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https://www.readbyqxmd.com/read/28346232/the-future-is-now-neuroprotection-during-cardiopulmonary-resuscitation
#1
Johanna C Moore, Jason A Bartos, Timothy R Matsuura, Demetris Yannopoulos
PURPOSE OF REVIEW: Survival with favorable neurological function after cardiac arrest remains low. The purpose of this review is to identify recent advances that focus on neuroprotection during cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Multiple strategies have been shown to enhance neuroprotection during CPR. Brain perfusion during CPR is increased with therapies such as active compression decompression CPR and intrathoracic pressure regulation that improve cardiac preload and decrease intracranial pressure...
March 24, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28345479/imaging-the-physiological-evolution-of-the-ischemic-penumbra-in-acute-ischemic-stroke
#2
Richard Leigh, Linda Knutsson, Jinyuan Zhou, Peter Cm van Zijl
We review the hemodynamic, metabolic and cellular parameters affected during early ischemia and their changes as a function of approximate cerebral blood flow ( CBF) thresholds. These parameters underlie the current practical definition of an ischemic penumbra, namely metabolically affected but still viable brain tissue. Such tissue is at risk of infarction under continuing conditions of reduced CBF, but can be rescued through timely intervention. This definition will be useful in clinical diagnosis only if imaging techniques exist that can rapidly, and with sufficient accuracy, visualize the existence of a mismatch between such a metabolically affected area and regions that have suffered cell depolarization...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28345124/evaluation-of-cortical-brain-parenchyma-by-diffusion-and-perfusion-mri-before-and-after-chronic-subdural-hematoma-surgery
#3
Bekir Akgun, Hakan Cakin, Sait Ozturk, Hanefi Yildirim, Izzet Okcesiz, Saim Kazan, Fatih Serhat Erol
AIM: To evaluate microcirculatory changes in neighboring parenchyma as a result of pressure due to chronic subdural hematoma (CSDH) in early and late periods after hematoma drainage. MATERIAL AND METHODS: The subjects comprised 25 patients who underwent CSDH drainage. Brain diffusion and perfusion MRIs were obtained preoperatively, 48 h (early period) and 2 months (late period) postoperatively. Measurements were performed on 1 cm2 regions of interest in the neighboring parenchymal tissue...
February 21, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28344178/systemic-and-cerebral-concentration-of-nimodipine-during-established-and-experimental-vasospasm-treatment
#4
Walid Albanna, Miriam Weiss, Catharina Conzen, Hans Clusmann, Toni Schneider, Martin Reinsch, Marguerite Müller, Martin Wiesmann, Anke Höllig, Gerrit Alexander Schubert
BACKGROUND: Oral nimodipine is an established prophylactic agent for cerebral vasospasm after subarachnoid hemorrhage (SAH). In highly selected cases, intraarterial or intravenous application of nimodipine may be considered; optimum dosage and modality of application, however, remain a matter of debate. Analysis of nimodipine concentration in serum, CSF and cerebral microdialysate in context of currently effective dose and route of application (oral, IA, IV) is the purpose of this investigation...
March 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28343848/capillary-dysfunction-is-associated-with-symptom-severity-and-neurodegeneration-in-alzheimer-s-disease
#5
Rune B Nielsen, Lærke Egefjord, Hugo Angleys, Kim Mouridsen, Michael Gejl, Arne Møller, Birgitte Brock, Hans Brændgaard, Hanne Gottrup, Jørgen Rungby, Simon F Eskildsen, Leif Østergaard
INTRODUCTION: We examined whether cortical microvascular blood volume and hemodynamics in Alzheimer's disease (AD) are consistent with tissue hypoxia and whether they correlate with cognitive performance and the degree of cortical thinning. METHODS: Thirty-two AD patients underwent cognitive testing, structural magnetic resonance imaging (MRI), and perfusion MRI at baseline and after 6 months. We measured cortical thickness, microvascular cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and capillary transit time heterogeneity (CTH) and estimated tissue oxygen tension (PtO2)...
March 23, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/28343223/sildenafil-enhances-quantity-of-immature-neurons-and-promotes-functional-recovery-in-the-developing-ischemic-mouse-brain
#6
Jonas Engels, Natalie Elting, Lisa Braun, Ivo Bendix, Josephine Herz, Ursula Felderhoff-Müser, Mark Dzietko
BACKGROUND: Hypoxic-ischemic (HI) injury to the developing brain occurs in 1 out of 1,000 live births and remains a major cause of significant morbidity and mortality. A large number of survivors suffer from long-term sequelae including seizures and neurological deficits. However, the pathophysiological mechanisms of recovery after HI insult are not clearly understood, and preventive measures or clinical treatments are nonexistent or not sufficiently effective in the clinical setting...
