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Traumatic cerebrovascular injury

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https://www.readbyqxmd.com/read/27916030/-short-term-outcomes-of-lung-transplant-recipients-using-organs-from-brain-death-donors
#1
W X He, C Jiang, X G Liu, W Huang, C Chen, L Jiang, B Yang, K Wu, Q K Chen, Y Yang, Y M Yu, G N Jiang
Objective: To assess short-term outcomes after lung transplantation with organs procured following brain death. Methods: Between April 2015 and July 2016, all 17 recipients after lung transplantation using organs from brain death donors (DBD) at Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine were enrolled in this study. All patients were male, aging (60±7) years, including 11 chronic obstructive pulmonary disease, 5 idiopathic pulmonary fibrosis, 1 silicosis...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27907955/decompressive-craniectomy-in-neurocritical-care
#2
Erik G Hayman, David B Kurland, Zachary Grunwald, Sebastian Urday, Kevin N Sheth, J Marc Simard
Neurosurgeons increasingly use decompressive craniectomy (DC) in neurocritical care. In this review, the authors summarize the topic of DC for the neurointensivist. Following a brief overview of the procedure, the major indications for the procedure are described. This includes a review of the literature regarding well-established indications, such as infarction and traumatic brain injury, as well as lesser known indications, including intracerebral hemorrhage, ruptured cerebrovascular malformations, sinus thrombosis, and infection...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27834539/chronic-cerebrovascular-abnormalities-in-a-mouse-model-of-repetitive-mild-traumatic-brain-injury
#3
Cillian E Lynch, Gogce Crynen, Scott Ferguson, Benoit Mouzon, Daniel Paris, Joseph Ojo, Paige Leary, Fiona Crawford, Corbin Bachmeier
PRIMARY OBJECTIVE: To investigate the status of the cerebrovasculature following repetitive mild traumatic brain injury (r-mTBI). RESEARCH DESIGN: TBI is a risk factor for development of various neurodegenerative disorders. A common feature of neurodegenerative disease is cerebrovascular dysfunction which includes alterations in cerebral blood flow (CBF). TBI can result in transient reductions in CBF, with severe injuries often accompanied by varying degrees of vascular pathology post-mortem...
2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27815845/the-craniocervical-junction-embryology-anatomy-biomechanics-and-imaging-in-blunt-trauma
#4
REVIEW
Curtis Edward Offiah, Emily Day
: Imaging of the blunt traumatic injuries to the craniocervical junction can be challenging but central to improving morbidity and mortality related to such injury. The radiologist has a significant part to play in the appropriate management of patients who have suffered injury to this vital junction between the cranium and the spine. Knowledge of the embryology and normal anatomy as well as normal variant appearances avoids inappropriate investigations in these trauma patients. Osseous injury can be subtle while representing important radiological red flags for significant underlying ligamentous injury...
November 4, 2016: Insights Into Imaging
https://www.readbyqxmd.com/read/27767400/reliability-assessment-of-the-biffl-scale-for-blunt-traumatic-cerebrovascular-injury-as-detected-on-computer-tomography-angiography
#5
Paul M Foreman, Christoph J Griessenauer, Kimberly P Kicielinski, Philip G R Schmalz, Brandon G Rocque, Matthew R Fusco, Joseph C Sullivan, John P Deveikis, Mark R Harrigan
OBJECTIVE Blunt traumatic cerebrovascular injury (TCVI) represents structural injury to a vessel due to high-energy trauma. The Biffl Scale is a widely accepted grading scheme for these injuries that was developed using digital subtraction angiography. In recent years, screening CT angiography (CTA) has been used to identify patients with TCVI. The reliability of this scale, with injuries assessed using CTA, has not yet been determined. METHODS Seven independent raters, including 2 neurosurgeons, 2 neuroradiologists, 2 neurosurgical residents, and 1 neurosurgical vascular fellow, independently reviewed each presenting CTA of the neck performed in 40 patients with confirmed TCVI and assigned a Biffl grade...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27755938/arterial-spin-labeling-perfusion-of-the-brain-emerging-clinical-applications
#6
Sven Haller, Greg Zaharchuk, David L Thomas, Karl-Olof Lovblad, Frederik Barkhof, Xavier Golay
Arterial spin labeling (ASL) is a magnetic resonance (MR) imaging technique used to assess cerebral blood flow noninvasively by magnetically labeling inflowing blood. In this article, the main labeling techniques, notably pulsed and pseudocontinuous ASL, as well as emerging clinical applications will be reviewed. In dementia, the pattern of hypoperfusion on ASL images closely matches the established patterns of hypometabolism on fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) images due to the close coupling of perfusion and metabolism in the brain...
