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https://www.readbyqxmd.com/read/27888818/high-altitude-illness
#1
Anna Hartman-Ksycińska, Jolanta Kluz-Zawadzka, Bogumił Lewandowski
High-altitude illness is a result of prolonged high-altitude exposure of unacclimatized individuals. The illness is seen in the form of acute mountain sickness (AMS) which if not treated leads to potentially life-threatening high altitude pulmonary oedema and high-altitude cerebral oedema. Medical problems are caused by hypobaric hypoxia stimulating hypoxia-inducible factor (HIF) release. As a result, the central nervous system, circulation and respiratory system function impairment occurs. The most important factor in AMS treatment is acclimatization, withdrawing further ascent and rest or beginning to descent; oxygen supplementation, and pharmacological intervention, and, if available, a portable hyperbaric chamber...
2016: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/27884858/hemicraniectomy-versus-medical-treatment-with-large-mca-infarct-a-review-and-meta-analysis
#2
Paul Alexander, Diane Heels-Ansdell, Reed Siemieniuk, Neera Bhatnagar, Yaping Chang, Yutong Fei, Yuqing Zhang, Shelley McLeod, Kameshwar Prasad, Gordon Guyatt
OBJECTIVE: Large middle cerebral artery stroke (space-occupying middle-cerebral-artery (MCA) infarction (SO-MCAi)) results in a very high incidence of death and severe disability. Decompressive hemicraniectomy (DHC) for SO-MCAi results in large reductions in mortality; the level of function in the survivors, and implications, remain controversial. To address the controversy, we pooled available randomised controlled trials (RCTs) that examined the impact of DHC on survival and functional ability in patients with large SO-MCAi and cerebral oedema...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27878561/pseudotumoral-brain-lesions-mri-review
#3
Dimitri Renard, Giovanni Castelnovo, Anne Le Floch, Jean-Sebastien Guillamo, Eric Thouvenot
Single or multiple space-occupying lesions on brain MRI, with or without contrast enhancement and/or perilesional oedema, evoke a neoplastic origin. However, a multitude of non-neoplastic disorders can simulate cerebral neoplasia. In this review, we will discuss the MRI characteristics of non-neoplastic disorders that can mimic cerebral neoplasia. Distinguishing MRI characteristics are discussed for each of these non-neoplastic disorders.
November 22, 2016: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/27873213/is-management-of-hyperglycaemia-in-acute-phase-stroke-still-a-dilemma
#4
REVIEW
C Savopoulos, G Kaiafa, I Kanellos, A Fountouki, D Theofanidis, A I Hatzitolios
INTRODUCTION: Close monitoring of blood glucose levels during the immediate post-acute stroke phase is of great clinical value, as there is evidence that the risk of neurological deterioration is associated with both hyper- and hypoglycaemia. The aim of this review paper is to summarise the evidence on post-stroke blood glucose management and its impact on clinical outcomes, during the early post-acute stage. FINDINGS: Post-stroke hyperglycaemia has been associated with increased cerebral oedema, haemorrhagic transformation, lower likelihood of recanalisation and deteriorating neurological state...
November 21, 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27862464/randomized-assessment-of-imatinib-in-patients-with-acute-ischaemic-stroke-treated-with-intravenous-thrombolysis
#5
N Wahlgren, M Thorén, B Höjeberg, T-B Käll, A-C Laska, C Sjöstrand, J Höijer, H Almqvist, S Holmin, A Lilja, L Fredriksson, D Lawrence, U Eriksson, N Ahmed
BACKGROUND: Imatinib, a tyrosine kinase inhibitor, has been shown to restore blood-brain barrier integrity and reduce infarct size, haemorrhagic transformation and cerebral oedema in stroke models treated with tissue plasminogen activator. We evaluated the safety of imatinib, based on clinical and neuroradiological data, and its potential influence on neurological and functional outcomes. METHODS: A phase II randomized trial was performed in patients with acute ischaemic stroke treated with intravenous thrombolysis...
