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intra cerebral hemorrhage

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https://www.readbyqxmd.com/read/29130951/prehospital-computed-tomography-angiography-in-acute-stroke-management
#1
Michael Kettner, Stefan Alexander Helwig, Andreas Ragoschke-Schumm, Lenka Schwindling, Safwan Roumia, Isabel Keller, Daniel Martens, Johann Kulikovski, Matthias Manitz, Martin Lesmeister, Silke Walter, Iris Quasar Grunwald, Thomas Schlechtriemen, Wolfgang Reith, Klaus Fassbender
BACKGROUND: An ambulance equipped with a computed tomography (CT) scanner, a point-of-care laboratory, and telemedicine capabilities (mobile stroke unit [MSU]) has been shown to enable the delivery of thrombolysis to stroke patients directly at the emergency site, thereby significantly decreasing time to treatment. However, work-up in an MSU that includes CT angiography (CTA) may also potentially facilitate triage of patients directly to the appropriate target hospital and specialized treatment, according to their individual vascular pathology...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29125027/thromboembolic-complications-during-endovascular-treatment-of-ruptured-cerebral-aneurysms
#2
Motohiro Nomura, Kentaro Mori, Akira Tamase, Tomoya Kamide, Syunsuke Seki, Yu Iida, Kazutaka Shirokane, Eiichi Baba, Atsushi Tsuchiya, Hiroshi Shima
Background In cases of subarachnoid hemorrhage due to aneurysm rupture, the administration of an anticoagulant or antiplatelet agent involves the risk of rebleeding from the aneurysm. There is a possibility of inducing thromboembolic events during the endovascular embolization of ruptured cerebral aneurysms. Patients and methods From April 2006 to March 2017, we treated a total of 70 patients with ruptured cerebral aneurysms with an endovascular technique. Among them, five patients (7.1%) showed intra-arterial thrombus formation...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29118793/feasibility-of-real-time-angiographic-perfusion-imaging-in-the-treatment-of-cerebral-vasospasm
#3
Christopher Donaldson, Anthea H O'Neill, Lee-Anne Slater, Winston Chong, Leon T Lai, Ronil V Chandra
Background: Objective assessment and quantification of the severity of cerebral vasospasm following aneurysmal subarachnoid hemorrhage is not routinely utilized. We investigated the feasibility of angiographic perfusion imaging derived from digital subtraction angiography (DSA) following endovascular vasospasm treatment procedures. Methodology: Real-time blood flow analysis was performed using parametric color coding on pre- and postintervention DSA. Semiquantitative parenchymal perfusion parameters (arrival time [AT] of contrast, time to peak [TTP] opacification, and mean transit time [MTT] of contrast) were calculated across 3 vascular territories (anterior cerebral artery [ACA], middle cerebral artery [MCA], and lenticulostriate arteries) using standard 2-D angiographic perfusion software...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29114365/stroke-subtypes-risk-factors-and-mortality-rate-in-northwest-of-iran
#4
Mehdi Farhoudi, Kaveh Mehrvar, Homayoun Sadeghi-Bazargani, Mazyar Hashemilar, Manouchehr Seyedi-Vafaee, Elyar Sadeghi-Hokmabad, Reza Rikhtegar, Babak Saber-Maroof, Mohammad Abutalebi, Mahsa Rezaei, Sahar Vaferi, Alireza Aghili, Omid Ebrahimi
Background: Stroke is the second most common cause of death and first cause of disability in adults in the world. About 80% of all stroke deaths occur in developing countries. So far, the data on stroke epidemiology have been limited in Iran. Therefore, this study was focused on stroke demographic data, risk factors, types and mortality. Methods: A retrospective study was done in two university tertiary referral hospitals in Tabriz, northwest of Iran, from March 2008 to April 2013. Patients diagnosed with stroke were enrolled in the study...