November 2016: Radiology
https://www.readbyqxmd.com/read/27740992/positron-emission-tomography-and-single-photon-emission-computed-tomography-in-neurology
#7
Robert S Miletich
PURPOSE OF REVIEW: Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are now available for routine clinical applications in neurology. This article discusses their diagnostic use in dementia, brain tumors, epilepsy, parkinsonism, cerebrovascular disease, and traumatic brain injury. RECENT FINDINGS: Neuromolecular imaging, also known as nuclear neurology, involves clinical imaging of both basal regional physiology (perfusion, metabolism, and transport mechanisms) and specific neurochemical physiology (currently, only the dopamine transporter)...
October 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27736719/cerebrovascular-dysfunction-following-subfailure-axial-stretch
#8
E David Bell, Anthony J Donato, Kenneth L Monson
Cerebral blood vessels are vital to maintaining the health of the brain. Traumatic brain injury (TBI) commonly results in autoregulatory dysfunction and associated failure of cerebral vessels to maintain homeostasis in the brain. While post-injury changes to brain biochemistry are known to contribute to this dysfunction, tissue deformation may also directly alter vascular smooth muscle cell (SMC) function. As a first step toward understanding stretch-induced dysfunction, this study investigates the effect of overstretch on the contractile behavior of SMCs in middle cerebral arteries (MCAs)...
September 22, 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/27693818/correlation-of-homocysteine-with-cerebral-hemodynamic-abnormality-endothelial-dysfunction-markers-and-cognition-impairment-in-patients-with-traumatic-brain-injury
#9
Masoud Hatefi, Someyeh Behzadi, Masoud Moghadas Dastjerdi, Alireza Abootalebi Ghahnavieh, Asghar Rahmani, Fatemeh Madizadeh, Mohammad Reza Hafezi Ahmadi, Khairollah Asadollahi
OBJECTIVE: This study aimed to assess any correlation between serum levels of homocysteine (Hcy) with markers of cerebral hemodynamic, endothelial dysfunction and cognition impairment in patients with traumatic brain injury (TBI). METHODS: By a cross-sectional study, all clinical data and serum levels of homocysteine of 85 TBI patients were collected. The pulsatility indices (PI) of the middle cerebral artery (MCA) were recorded by transcranial color-coded doppler ultrasonography (TCD) and cereberovascular reactivity (CVR)...
September 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27693768/the-role-of-intraoperative-cerebral-angiography-in-transorbital-intracranial-penetrating-trauma-a-case-report-and-literature-review
#10
Jonathan P Riley, Andrew B Boucher, Denise S Kim, Daniel L Barrow, Matthew R Reynolds
BACKGROUND: Transorbital intracranial penetrating trauma (TIPT) with a retained intracranial foreign body is a rare event lacking a widely-accepted diagnostic and therapeutic algorithm. Intraoperative catheter angiography (IOA) has been advocated by some authorities to rule out cerebrovascular injury prior and/or subsequent to removal of the object, but no standard of care currently exists. CASE DESCRIPTION: A 19-year-old male was involved in a construction site accident whereby a framing nail penetrated the left globe, traversed the lateral bony orbit, and terminated in the mid-temporal lobe...
