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intra cerebral hemorrhage

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https://www.readbyqxmd.com/read/28503488/treatment-of-cerebral-vasospasm-in-an-infant-using-a-modified-dotter-technique
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
April 26, 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
#7
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
#8
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
https://www.readbyqxmd.com/read/28399456/elevated-hemoglobin-is-associated-with-cerebral-infarction-in-tibetan-patients-with-primary-hemorrhagic-neurovascular-diseases
#9
Ruiqi Chen, Anqi Xiao, Lu Ma, Hao Li, Sen Lin, Chao You
OBJECTIVES: Although many studies have focused on primary hemorrhagic neurovascular diseases (PHNVDs) in different races, studies of PHNVDs in the plateau area of China are still insufficient. Chinese Tibetan people are the largest population living in the plateau area. Previous studies have shown that Tibetan PHNVD patients have a significantly higher incidence of cerebral infarction, but the mechanism remains uncertain. This study aimed to develop a better understanding on the mechanism of their high risk of cerebral infarction...
March 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28395418/-efficacy-comparison-of-three-vascular-recanalization-in-patients-with-acute-vertebrobasilar-occlusion
#10
G H Ni, C Liang, W D Zhao, X Y Tian, H G Sun, S R Gao, L S Ding
Objectives: To investigate the therapeutic effects of intravenous thrombolysis, intra-artery thrombolysis, mechanical thrombectomy on patients with acute vertebrobasilar occlusion. Methods: Retrospective analysis of clinical data of patients with acute vertebrobasilar occlusion, admitted to Huai'an First People's Hospital and Bingtuan Qishi Hospital from January 2014 to January 2016, was performed. According to different vascular recanalization, these patients were divided into intravenous thrombolysis group, intra-artery thrombolysis group and mechanical thrombectomy group...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28355735/-clinical-application-of-hybrid-surgery-for-the-treatment-of-cerebral-arteriovenous-malformations
#11
H X Wu, Rexiti Paerhati, G J Feng, X P Yang, P Zhao, Q L Liu, G Li, X G Li, D H Wang
Objective: To investigate the application of hybrid technique for the treatment of cerebral arteriovenous malformations (CAVMs) and to assess the value of hybrid technique. Methods: The cases of CAVMs treated in Qilu hospital and People's Hospital of Xinjiang Uygur Autonomous Region from July 2011 to July 2016 were analyzed retrospectively.Two modes of hybrid surgery, "angiographic diagnosis-craniotomy lesion resection or/and hematoma clearance-intraoperative angiography evaluation" and "angiographic diagnosis-intraoperative embolization-craniotomy lesion resection or/and hematoma clearance-intraoperative angiography evaluation" were applied for all the cases...
March 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28339483/temporal-evolution-of-vasospasm-and-clinical-outcome-after-intra-arterial-vasodilator-therapy-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#12
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
#13
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
#14
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
#15
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
#16
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...
June 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
#17
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
#18
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
#19
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
#20
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
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