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https://www.readbyqxmd.com/read/27894886/utility-of-urgent-computed-tomography-angiography-in-the-setting-of-intraparenchymal-brain-hemorrhage
#1
Omran Kaskar, Larry B Goldstein
BACKGROUND AND PURPOSE: Patients presenting with an intracerebral hemorrhage (ICH) generally have an initial noncontrast computed tomography (NCCT) of the brain. Computed tomography angiography (CTA) can help identify secondary causes of ICH and detect a "spot sign." We hypothesized that performing an urgent CTA in the setting of a presumed primary ICH has only limited utility and did not alter urgent management. METHODS: This was a retrospective study of consecutive patients presenting with a primary ICH identified from the Duke University Stroke Registry from 2010 to 2013 who had an ICH detected on an initial NCCT...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27323783/matrix-metalloproteinases-in-the-brain-and-blood-brain-barrier-versatile-breakers-and-makers
#2
REVIEW
Ralf G Rempe, Anika Ms Hartz, Björn Bauer
Matrix metalloproteinases are versatile endopeptidases with many different functions in the body in health and disease. In the brain, matrix metalloproteinases are critical for tissue formation, neuronal network remodeling, and blood-brain barrier integrity. Many reviews have been published on matrix metalloproteinases before, most of which focus on the two best studied matrix metalloproteinases, the gelatinases MMP-2 and MMP-9, and their role in one or two diseases. In this review, we provide a broad overview of the role various matrix metalloproteinases play in brain disorders...
September 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/26621678/factors-influencing-the-outcome-gos-in-reconstructive-cranioplasty
#3
U R Krause-Titz, N Warneke, S Freitag-Wolf, H Barth, H M Mehdorn
After performing a decompressive craniectomy, a cranioplastic surgery is usually warranted. The complications of this reconstructive procedure may differ from the initial operation. The authors of this study report on their experience to define patient-specific and procedural risk factors for possible complications following cranioplasty influencing the outcome (Glasgow Outcome Scale (GOS)), mobility, shunt dependency, and seizures. A retrospective analysis of 263 patients of all ages and both sexes who had undergone cranioplasty after craniectomy for traumatic brain injury (including chronic subdural hematoma), subarachnoidal hemorrhage (including intracerebral hemorrhage), ischemic stroke, and tumor surgery in one single center in 12 years from January 2000 to March 2012 has been carried out...
January 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/25845759/safety-of-intravenous-thrombolysis-for-acute-ischemic-stroke-in-specific-conditions
#4
REVIEW
Georgios Tsivgoulis, Apostolos Safouris, Andrei V Alexandrov
INTRODUCTION: Intravenous administration of tissue-type plasminogen activator (IV-tPA) remains the only approved therapy that may reverse neurological deficit in patients with acute ischemic stroke (AIS). During the past 20 years, accumulating real-word experience have provided additional information regarding its safety and efficacy in various clinical settings that were originally considered as contraindications for systemic thrombolysis. AREAS COVERED: In this narrative review, we address the safety of intravenous thrombolysis (IVT) in specific conditions: dissection of the aortic arch of extracranial and intracranial arteries, concomitant presence of unruptured intracranial aneurysms, arteriovenous malformations and dural fistulas, co-existing brain tumors as well as in conditions mimicking AIS...
June 2015: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/24990835/-case-of-acute-ischemic-stroke-due-to-cardiac-myxoma-treated-by-intravenous-thrombolysis-and-endovascular-therapy
#5
Yuki Kamiya, Hiroo Ichikawa, Keita Mizuma, Kazuhiro Itaya, Yuki Shimizu, Mitsuru Kawamura
A 48-year-old woman with no previous neurological diseases was transferred to our hospital because of sudden-onset unconsciousness. On arrival, she showed consciousness disturbance (E1V1M3 on the Glasgow Coma Scale), tetraplegia, right conjugate deviation and bilateral pathological reflexes. These symptoms resulted in a NIH stroke scale score of 32. Brain diffusion-weighted MR imaging (DWI) showed multiple hyper-intense lesions, and MR angiography revealed occlusions of the basilar artery (BA) and superior branch of the right middle cerebral artery (MCA)...
