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intra cerebral hemorrhage

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https://www.readbyqxmd.com/read/29765391/abciximab-reopro-dosing-strategy-for-the-management-of-acute-intraprocedural-thromboembolic-complications-during-pipeline-flow-diversion-treatment-of-intracranial-aneurysms
#1
Li-Mei Lin, Bowen Jiang, Jessica K Campos, Narlin B Beaty, Matthew T Bender, Rafael J Tamargo, Judy Huang, Geoffrey P Colby, Alexander L Coon
Background: Flow diversion with the Pipeline embolization device (PED) is an effective neuro-endovascular method and increasingly accepted for the treatment of cerebral aneurysms. Acute in situ thrombosis is a known complication of PED procedures. There is limited experience in the flow diversion literature on the use of abciximab (ReoPro) for the management of acute thrombus formation in PED cases. Methods: Data were collected retrospectively on patients who received intra-arterial (IA) ReoPro with or without subsequent intravenous (IV) infusion during PED flow diversion treatment of intracranial aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29753899/co-adjuvant-treatment-of-vasospasm-in-ruptured-unsecured-cerebral-aneurysms-with-aggressive-angioplasty-intra-arterial-nimodipine-and-aneurysm-embolization
#2
Ching-Chang Chen, Alvin Yi-Chou Wang, Chun-Ting Chen, Po-Chuan Hsieh
BACKGROUND: Vasospasm is a major cause of morbidity and mortality in patients following aneurysmal subarachnoid hemorrhage (SAH). Although early treatment of ruptured aneurysms is advocated, delayed intervention complicates the treatment strategy and leading to significant vasospasm and a poor prognosis. We report our experience of endovascular protocol for occlusion of the unsecured aneurysm and angioplasty for vasospasm in a single session. METHODS: A total of 24 cases with significant vasospasm and unsecured ruptured cerebral aneurysm were reviewed among 660 aneurysmal SAH patients between January 2011 and May 2017...
May 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29733918/complication-rate-of-intraarterial-treatment-of-severe-cerebral-vasospasm-after-subarachnoid-hemorrhage-with-nimodipine-and-percutaneous-transluminal-balloon-angioplasty-worth-the-risk
#3
Daniela Adami, Joachim Berkefeld, Johannes Platz, Jürgen Konczalla, Waltraud Pfeilschifter, Stefan Weidauer, Marlies Wagner
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a complication of aneurysmal subarachnoid hemorrhage (SAH). Arterial cerebral vasospasm (CVS) is discussed as the main pathomechanism for DCI. Due to positive effects of per os nimodipine, intraarterial nimodipine application is used in patients with DCI. Further, percutaneous transluminal balloon angioplasty (PTA) is applied in focal high-grade spasm of intracranial arteries. However, clinical benefits of those techniques are unconfirmed in randomized trials so far, and complications might occur...
May 4, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29692479/evaluation-of-near-infrared-spectroscopy-as-screening-tool-for-detecting-intracranial-hematomas-in-patients-with-traumatic-brain-injury
#4
V Trehan, Vikas Maheshwari, S V Kulkarni, Sanjeev Kapoor, Anurakshat Gupta
Background: Traumatic Brain Injury (TBI) is one of the most common surgical emergencies in service hospitals of India. Computed tomography (CT) has been a consistent and reliable technique for detecting intracranial hemorrhages but is limited by its non-availability in most service hospitals. Therefore the need for a cheaper, portable and easily available option required to be explored. The aim of this study was to determine the sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of Near Infra Red Spectroscopy (NIRS) against the gold standard of NCCT head...
April 2018: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29689584/bedside-ultrasound-guided-percutaneous-needle-aspiration-of-intra-and-extra-axial-intracranial-hemorrhage-in-neonates
#5
Mehmet N Cizmeci, Liesbeth Thewissen, Alexandra Zecic, Peter A Woerdeman, Bart de Boer, Edward Baert, Paul Govaert, Jeroen Dudink, Floris Groenendaal, Maarten Lequin, Linda S de Vries
Intracranial hemorrhage is an important cause of brain injury in the neonatal population and bedside percutaneous needle aspiration has emerged as an alternative due to the major risks that can be caused by standard neurosurgical decompression. We aimed to assess the effectiveness of this minimally invasive bedside technique and conducted a retrospective analysis of all newborn infants with a large extra-axial hemorrhage associated with a parenchymal hemorrhage causing a midline shift, managed at three academic centers over a 15-year period...
