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Cerebral oedema

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https://www.readbyqxmd.com/read/29165777/the-use-of-crystalloids-in-traumatic-brain-injury
#1
Wojciech Dąbrowski, Tom Woodcock, Ziemowit Rzecki, Manu L N G Malbrain
Fluid therapy is one of the most important treatments in patients with traumatic brain injury (TBI) as both hypo- and hypervolaemia can cause harm. The main goals of fluid therapy for patients with TBI are to optimize cerebral perfusion and to maintain adequate cerebral oxygenation. The avoidance of cerebral oedema is clearly essential. The current weight of evidence in the published literature suggests that albumin therapy is harmful and plasma substitutes have failed to demonstrate superiority over crystalloids solutions...
November 22, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29146727/primary-intraventricular-haemorrhage-due-to-rupture-of-giant-varix-of-the-basal-vein-of-rosenthal-in-a-patient-with-long-standing-direct-ccf-angiographic-features-and-treatment-considerations
#2
Chinmay P Nagesh, Aneesh Mohimen, Santhosh K Kannath, Jayadevan E Rajan
Direct carotid cavernous fistulae (CCF) are often detected early and treated promptly resulting in a paucity of literature regarding its long-term evolution. We present a case of high flow post-traumatic direct CCF that was neglected for over 6 years and presented with a rare manifestation of primary intraventricular haemorrhage. Occlusions of the primary venous outlets likely resulted in engorgement of the deep venous system. The segmental anatomy of the shunting basal vein is critical to the clinical presentation and may range from basal ganglia or brainstem oedema/infarctions to uniquely, as in our case, isolated intraventricular haemorrhage secondary to variceal rupture...
November 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29079252/effect-of-an-intensified-multifactorial-intervention-on-cardiovascular-outcomes-and-mortality-in-type-2-diabetes-j-doit3-an-open-label-randomised-controlled-trial
#3
Kohjiro Ueki, Takayoshi Sasako, Yukiko Okazaki, Masayuki Kato, Sumie Okahata, Hisayuki Katsuyama, Mikiko Haraguchi, Ai Morita, Ken Ohashi, Kazuo Hara, Atsushi Morise, Kazuo Izumi, Naoki Ishizuka, Yasuo Ohashi, Mitsuhiko Noda, Takashi Kadowaki
BACKGROUND: Limited evidence suggests that multifactorial interventions for control of glucose, blood pressure, and lipids reduce macrovascular complications and mortality in patients with type 2 diabetes. However, safe and effective treatment targets for these risk factors have not been determined for such interventions. METHODS: In this multicentre, open-label, randomised, parallel-group trial, undertaken at 81 clinical sites in Japan, we randomly assigned (1:1) patients with type 2 diabetes aged 45-69 years with hypertension, dyslipidaemia, or both, and an HbA1c of 6·9% (52·0 mmol/mol) or higher, to receive conventional therapy for glucose, blood pressure, and lipid control (targets: HbA1c <6·9% [52·0 mmol/mol], blood pressure <130/80 mm Hg, LDL cholesterol <120 mg/dL [or 100 mg/dL in patients with a history of coronary artery disease]) or intensive therapy (HbA1c <6·2% [44·3 mmol/mol], blood pressure <120/75 mm Hg, LDL cholesterol <80 mg/dL [or 70 mg/dL in patients with a history of coronary artery disease])...
October 24, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29049834/percutaneous-left-atrial-unloading-to-prevent-pulmonary-oedema-and-to-facilitate-ventricular-recovery-under-extracorporeal-membrane-oxygenation-therapy
#4
Alexander M Bernhardt, Mathias Hillebrand, Yalin Yildirim, Samer Hakmi, Florian M Wagner, Stefan Blankenberg, Hermann Reichenspurner, Edith Lubos
OBJECTIVES: Left-sided unloading during extracorporeal membrane oxygenation (ECMO) therapy is crucial to prevent pulmonary oedema and facilitate ventricular recovery. We present the case of a 55-year-old man under ECMO therapy with pre-existing left ventricular (LV) thrombus formation and in need of ventricular unloading. METHODS: We implanted a 21-Fr TandemHeart Protek Solo trans-septal cannula into the left atrium using a trans-septal approach via the femoral vein...