September 28, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27614225/traumatic-brain-injury-induced-autoregulatory-dysfunction-and-spreading-depression-related-neurovascular-uncoupling-pathomechanism-and-therapeutic-implications
#11
Peter Toth, Nikolett Szarka, Eszter Farkas, Erzsebet Ezer, Endre Czeiter, Krisztina Amrein, Zoltan I Ungvari, Jed A Hartings, Andras Buki, Akos Koller
Traumatic brain injury (TBI) is a major health problem worldwide. In addition to its high mortality (35-40%) survivors are left with cognitive, behavioral and communicative disabilities. While little can be done to reverse initial, primary brain damage caused by trauma, the secondary injury of cerebral tissue due to cerebromicrovascular alterations and dysregulation of cerebral blood flow (CBF) is potentially preventable. This review focuses on functional, cellular and molecular changes of autoregulatory function of CBF (with special focus on cerebrovascular myogenic response) that occur in cerebral circulation after TBI and explores the links between autoregulatory dysfunction, impaired myogenic response, microvascular impairment and the development of secondary brain damage...
September 9, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27604743/magnetic-resonance-imaging-in-experimental-traumatic-brain-injury
#12
Qiang Shen, Lora Tally Watts, Wei Li, Timothy Q Duong
Traumatic brain injury (TBI) is a leading cause of death and disability in the USA. Common causes of TBI include falls, violence, injuries from wars, and vehicular and sporting accidents. The initial direct mechanical damage in TBI is followed by progressive secondary injuries such as brain swelling, perturbed cerebral blood flow (CBF), abnormal cerebrovascular reactivity (CR), metabolic dysfunction, blood-brain-barrier disruption, inflammation, oxidative stress, and excitotoxicity, among others. Magnetic resonance imaging (MRI) offers the means to noninvasively probe many of these secondary injuries...
2016: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27582726/the-controlled-cortical-impact-model-applications-considerations-for-researchers-and-future-directions
#13
REVIEW
Nicole D Osier, C Edward Dixon
Controlled cortical impact (CCI) is a mechanical model of traumatic brain injury (TBI) that was developed nearly 30 years ago with the goal of creating a testing platform to determine the biomechanical properties of brain tissue exposed to direct mechanical deformation. Initially used to model TBIs produced by automotive crashes, the CCI model rapidly transformed into a standardized technique to study TBI mechanisms and evaluate therapies. CCI is most commonly produced using a device that rapidly accelerates a rod to impact the surgically exposed cortical dural surface...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27581318/revisiting-secondary-normal-pressure-hydrocephalus-does-it-exist-a-review
#14
Badih Daou, Petra Klinge, Stavropoula Tjoumakaris, Robert H Rosenwasser, Pascal Jabbour
OBJECTIVE There are several etiologies that can lead to the development of secondary normal pressure hydrocephalus (sNPH). The aim of this study was to evaluate the etiology, diagnosis, treatment, and outcome in patients with sNPH and to highlight important differences between the separate etiologies. METHODS A comprehensive review of the literature was performed to identify studies conducted between 1965 and 2015 that included data regarding the etiology, treatment, diagnosis, and outcome in patients with sNPH...
September 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27554429/cerebral-perfusion-changes-in-post-concussion-syndrome-a-prospective-controlled-cohort-study
#15
Karen M Barlow, Lorenzo D Marcil, Deborah Dewey, Helen L Carlson, Frank P MacMaster, Brian L Brooks, R Marc Lebel
The biology of post-concussive symptoms is unclear. Symptoms are often increased during activities, and have been linked to decreased cerebrovascular reactivity and perfusion. The aim of this study was to examine cerebral blood flow (CBF) in children with different clinical recovery patterns following mild traumatic brain injury (mTBI). This was a prospective controlled cohort study of children with mTBI (ages 8 to 18 years) who were symptomatic with post-concussive symptoms at one month post-injury (symptomatic, n = 27) and children who had recovered quickly (asymptomatic, n = 24)...
