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Traumatic cerebrovascular injury

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https://www.readbyqxmd.com/read/29775142/aspirin-for-primary-prevention-of-stroke-in-traumatic-cerebrovascular-injury-association-with-increased-risk-of-transfusion
#1
Russell L Griffin, Stephanie R Falatko, Stella Aslibekyan, Virginia Strickland, Mark R Harrigan
OBJECTIVE Blunt traumatic extracranial carotid or vertebral artery injury (i.e., traumatic cerebrovascular injury [TCVI]) occurs in 1%-2% of all blunt trauma admissions, carries a 10% risk of thromboembolic ischemic stroke, and accounts for up to 9600 strokes annually in the US. Screening CT angiograms (CTAs) of patients with trauma has become ubiquitous in recent years, and patients with initially asymptomatic TCVI are commonly treated with antiplatelet agents to prevent stroke. Prophylaxis with antiplatelets is thought to be safer than anticoagulation, which carries a significant risk of hemorrhage in patients with trauma...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29753293/risk-assessment-of-in-hospital-mortality-of-patients-with-epilepsy-a-large-cohort-study
#2
Yang Si, Xiaoqiang Xiao, Shunju Xiang, Jing Liu, Qianning Mo, Hongbin Sun
PURPOSE: This study aimed to explore the mortality risks of hospitalized patients with epilepsy (PWE). METHODS: Our data source was extracted from discharge abstracts in a hospital medical database. Various clinical variables, including demographical characteristics, natural features of epilepsy, and comprehensive set of comorbidities, were screened to investigate the risk. Comorbidities were defined using a validated ICD-10-based classification. The distributions of comorbid conditions and demographics were presented...
May 9, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29742729/complications-in-transorbital-penetrating-injury-by-bamboo-branch-a-case-report
#3
Lei Feng, Xiaojun He, Jie Chen, Shuang Ni, Biao Jiang, Jian-Ming Hua
RATIONALE: Wooden transorbital penetrating injury is an uncommon and serious trauma that may cause multiply complications. PATIENT CONCERNS: Here we describe a 62-year-old Chinese woman with a transorbital penetrating injury caused by a long bamboo branch. DIAGNOSIS: Computed tomography scan and magnetic resonance imaging showed the presence of a wooden foreign body. INTERVENTIONS: Cerebrovascular digital subtraction angiography and temporary balloon occlusion were performed with general anesthesia...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29717625/remote-changes-in-cortical-excitability-after-experimental-tbi-and-functional-reorganization
#4
Derek R Verley, Daneil Torolira, Brandon Pulido, Boris Gutman, Anatol Bragin, Andrew Mayer, Neil G Harris
Although cognitive and behavioral deficits are well known to occur following traumatic brain injury (TBI), motor deficits that occur, even after mild trauma are far less known, yet are equally persistent. This study was aimed at making progress toward determining how the brain reorganizes in response to TBI. We used the adult rat, controlled cortical impact injury model to study the ipsilesional forelimb map evoked by electrical stimulation of the affected limb, as well as the contralesional forelimb map evoked by stimulation of the unaffected limb, both before injury and at 1,2,3 and 4wks after using fMRI...
May 2, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29687019/phosphodiesterase-5-inhibition-potentiates-cerebrovascular-reactivity-in-chronic-traumatic-brain-injury
#5
Kimbra Kenney, Franck Amyot, Carol Moore, Margalit Haber, L Christine Turtzo, Christian Shenouda, Erika Silverman, Yunhua Gong, Bao-Xi Qu, Leah Harburg, Eric M Wassermann, Hanzhang Lu, Ramon Diaz-Arrastia
Background: Traumatic cerebrovascular injury (TCVI), a common consequence of traumatic brain injury (TBI), presents an attractive therapeutic target. Because phosphodiesterase-5 (PDE5) inhibitors potentiate the action of nitric oxide (NO) produced by endothelial cells, they are candidate therapies for TCVI. This study aims to: (1) measure cerebral blood flow (CBF), cerebrovascular reactivity (CVR), and change in CVR after a single dose of sildenafil (ΔCVR) in chronic TBI compared to uninjured controls; (2) examine the safety and tolerability of 8-week sildenafil administration in chronic symptomatic moderate/severe TBI patients; and as an exploratory aim, (3) assess the effect of an 8-week course of sildenafil on chronic TBI symptoms...
