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intra cerebral hemorrhage

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https://www.readbyqxmd.com/read/28757174/-atrial-fibrillation-thromboembolic-risk-factor-or-marker-from-concept-to-therapy
#1
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 27, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28744689/pediatric-cerebellar-giant-cavernous-malformation-case-report-and-review-of-literature
#2
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...
July 25, 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
#3
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
#4
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
https://www.readbyqxmd.com/read/28725968/microglial-mediated-pdgf-cc-activation-increases-cerebrovascular-permeability-during-ischemic-stroke
#5
Enming Joseph Su, Chunzhang Cao, Linda Fredriksson, Ingrid Nilsson, Christina Stefanitsch, Tamara K Stevenson, Juanjuan Zhao, Margret Ragsdale, Yu-Yo Sun, Manuel Yepes, Chia-Yi Kuan, Ulf Eriksson, Dudley K Strickland, Daniel A Lawrence, Li Zhang
Treatment of acute ischemic stroke with the thrombolytic tissue plasminogen activator (tPA) can significantly improve neurological outcomes; however, thrombolytic therapy is associated with an increased risk of intra-cerebral hemorrhage (ICH). Previously, we demonstrated that during stroke tPA acting on the parenchymal side of the neurovascular unit (NVU) can increase blood-brain barrier (BBB) permeability and ICH through activation of latent platelet-derived growth factor-CC (PDGF-CC) and signaling by the PDGF receptor-α (PDGFRα)...
July 19, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28702117/balloon-angioplasty-for-intracranial-atherosclerotic-disease-a-multicenter-study
#6
Lakshmi Sudha Prasanna Karanam, Mukesh Sharma, Anand Alurkar, Sridhar Reddy Baddam, Vijaya Pamidimukkala, Raghavasarma Polavarapu
AIM: To evaluate the role and efficacy of the balloon angioplasty in intracranial atherosclerotic disease (ICAD) in patients who presented with acute stroke due to vessel occlusion and in patients with symptomatic disease despite optimum medical management. METHODS: From 2013 to 2016, a total of 39 patients (24 males and 15 females with a mean age of 64.5 years) underwent balloon angioplasty over a period of 2 years and 8 months in three different institutions in India...
June 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#7
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28619839/transcranial-duplex-sonography-predicts-outcome-following-an-intracerebral-hemorrhage
#8
P Camps-Renom, J Méndez, E Granell, F Casoni, L Prats-Sánchez, A Martínez-Domeño, D Guisado-Alonso, J Martí-Fàbregas, R Delgado-Mederos
BACKGROUND AND PURPOSE: Several radiologic features such as hematoma volume are related to poor outcome following an intra- cerebral hemorrhage and can be measured with transcranial duplex sonography. We sought to determine the prognostic value of transcranial duplex sonography in patients with intracerebral hemorrhage. MATERIALS AND METHODS: We conducted a prospective study of patients diagnosed with spontaneous intracerebral hemorrhage. Transcranial duplex sonography examinations were performed within 2 hours of baseline CT, and we recorded the following variables: hematoma volume, midline shift, third ventricle and lateral ventricle diameters, and the pulsatility index in both MCAs...
June 15, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28602923/successful-hybrid-neurovascular-surgery-for-a-ruptured-basilar-artery-dissecting-aneurysm-in-a-patient-with-jeopardized-collateral-circulation-associated-with-aortitis-syndrome-case-report
#9
Kazuaki Yamamoto, Takahisa Mori, Tsuyoshi Watanabe, Tomonori Iwata, Gakuji Gondo, Masahiko Tanaka, Satoshi Tanaka
BACKGROUND: Dissecting aneurysms of the basilar artery (BA) are rare lesions and the management of them has been controversial and challenging. The treatment becomes much more difficult when the patient has a disorder such as aortitis syndrome, which makes cerebral arteries occluded and tortuous. The authors describe a case of a ruptured BA dissecting aneurysm associated with aortitis syndrome, successfully treated with hybrid neurovascular surgery. CASE DESCRIPTION: A 64-year-old woman with a medical history of aortitis syndrome developed a severe headache and was diagnosed with a subarachnoid hemorrhage from a BA dissecting aneurysm...
June 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28600750/intra-operative-hemorrhage-due-to-hyperperfusion-during-direct-revascularization-surgery-in-an-adult-patient-with-moyamoya-disease-a-case-report
#10
Hiroki Uchida, Hidenori Endo, Miki Fujimura, Toshiki Endo, Kuniyasu Niizuma, Teiji Tominaga
Hemorrhagic complication is one of the notable surgical complications of the revascularization surgery for moyamoya disease (MMD). Cerebral hyperperfusion (CHP) has been considered as the underlying cause of this complication. It mostly occurs several days after surgery, but the intra-operative hemorrhage immediately after bypass has not been reported previously. A 21-year-old woman presented right thalamic hemorrhage and was diagnosed as having MMD by cerebral angiography. In light of the location of the hemorrhage at the vascular territory of posterior circulation and the manifestation of transient ischemic attack during the follow-up period, she underwent revascularization surgery to prevent future ischemic attack and rebleeding...