November 14, 2016: Journal of Internal Medicine
https://www.readbyqxmd.com/read/27808032/-acute-surgical-treatment-of-malignant-stroke
#6
Alexander Lilja-Cyron, Vagn Eskesen, Klaus Hansen, Daniel Kondziella, Jesper Kelsen
Malignant stroke is an intracranial herniation syndrome caused by cerebral oedema after a large hemispheric or cerebellar stroke. Malignant middle cerebral artery infarction is a devastating disease with a mortality around 80% despite intensive medical treatment. Decompressive craniectomy reduces mortality and improves functional outcome - especially in younger patients (age ≤ 60 years). Decompression of the posterior fossa is a life-saving procedure in patients with malignant cerebellar infarctions and often leads to good neurological outcome...
October 24, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27799499/cervical-artery-dissection-at-high-altitude-an-overview-of-two-patients
#7
Shreeyukta Bhattarai, William Elson, Rashila Pradhan, Prativa Pandey
While altitude illness is common in the Himalayas, conditions unrelated to altitude illness also occur. High altitude cerebral oedema HACE is a global phenomenon of gradual onset affecting both cerebral hemispheres. We outline two cases of cervical artery dissection presenting with sudden onset of focal neurological symptoms at high altitude.
July 2016: Journal of Travel Medicine
https://www.readbyqxmd.com/read/27770771/evaluation-of-efficacy-safety-and-tolerability-of-ambrisentan-in-chinese-adults-with-pulmonary-arterial-hypertension-a-prospective-open-label-cohort-study
#8
Y Huo, Z C Jing, X F Zeng, J M Liu, Z X Yu, G C Zhang, Y Li, Y Wang, Q S Ji, P Zhu, B X Wu, Y Zheng, P P Wang, J Li
BACKGROUND: Although several new drugs have been approved in recent years, pulmonary arterial hypertension (PAH) remains a rapidly progressive disease with a poor prognosis. Ambrisentan, a selective endothelin type A antagonist, has been approved for treatment of PAH. This open label study assessed the efficacy and safety of ambrisentan in Chinese subjects with PAH. METHODS: Eligible patients with PAH (World Health Organisation [WHO] functional class [FC] II orIII) were enrolled and received Ambrisentan (5 mg) once daily for a 12-week preliminary evaluation period, and a 12-week dose-adjustment period (dose titration to 10 mgallowed)...
October 22, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27770229/whole-brain-analysis-of-postmortem-density-changes-of-grey-and-white-matter-on-computed-tomography-by-statistical-parametric-mapping
#9
Yuichi Nishiyama, Hidekazu Kanayama, Hiroshi Mori, Keiji Tada, Yasushi Yamamoto, Takashi Katsube, Haruo Takeshita, Kazunori Kawakami, Hajime Kitagaki
OBJECTIVES: This study examined the usefulness of statistical parametric mapping (SPM) for investigating postmortem changes on brain computed tomography (CT). METHODS: This retrospective study included 128 patients (23 - 100 years old) without cerebral abnormalities who underwent unenhanced brain CT before and after death. The antemortem CT (AMCT) scans and postmortem CT (PMCT) scans were spatially normalized using our original brain CT template, and postmortem changes of CT values (in Hounsfield units; HU) were analysed by the SPM technique...
October 21, 2016: European Radiology
https://www.readbyqxmd.com/read/27733124/hypertonic-saline-alleviates-experimentally-induced-cerebral-oedema-through-suppression-of-vascular-endothelial-growth-factor-and-its-receptor-vegfr2-expression-in-astrocytes
#10
Linqiang Huang, Wei Cao, Yiyu Deng, Gaofeng Zhu, Yongli Han, Hongke Zeng
BACKGROUND: Cerebral oedema is closely related to the permeability of blood-brain barrier, vascular endothelial growth factor (VEGF) and its receptor vascular endothelial growth factor receptor 2 (VEGFR2) all of which are important blood-brain barrier (BBB) permeability regulatory factors. Zonula occludens 1 (ZO-1) and claudin-5 are also the key components of BBB. Hypertonic saline is widely used to alleviate cerebral oedema. This study aimed to explore the possible mechanisms underlying hypertonic saline that ameliorates cerebral oedema effectively...