April 2018: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29672322/isolated-traumatic-diastasis-of-the-clival-synchondroses-without-clival-fracture
#6
Amir H Faraji, Pawel G Ochalski, Alp Ozpinar, Jason E Blatt, Ian F Pollack
Traumatic clival fractures in the pediatric population are associated with high mortality rates. In our previously reported series, a subset of clival fractures were associated with traumatic diastasis of the surrounding clival synchondroses. Herein, we describe a pediatric case of an isolated traumatic diastasis of the clival synchondroses without clival fracture with significant injury to neurovascular structures. To our knowledge this is the first report to describe this entity. Careful radiological attention should be made towards the clival synchondroses in crushing head injuries to best tailor screening for cerebrovascular injury even in the absence of clival fractures...
April 19, 2018: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29660548/how-to-deal-with-the-empty-space-after-organ-removal-for-transplantation-a-single-medical-center-experience
#7
Ding-Ping Sun, Ling-Hsien Lee, Yu-Feng Tian, Hong-Xiang Zheng, Jinn-Rung Kuo, Che-Chuan Wang
PURPOSE: Dealing with the empty space after organ removal for transplantation has not been investigated. MATERIALS AND METHODS: From January 28, 2005, to November 21, 2017, 111 organ donors were enrolled in this study. They were divided into three groups: no replacement, replaced with paper printed with organ graphics, or replaced with 3D-printed simulated organs after the organs were removed at different periods. The donor's age, gender, etiology of admission, characteristic and clinical pictures, time interval between admission and the date of donation, and time interval between donor coordinator consultations were evaluated...
April 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29648973/male-and-female-mice-exhibit-divergent-responses-of-the-cortical-vasculature-to-traumatic-brain-injury
#8
Amandine Jullienne, Arjang Salehi, Bethann Affeldt, Mohsen Baghchechi, Elizabeth Haddad, Angela Avitua, Mark Walsworth, Isabelle Enjalric, Mary Hamer, Sonali Bhakta, Jiping Tang, John Zhang, William J Pearce, Andre Obenaus
We previously reported that traumatic brain injuries (TBI) alter cerebrovasculature near the injury site in rats, followed by revascularization over a 2-week period. Here, we tested our hypothesis that male and female adult mice have differential cerebrovascular responses following a moderate controlled cortical impact (CCI). Using in vivo magnetic resonance imaging (MRI), a new technique called vessel painting, and immunohistochemistry, we found no differences between males and females in lesion volume, neurodegeneration, blood-brain barrier (BBB) alteration and microglia activation...
March 5, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29627171/comparison-of-nicardipine-with-clevidipine-in-the-management-of-hypertension-in-acute-cerebrovascular-diseases
#9
Zachary Rosenfeldt, Katelyn Conklen, Breck Jones, Don Ferrill, Maithili Deshpande, Fazeel M Siddiqui
BACKGROUND AND PURPOSE: In acute stroke, hypertension worsens outcomes. Guidelines do not mention a preferred antihypertensive agent. This present study aimed to compare the efficacy and safety of nicardipine and clevidipine in acute stroke. METHODS: This retrospective review compared nicardipine with clevidipine for hypertension in acute stroke patients from March 17, 2015 to December 23, 2016. Ischemic and hemorrhagic stroke types were evaluated. Patients were excluded if under 18 years, had traumatic brain injury, had intracranial neoplasm, were on dialysis, had both study drugs during the stroke admission, or the study drug was infused for less than 1 hour...
April 4, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29597251/-appropriate-treatment-and-therapeutic-window-in-spasticity-treatment-with-incobotulinumtoxina-from-100-to-1000-units
#10
Giancarlo Ianieri, Riccardo Marvulli, Giulia Alessia Gallo, Pietro Fiore, Marisa Megna
Many neurological diseases (ischemic and hemorrhagic stroke, multiple sclerosis, infant cerebral palsy, spinal cord injuries, traumatic brain injury, and other cerebrovascular disorders) may cause muscle spasticity. Different therapeutic strategies have been proposed for the treatment of spasticity. One of the major treatments for tone modulation is botulinum toxin type A (BTX-A), performed in addition to other rehabilitation strategies based on individualized multidisciplinary programs aimed at achieving certain goals for each patient...
