yoo, Hashem Shaltoni, Alex Abou-Chebl, Peng R Chen, Gavin W Britz, Roberta Novakovic, Ashish Nanda, Ritesh Kaushal, Mohammad A Issa, Michael R Frankel, Rishi Gupta
BACKGROUND: The Interventional Management of Stroke III (IMS-III) trial demonstrated no benefit for intravenous recombinant tissue plasminogen activator (IV rt-PA) followed by endovascular therapy versus IV rt-PA alone. However, IMS-III mostly included earlier generation devices. The recent thrombectomy trials have incorporated the stent-retriever technology, but their generalizability remains unknown. METHODS: The North American Solitaire Acute Stroke (NASA) registry recruited patients treated with the Solitaire FR™ device between March 2012 and February 2013...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27737684/management-of-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#13
REVIEW
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27733961/simulator-based-angiography-and-endovascular-neurosurgery-curriculum-a-longitudinal-evaluation-of-performance-following-simulator-based-angiography-training
#14
J Scott Pannell, David R Santiago-Dieppa, Arvin R Wali, Brian R Hirshman, Jeffrey A Steinberg, Vincent J Cheung, David Oveisi, Jon Hallstrom, Alexander A Khalessi
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded...
August 29, 2016: Curēus
https://www.readbyqxmd.com/read/27703060/quantitative-assessment-of-parent-vessel-and-distal-intracranial-hemodynamics-following-pipeline-flow-diversion
#15
Sophia F Shakur, Victor A Aletich, Sepideh Amin-Hanjani, Ahmed E Hussein, Fady T Charbel, Ali Alaraj
BACKGROUND: Pipeline embolization devices (PEDs) are commonly used for endovascular treatment of cerebral aneurysms but can be associated with delayed ipsilateral intraparenchymal hemorrhage. Although intra-aneurysmal hemodynamic changes have been studied, parent vessel and intracranial hemodynamics after PED use are unknown. We examine the impact of flow diversion on parent artery and distal intracranial hemodynamics. METHOD: Patients with internal carotid cerebral aneurysms treated with PED who had flow volume rate, flow velocities, pulsatility index, resistance index, Lindegaard ratio, and wall shear stress (WSS) obtained after treatment using quantitative magnetic resonance angiography were reviewed...
October 4, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27668240/blood-pressure-in-acute-intra-cerebral-hemorrhage
#16
COMMENT
Simona Lattanzi, Mauro Silvestrini
No abstract text is available yet for this article.
August 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27621948/mechanical-solitaire-thrombectomy-with-low-dose-booster-tirofiban-injection
#17
Duck-Ho Goh, Sung-Chul Jin, Hae Woong Jeong, Sam Yeol Ha
PURPOSE: Mechanical thrombectomy using a Solitaire stent has been associated with a high recanalization rate and favorable clinical outcome in intra-arterial thrombolysis. To achieve a higher recanalization rate for mechanical Solitaire thrombectomy, we used an intra-arterial low-dose booster tirofiban injection into the occluded segment after stent deployment. We report the safety and recanalization rates for mechanical Solitaire thrombectomy with a low-dose booster tirofiban injection...
September 2016: Neurointervention
https://www.readbyqxmd.com/read/27608697/acute-myeloid-leukemia-presenting-as-intracerebral-granulocytic-sarcoma
#18
E Dhandapani, Thirumavalavan, Sowrirajan
The CNS involvement of acute myeloid leukemia (AML) is more commonly manifest as meningeal involvement. Rarely it may present as intravascular tumor aggregates called granulocytic sarcoma which presents as intracranial hemorrhage. We are presenting a case of intracranial, intra-parenchymal granulocytic sarcoma (other names: chloroma, extramedullary myeloblastoma), presenting as acute hemiplegia without cerebral hemorrhage.
October 2015: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27601379/influence-of-device-choice-on-the-effect-of-intra-arterial-treatment-for-acute-ischemic-stroke-in-mr-clean-multicenter-randomized-clinical-trial-of-endovascular-treatment-for-acute-ischemic-stroke-in-the-netherlands
#19
Diederik W Dippel, Charles B Majoie, Yvo B Roos, Aad van der Lugt, Robert J van Oostenbrugge, Wim H van Zwam, Hester F Lingsma, Peter J Koudstaal, Kilian M Treurniet, Lucie A van den Berg, Debbie Beumer, Puck S Fransen, Olvert A Berkhemer
BACKGROUND AND PURPOSE: Intra-arterial treatment by means of retrievable stents has been proven safe and effective. In MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), the choice of the type of thrombectomy device was left to the discretion of the interventionist. The aim of this study was to explore the differences in functional outcome, neurological recovery, reperfusion, extent of infarction, and adverse events according to stent type and make...
October 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27585660/imaging-and-clinical-findings-in-segmental-arterial-mediolysis-sam
#20
Kinan Alhalabi, Christine Menias, Robert Hines, Ihsan Mamoun, Sailendra Naidu
Segmental arterial mediolysis (SAM) is an uncommon, non-atherosclerotic, non-inflammatory arteriopathy that tends to affect the medium-sized splanchnic branches of the aorta along with renal, carotid, cerebral, and coronary arteries. The clinical presentation ranges from asymptomatic to severe, life-threatening intra-abdominal hemorrhage and shock. SAM overlaps clinically and radiologically with other inflammatory vasculitides. This article describes the pathologic-radiologic correlation, imaging findings, and the management of the disease...
September 1, 2016: Abdominal Radiology
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