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Cerebral oedema

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
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
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
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
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
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
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
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
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
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
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
Graeme J Hankey
No abstract text is available yet for this article.
October 2016: Lancet Neurology
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
Kyle D Wilson, Sonja J Stutz, Lorenzo F Ochoa, Gustavo A Valbuena, Petra D Cravens, Kelly T Dineley, Gracie Vargas, Robin Stephens
BACKGROUND: Cerebral malaria is one of the most severe complications of Plasmodium falciparum infection and occurs mostly in young African children. This syndrome results from a combination of high levels of parasitaemia and inflammation. Although parasite sequestration in the brain is a feature of the human syndrome, sequestering strains do not uniformly cause severe malaria, suggesting interplay with other factors. Host genetic factors such as mutations in the promoters of the cytokines IL-10 and TNF are also clearly linked to severe disease...
2016: Malaria Journal
Dominic Kaddu-Mulindwa, Frank Lammert, Alexander Maßmann, Andreas Link
HISTORY AND ADMISSION FINDINGS: A 23-year old female patient is referred to our intensive care unit from another hospital because of progredient neurological deterioration with sopor. One week before, she had experienced non-specific pain in her upper right stomach combined with vomitus and nausea. For two days, she had been treated with ciprofloxacin 2 × 500 mg / d by her primary care physician. Except for appendectomy in childhood, no other diseases were reported. Clinical investigation: Physical examination reveals mild scleral and dermal jaundice...
August 2016: Deutsche Medizinische Wochenschrift
Stefan C Kane, Shaun P Brennecke, Fabricio da Silva Costa
The neurological complications of pre-eclampsia, including eclampsia (seizures) and intracerebral haemorrhage, are responsible for much of the maternal morbidity and mortality associated with this condition. Animal models and neuroimaging in humans suggest that pre-eclampsia is associated with a loss of cerebral autoregulation, which consequent hyperperfusion and vasogenic oedema. Treatments given to pre-eclamptic women are aimed at preventing these cerebral sequelae, and include antihypertensive agents (to prevent intracranial haemorrhage) and magnesium sulphate (for seizure prophylaxis)...
August 3, 2016: Ultrasound in Obstetrics & Gynecology
Thomas Y K Chan
Fatal anaphylactic reactions to lignocaine are very rare. In this review of published reports, the main objective is to determine the characteristics of fatal allergic reactions to lignocaine and describe the forensic investigations of anaphylaxis related deaths. From 1957 to 2012, there were seven reports of single case and one report of 8 cases with sufficient information for review. Fatal anaphylactic reactions to lignocaine were generally characterised by fast onset of symptoms (within seconds to <30min of drug exposure) and rapid progression to cardiopulmonary arrest and death (23min to ∼1h)...
September 2016: Forensic Science International
J M Pardal-Fernandez, M C Carrascosa-Romero, A Grande, M Martinez-Gonzalez, B Godes-Medrano
INTRODUCTION: Leucinosis is a severe neonatal metabolic disease. It is the consequence of the genetically determined enzyme deficiency of the complex formed by decarboxylase-dihydrolipoyl transacylase and dihydrolipoyl dehydrogenase, and of the subsequent accumulation of precursor metabolites, long branched-chain amino acids and their alpha ketoacids. They are powerful neurotoxins, responsible for the swift onset of oedema and diffuse cerebral demyelination. Delays in its diagnosis usually result in severe psychomotor sequelae or even death...
August 16, 2016: Revista de Neurologia
Omar C Logue, Eric M George, Gene L Bidwell
Preeclampsia (PE) is a form of gestational hypertension that complicates ∼5% of pregnancies worldwide. Over 70% of the fatal cases of PE are attributed to cerebral oedema, intracranial haemorrhage and eclampsia. The aetiology of PE originates from abnormal remodelling of the maternal spiral arteries, creating an ischaemic placenta that releases factors that drive the pathophysiology. An initial neurological outcome of PE is the absence of the autonomically regulated cardiovascular adaptations to pregnancy...
August 1, 2016: Clinical Science (1979-)
S-H Xu, M-S Yin, B Liu, M-L Chen, G-W He, P-P Zhou, Y-J Cui, D Yang, Y-L Wu
Disruption of blood-brain barrier (BBB) and subsequent oedema are major causes of the pathogenesis in ischaemic stroke with which the current clinical therapy remains unsatisfied. In this study, we examined the therapeutic effect of tetramethylpyrazine-2'-O-sodium ferulate (TSF)-a novel analogue of tetramethylpyrazine in alleviating BBB breakdown and brain oedema after cerebral ischaemia/reperfusion (I/R). Then, we explored the potential mechanism of the protection on BBB disruption in cerebral I/R rat models...
July 6, 2016: Human & Experimental Toxicology
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