June 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28596447/impact-of-thrombus-length-on-outcomes-after-intra-arterial-aspiration-thrombectomy-in-the-therapy-trial
#11
RANDOMIZED CONTROLLED TRIAL
Albert J Yoo, Pooja Khatri, J Mocco, Osama O Zaidat, Rishi Gupta, Donald Frei, Demetrius Lopes, Harish Shownkeen, Olvert A Berkhemer, Denise Meyer, Susana S Hak, Sophia S Kuo, Hope Buell, Arani Bose, Siu Po Sit, Rüdiger von Kummer
BACKGROUND AND PURPOSE: Increasing thrombus length (TL) impedes recanalization after intravenous (IV) thrombolysis. We sought to determine whether the clinical benefit of aspiration thrombectomy relative to IV r-tPA (recombinant tissue-type plasminogen activator) may be greater at longer TL. METHODS: THERAPY was a randomized trial of aspiration thrombectomy plus IV r-tPA versus IV r-tPA alone in large-vessel stroke patients with prospective TL measurement ≥8 mm...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28596196/effect-of-retrievable-stent-size-on-endovascular-treatment-of-acute-ischemic-stroke-a-multicenter-study
#12
D Yang, Y Hao, W Zi, H Wang, D Zheng, H Li, M Tu, Y Wan, P Jin, G Xiao, Y Xiong, G Xu, X Liu
BACKGROUND AND PURPOSE: In clinical practice, stent diameter is one of the variable properties important for endovascular treatment. A consensus guideline for stent retriever size selection has yet to be established. The aim of this study was to investigate the effects of different diameters of Solitaire retrievers on outcomes. MATERIALS AND METHODS: Of 628 patients enrolled from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry, 256 were treated with the Solitaire 4-mm device and 372, with the 6-mm device...
June 8, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28503488/treatment-of-cerebral-vasospasm-in-an-infant-using-a-modified-dotter-technique
#13
Brian M Snelling, Samir Sur, Sumedh S Shah, Eric C Peterson
An 8-month old female presented with spontaneous subarachnoid hemorrhage and was treated successfully with endovascular coil embolization of the ruptured aneurysm. Transcranial Doppler ultrasound performed four days later demonstrated middle cerebral artery (MCA) velocities greater than 350 cm/sec on the right and greater than 200 cm/sec on the left, despite medical management. The patient demonstrated no focal neurological deficits, though examination was limited by our patient's sedation and intubation. Angiography revealed severe vasospasm of the supraclinoid internal carotid and MCA territories, bilaterally...
March 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28487393/potent-thrombolytic-effect-of-n-acetylcysteine-on-arterial-thrombi
#14
Sara Martinez de Lizarrondo, Clément Gakuba, Bradley A Herbig, Yohann Repessé, Carine Ali, Cécile V Denis, Peter Lenting, Emmanuel Touzé, Scott L Diamond, Denis Vivien, Maxime Gauberti
Background -Platelet crosslinking during arterial thrombosis involves von Willebrand Factor (VWF) multimers. Therefore, proteolysis of VWF appears promising to disaggregate platelet-rich thrombi and restore vessel patency in acute thrombotic disorders such as ischemic stroke, acute coronary syndrome or acute limb ischemia. N-Acetylcysteine (NAC, a clinically approved mucolytic drug) can reduce intrachain disulfide bonds in large polymeric proteins. In the present study, we postulated that NAC might cleave the VWF multimers inside occlusive thrombi, thereby leading to their dissolution and arterial recanalization...