April 24, 2018: Neuropediatrics
https://www.readbyqxmd.com/read/29658352/chronic-subdural-collection-overlying-an-intra-axial-hemorrhagic-lesion-in-chronic-myelomonocytic-leukemia-special-report-and-review-of-the-literature
#6
Anne-Laure Bernat, Stefano Maria Priola, Ahmad Elsawy, Faisal Farrash, Shervin Taslimi, Fred Gentili
Chronic myelomonocytic leukaemia (CMML) is a clonal hematopoietic stem cell disorder characterized by the presence of an absolute monocytosis in the peripheral blood (>1 x 109 /L) and the presence of myelodysplastic and myeloproliferative features in the bone marrow. Involvement of the central nervous system (CNS) is uncommon in CMML. Areas covered: Herein described is a case report of a CMML patient who presents with symptomatic chronic subdural collection overlying a haemorrhagic brain lesion, along with diffuse dural infiltration, after two cycles of azacytidine...
April 19, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29628949/safety-of-diagnostic-cerebral-and-spinal-digital-subtraction-angiography-in-a-developing-country-a-single-center-experience
#7
Qasim Bashir, Asim Ishfaq, Ammad Anwar Baig
Background: Digital subtraction angiography (DSA) remains the gold standard imaging modality for cerebrovascular disorders. In contrast to developed countries, the safety of the procedure is not extensively reported from the developing countries. Herein, we present a retrospective analysis of the basic technique, indications, and outcomes in 286 patients undergoing diagnostic cerebral and spinal angiography in a developing country, Pakistan. Methods: A retrospective review of patient demographics, procedural technique and complication rates of 286 consecutive patients undergoing the diagnostic cerebral/spinal angiography procedure at one institution from May 2013 to December 2015 was performed...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29574224/the-incidence-and-impact-of-secondary-cerebral-insults-on-outcome-following-aneurysmal-subarachnoid-hemorrhage
#8
Sean Doerfler, Jennifer Faerber, Guy M McKhann, J Paul Elliott, H Richard Winn, Monisha Kumar, Joshua Levine, Peter D Le Roux
INTRODUCTION: Secondary cerebral insults can adversely impact patients with traumatic brain injury. By contrast, the incidence of secondary cerebral insults after aneurysmal subarachnoid hemorrhage (SAH) and their impact on outcome have been less well studied. METHODS: Four hundred and twenty one SAH patients who underwent surgical occlusion of their ruptured aneurysm and who received ICU care for ≥48 hours were retrospectively identified from a prospective observational database...
March 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29571881/neutrophil-to-lymphocyte-ratio-improves-outcome-prediction-of-acute-intracerebral-hemorrhage
#9
Simona Lattanzi, Claudia Cagnetti, Claudia Rinaldi, Stefania Angelocola, Leandro Provinciali, Mauro Silvestrini
BACKGROUND: The inflammatory response plays a role in determining the course of intra-cerebral hemorrhage (ICH) and immune parameters may have prognostic value. The aim of the study was to determine whether the peripheral leukocyte counts and neutrophil-to-lymphocyte ratio (NLR) were associated to 30-day functional status after ICH, and improved the accuracy of outcome prediction when added to the Modified ICH score. METHODS: We retrospectively identified consecutive patients with spontaneous ICH who underwent blood sampling and cranial CT neuroimaging within 24 h from onset...
April 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29547164/aggressive-management-of-vasospasm-with-direct-intra-arterial-nimodipine-therapy
#10
Vinayak Narayan, Hima Pendharkar, Bhagavatula Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla
Background: The conventional medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is associated with uncertainty of outcome and complications. Aims and Objectives: To examine the effect of direct intra-arterial nimodipine therapy on outcome in patients with delayed cerebral ischemia (DCI). Settings and Design: The retrospective observational study was conducted at a single neurosurgical unit and interventional neuroradiolgy suite of a center managing SAH...