March 28, 2018: Toxins
https://www.readbyqxmd.com/read/29554345/the-role-of-the-visor-flap-in-scalp-reconstruction-a-case-series-of-21-patients
#11
Marco Ellis, Lisa Hwang, Ni-Ka Ford, Konstantin Slavin
BACKGROUND: Full-thickness scalp defects pose a reconstructive problem, especially in the setting of infection, chemotherapy/radiation, and underlying cranial defects. Current options include dermal matrices, skin grafts, and local flaps. Local flaps often fail, requiring subsequent microvascular free flap reconstruction. OBJECTIVE: To describe the visor flap, a novel bipedicled advancement flap design, and its role in reconstruction of scalp defects. METHODS: A retrospective review of 21 adult patients who developed scalp defects reconstructed using the visor flap from 2013 to 2017...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29514340/a-comparison-of-veterans-with-post-traumatic-stress-disorder-with-mild-traumatic-brain-injury-and-with-both-disorders-understanding-multimorbidity
#12
Joseph F Kulas, Robert A Rosenheck
Introduction: Mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) are common military service-related conditions diagnosed both singly and together in veterans returning from recent military conflicts overseas. The impact of these disorders in real-world Veterans Health Administration practice has not been studied extensively, and few studies have examined the association of these disorders both by themselves and together with sociodemographic characteristics, psychiatric and medical comorbidities, health service utilization, and psychotropic medication fills...
March 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29497851/resolution-of-traumatic-bilateral-vertebral-artery-injury
#13
REVIEW
Yutaka Igarashi, Takahiro Kanaya, Shoji Yokobori, Takeshi Tsukamoto, Hiroyuki Yokota
PURPOSE: Cerebrovascular ischaemia is a rare but serious complication of damage to the carotid or vertebral arteries in the neck caused by blunt injury to the neck. Screening for blunt cerebrovascular injury should be performed in patients with certain signs or symptoms and risk factors. We described a case of traumatic bilateral vertebral artery injury (VAI) including unilateral vertebral arterial occlusion that resolved 3 months post-injury with antiplatelet and direct oral anticoagulant therapy...
March 1, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29492580/induced-dynamic-intracranial-pressure-and-cerebrovascular-reactivity-assessment-of-cerebrovascular-autoregulation-after-traumatic-brain-injury-with-high-intracranial-pressure-in-rats
#14
Denis E Bragin, Gloria L Statom, Edwin M Nemoto
OBJECTIVE: In previous work we showed that high intracranial pressure (ICP) in the rat brain induces a transition from capillary (CAP) to pathological microvascular shunt (MVS) flow, resulting in brain hypoxia, edema, and blood-brain barrier (BBB) damage. This transition was correlated with a loss of cerebral blood flow (CBF) autoregulation undetected by static autoregulatory curves but identified by induced dynamic ICP (iPRx) and cerebrovascular (iCVRx) reactivity. We hypothesized that loss of CBF autoregulation as correlated with MVS flow would be identified by iPRx and iCVRx in traumatic brain injury (TBI) with elevated ICP...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29492577/visualizing-cerebrovascular-autoregulation-insults-and-their-association-with-outcome-in-adult-and-paediatric-traumatic-brain-injury
#15
Marine Flechet, Geert Meyfroidt, Ian Piper, Giuseppe Citerio, Iain Chambers, Patricia A Jones, Tsz-Yan Milly Lo, Per Enblad, Pelle Nilsson, Bart Feyen, Philippe Jorens, Andrew Maas, Martin U Schuhmann, Rob Donald, Laura Moss, Greet Van den Berghe, Bart Depreitere, Fabian Güiza
OBJECTIVE:   The aim of this study is to assess visually the impact of duration and intensity of cerebrovascular autoregulation insults on 6-month neurological outcome in severe traumatic brain injury. MATERIAL AND METHODS:   Retrospective analysis of prospectively collected minute-by-minute intracranial pressure (ICP) and mean arterial blood pressure data of 259 adult and 99 paediatric traumatic brain injury (TBI) patients from multiple European centres. The relationship of the 6-month Glasgow Outcome Scale with cerebrovascular autoregulation insults (defined as the low-frequency autoregulation index above a certain threshold during a certain time) was visualized in a colour-coded plot...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29492531/what-determines-outcome-in-patients-that-suffer-raised-intracranial-pressure-after-traumatic-brain-injury