May 9, 2017: Circulation
https://www.readbyqxmd.com/read/28485774/the-clinical-study-on-the-treatment-for-acute-cerebral-infarction-by-intra-arterial-thrombolysis-combined-with-mild-hypothermia
#15
L-L Ma, L Song, X-D Yu, T-X Yu, H Liang, J-X Qiu, L Tan
OBJECTIVE: This study was purposed to evaluate the clinical efficacy of the treatment for acute cerebral infarction by intra-arterial thrombolysis combined with mild hypothermia. PATIENTS AND METHODS: Thirty patients, diagnosed with acute anterior circulation cerebral infarction and admitted to the Hospital between January 2013 and September 2015, were randomly divided into the control group and the mild hypothermia group, each group comprising 15 cases. The treatment of intra-arterial thrombolysis combined with mild hypothermia was administered to the mild hypothermia group, while only the treatment of intra-arterial thrombolysis was performed on the control group...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28484525/invasive-aspergillus-sinusitis-with-orbitocranial-extension
#16
Saleh S Baeesa, Rakan F Bokhari, Khalid B Alghamdi, Hisham B Alem, Jaudah A Al-Maghrabi, Tariq A Madani
CONTEXT: Invasive sinonasal aspergillosis is a silently progressive disease that, left untreated, may invade the adjacent intracranial and intra-orbital compartments incurring serious morbidity. AIM: To evaluate our results of a collaborative surgical management plans for patients with invasive sinonasal aspergillosis with orbitocranial extension. SETTING AND DESIGN: Retrospective study. MATERIALS AND METHODS: Between the years 2000 and 2012, 12 patients with Aspergillus sinusitis with orbitocranial extension were treated at our institution...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28471899/angioinvasive-aspergillus-associated-stroke-in-an-immunocompetent-host-following-cardiac-surgery-and-ecmo
#17
Tapan Kavi, Nikhil Madan, Tamara Majic, Axel Rosengart, Marcel Maya, Serguei Bannykh, Shouri Lahiri
INTRODUCTION: Invasive cerebral aspergillosis is an uncommon cause of stroke among immunocompetent patients and has not been reported in association with cardiac surgery or extracorporeal membrane oxygenation (ECMO). We report the case of an immunocompetent host who developed aspergillus-associated stroke following coronary artery bypass graft (CABG) and ECMO. CASE REPORT: A 59-year-old woman developed cardiogenic shock after 3-vessel-CABG requiring intra-aortic balloon pump placement and subsequent veno-arterial ECMO...
May 2017: Neurologist
https://www.readbyqxmd.com/read/28446625/use-of-noncontrast-computed-tomography-and-computed-tomographic-perfusion-in-predicting-intracerebral-hemorrhage-after-intravenous-alteplase-therapy
#18
MULTICENTER STUDY
Connor Batchelor, Pooneh Pordeli, Christopher D d'Esterre, Mohamed Najm, Fahad S Al-Ajlan, Mari E Boesen, Connor McDougall, Lisa Hur, Enrico Fainardi, Jai Jai Shiva Shankar, Marta Rubiera, Alexander V Khaw, Michael D Hill, Andrew M Demchuk, Tolulope T Sajobi, Mayank Goyal, Ting-Yim Lee, Richard I Aviv, Bijoy K Menon
BACKGROUND AND PURPOSE: Intracerebral hemorrhage is a feared complication of intravenous alteplase therapy in patients with acute ischemic stroke. We explore the use of multimodal computed tomography in predicting this complication. METHODS: All patients were administered intravenous alteplase with/without intra-arterial therapy. An age- and sex-matched case-control design with classic and conditional logistic regression techniques was chosen for analyses. Outcome was parenchymal hemorrhage on 24- to 48-hour imaging...
June 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28442781/spreading-depolarization-remarkably-exacerbates-ischemia-induced-tissue-acidosis-in-the-young-and-aged-rat-brain
#19
Ákos Menyhárt, Dániel Zölei-Szénási, Tamás Puskás, Péter Makra, M Tóth Orsolya, Borbála É Szepes, Réka Tóth, Orsolya Ivánkovits-Kiss, Tihomir P Obrenovitch, Ferenc Bari, Eszter Farkas
Spreading depolarizations (SDs) occur spontaneously in the cerebral cortex of subarachnoid hemorrhage, stroke or traumatic brain injury patients. Accumulating evidence prove that SDs exacerbate focal ischemic injury by converting zones of the viable but non-functional ischemic penumbra to the core region beyond rescue. Yet the SD-related mechanisms to mediate neurodegeneration remain poorly understood. Here we show in the cerebral cortex of isoflurane-anesthetized, young and old laboratory rats, that SDs propagating under ischemic penumbra-like conditions decrease intra and- extracellular tissue pH transiently to levels, which have been recognized to cause tissue damage...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28425317/mortality-risk-factors-from-converting-off-pump-coronary-artery-bypass-to-on-pump-coronary-artery-bypass
#20
Na Miao, Feng Yang, Zhongtao Du, Chunjing Jiang, Xing Hao, Jinhong Wang, Yu Jiang, Xiaofang Yang, Haixiu Xie, Xiaotong Hou
INTRODUCTION: A number of large-scale retrospective studies revealed that off-pump coronary artery bypass (OPCAB) was superior to on-pump coronary artery bypass (ONCAB). The aim of the study was to investigate risk factors for mortality when OPCAB is converted to ONCAB. METHODS: Patients who underwent OPCAB conversion to ONCAB at the Beijing Anzhen Hospital between January 2003 and January 2013 were assigned to the non-survivor and survivor groups. Background demographics, illness history and preoperative, intraoperative and postoperative variables were compared...
April 1, 2017: Perfusion
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