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https://www.readbyqxmd.com/read/29792540/cerebral-amyloid-angiopathy-diagnosis-and-potential-therapies
#1
Stewart A Weber, Ranish K Patel, Helmi L Lutsep
Cerebral amyloid angiopathy (CAA) is characterized by the pathologic deposition of amyloid-beta within cortical and leptomeningeal arteries, arterioles, capillaries and, in rare cases, the venules of the brain. It is often associated with the development of lobar intracerebral hemorrhages but may cause other neurologic symptoms or be asymptomatic. Magnetic resonance imaging characteristics, such as lobar microbleeds, support a diagnosis of CAA and assist with hemorrhage risk assessments. Immunosuppressants are used to treat rarer inflammatory forms of CAA...
May 24, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29792264/paradoxical-brain-embolism-shadowing-massive-pulmonary-embolism
#2
François Bagate, Alexandre Bedet, Armand Mekontso Dessap, Guillaume Carteaux
Patent foramen ovale is frequently observed in the general population. In case of massive pulmonary embolism, the sudden increase in the right heart cavity's pressure may cause a right-to-left shunting across this foramen, which could be associated with conflicting outcomes. Herein, we report a case of reversible cardiac arrest preceded by seizures, and followed by hemodynamic stability without any vasopressor. A brain CT-scan showed a limited ischemic stroke. Initial echocardiographic assessment revealed an acute cor pulmonale and a right-to-left intracardiac shunt across a large patent foramen ovale, suggesting the diagnosis of massive pulmonary embolism that was lately confirmed by a multidetector CT-angiography...
May 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29792042/imaging-predictors-of-outcome-in-acute-spontaneous-subarachnoid-hemorrhage-a-review-of-the-literature
#3
Isabel Fragata, Patrícia Canhão
Spontaneous subarachnoid hemorrhage (SAH) accounts for about 5% of strokes, but has a very high morbidity and mortality. Many survivors are left with important cognitive impairment and are severely incapacitated. Prediction of complications such as vasospasm and delayed cerebral ischemia, and of clinical outcome after SAH, is challenging. Imaging studies are essential in the initial evaluation of SAH patients and are increasingly relevant in assessing for complications and prognosis. In this article, we reviewed the role of imaging studies in evaluating early brain injury and predicting complications as well as clinical and neuropsychological prognosis after acute SAH...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29790836/minocycline-promotes-post-hemorrhagic-neurogenesis-via-m2-microglia-polarization-via-up-regulation-of-the-trkb-bdnf-pathway-in-rats
#4
Miao Hongsheng, Runming Li, Cong Han, Xiuzhen Lu, Hang Zhang
Intracerebral hemorrhage (ICH) is a devastating disease worldwide with increasing mortality. The present study investigated whether minocycline was neuroprotective and induced M2 microglial polarization via up-regulation of the TrkB/BDNF pathway after ICH. ICH was induced via injection of autologous blood into 150 Sprague-Dawley (S-D) rats. A selective TrkB antagonist (ANA 12) and agonist (HIOC) were used to investigate the mechanism of minocycline-induced neuroprotection. Minocycline improved ICH-induced neurological deficits and reduced M1 microglia marker protein (CD68, CD16) expression as well as M2 microglial polarization (CD206 and arginase 1 protein)...
May 23, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29790685/f2-isoprostanes-and-f4-neuroprostanes-as-markers-of-intracranial-aneurysm-development
#5
Anna Syta-Krzyżanowska, Iwona Jarocka-Karpowicz, Jan Kochanowicz, Grzegorz Turek, Robert Rutkowski, Krzysztof Gorbacz, Zenon Mariak, Elżbieta Skrzydlewska
BACKGROUND: Intracranial aneurysms are common, occurring in about 1-2% of the population. Saccular aneurysm is a pouch-like pathological dilatation of an intracranial artery that develops when the cerebral artery wall becomes too weak to resist hemodynamic pressure and distends. OBJECTIVES: The aim of this study was to determine whether the development of intracranial aneurysms and subarachnoid hemorrhage (SAH) affects neuronal phospholipid metabolism, and what influence different invasive treatments have on brain free radical phospholipid metabolism...
April 24, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29790469/intraventricular-ganglioglioma-presenting-with-spontaneous-hemorrhage
#6
Alexandre Rainha Campos, Luisa Biscoito, Maria Gabriela Gasparinho
Intraventricular gangliogliomas presenting with spontaneous hemorrhage are rare. Due to high density of important tracts lateral to the ventricular atrium, the intraparietal trans sulcal approach is a good option to remove lesions in this location. These tracts are displaced and sometimes destroyed by the presence of large masses. A 33-year-old male presented with a sudden headache and a generalized seizure. He had a left visual field hemianopia and left visual field neglect. Brain computer tomography and magnetic resonance imaging revealed a hemorrhagic tumor located in his right atrium...