2014: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/24277723/seizure-prophylaxis-in-neurocritical-care-a-review-of-evidence-based-support
#6
REVIEW
A Shaun Rowe, Haley Goodwin, Gretchen M Brophy, Jennifer Bushwitz, Amber Castle, David Deen, Dachelle Johnson, Christine Lesch, Norah Liang, Emily Potter, Christina Roels, Karen Samaan, Denise H Rhoney
Seizures are a well-described complication of acute brain injury and neurosurgery. Antiepileptic drugs (AEDs) are frequently utilized for seizure prophylaxis in neurocritical care patients. In this review, the Neurocritical Care Society Pharmacy Section describes the evidence associated with the use of AEDs for seizure prophylaxis in patients with intracerebral tumors, traumatic brain injury, aneurysmal subarachnoid hemorrhage, craniotomy, ischemic stroke, and intracerebral hemorrhage. Clear evidence indicates that the short-term use of AEDs for seizure prophylaxis in patients with traumatic brain injury and aneurysmal subarachnoid hemorrhage may be beneficial; however, evidence to support the use of AEDs in other disease states is less clear...
2014: Pharmacotherapy
https://www.readbyqxmd.com/read/24266541/clinical-application-of-perfusion-computed-tomography-in-neurosurgery
#7
REVIEW
Abel Po-Hao Huang, Jui-Chang Tsai, Lu-Ting Kuo, Chung-Wei Lee, Hong-Shiee Lai, Li-Kai Tsai, Sheng-Jean Huang, Chien-Min Chen, Yuan-Shen Chen, Hao-Yu Chuang, Max Wintermark
OBJECT: Currently, perfusion CT (PCT) is a valuable imaging technique that has been successfully applied to the clinical management of patients with ischemic stroke and aneurysmal subarachnoid hemorrhage (SAH). However, recent literature and the authors' experience have shown that PCT has many more important clinical applications in a variety of neurosurgical conditions. Therefore, the authors share their experiences of its application in various diseases of the cerebrovascular, neurotraumatology, and neurooncology fields and review the pertinent literature regarding expanding PCT applications for neurosurgical conditions, including pitfalls and future developments...
February 2014: Journal of Neurosurgery
https://www.readbyqxmd.com/read/23788113/causes-of-diplopia-in-the-emergency-department-diagnostic-accuracy-of-clinical-assessment-and-of-head-computed-tomography
#8
Peiman Nazerian, Simone Vanni, Claudia Tarocchi, Emilio Portaccio, Nadia Vannucci, Ombretta Para, Giuseppe Giannazzo, Chiara Gigli, Stefano Grifoni
BACKGROUND: Studies on frequency and underlying diseases causing binocular diplopia in patients presenting to the emergency department (ED) are lacking. OBJECTIVE: To evaluate the prevalence of different diseases causing diplopia and the role of medical history, clinical examination, and unenhanced head computed tomography (UHCT) in the identification of secondary diplopia. METHODS: Diplopic patients presenting to the ED were enrolled prospectively...
April 2014: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/23735170/perinatally-hiv-infected-youth-presenting-with-acute-stroke-progression-evolution-of-ischemic-disease-on-neuroimaging
#9
Izlem Izbudak, Majid Chalian, Nancy Hutton, Visveshwar Baskaran, Lori Jordan, George K Siberry, Philippe Gailloud, Allison L Agwu
BACKGROUND AND PURPOSE: Although HIV infection is decreasing in infants and children, there is a steady cohort of perinatally HIV-infected (PHIV) children that are growing older. Increased risk of acute stroke has been reported in PHIV children. Our goal was to evaluate evolution/progression of neuroimaging findings in PHIV youth initially presenting with acute stroke. MATERIALS AND METHODS: The medical records of PHIV pediatric patients (n = 179) from 1996 to 2010 were reviewed and patients with clinical documentation of acute stroke referred to the neuroradiology service were eligible for the study...
July 2013: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/22754722/implementation-of-cerebral-microdialysis-at-a-community-based-hospital-a-5-year-retrospective-analysis
#10
Jeff W Chen, Shana L Rogers, Zoe J Gombart, David E Adler, Sandy Cecil
BACKGROUND: Cerebral microdialysis (MD) provides valuable information about brain metabolism under normal and pathologic conditions. The CMA 600 microdialysis analyzer received US Food and Drug Administration (FDA) approval for clinical use in the United States in 2005. Since then, cerebral MD has been increasingly utilized nationally in the multimodal monitoring of traumatic brain injury (TBI), stroke, aneurysmal subarachnoid hemorrhage, and brain tumors. We describe a 5-year, single-institutional experience using cerebral MD at a community-based hospital, Legacy Emanuel Medical Center (LEMC)...