October 13, 2016: BMC Neuroscience
https://www.readbyqxmd.com/read/27721832/management-of-severe-rhabdomyolysis-and-exercise-associated-hyponatremia-in-a-female-with-anorexia-nervosa-and-excessive-compulsive-exercising
#11
Marwan El Ghoch, Simona Calugi, Riccardo Dalle Grave
This case report describes the management of a 49-year-old female with restricting-type anorexia nervosa and excessive compulsive exercising associated with rhabdomyolysis, high levels of serum creatine kinase (CK) (3,238 U/L), and marked hyponatremia (Na(+): 123 mEq/L) in the absence of purging behaviours or psychogenic polydipsia; it is the first case report to describe exercise-associated hyponatremia in a patient with anorexia nervosa. The patient, who presented with a body mass index (BMI) of 13.4 kg/m(2), was successfully treated by means of an adapted inpatient version of an enhanced form of cognitive behavioural therapy (CBT-E)...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27696270/new-technologies-new-insights-into-the-pathogenesis-of-hepatic-encephalopathy
#12
Luisa Baker, Bernard Lanz, Fausto Andreola, Javier Ampuero, Anisha Wijeyesekera, Elaine Holmes, Nicolaas Deutz
Hepatic encephalopathy (HE) is a neuropsychiatric syndrome which frequently accompanies acute or chronic liver disease. It is characterized by a variety of symptoms of different severity such as cognitive deficits and impaired motor functions. Currently, HE is seen as a consequence of a low grade cerebral oedema associated with the formation of cerebral oxidative stress and deranged cerebral oscillatory networks. However, the pathogenesis of HE is still incompletely understood as liver dysfunction triggers exceptionally complex metabolic derangements in the body which need to be investigated by appropriate technologies...
September 30, 2016: Metabolic Brain Disease
https://www.readbyqxmd.com/read/27695548/a-cost-effectiveness-based-safety-and-efficacy-study-of-resterilized-intra-parenchymal-catheter-based-intracranial-pressure-monitoring-in-developing-world
#13
Deepak Kumar Gupta, Ajay Bisht, Priyam Batra, Purva Mathur, Ashok Kumar Mahapatra
BACKGROUND: The management of traumatic brain injury (TBI) aims to maintain the normal cerebral perfusion in spite of the mass lesions that may occur (haematoma, contusion, and oedema). The monitoring of the intracranial pressure (ICP) is a step in that direction. The intra-parenchymal catheters have the lowest incidence of infection compared to intra-ventricular/subdural catheters with reliable and accurate pressure recordings. The major disadvantage of the intra-parenchymal catheters is the cost, especially in developing nations...
October 2016: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/27676780/predictors-of-functional-and-professional-outcomes-in-patients-with-severe-traumatic-brain-injury
#14
Soumaya Boudokhane, Hichem Ben Brahim, Aymen Haj Salah, Houda Migaou, Anis Jellad, Zohra Ben Salah Frih
OBJECTIVE: To determine factors influencing long-term functional and professional outcomes in patients post severe traumatic brain injury (STBI). MATERIAL/PATIENTS AND METHODS: A descriptive analytical transversal and cross-sectional study involving patients with STBI dated more than 1 year and managed in rehabilitation department on an outpatient basis. Described parameters were: coma duration, post-traumatic amnesia duration (PTA), duration of hospitalization in intensive care unit, rehabilitation delay management, brain imaging findings, motor impairment, neuropsychological impairment assessed with Neurobehavioral Rating Scale-Revised (NRS-R), functional outcomes assessed with Functional Independence Measure (FIM) and disability assessed with Glasgow Outcome Scale (GOS)...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27670365/severe-malaria-what-s-new-on-the-pathogenesis-front
#15
Samuel Crocodile Wassmer, Georges Emile Raymond Grau
Plasmodium falciparum causes the most severe and fatal form of malaria in humans with over half a million deaths each year. Cerebral malaria, a complex neurological syndrome of severe falciparum malaria, is often fatal and represents a major public health burden. Despite vigorous efforts, the pathophysiology of cerebral malaria remains to be elucidated, thereby hindering the development of adjunctive therapies. In recent years, multidisciplinary and collaborative approaches have led to groundbreaking progress both in the laboratory and in the field...