July 6, 2017: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/29079662/endovascular-treatment-for-cerebral-vasospasm-following-aneurysmal-subarachnoid-hemorrhage-predictors-of-outcome-and-retreatment
#5
Jennifer D Sokolowski, Ching-Jen Chen, Dale Ding, Thomas J Buell, Daniel M Raper, Natasha Ironside, Davis G Taylor, Robert M Starke, Kenneth Liu
OBJECTIVE: Although endovascular therapy has been widely adopted for the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH), its effect on clinical outcomes remains incompletely understood. The aims of this retrospective cohort study are to evaluate the outcomes of endovascular intervention for post-aSAH vasospasm and identify predictors of functional independence at discharge and repeat endovascular vasospasm treatment. METHODS: We assessed the baseline and outcomes data for patients with aSAH who underwent endovascular vasospasm treatment at our institution, including intra-arterial (IA) vasodilator infusion and angioplasty...
October 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29067043/surgical-outcome-of-spontaneous-supra-tentorial-intracerebral-hemorrhage
#6
Waqar Aziz Rehman, Muhammad Sohaib Anwar
OBJECTIVE: To assess the risks and benefits of surgical treatment (Open Craniotomy) of Intra-cerebral hematoma (ICH). METHODS: Twenty seven patients of ICH who underwent surgical treatment at Neurosurgical department of Sheikh Zayed Hospital, Rahim Yar Khan, from 1(st) January 2015 to 31(st) December 2015 were included in this study. The primary outcome measured was death and improvement in GCS Status among survivor's at three months. RESULTS: Mean age of the patients was 58...
July 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29059119/early-management-of-acute-cerebrovascular-accident
#7
Jody Manners, Alexis Steinberg, Lori Shutter
PURPOSE OF REVIEW: Stroke is common and often presents as a neurologic emergency that requires rapid evaluation and treatment to minimize debilitation. Recent advances in therapy expanded time windows for intra-arterial thrombectomy in ischemic stroke, and surgical interventions for clot evacuation in large intracranial hemorrhage have recently proven feasible. This review discusses recent data regarding new therapeutic options in both ischemic and hemorrhagic stroke, notably in scenarios in which therapy was previously limited to supportive care...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28973669/transcranial-doppler-waveforms-during-intra-aortic-balloon-pump-counterpulsation-for-vasospasm-detection-after-subarachnoid-hemorrhage
#8
Nicholas A Morris, Nathan Manning, Randolph S Marshall, E Sander Connolly, Jan Claassen, Sachin Agarwal, David J Roh, J Michael Schmidt, Soojin Park
BACKGROUND: Transcranial Doppler ultrasound is a standard screening tool for vasospasm after subarachnoid hemorrhage. Prevention of vasospasm-induced delayed cerebral ischemia after subarachnoid hemorrhage depends on optimization of cerebral perfusion pressure, which can be challenged by neurogenic stress cardiomyopathy. Intra-aortic balloon pumps have been utilized to augment cerebral perfusion, but they change the transcranial Doppler waveform, altering its interpretability for vasospasm screening...
July 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28956512/higher-dose-intra-arterial-milrinone-and-intra-arterial-combined-milrinone-nimodipine-infusion-as-a-rescue-therapy-for-refractory-cerebral-vasospasm
#9
Enes Duman, Fatma Karakoç, H Ulas Pinar, Rafi Dogan, Ali Fırat, Erkan Yıldırım
Background Cerebral vasospasm (CV) is a major cause of delayed morbidity and mortality in patients with subarachnoid hemorrhage (SAH). Various cerebral protectants have been tested in patients with aneurysmal SAH. We aimed to research the success rate of treatment of CV via intra-arterial milrinone injection and aggressive pharmacological therapy for refractory CV. Methods A total of 25 consecutive patients who received intra-arterial milrinone and nimodipine treatment for CV following SAH between 2014 and 2017 were included in the study...
December 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28944903/gpvi%C3%A2-fc%C3%A2-peg-improves-cerebral-infarct-volume-and-cerebral-thrombosis-in-mouse-model-with-cerebral-thrombosis
#10
Yimae Wufuer, Xuefeng Shan, Magaoweiya Sailike, Kamile Adilaimu, Songfeng Ma, Huguo Wang
Cerebral thrombosis is one of the most common causes of cerebral infarction, and anticoagulation therapy is a routine treatment in patients with hemorrhagic cerebral venous thrombosis. The hemostatic function of platelets is important for the anticoagulation therapy of thrombosis. Glycoprotein VI (GPVI) is reported as the major signaling receptor for collagen and is exclusively expressed on platelets and megakaryocytes, initiating platelet recruitment at sites of vascular injury and demonstrating numerous beneficial effects for patients with cerebral thrombosis...