March 25, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28342045/effects-of-an-alveolar-recruitment-maneuver-on-subdural-pressure-brain-swelling-and-mean-arterial-pressure-in-patients-undergoing-supratentorial-tumour-resection-a-randomized-crossover-study
#7
Alana M Flexman, Peter A Gooderham, Donald E Griesdale, Ruth Argue, Brian Toyota
PURPOSE: Although recruitment maneuvers have been advocated as part of a lung protective ventilation strategy, their effects on cerebral physiology during elective neurosurgery are unknown. Our objectives were to determine the effects of an alveolar recruitment maneuver on subdural pressure (SDP), brain relaxation score (BRS), and cerebral perfusion pressure among patients undergoing supratentorial tumour resection. METHODS: In this prospective crossover study, patients scheduled for resection of a supratentorial brain tumour were randomized to undergo either a recruitment maneuver (30 cm of water for 30 sec) or a "sham" maneuver (5 cm of water for 30 sec), followed by the alternative intervention after a 90-sec equilibration period...
March 24, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28341992/a-semi-automated-volumetric-software-for-segmentation-and-perfusion-parameter-quantification-of-brain-tumors-using-320-row-multidetector-computed-tomography-a-validation-study
#8
Soo Young Chae, Sangil Suh, Inseon Ryoo, Arim Park, Kyoung Jin Noh, Hackjoon Shim, Hae Young Seol
PURPOSE: We developed a semi-automated volumetric software, NPerfusion, to segment brain tumors and quantify perfusion parameters on whole-brain CT perfusion (WBCTP) images. The purpose of this study was to assess the feasibility of the software and to validate its performance compared with manual segmentation. METHODS: Twenty-nine patients with pathologically proven brain tumors who underwent preoperative WBCTP between August 2012 and February 2015 were included...
March 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#9
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28338505/effects-of-hypertonic-saline-and-sodium-lactate-on-cortical-cerebral-microcirculation-and-brain-tissue-oxygenation
#10
Vlasta Dostalova, Jitka Schreiberova, Vlasta Dostalova, Jiri Paral, Jaroslav Kraus, Alena Ticha, Vera Radochova, Pavel Dostal
BACKGROUND: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of hypertonic saline (HTS) and sodium lactate (HTL) on cerebral cortical microcirculation and brain tissue oxygenation in a rabbit craniotomy model. METHODS: Rabbits (weight, 1.5 to 2.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3...
March 23, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28338432/dual-labeling-with-5-aminolevulinic-acid-and-fluorescein-for-fluorescence-guided-resection-of-high-grade-gliomas-technical-note
#11
Eric Suero Molina, Johannes Wölfer, Christian Ewelt, André Ehrhardt, Benjamin Brokinkel, Walter Stummer
OBJECTIVE Fluorescence guidance with 5-aminolevulinic acid (5-ALA) helps improve resections of malignant gliomas. However, one limitation is the low intensity of blue light for background illumination. Fluorescein has recently been reintroduced into neurosurgery, and novel microscope systems are available for visualizing this fluorochrome, which highlights all perfused tissues but has limited selectivity for tumor detection. Here, the authors investigate a combination of both fluorochromes: 5-ALA for distinguishing tumor and fluorescein for providing tissue fluorescence of adjacent brain tissue...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28336575/pharmacologic-profile-of-naloxegol-a-peripherally-acting-%C3%A2%C2%B5-opioid-receptor-antagonist-for-the-treatment-of-opioid-induced-constipation
#12
Eike Floettmann, Khanh Bui, Mark Sostek, Kemal Payza, Michael Eldon
Opioid-induced constipation (OIC) is a common side effect of opioid pharmacotherapy for the management of pain because opioid agonists bind to µ-opioid receptors in the enteric nervous system (ENS). Naloxegol, a polyethylene glycol derivative of naloxone and a peripherally acting µ-opioid receptor antagonist, targets the physiologic mechanisms that cause OIC. Pharmacologic measures of opioid activity and pharmacokinetic measures of central nervous system (CNS) penetration were employed to characterize the mechanism of action of naloxegol...
March 23, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28331228/traumatic-brain-injury-results-in-acute-rarefication-of-the-vascular-network
#13
Andre Obenaus, Michelle Ng, Amanda M Orantes, Eli Kinney-Lang, Faisal Rashid, Mary Hamer, Richard A DeFazio, Jiping Tang, John H Zhang, William J Pearce
The role of the cerebrovascular network and its acute response to TBI is poorly defined and emerging evidence suggests that cerebrovascular reactivity is altered. We explored how cortical vessels are physically altered following TBI using a newly developed technique, vessel painting. We tested our hypothesis that a focal moderate TBI results in global decrements to structural aspects of the vasculature. Rats (naïve, sham-operated, TBI) underwent a moderate controlled cortical impact. Animals underwent vessel painting perfusion to label the entire cortex at 1 day post TBI followed by whole brain axial and coronal images using a wide-field fluorescence microscope...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28331022/effect-of-non-pharmacological-intervention-for-apathy-response-to-one-on-one-reminiscence-based-intervention
#14
Akira Okada, Tetsuya Ueda
Apathy has adverse consequences for patients and caregivers. However, the therapeutic approach remains uncertain. Here, we present the case of a man aged 67 years who only developed apathy after surgery for oesophageal cancer. He showed no response to intervention with donepezil, a 'brain training' video game and psychoeducation for apathy. Subsequently, we implemented a programme designed to facilitate recall of 2 themes (editorial content and television shows during the week) once a week. After 3 months, the scores of 2 apathy scales rated by the patient's wife, psychological test scores and brain perfusion single-photon emission CT data improved compared with those obtained before intervention...