2012: Surgical Neurology International
https://www.readbyqxmd.com/read/22531657/-primary-clivus-diffuse-large-b-cell-lymphoma-presenting-with-posterior-neck-pain-and-bilateral-abducens-nerve-palsy
#11
Akira Yokote, Yoshio Tsuboi, Kousuke Fukuhara, Jun Tsugawa, Hirosato Inoue, Mikiko Aoki, Kazuki Nabeshima, Hitoshi Tsugu, Toru Inoue, Tatsuo Yamada
Bilateral abducens nerve palsy is an unusual clinical presentation, which could be caused by stroke, aneurysm, trauma and malignant neoplasm. We describe here a patient with bilateral abducens nerve palsy caused by large B cell lymphoma originated from clivus. An 83-year-old woman admitted to our hospital because of diplopia and severe posterior neck pain. Her diplopia developed one month before and progressed to her admission. Neurological examination revealed bilateral abducens nerve palsy. Brain MRI with enhancement lesion in the clivus, suggesting that bilateral petroclival segment of the abducens nerves were affected by the lesion...
2012: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/22517375/eleven-years-experience-with-korean-cardiac-myxoma-patients-focus-on-embolic-complications
#12
Seung-Jae Lee, Jae-Hyun Kim, Chan-Young Na, Sam-Sae Oh
BACKGROUND: Cardiac myxomas are rare but are the most common cardiac tumors. This study is based on our clinical experience with cardiac myxomas over a period of 11 years at Sejong General Hospital. We focused on the embolic complications of patients with cardiac myxoma. METHODS: We retrospectively reviewed the medical records of 59 consecutive patients with cardiac myxoma who were treated between January 2000 and March 2011. The myxomas were divided into two types: type 1, with an irregular or villous surface and a soft consistency, and type 2, with a smooth surface and a compact consistency...
2012: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/22133167/incidental-findings-on-cranial-imaging-in-nonagenarians
#13
COMPARATIVE STUDY
Wajd N Al-Holou, Adam Khan, Thomas J Wilson, William R Stetler, Gaurang V Shah, Cormac O Maher
OBJECT: The aim of this article was to report on the nature and prevalence of incidental imaging findings in a consecutive series of patients older than 90 years of age who underwent intracranial imaging for any reason. METHODS: The authors retrospectively reviewed the electronic medical and imaging records of consecutive patients who underwent brain MR imaging at a single institution over a 153-month interval and were at least 90 but less than 100 years of age at the time of the imaging study...
December 2011: Neurosurgical Focus
https://www.readbyqxmd.com/read/22005307/-role-of-transesophageal-echocardiography-in-the-assessment-and-therapeutic-management-of-patients-with-acute-ischemic-cerebral-events-before-the-age-of-65
#14
António Gaspar, Isabel Silva, António Costeira Pereira, Nuno Salomé, José António Mariz, Aida Brandão, Francisco Fernandes, Alda Simões, Alberto Salgado, Adelino Correia
INTRODUCTION: Ischemic stroke is the leading cause of mortality in Portugal, with around 30 to 50 % of cases being of cardioembolic etiology. Transesophageal echocardiography (TEE) has assumed growing importance in the detection of cardiac sources of embolism. However, there is controversy regarding the implications of TEE findings for the therapeutic approach to patients with ischemic stroke. OBJECTIVES: To analyze TEE findings in the diagnostic work-up of patients with ischemic cerebral events and to determine their influence on therapeutic strategy...
July 2011: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/21990632/cerebral-revascularization-for-ischemic-disease-in-the-21st-century
#15
Nicholas C Bambakidis, Shakeel A Chowdhry
Shortly after the first extracranial to intracranial (EC-IC) carotid artery bypass was performed by Yasargil in 1967 for internal carotid artery occlusion, cerebral revascularization became widely accepted in the neurosurgical field, and the procedures became increasingly used as practitioners began to master the technical aspects of the surgery. The procedures were performed for intracranial arterial stenosis and occlusion and used as an adjunct in the treatment of large aneurysms and skull base tumors. The results of the EC-IC bypass group trial in 1985 were surprising to many and sobering to all; EC-IC bypass for stenosis or occlusion of the high internal carotid artery or middle cerebral artery did not decrease the risk of subsequent stroke compared with medical management...