November 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28912883/tirofiban-facilitates-the-reperfusion-process-during-endovascular-thrombectomy-in-icas
#11
Hongchen Zhao, Jinhua Zhang, Danyan Gu, Zongjie Shi, Jie Pan, Yu Geng, Tianming Shi
The aim of the present study was to assess the use of tirofiban injections for rescue therapy following artery reocclusion due to intra-luminal thrombosis during endovascular thrombectomy in patients with acute ischemic stroke (AIS). A total of seven cases of patients treated with adjunctive tirofiban injections following failed endovascular thrombectomy due to instant intra-luminal thrombosis were retrospectively assessed. A Solitaire stent was used as the primary thrombectomy device in all patients. Tirofiban was injected intra-arterially via a temporarily deployed Solitaire stent with continuous intravenous infusion for the subsequent 24 h; half of the conventionally recommended dose was employed...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28910888/-endoscopic-salvage-treatment-for-optic-neuropathy-caused-by-sinonasal-fibro-osseous-lesions
#12
J Deng, F H Chen, Y Y Lai, J B Shi
Objective: To summarize the surgical techniques, benefits and limitations of transnasal endoscopic resection and optic nerve decompression for patients with optic neuropathy caused by fibro-osseous lesions. Methods: Eight patients with optic neuropathy caused by fibro-osseous lesions who accepted endoscopic surgery of either resection of the lesion or decompression of optic nerve in Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University from 2007 to 2016 were retrospectively reviewed and followed until April, 2017...
September 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28903884/successful-outcome-of-severe-intra-cerebral-bleeding-associated-with-acquired-factor-v-inhibition-utilization-of-multiple-therapeutic-agents
#13
Panagiotis Andreadis, Katerina Kafantari, Aleka Agapidou, Sofia Vakalopoulou, Efthymia Vlachaki
BACKGROUND: Acquired coagulation Factor inhibitors are antibodies that either inhibit the activity or increase the clearance of a clotting factor leading to an increased risk of bleeding. Most of the times, the disorder is attributed to Factor VIII inhibition (Acquired Hemophilia A), however other coagulation factors could also be implicated. CASE REPORT: We herein would like to report an interesting case of a patient who underwent Coronary Artery Bypass Graft and received antibiotic treatment after surgery with a third-generation cephalosporin...
September 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28881141/elongated-plant-virus-based-nanoparticles-for-enhanced-delivery-of-thrombolytic-therapies
#14
Andrzej S Pitek, Yunmei Wang, Sahil Gulati, Huiyun Gao, Phoebe L Stewart, Daniel I Simon, Nicole F Steinmetz
Thrombotic cardiovascular disease, including acute myocardial infarction, ischemic stroke, and venous thromboembolic disease, is the leading cause of morbidity and mortality worldwide. While reperfusion therapy with thrombolytic agents reduces mortality from acute myocardial infarction and disability from stroke, thrombolysis is generally less effective than mechanical reperfusion and is associated with fatal intracerebral hemorrhage in up to 2-5% of patients. To address these limitations, we propose the tobacco mosaic virus (TMV)-based platform technology for targeted delivery of thrombolytic therapies...
