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intra cerebral hemorrhage

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https://www.readbyqxmd.com/read/28339483/temporal-evolution-of-vasospasm-and-clinical-outcome-after-intra-arterial-vasodilator-therapy-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#1
Laleh Daftari Besheli, Can Ozan Tan, Donnie L Bell, Joshua A Hirsch, Rajiv Gupta
Intra-arterial (IA) vasodilator therapy is one of the recommended treatments to minimize the impact of aneurysmal subarachnoid hemorrhage-induced cerebral vasospasm refractory to standard management. However, its usefulness and efficacy is not well established. We evaluated the effect IA vasodilator therapy on middle cerebral artery blood flow and on discharge outcome. We reviewed records for 115 adults admitted to Neurointensive Care Unit to test whether there was a difference in clinical outcome (discharge mRS) in those who received IA infusions...
2017: PloS One
https://www.readbyqxmd.com/read/28335661/safety-and-efficacy-of-balloon-angioplasty-of-the-anterior-cerebral-artery-for-vasospasm-treatment-after-subarachnoid-hemorrhage
#2
Nauman S Chaudhry, Jennifer L Orning, Sophia F Shakur, Sepideh Amin-Hanjani, Victor A Aletich, Fady T Charbel, Ali Alaraj
Balloon angioplasty is often performed for symptomatic vasospasm following aneurysmal subarachnoid hemorrhage. Angioplasty of the anterior cerebral artery (ACA), however, is perceived to be a challenging endeavor and not routinely performed due to technical and safety concerns. Here, we evaluate the safety and efficacy of balloon angioplasty of the anterior cerebral artery for vasospasm treatment. Patients with vasospasm following subarachnoid hemorrhage who underwent balloon angioplasty at our institution between 2011 and 2016 were retrospectively reviewed...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28297692/-ruptured-aneurysm-of-bihemispheric-anterior-cerebral-artery-a1-a2-junction-a-case-report
#3
Nao Shimooka, Shiromaru Ishida, Masato Kawai
We report a rare case with a ruptured aneurysm of the bihemispheric anterior cerebral artery(ACA), a rare anomaly of the ACA. A 50-year-old female experienced a sudden onset of severe posterior cervical pain. CT revealed diffuse subarachnoid hemorrhage(SAH)and intra cerebral hemorrhage of the left rectal gyrus. Cerebral angiography showed the left bihemispheric ACA and hypoplasia of the right ACA. A saccular aneurysm was indicated at the A1-A2 junction of the left bihemispheric ACA. A neck clipping was performed completely through the right transsylvian approach...
March 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28288394/blood-blister-like-aneurysms-in-tibetans-a-retrospective-observational-study
#4
Ruiqi Chen, Anqi Xiao, Hao Li, Lu Ma, Sen Lin, Chao You
OBJECT: Although research on blood blister-like aneurysms (BLAs) in different population is well documented, studies of that in the plateau area remain elusive. This study aimed to develop a better understanding of BLAs in Tibetan population, which is a typical representation of people in plateau area. METHODS: In this retrospective observational study, the hospital information system (HIS) was used to search for consecutive patients with BLAs by using the discharge diagnoses...
March 6, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28277460/aspects-ct-in-acute-ischemia-review-of-current-data
#5
Supada Prakkamakul, Albert J Yoo
The Alberta Stroke Program Early CT score (ASPECTS) is a 10-point semiquantitative topographic scoring system developed for the assessment of early ischemic changes (EICs) on noncontrast-enhanced computed tomography (NCCT) in patients with acute ischemic stroke involving the middle cerebral artery (MCA) territory. One point is subtracted from a total score of 10, if an EIC is present in any part of each of the ASPECTS regions. Higher ASPECTS has been associated with better outcomes and a lower risk of symptomatic intracerebral hemorrhage...
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28241129/how-should-we-lower-blood-pressure-after-cerebral-hemorrhage-a-systematic-review-and-meta-analysis
#6
Simona Lattanzi, Claudia Cagnetti, Leandro Provinciali, Mauro Silvestrini
BACKGROUND: The optimal treatment of high blood pressure (BP) after acute intra-cerebral hemorrhage (ICH) is controversial. SUMMARY: The aim of the study was to evaluate the safety and efficacy of early intensive vs. conservative BP lowering treatment in patients with ICH. Randomized controlled trials with active and control groups receiving intensive and conservative BP lowering treatments were identified. The following outcomes were assessed: 3-month mortality and combined death or major disability, 24-h hematoma growth, early neurological deterioration, occurrence of hypotension, severe hypotension, and serious treatment-emergent adverse events...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28238163/use-of-rivaroxaban-in-patients-with-stroke
#7
REVIEW
Danilo Toni, Antonio Carolei, Valeria Caso, Domenico Consoli, Massimo Del Sette, Domenico Inzitari, Maurizio Melis, Giuseppe Micieli, Leandro Provinciali, Stefano Ricci, Paola Santalucia, Vito Toso
Rivaroxaban, an inhibitor of Factor Xa, is a direct oral anti-coagulant that has been found to be non-inferior to warfarin in preventing cerebral ischemia in patients with non-valvular atrial fibrillation and in the subgroup of patients with a history of the previous stroke or transient ischemic attack. Vascular neurologists in daily clinical practice may encounter patients taking rivaroxaban or patients who may benefit from its use. In this paper, we review the current clinical indications, contraindications, and clinical management guidelines for rivaroxaban while providing a special focus on neurological aspects and expert opinions on rivaroxaban therapy management in various situations that a neurologist may encounter when treating patients with an ischemic stroke (including those requiring intravenous or intra-arterial reperfusion therapy) and patients with an intracerebral hemorrhage...
February 25, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28179050/cerebral-amyloid-angiopathy-in-stroke-medicine
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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