September 2010: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/21596366/loss-of-brcc3-deubiquitinating-enzyme-leads-to-abnormal-angiogenesis-and-is-associated-with-syndromic-moyamoya
#16
Snaigune Miskinyte, Matthew G Butler, Dominique Hervé, Catherine Sarret, Marc Nicolino, Jacob D Petralia, Francoise Bergametti, Minh Arnould, Van N Pham, Aniket V Gore, Konstantinos Spengos, Steven Gazal, France Woimant, Gary K Steinberg, Brant M Weinstein, Elisabeth Tournier-Lasserve
Moyamoya is a cerebrovascular angiopathy characterized by a progressive stenosis of the terminal part of the intracranial carotid arteries and the compensatory development of abnormal and fragile collateral vessels, also called moyamoya vessels, leading to ischemic and hemorrhagic stroke. Moyamoya angiopathy can either be the sole manifestation of the disease (moyamoya disease) or be associated with various conditions, including neurofibromatosis, Down syndrome, TAAD (autosomal-dominant thoracic aortic aneurysm), and radiotherapy of head tumors (moyamoya syndromes)...
June 10, 2011: American Journal of Human Genetics
https://www.readbyqxmd.com/read/21051064/-cardiac-myxoma-complicated-with-cerebral-aneurysms-and-revealed-by-an-ischemic-stroke
#17
M Messouak, A Zaam, M Maaroufi, I Lahlou, M F Belahsen, O Messouak
INTRODUCTION: Myxoma is a rare benign primary cardiac tumor. It may cause vascular complications. Neurological symptoms may precede or accompany the diagnosis of myxoma with systemic embolization occurring most often in the cerebral circulation. OBSERVATION: We report a case of cardiac myxoma complicated with cerebral aneurysms and revealed by an ischemic stroke in a 21-year-old patient. The cardiac myxoma was discovered during the transthoracic echocardiography performed as part of the etiological work-up...
February 2011: Revue Neurologique
https://www.readbyqxmd.com/read/19915983/impact-of-pattern-of-admission-on-ich-outcomes
#18
Neeraj Sunderrajan Naval, J Ricardo Carhuapoma
BACKGROUND: Intracerebral hemorrhage (ICH) is associated with the highest mortality of all strokes. Admission to a Neurosciences Critical Care Unit (NCCU) compared to a general ICU has been associated with reduced mortality following ICH. Such association has led to several hospitals transferring ICH patients to Neuro-ICUs in tertiary care centers. However, delays in optimizing ICH management prior to and during transfer can lead to deleterious consequences. To compare functional outcomes in ICH patients admitted to our NCCU directly from the ED versus inter-hospital transfer admissions...
April 2010: Neurocritical Care
https://www.readbyqxmd.com/read/19892994/acute-brain-infarcts-after-spontaneous-intracerebral-hemorrhage-a-diffusion-weighted-imaging-study
#19
COMPARATIVE STUDY
Shyam Prabhakaran, Rajesh Gupta, Bichun Ouyang, Sayona John, Richard E Temes, Yousef Mohammad, Vivien H Lee, Thomas P Bleck
BACKGROUND AND PURPOSE: We aimed to determine the prevalence of acute brain infarcts using diffusion-weighted imaging (DWI) in patients with spontaneous intracerebral hemorrhage (ICH). METHODS: We collected data on consecutive patients with spontaneous ICH admitted to our institution between August 1, 2006 and December 31, 2008 and in whom DWI was performed within 28 days of admission. Patients with hemorrhage attributable to trauma, tumor, aneurysm, vascular malformation, and hemorrhagic conversion of arterial or venous infarction were excluded...
January 2010: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/19812380/cerebrovascular-disease-in-childhood-cancer-survivors-a-children-s-oncology-group-report
#20
REVIEW
B Morris, S Partap, K Yeom, I C Gibbs, P G Fisher, A A King
BACKGROUND: Curative therapy for childhood cancer has dramatically improved over past decades. Therapeutic radiation has been instrumental in this success. Unfortunately, irradiation is associated with untoward effects, including stroke and other cerebrovascular disease (CVD). The Children's Oncology Group (COG) has developed guidelines for screening survivors at risk for persistent or late sequelae of cancer therapy. OBJECTIVES: This review summarizes the pathophysiology and relevant manifestations of radiation-induced CVD and outlines the specific patient groups at risk for early-onset stroke...
December 1, 2009: Neurology
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