March 29, 2018: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29789947/relationship-between-brain-function-aeeg-and-brain-structure-mri-and-their-predictive-value-for-neurodevelopmental-outcome-of-preterm-infants
#7
Britta Hüning, Tobias Storbeck, Nora Bruns, Frauke Dransfeld, Julia Hobrecht, Julia Karpienski, Selma Sirin, Bernd Schweiger, Christel Weiss, Ursula Felderhoff-Müser, Hanna Müller
To improve the prediction of neurodevelopmental outcome in very preterm infants, this study used the combination of amplitude-integrated electroencephalography (aEEG) within the first 72 h of life and cranial magnetic resonance imaging (MRI) at term equivalent age. A single-center cohort of 38 infants born before 32 weeks of gestation was subjected to both investigations. Structural measurements were performed on MRI. Multiple regression analysis was used to identify independent factors including functional and structural brain measurements associated with outcome at a corrected age of 24 months...
May 22, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29787871/spontaneous-intracerebral-hemorrhage-in-a-plateau-area-a-study-based-on-the-tibetan-population
#8
Ruiqi Chen, Anqi Xiao, Chao You, Lu Ma
OBJECTIVE: To reveal characteristics of spontaneous intracerebral hemorrhage (sICH) in a plateau area based on the Tibetan population. METHODS: Data of Tibetan and Han patients (control group) with sICH treated at our center from January 2013 to April 2017 were retrospectively reviewed. RESULTS: A total of 122 Tibetan and 927 Han patients were included. Compared with Han patients, Tibetan patients were older (54.7±11.2 VS 50.9±18.3 years, P=0...
May 19, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29787575/safety-of-intravenous-alteplase-within-4-5-hours-for-patients-awakening-with-stroke-symptoms
#9
Victor C Urrutia, Roland Faigle, Steven R Zeiler, Elisabeth B Marsh, Mona Bahouth, Mario Cerdan Trevino, Jennifer Dearborn, Richard Leigh, Susan Rice, Karen Lane, Mustapha Saheed, Peter Hill, Rafael H Llinas
BACKGROUND: Up to 25% of acute stroke patients first note symptoms upon awakening. We hypothesized that patients awaking with stroke symptoms may be safely treated with intravenous alteplase (IV tPA) using non-contrast head CT (NCHCT), if they meet all other standard criteria. METHODS: The SAfety of Intravenous thromboLytics in stroke ON awakening (SAIL ON) was a prospective, open-label, single treatment arm, pilot safety trial of standard dose IV tPA in patients who presented with stroke symptoms within 0-4...
2018: PloS One
https://www.readbyqxmd.com/read/29785469/early-detection-of-cerebral-infarction-after-focal-ischemia-using-a-new-mri-indicator
#10
Yukako Nakajo, Qiang Zhao, Jun-Ichiro Enmi, Hidehiro Iida, Jun C Takahashi, Hiroharu Kataoka, Keiko Yamato, Hiroji Yanamoto
Prolongation of the T2 relaxation time, an increase in T2-weighted signal intensity (T2-SI), and a decrease in the apparent diffusion coefficient (ADC) calculated from diffusion-weighted images (DWI) on magnetic resonance imaging (MRI) are conventional indicators of the vasogenic (interstitial) or cytotoxic (cellular) cerebral edema that develops after ischemic stroke. However, these parameters obtained on stroke imaging have not given us a precise threshold at which we can determine the viability or vulnerability of the tissue, allowing us to decide on an intervention that will help reversible tissue in the acute phase...
May 21, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29784284/routine-surveillance-imaging-following-mild-traumatic-brain-injury-with-intracranial-hemorrhage-may-not-be-necessary
#11
Smruti K Patel, Yair M Gozal, Bryan M Krueger, James C Bayley, Suzanne Moody, Norberto Andaluz, Richard A Falcone, Karin S Bierbrauer
BACKGROUND: Mild traumatic brain injury (mTBI) comprises the majority of pediatric traumatic brain injury. Children with mTBI even with traumatic intracranial hemorrhage (tICH) rarely experience a clinically significant neurologic decline (CSND). The utility of routine surveillance imaging in the pediatric population also remains controversial, especially owing to concerns about the risks of radiation exposure at a young age. This study aims to identify demographic or injury-related characteristics that may facilitate recognition of children at risk of progression with mTBI...
April 27, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29781369/contralateral-extensive-cerebral-hemorrhagic-venous-infarction-caused-by-retrograde-venous-reflux-into-the-opposite-basal-vein-of-rosenthal-in-posttraumatic-carotid-cavernous-fistula-a-case-report-and-literature-review
#12
Prasert Iampreechakul, Adisak Tanpun, Punjama Lertbusayanukul, Somkiet Siriwimonmas
We describe a patient with traumatic carotid-cavernous fistula (CCF), subsequently developing contralateral extensive hemorrhagic venous infarction from retrograde venous reflux into the opposite basal vein of Rosenthal. A 54-year-old woman was involved in a motor vehicle accident and sustained severe traumatic brain injury. Two months later, she developed bilateral proptosis and audible bruit. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the brain demonstrated the right direct CCF...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29780579/managing-portal-hypertension-in-patients-with-liver-cirrhosis
#13
REVIEW
Tilman Sauerbruch, Robert Schierwagen, Jonel Trebicka
Portal hypertension is one cause and a part of a dynamic process triggered by chronic liver disease, mostly induced by alcohol or incorrect nutrition and less often by viral infections and autoimmune or genetic disease. Adequate staging - continuously modified by current knowledge - should guide the prevention and treatment of portal hypertension with defined endpoints. The main goals are interruption of etiology and prevention of complications followed, if necessary, by treatment of these. For the past few decades, shunts, mostly as intrahepatic stent bypass between portal and hepatic vein branches, have played an important role in the prevention of recurrent bleeding and ascites formation, although their impact on survival remains ambiguous...