March 2018: Neurology India
https://www.readbyqxmd.com/read/29545253/randomized-assessment-of-the-safety-and-efficacy-of-intra-arterial-infusion-of-autologous-stem-cells-in-subacute-ischemic-stroke
#11
V Bhatia, V Gupta, D Khurana, R R Sharma, N Khandelwal
BACKGROUND AND PURPOSE: Stroke is a debilitating illness for which treatment window is limited. Most patients present to the healthcare facility beyond that window. Autologous stem cells have shown some promise for this group of patients. This study was performed to evaluate the safety and the efficacy of intra-arterial infusion of bone marrow-derived mononuclear cells in patients with middle cerebral artery ischemic stroke. MATERIALS AND METHODS: A prospective, randomized, open-label, blinded-end point study was performed from July 2015 to June 2016...
May 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29510287/endovascular-treatments-in-combination-with-extracranial-intracranial-bypass-for-complex-intracranial-aneurysms
#12
REVIEW
Kenichi Sato, Hidenori Endo, Miki Fujimura, Toshiki Endo, Yasushi Matsumoto, Hiroaki Shimizu, Teiji Tominaga
BACKGROUND: Although most intracranial aneurysms can be treated with microsurgery or endovascular procedure alone, a subset of aneurysms may require a combined approach. The purpose of this study was to assess the efficacy of endovascular interventions combined with bypass surgery for the treatment of complex intracranial aneurysms. METHODS: We retrospectively reviewed medical records from a prospectively maintained patient database to identify patients who underwent endovascular treatment of an intracranial aneurysm at our institutes between 2007 and 2017...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29412114/caveolin-1-in-stroke-neuropathology-and-neuroprotection-a-novel-molecular-therapeutic-target-for-ischemic-related-injury
#13
Shanshan Wang, Brian P Head
Cardiovascular disease and associated cerebral stroke are a global epidemic attributed to genetic and epigenetic factors, such as diet, life style and an increasingly sedentary existence due to technological advances in both the developing and developed world. There are approximately 5.9 million stroke-related deaths worldwide annually. Current epidemiological data indicate that nearly 16.9 million people worldwide suffer a new or recurrent stroke yearly. In 2014 alone, 2.4% of adults in the United States (U...
February 5, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29406970/adjuvant-intra-arterial-rt-pa-injection-at-the-initially-deployed-solitaire-stent-enhances-the-efficacy-of-mechanical-thrombectomy-in-acute-ischemic-stroke
#14
Ting-Yu Yi, Wen-Huo Chen, Yan-Min Wu, Mei-Fang Zhang, Ding-Lai Lin, Xiao-Hui Lin
BACKGROUND: Both intra-arterial recombinant tissue plasminogen activator (rt-PA) and stent retrieval are effective for treating acute ischemic stroke. The goal of this study was to evaluate the effectiveness of stent retrieval combined with intra-arterial rt-PA administration via micro-catheter (called the complex technique) in acute ischemic stroke. MATERIAL AND METHODS: A retrospective analysis was performed of 93 consecutive patients treated between 2015 and 2017 for occlusions of the intracranial large artery using the complex technique (n=37) or stent retrieval alone (n=56) in our stroke center...
March 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29402765/computed-tomography-perfusion-derived-blood-brain-barrier-permeability-does-not-yet-improve-prediction-of-hemorrhagic-transformation
#15
Alexander D Horsch, Edwin Bennink, Tom van Seeters, L Jaap Kappelle, Yolanda van der Graaf, Willem P T M Mali, Hugo W A M de Jong, Birgitta K Velthuis, Jan Willem Dankbaar
INTRODUCTION: Hemorrhagic transformation (HT) in acute ischemic stroke can occur as a result of reperfusion treatment. While withholding treatment may be warranted in patients with increased risk of HT, prediction of HT remains difficult. Nonlinear regression analysis can be used to estimate blood-brain barrier permeability (BBBP). The aim of this study was to identify a combination of clinical and imaging variables, including BBBP estimations, that can predict HT. MATERIALS AND METHODS: From the Dutch acute stroke study, 545 patients treated with intravenous recombinant tissue plasminogen activator and/or intra-arterial treatment were selected, with available admission extended computed tomography (CT) perfusion and follow-up imaging...