September 23, 2016: International Journal for Parasitology
https://www.readbyqxmd.com/read/27609587/clinical-aspects-of-symptomatic-hyponatremia
#16
Dirk Weismann, Andreas Schneider, Charlotte Höybye
Hyponatremia (HN) is a common condition, with a large number of aetiologies and a complicated treatment. While chronic HN has been shown to be a predictor of poor outcome, sodium-increasing treatments in chronic stable and asymptomatic HN has not proven to increase life expectancy. For symptomatic HN, in contrast, the necessity for urgent treatment has broadly been accepted to avoid the development of fatal cerebral oedema. On the other hand, a too rapid increase of serum sodium in chronic HN may result in cerebral damage due to osmotic demyelination...
September 8, 2016: Endocrine Connections
https://www.readbyqxmd.com/read/27601532/fulminant-high-altitude-blindness
#17
Evgeny Mashkovskiy, Piotr Szawarski, Pavel Ryzhkov, Tomaz Goslar, Irena Mrak
Prolonged altitude exposure even with acclimatization continues to present a physiological challenge to all organ systems including the central nervous system. We describe a case of a 41-year-old Caucasian female climber who suffered severe visual loss that was due to possible optic nerve pathology occurring during a high altitude expedition in the Himalayas. This case is atypical of classic high altitude cerebral oedema and highlights yet another danger of prolonged sojourn at extreme altitudes.
June 2016: Journal of Travel Medicine
https://www.readbyqxmd.com/read/27567243/safety-and-efficacy-of-intravenous-glyburide-on-brain-swelling-after-large-hemispheric-infarction-games-rp-a-randomised-double-blind-placebo-controlled-phase-2-trial
#18
Kevin N Sheth, Jordan J Elm, Bradley J Molyneaux, Holly Hinson, Lauren A Beslow, Gordon K Sze, Ann-Christin Ostwaldt, Gregory J Del Zoppo, J Marc Simard, Sven Jacobson, W Taylor Kimberly
BACKGROUND: Preclinical models of stroke have shown that intravenous glyburide reduces brain swelling and improves survival. We assessed whether intravenous glyburide (RP-1127; glibenclamide) would safely reduce brain swelling, decrease the need for decompressive craniectomy, and improve clinical outcomes in patients presenting with a large hemispheric infarction. METHODS: For this double-blind, randomised, placebo-controlled phase 2 trial, we enrolled patients (aged 18-80 years) with a clinical diagnosis of large anterior circulation hemispheric infarction for less than 10 h and baseline diffusion-weighted MRI image lesion volume of 82-300 cm(3) on MRI at 18 hospitals in the USA...
October 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27567242/glyburide-for-cerebral-oedema-could-an-old-dog-have-a-new-trick
#19
Graeme J Hankey
No abstract text is available yet for this article.
October 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27558992/serial-magnetic-resonance-imaging-findings-of-intracerebral-spread-of-listeria-utilising-subcortical-u-fibres-and-the-extreme-capsule
#20
Charlie Chia-Tsong Hsu, Dalveer Singh, Trevor William Watkins, Gigi Nga Chi Kwan, Matt Skalski, Sachintha Hapugoda, Ipeson Korah
We present a case of Listeria monocytogenes cerebral abscess with axonal spread via the subcortical U-fibres and extreme capsule on magnetic resonance imaging, with follow-up studies demonstrating serial reduction in oedema and enhancement pattern of the white-matter fibre tracts following antimicrobial treatment. We discuss the microbiological mechanism of bacterial mobility to account for these unique imaging features. Recognition of this distinct pattern of spread of L. monocytogenes cerebral abscess may aid in diagnosis and enable early microbiological culture and treatment...
August 24, 2016: Neuroradiology Journal
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