November 21, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27534950/neurosurgical-emergencies-in-sports-neurology
#16
REVIEW
Vin Shen Ban, James A Botros, Christopher J Madden, H Hunt Batjer
PURPOSE OF REVIEW: Athletic neurosurgical emergencies are injuries that can lead to mortality or significant morbidity and require immediate recognition and treatment. This review article discusses the epidemiology of sports-related traumatic brain injury (TBI) with an attempt to quantify the incidence of neurosurgical emergencies in sports. Emergencies such as intracranial hemorrhage, second impact syndrome, vascular injuries, and seizures are discussed. RECENT FINDINGS: The incidence of sports-related TBI presenting to level I or II trauma centers in the USA is about 10 in 100,000 population per year...
September 2016: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/27533909/unfractionated-heparin-after-tbi-reduces-in-vivo-cerebrovascular-inflammation-brain-edema-and-accelerates-cognitive-recovery
#17
Katsuhiro Nagata, Kenichiro Kumasaka, Kevin D Browne, Shengjie Li, Jesse St-Pierre, John Cognetti, Joshua Marks, Victoria E Johnson, Douglas H Smith, Jose L Pascual
BACKGROUND: Severe traumatic brain injury (TBI) may increase the risk of venous thromboembolic complications; however, early prevention with heparinoids is often withheld for its anticoagulant effect. New evidence suggests low molecular weight heparin reduces cerebral edema and improves neurological recovery after stroke and TBI, through blunting of cerebral leukocyte (LEU) recruitment. It remains unknown if unfractionated heparin (UFH) similarly affects brain inflammation and neurological recovery post-TBI...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27471889/blunt-cerebrovascular-injuries-in-severe-traumatic-brain-injury-incidence-risk-factors-and-evolution
#18
Pierre Esnault, Mickaël Cardinale, Henry Boret, Erwan D'Aranda, Ambroise Montcriol, Julien Bordes, Bertrand Prunet, Christophe Joubert, Arnaud Dagain, Philippe Goutorbe, Eric Kaiser, Eric Meaudre
OBJECTIVE Blunt cerebrovascular injuries (BCVIs) affect approximately 1% of patients with blunt trauma. An antithrombotic or anticoagulation therapy is recommended to prevent the occurrence or recurrence of neurovascular events. This treatment has to be carefully considered after severe traumatic brain injury (TBI), due to the risk of intracranial hemorrhage expansion. Thus, the physician in charge of the patient is confronted with a hemorrhagic and ischemic risk. The main objective of this study was to determine the incidence of BCVI after severe TBI...
July 29, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27471490/ventricular-tract-hemorrhage-following-intracranial-nail-removal-utility-of-real-time-endovascular-assistance
#19
Robert C Rennert, Jeffrey A Steinberg, Jayson Sack, J Scott Pannell, Alexander A Khalessi
Penetrating brain trauma commonly results in occult neurovascular injury. Detailed cerebrovascular imaging can evaluate the relationship of intracranial foreign bodies to major vascular structures, assess for traumatic pseudoaneurysms, and ensure hemostasis during surgical removal. We report a case of a self-inflicted intracranial nail gun injury causing a communicating ventricular tract hemorrhage upon removal, as well as a delayed pseudoaneurysm. Pre- and post-operative vascular imaging, as well as intra-operative endovascular assistance, was critical to successful foreign body removal in this patient...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27432678/imaging-of-head-trauma
#20
Sandra Rincon, Rajiv Gupta, Thomas Ptak
Imaging is an indispensable part of the initial assessment and subsequent management of patients with head trauma. Initially, it is important for diagnosing the extent of injury and the prompt recognition of treatable injuries to reduce mortality. Subsequently, imaging is useful in following the sequelae of trauma. In this chapter, we review indications for neuroimaging and typical computed tomography (CT) and magnetic resonance imaging (MRI) protocols used in the evaluation of a patient with head trauma. We review the role of CT), the imaging modality of choice in the acute setting, and the role of MRI in the evaluation of patients with head trauma...
2016: Handbook of Clinical Neurology
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