November 6, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28881114/intra-arterial-and-intravenous-tirofiban-infusion-for-thromboembolism-during-endovascular-coil-embolization-of-cerebral-aneurysm
#15
Sang Heum Kim, Tae Gon Kim, Min Ho Kong
OBJECTIVE: Thromboembolism is the one of the most serious complications that can occur during endovascular coil embolization of cerebral aneurysm. We report on the effectiveness and safety of intra-arterial/intravenous (IA/IV) glycoprotein IIb/IIIa inhibitor (tirofiban) infusion for treating thromboembolism during endovascular coil embolization of cerebral aneurysm. METHODS: We performed a retrospective analysis of 242 patients with ruptured or unruptured cerebral aneurysms (n=264) who underwent endovascular coil embolization from January 2011 to June 2014...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28813763/simultaneous-onset-of-deep-vein-thrombosis-pulmonary-embolism-cerebral-infarction-and-myocardial-infarction-in-a-patient-with-patent-foramen-ovale
#16
Jimmy Yee, Vishesh Kumar, Alex Pham, Kashif Shaikh, Muhammad Omar, Adam Stys, Marian Petrasko
Paradoxical embolism is a known complication with intra-cardiac shunts. It should be considered in the differential as the pathophysiologic mechanism of simultaneous thromboembolism in the venous and systemic vasculature. We present a case of simultaneous deep venous thrombosis, pulmonary embolism and myocardial infarction in the presence of a confirmed patent foramen ovale on echocardiography. Thrombolytic therapy was administered. Subsequent concerns of intracranial hemorrhage on imaging of the brain complicated the management and added to the challenge of co-managing the clot burden in our patient...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28757174/-atrial-fibrillation-thromboembolic-risk-factor-or-marker-from-concept-to-therapy
#17
Jean-Yves Le Heuzey
The main complication of atrial fibrillation is stroke. Twenty years ago, the interest of vitamin K antagonist has been clearly demonstrated but these drugs are difficult to manage. For the last 10 years, direct oral anticoagulants have been developed. These drugs have demonstrated a non-inferiority as compared to vitamin K antagonist and a clear decrease in intra cerebral hemorrhages. Anticoagulation is indicated in a large majority of patients with atrial fibrillation. Nevertheless, many points remained questionable, like the anticoagulation of low risk patients, the choice of oral anticoagulants dosages, the anticoagulation according to the type of atrial fibrillation and the strategy in coronary artery disease patients for example...
July 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28744689/pediatric-cerebellar-giant-cavernous-malformation-case-report-and-review-of-literature
#18
Javier Villaseñor-Ledezma, Marcelo Budke, Juan-Antonio Alvarez-Salgado, María-Angeles Cañizares, Luis Moreno, Francisco Villarejo
BACKGROUND AND IMPORTANCE: Giant cavernous malformations (GCM) are low flow, angiographically occult vascular lesions, with a diameter >4 cm. Cerebellar GCMs are extremely rare, with only seven cases reported based on English literature. These lesions are most commonly seen in the pediatric age group, which is known to have an increased risk of hemorrhage, being surgery clearly recommended. CLINICAL PRESENTATION: An 18-month-old girl presented with a 6-month history of cervical torticollis and upper extremities clumsiness...
December 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28735256/comparison-of-multimodal-intra-arterial-treatment-versus-intravenous-thrombolysis-for-hypertensive-patients-with-severe-large-vessel-cerebral-infarction
#19
Zuojun Tian, Geng Liao, Shaoming Li, Yuechun Shen, Changbing Chen, Lei Liu, Yiheng Li
Since intravenous thrombolysis (IVT) is often associated with poor outcomes in hypertensive patients with severe acute cerebral infarction (ACI) due to occlusions of the internal carotid, basilar, or proximal middle cerebral artery, we evaluated whether multimodal intra-arterial treatment (IAT) might improve functional outcomes in this patient population. We retrospectively reviewed the charts of eligible patients who underwent multimodal IAT including intra-arterial thrombolysis, mechanical thrombectomy, balloon and/or stent angioplasty (IAT group) or IVT alone (IVT group)...
July 21, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28730951/penumbra-and-re-canalization-acute-computed-tomography-in-ischemic-stroke-evaluation-practise-study-protocol
#20
Salwa El-Tawil, Joanna Wardlaw, Ian Ford, Grant Mair, Tom Robinson, Lalit Kalra, Keith W Muir
Rationale Multimodal imaging, including computed tomography angiography and computed tomography perfusion imaging, yields additional information on intracranial vessels and brain perfusion and can differentiate between ischemic core and penumbra which may affect patient selection for intravenous thrombolysis. Hypothesis The use of multimodal imaging will increase the number of patients receiving intravenous thrombolysis and lead to better treatment outcomes. Sample size 400 patients. Methods and design PRACTISE is a prospective, multicenter, randomized, controlled trial in which patients presenting within 4...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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