March 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28330412/early-asymmetric-cardio-cerebral-causality-and-outcome-after-severe-traumatic-brain-injury
#15
Lei Gao, Peter Smieleweski, Marek Czosnyka, Ari Ercole
The brain and heart are two vital systems in health and disease, increasingly recognised as a complex, interdependent network with constant information flow in both directions. After severe traumatic brain injury (TBI), the causal, directed interactions between the brain, heart and autonomic nervous system have not been well established. Novel methods are needed to probe unmeasured, potentially prognostic information in complex biological networks that are not revealed via traditional means. In this study, we examined potential bi-directional causality between intracranial pressure (ICP), mean arterial pressure (MAP) and heart rate (HR) and its relationship to mortality in a 24-hour period early after TBI...
March 23, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28328739/effects-of-a-brief-cognitive-behavioural-therapy-group-intervention-on-baseline-brain-perfusion-in-adolescents-with-major-depressive-disorder
#16
Zrinka Sosic-Vasic, Birgit Abler, Georg Grön, Paul Plener, Joana Straub
A number of neuroimaging studies have identified altered regional cerebral blood flow (rCBF) related to major depressive disorder (MDD) in adult samples, particularly in the lateral prefrontal, cingular and temporal regions. In contrast, neuroimaging investigations in adolescents with MDD are rare, although investigating young patients during a significant period of brain maturation might offer valuable insights into the neural mechanisms of MDD. We acquired perfusion images obtained with continuous arterial spin labelling in 21 medication-naive adolescents with MDD before and after a five-session cognitive behavioural group therapy (group CBT)...
April 12, 2017: Neuroreport
https://www.readbyqxmd.com/read/28328241/perfusion-ct-in-acute-stroke-effectiveness-of-automatically-generated-colour-maps
#17
Maja Ukmar, Ferruccio Degrassi, Roberta Antea Pozzi Mucelli, Francesca Neri, Fabio Pozzi Mucelli, Maria Assunta Cova
OBJECTIVE: To evaluate the accuracy of perfusion CT (pCT) in the definition of the infarcted core and the penumbra, comparing the data obtained from the evaluation of parametric maps [cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT)] with software-generated colour maps. METHODS: A retrospective analysis was performed to identify patients with suspected acute ischaemic strokes and who had undergone unenhanced CT and pCT carried out within 4...
April 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28327964/imaging-approaches-to-stroke-and-neurovascular-disease
#18
Seena Dehkharghani, Jalal Andre
Imaging is paramount to the diagnosis and management of ischemic stroke, offering a battery of structural and functional probes of cerebrovascular physiology. The technical underpinnings of stroke imaging continue to evolve, bringing the neuroscience community increasingly closer to high-resolution, tissue-level biomarkers of brain perfusion, metabolism, and viability. The rapid expansion of neuroimaging in this domain has met with controversies, and in many respects, a lack of generalizable conclusions regarding optimized use in cerebrovascular disease...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327077/regional-muscle-tissue-saturation-is-an-indicator-of-global-inadequate-circulation-during-cardiopulmonary-bypass-a-randomized-porcine-study-using-muscle-intestinal-and-brain-tissue-metabolomics
#19
Sisse Anette Thomassen, Benedict Kjærgaard, Preben Sørensen, Jan Jesper Andreasen, Anders Larsson, Bodil Steen Rasmussen
BACKGROUND: Muscle tissue saturation (StO2) measured with near-infrared spectroscopy has generally been considered a measurement of the tissue microcirculatory condition. However, we hypothesized that StO2 could be more regarded as a fast and reliable measure of global than of regional circulatory adequacy and tested this with muscle, intestinal and brain metabolomics at normal and two levels of low cardiopulmonary bypass blood flow rates in a porcine model. METHODS: Twelve 80 kg pigs were connected to normothermic cardiopulmonary bypass with a blood flow of 60 mL/kg/min for one hour, reduced randomly to 47...
April 2017: Perfusion
https://www.readbyqxmd.com/read/28324779/frontocingulate-cerebral-blood-flow-and-cerebrovascular-reactivity-associated-with-antidepressant-response-in-late-life-depression
#20
Margarita Abi Zeid Daou, Brian D Boyd, Manus J Donahue, Kimberly Albert, Warren D Taylor
BACKGROUND: Vascular pathology is common in late-life depression (LLD) and may contribute to alterations in cerebral blood flow (CBF) and cerebrovascular reactivity (CVR). In turn, such hemodynamic deficits may adversely affect brain function and clinical course. The goal of this study was to examine whether altered cerebral hemodynamics in depressed elders predicted antidepressant response. METHODS: 21 depressed elders completed cranial 3T MRI, including a pseudo-continuous Arterial Spin Labeling (pcASL) acquisition on both room air and during a hypercapnia challenge...
March 16, 2017: Journal of Affective Disorders
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