September 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29031810/the-role-of-three-dimensional-pseudo-continuous-arterial-spin-labelling-in-grading-and-differentiating-histological-subgroups-of-meningiomas
#5
Y Lu, J Xiong, B Yin, J Wen, L Liu, D Geng
AIM: To evaluate the usefulness of pseudo-continuous arterial spin labelling (pCASL) imaging in grading and differentiating histological subtypes of meningiomas. MATERIALS AND METHODS: In this prospective study, conventional magnetic resonance imaging (MRI) with contrast-enhanced T1-weighted images and pCASL were acquired with a 3 T MRI system before surgery in 125 consecutive patients with suspected meningiomas. Finally, the perfusion parameters were collected from 84 grade I and 23 grade II meningiomas...
October 11, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/29026384/clinical-and-cranial-computed-tomography-scan-findings-in-adults-following-road-traffic-accidents-in-kampala-uganda
#6
Geoffrey Erem, Samuel Bugeza, Elsie Kiguli Malwadde
BACKGROUND: Globally, road traffic accidents are a major cause of death and disability. The developing countries bear a disproportionately large share of the RTAs which account for about 85% of the deaths. Most of these RTAs result in head injury, which globally, most scholars and medical practitioners consider a significant economic, social and medical problem. In Mulago National referral hospital, RTA is the leading cause of surgical admission. OBJECTIVE: To describe the cranial computed tomography (CT) scan findings in adults following RTA in Mulago hospital...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/28959487/current-management-of-spontaneous-intracerebral-haemorrhage
#7
REVIEW
Cyrus K Dastur, Wengui Yu
Intracerebral haemorrhage (ICH) is the most devastating and disabling type of stroke. Uncontrolled hypertension (HTN) is the most common cause of spontaneous ICH. Recent advances in neuroimaging, organised stroke care, dedicated Neuro-ICUs, medical and surgical management have improved the management of ICH. Early airway protection, control of malignant HTN, urgent reversal of coagulopathy and surgical intervention may increase the chance of survival for patients with severe ICH. Intensive lowering of systolic blood pressure to <140 mm Hg is proven safe by two recent randomised trials...
March 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28953839/antidepressants-and-hyponatremia-in-a-patient-with-colectomy-a-case-report
#8
Madhavan Seshadri, Madhusudan Deepak Thalitaya, Tuno Simon, Catherine Odelola, Humphrey Enow
Antidepressants are routinely used by General Practitioners (GP) as well as Psychiatrists to treat Depression. They are tolerated well. However, in certain patient populations, they are associated with SIADH (Syndrome of Inappropriate Anti-Diuretic Hormone Secretion) and Hyponatremia. Various research studies have shown that all antidepressants are associated with Hyponatremia. Hyponatremia as a side effect of antidepressant therapy is more commonly seen in old age, chronic Kidney disease and Hypothyroidism...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28951182/surgical-treatment-of-mirror-mca-aneurysms-bilateral-and-unilateral-approach
#9
Vedat Acik, Gökhan Cavus, Emre Bilgin, Ali Arslan, Yurdal Gezercan, Ali İhsan Okten
OBJECTIVE: Currently, the optimal surgical approach for bilateral aneurysms remains controversial. Alternative interventional methods, such as unilateral or bilateral approaches, have been employed during a single session or two different sessions. The unilateral approach can be employed successfully to treat contralateral aneurysms that develop in a paramedian location. However, such an approach is more difficult for treating contralateral aneurysms in more distant locations. Unilateral approach can decrease complication rates, operation time and the length of hospital stay...