#16
Samuel Patrick Klein, Bart Depreitere
INTRODUCTION:  Episodes of raised intracranial pressure (ICP) after traumatic brain injury (TBI) are responsible for the majority of secondary brain injury events and thereby strongly affect long-term outcome. However, not all patients with major episodes of raised ICP suffer a poor outcome. The aim of the current analysis was to identify variables contributing to good outcome in patients suffering episodes of high ICP. METHODS:  Retrospective analysis of 20 severe TBI patients admitted to the University Hospitals Leuven between 2010 and 2014...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29492526/the-cerebrovascular-resistance-in-combined-traumatic-brain-injury-with-intracranial-hematomas
#17
Alex O Trofimov, George Kalentyev, Oleg Voennov, Michail Yuriev, Darya Agarkova, Svetlana Trofimova, Vera Grigoryeva
OBJECTIVE: The aim was to evaluate changes in cerebrovascular resistance (CVR) in combined traumatic brain injury (CTBI) in groups with and without intracranial hematomas (IH). MATERIALS AND METHODS: Treatment outcomes in 70 patients with CTBI (42 males and 28 females) were studied. Mean age was 35.5 ± 14.8 years (range, 15-73). The patients were divided into two groups: group 1 included 34 CTBI patients without hematomas; group 2 comprised 36 patients with CTBI and IH...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29478119/a-review-of-split-bolus-single-pass-ct-in-the-assessment-of-trauma-patients
#18
Cassandra Jeavons, Craig Hacking, Ludo F Beenen, Martin L Gunn
PURPOSE: The purpose of this study was to review and compare the image quality and radiation dose of split-bolus single-pass computed tomography(CT) in the assessment of trauma patients in comparison to standard multi-phase CT techniques. METHODS: An online electronic database was searched using the MESH terms "split-bolus," "dual phase," and "single pass." Inclusion criteria required the research article to compare a split contrast bolus protocol in a single-pass scan in the assessment of trauma patients...
February 24, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29452371/a-bidirectional-association-between-cognitive-ability-in-young-adulthood-and-epilepsy-a-population-based-cohort-study
#19
Merete Osler, Erik L Mortensen, Kaare Christensen, Gunhild T Christensen
Aim: To investigate the bidirectional association between cognitive ability in young adulthood and epilepsy. Methods: This cohort study included 1 159 076 men enrolled in the mandatory conscription board examination from the Danish Conscription Database (DCD; 658 465 men examined 1957-84), the Danish Defence Personnel Organization Database (DPOD; 216 509 men examined 1987-2005) and the Danish Conscription Registry (DCR; 284 102 men examined 2006-15). A supplementary analysis included 14 814 female volunteers...
February 14, 2018: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29431051/intra-and-extra-cranial-injury-burden-as-drivers-of-impaired-cerebrovascular-reactivity-in-traumatic-brain-injury
#20
Frederick Adam Zeiler, Joseph Donnelly, Basil Nourallah, Eric Peter Thelin, Leanne Calviello, Peter Smieleweski, Marek Czosnyka, Ari Ercole, David Menon
Impaired cerebrovascular reactivity has been associated with outcome following traumatic brain injury (TBI), but it is unknown how it is affected by trauma severity. Thus, we aimed to explore the relationship between intra-cranial (IC) and extra-cranial (EC) injury burden and cerebrovascular reactivity in TBI patients. We retrospectively included critically ill TBI patients. IC injury burden included detailed lesion and computerized tomography (CT) scoring (ie. Marshall, Rotterdam, Helsinki and Stockholm Scores) on admission...
February 12, 2018: Journal of Neurotrauma
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