2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29349617/use-of-venovenous-ecmo-for-neonatal-and-pediatric-ecmo-a-decade-of-experience-at-a-tertiary-children-s-hospital
#16
Jennifer L Carpenter, Yangyang R Yu, Darrell L Cass, Oluyinka O Olutoye, James A Thomas, Cole Burgman, Caraciolo J Fernandes, Timothy C Lee
BACKGROUND: Advances in extracorporeal membrane oxygenation (ECMO) have led to increased use of venovenous (VV) ECMO in the pediatric population. We present the evolution and experience of pediatric VV ECMO at a tertiary care institution. METHODS: A retrospective cohort study from 01/2005 to 07/2016 was performed, comparing by cannulation mode. Survival to discharge, complications, and decannulation analyses were performed. RESULTS: In total, 160 patients (105 NICU, 55 PICU) required 13 ± 11 days of ECMO...
March 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29262429/blood-pressure-management-for-acute-ischemic-and-hemorrhagic-stroke-the-evidence
#17
Sang-Bae Ko, Byung-Woo Yoon
Hypertension is the most common modifiable risk factor for stroke (both ischemic and hemorrhagic types). In the hyperacute phase, a majority of patients shows an elevated blood pressure (BP) at the time of presentation because of sympathetic hyperactivity or a physiological response to tissue ischemia. Therefore, BP may decrease spontaneously in a few hours and may drop further when complete recanalization is achieved. In stroke guidelines, an elevated BP is usually left untreated up to a systolic BP (SBP) of 220 mm Hg and a diastolic BP of 120 mm Hg...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29248175/calvarium-mass-as-the-first-presentation-of-glioblastoma-multiforme-a-very-rare-manifestation-of-high-grade-glioma
#18
S Taghipour Zahir, M Mortaz, M Baghi Yazdi, N Sefidrokh Sharahjin, M Shabani
Glioblastoma multiforme (GBM) is a high grade glial tumor, primarily located in cerebral hemispheres. The most common clinical presentations are slowly progressive neurological deficit such as motor weakness, seizure, and headaches that last less than three months. Calvarium and extra-axial invasion are very rare and generally occur after a brain biopsy or surgery, or secondary to radiotherapy of primary intra-axial glial tumors. We report a case of GBM with calvarium involvement in a 60-year-old man who presented with a frontal bump and left-sided clumsiness...
March 2018: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29232038/novel-techniques-and-preliminary-results-of-ex-vivo-liver-resection-and-autotransplantation-for-end-stage-hepatic-alveolar-echinococcosis-a-study-of-31-cases
#19
Xianwei Yang, Yiwen Qiu, Bin Huang, Wentao Wang, Shu Shen, Xi Feng, Yonggang Wei, Jianyong Lei, Jichun Zhao, Bo Li, Tianfu Wen, Lunan Yan
Ex vivo liver resection combined with autotransplantation is a recently introduced approach to cure end-stage hepatic alveolar echinococcosis (HAE), which is considered unresectable by conventional radical resection due to echinococcal dissemination into the crucial intrahepatic conduits and adjacent structures. This article aims discuss the manipulation details and propose reasonable indications for this promising technique. All patients successfully underwent liver autotransplantation with no intraoperative mortality...
December 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29217492/the-potential-role-of-ideal-mri-for-identification-of-lipids-and-hemorrhage-in-carotid-artery-plaques
#20
Faisal Khosa, Rachel E Clough, Xiaoen Wang, Ananth J Madhuranthakam, Robert L Greenman
Hemorrhage and lipid deposits contribute to instability in atherosclerotic plaques. Unstable carotid artery plaques can lead to cerebral ischemic events. While MRI studies have shown the ability to identify plaque components, the identification of hemorrhage and lipids has proven to be problematic. The purpose of this study was to quantitatively evaluate the potential of the MRI fat/water separation method known as iterative decomposition of water and fat with echo asymmetry and least squares estimation (IDEAL) to complement and improve existing methods for the identification of hemorrhage and lipids in carotid artery plaques...
June 2018: Magnetic Resonance Imaging
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