September 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28951125/manipulating-ocular-endothelial-tight-junctions-applications-in-treatment-of-retinal-disease-pathology-and-ocular-hypertension
#10
REVIEW
Matthew Campbell, Paul S Cassidy, Jeffrey O'Callaghan, Darragh E Crosbie, Pete Humphries
Protein levels of endothelial tight-junctions of the inner retinal microvasculature, together with those of Schlemm's canal, can be readily manipulated by RNA interference (RNAi), resulting in the paracellular clefts between such cells to be reversibly modulated. This facilitates access to the retina of systemically-deliverable low molecular weight, potentially therapeutic compounds, while also allowing potentially toxic material, for example, soluble Amyloid-β1-40, to be removed from the retina into the peripheral circulation...
September 22, 2017: Progress in Retinal and Eye Research
https://www.readbyqxmd.com/read/28892994/life-threatening-severe-hypernatraemic-dehydration-in-neonates-a-report-of-two-cases
#11
Priyaja Paramasivam, Sujay Kumar Earan, Arulkumaran Arunagirinadhan, Shilpa Kantamneni
Hypernatraemic dehydration in neonates may lead to potentially lethal consequences like cerebral oedema, intracranial haemorrhage, hydrocephalus and gangrene. In the light of increase in the infants presenting with hypernatraemic dehydration, there is a definitive need to heighten the awareness and have a high degree of suspicion in diagnosis for this potentially lethal condition. We report two neonates of severe hypernatraemia with dehydration highlighting its diagnosis and management. Treatment of hypernatraemic dehydration involves correction of electrolyte imbalance by careful restoration of fluids and ensuring appropriate intake of calories...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28872345/intra-cerebral-cannabidiol-infusion-induced-neuroprotection-is-partly-associated-with-the-tnf-%C3%AE-tnfr1-nf-%C3%B0%C2%BAb-pathway-in-transient-focal-cerebral-ischaemia
#12
Sepideh Khaksar, Mohammad Reza Bigdeli
BACKGROUND: Stroke is a neurological disease, which, in addition to high mortality, imposes many financial and mental burdens on families and the society. The main objective of this study was to investigate the effect of cannabidiol (CBD) on one of the major inflammatory pathways in cerebral ischaemia. METHOD: Using stereotaxic surgery, the cannula was implanted into the right lateral ventricle of rats. CBD (50, 100, and 200 ng/rat; i.c.v.) was administrated for five consecutive days...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28866699/a-sudden-paediatric-death-due-to-hand-foot-and-mouth-disease-the-importance-of-vigilance
#13
R Rahimi, E Omar, T S Tuan Soh, S F A Mohd Nawi, S Md Noor
BACKGROUND: Hand, foot and mouth disease (HFMD) is caused by enteroviruses such as Coxsackie virus A16 (CVA16) and Enterovirus 71 (EV71). The diagnostic hallmarks are oral ulcers and maculo-papular or vesicular rash on the hands and feet. Severe form of this disease can lead to death due to neurological and cardiopulmonary complications. This case report aims to describe a fatal case of HFMD with minimal oral and skin manifestations. CASE REPORT: A four-year-old girl was brought to a hospital after suddenly becoming unresponsive at home...
August 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28861076/case-of-meningitis-in-a-neonate-caused-by-an-extended-spectrum-beta-lactamase-producing-strain-of-hypervirulent-klebsiella-pneumoniae
#14
Khalit S Khaertynov, Vladimir A Anokhin, Yuri N Davidyuk, Irina V Nicolaeva, Svetlana V Khalioullina, Dina R Semyenova, Evgeny Y Alatyrev, Natalia N Skvortsova, Levon G Abrahamyan
Klebsiella pneumoniae is one of the most important infectious agents among neonates. This pathogen has a potential to develop an increased antimicrobial resistance and virulence. The classic non-virulent strain of K. pneumoniae, producing an extended-spectrum beta-lactamases (ESBL), is associated with nosocomial infection mainly in preterm neonates. Hypervirulent K. pneumoniae strains are associated with invasive infection among previously healthy ambulatory patients, and most of them exhibit antimicrobial susceptibility...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28857714/calcium-channel-blockade-with-nimodipine-reverses-mri-evidence-of-cerebral-oedema-following-acute-hypoxia
#15
Matthew J Rowland, Martyn Ezra, Anderson Winkler, Payashi Garry, Catherine Lamb, Michael Kelly, Thomas W Okell, Jon Westbrook, Richard G Wise, Gwenaëlle Douaud, Kyle Ts Pattinson
Acute cerebral hypoxia causes rapid calcium shifts leading to neuronal damage and death. Calcium channel antagonists improve outcomes in some clinical conditions, but mechanisms remain unclear. In 18 healthy participants we: (i) quantified with multiparametric MRI the effect of hypoxia on the thalamus, a region particularly sensitive to hypoxia, and on the whole brain in general; (ii) investigated how calcium channel antagonism with the drug nimodipine affects the brain response to hypoxia. Hypoxia resulted in a significant decrease in apparent diffusion coefficient (ADC), a measure particularly sensitive to cell swelling, in a widespread network of regions across the brain, and the thalamus in particular...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28821524/the-association-between-intensive-care-unit-acquired-hypernatraemia-and-mortality-in-critically-ill-patients-with-cerebrovascular-diseases-a-single-centre-cohort-study-in-japan
#16
Takahiro Imaizumi, Masahiro Nakatochi, Yoshiro Fujita, Rie Nomura, Kenshi Watanabe, Michitaka Maekawa, Taishi Yamakawa, Takayuki Katsuno, Shoichi Maruyama
OBJECTIVES: Hypernatraemia is one of the major electrolyte disorders associated with mortality among critically ill patients in intensive care units (ICUs). It is unclear whether this applies to patients with cerebrovascular diseases in whom high sodium concentrations may be allowed in order to prevent cerebral oedema. This study aimed to examine the association between ICU-acquired hypernatraemia and the prognosis of patients with cerebrovascular diseases. DESIGN: A retrospective cohort study...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28821266/endogenous-hydrogen-sulphide-attenuates-nlrp3-inflammasome-mediated-neuroinflammation-by-suppressing-the-p2x7-receptor-after-intracerebral-haemorrhage-in-rats
#17
Hengli Zhao, Pengyu Pan, Yang Yang, Hongfei Ge, Weixiang Chen, Jie Qu, Jiantao Shi, Gaoyu Cui, Xin Liu, Hua Feng, Yujie Chen
BACKGROUND: Emerging studies have demonstrated the important physiological and pathophysiological roles of hydrogen sulphide (H2S) as a gasotransmitter for NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome-associated neuroinflammation in the central nervous system. However, the effects of H2S on neuroinflammation after intracerebral haemorrhage (ICH), especially on the NLRP3 inflammasome, remain unknown. METHODS: We employed a Sprague-Dawley rat of collagenase-induced ICH in the present study...
August 18, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28817088/the-role-of-neurogenic-inflammation-in-blood-brain-barrier-disruption-and-development-of-cerebral-oedema-following-acute-central-nervous-system-cns-injury
#18
REVIEW
Annabel J Sorby-Adams, Amanda M Marcoionni, Eden R Dempsey, Joshua A Woenig, Renée J Turner
Acute central nervous system (CNS) injury, encompassing traumatic brain injury (TBI) and stroke, accounts for a significant burden of morbidity and mortality worldwide, largely attributable to the development of cerebral oedema and elevated intracranial pressure (ICP). Despite this, clinical treatments are limited and new therapies are urgently required to improve patient outcomes and survival. Originally characterised in peripheral tissues, such as the skin and lungs as a neurally-elicited inflammatory process that contributes to increased microvascular permeability and tissue swelling, neurogenic inflammation has now been described in acute injury to the brain where it may play a key role in the secondary injury cascades that evolve following both TBI and stroke...
August 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28801335/hypercapnia-induced-cerebral-oedema-in-a-patient-with-copd-exacerbation-a-rare-and-under-recognised-entity
#19
Siddique Chaudhary, Ahsan Wahab, Shiny Varghese, Susan Jane Smith
No abstract text is available yet for this article.
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28798247/diffuse-cerebral-oedema-from-sickle-cell-vaso-occlusive-crisis
#20
Martin D Weaver, Hayan Dayoub, Emily Damuth, Tapan Kavi
No abstract text is available yet for this article.
August 10, 2017: BMJ Case Reports
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