2018: F1000Research
https://www.readbyqxmd.com/read/29778996/stent-and-flow-diverter-assisted-treatment-of-acutely-ruptured-brain-aneurysms
#14
José E Cohen, J Moshe Gomori, Ronen R Leker, Sergey Spektor, Hosni Abu El Hassan, Eyal Itshayek
OBJECTIVE: We present our experience with stent techniques in the management of acutely ruptured aneurysms, focusing on aneurysm occlusion rates, intraprocedural complications, and late outcomes. METHODS: We retrospectively reviewed the clinical records of patients treated by stent techniques during the early acute phase of aneurysmal rupture, from June 2011 to June 2016. Patients who underwent stenting for the management of unruptured aneurysms, or in a delayed fashion for a ruptured lesion, were excluded...
May 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29778597/microsurgical-clipping-of-ruptured-anterosuperior-projecting-anterior-communicating-artery-aneurysms-how-i-do-it
#15
Feng Xu, Nicholas C Bambakidis
In anterosuperior-projecting anterior communicating artery (ACoA) aneurysms, the aneurysm dome usually adheres to one or both proximal A2 segment, which may present technical difficulties. This video demonstrates microsurgical clipping of a ruptured anterosuperior-projecting AComA aneurysm. A 52-year-old male presented with a Hunt-Hess grade II subarachnoid hemorrhage (SAH). Computed tomography showed SAH in the basal cisterns, sylvian and interhemispheric fissures. Angiography demonstrated a wide-necked AComA aneurysm projecting anterosuperiorly...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29777884/neurosurgical-management-of-self-inflicted-cranial-crossbow-injury
#16
Charles G Kulwin, Andrew DeNardo, Saad Khairi, Troy Payner
BACKGROUND: While gun-related penetrating traumatic brain injuries make up the majority of cranial missile injuries, low-velocity penetrating injuries present significant clinical difficulties that cannot necessarily be identically managed. Bow hunting is an increasingly popular pastime, and a crossbow allows a unique mechanism to cause a self-inflicted cranial injury with a large, low-velocity projectile. Historically, arrow removal is described in an operating room setting, which provides limited knowledge of the location of vascular injury in the setting of post-removal hemorrhage, and may represent an inefficient use of operating room availability...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29775701/lithium-posttreatment-alleviates-blood-brain-barrier-injury-after-intracerebral-hemorrhage-in-rats
#17
Weishan Li, Rui Li, Sha Zhao, Cheng Jiang, Zhen Liu, Xiaobo Tang
Vasogenic cerebral edema formation after blood brain barrier (BBB) damage aggravates the devastating consequences of intracerebral hemorrhage (ICH). The present study aims to probe into a therapeutic method on BBB preservation after ICH with a glycogen synthase kinase-3β (GSK-3β) inhibitor, lithium. Intrastriatal infusion of semicoagulated autologous whole blood or sham surgery was performed on male Sprague-Dawley (SD) rats (n = 208).Experimental animals received administration of 4,6-disubstitutedpyrrolo-pyrimidine (TWS119), lithium alone or in combination with a phosphatidylinositol 3-kinase inhibitor, wortmannin, after ICH...
May 15, 2018: Neuroscience
https://www.readbyqxmd.com/read/29774193/predictable-values-of-decompressive-craniectomy-in-patients-with-acute-subdural-hematoma-comparison-between-decompressive-craniectomy-after-craniotomy-group-and-craniotomy-only-group
#18
Hyunjun Kim, Sang-Jun Suh, Ho-Jun Kang, Min-Seok Lee, Yoon-Soo Lee, Jeong-Ho Lee, Dong-Gee Kang
Objective: Patients with traumatic acute subdural hematoma (ASDH) often require surgical treatment. Among patients who primarily underwent craniotomy for the removal of hematoma, some consequently developed aggressive intracranial hypertension and brain edema, and required secondary decompressive craniectomy (DC). To avoid reoperation, we investigated factors which predict the requirement of DC by comparing groups of ASDH patients who did and did not require DC after craniotomy. Methods: The 129 patients with ASDH who underwent craniotomy from September 2007 to September 2017 were reviewed...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29773204/intracerebral-hemorrhage-and-sleep-disordered-breathing
#19
Lynda D Lisabeth, Richard V Scheer, Chengwei Li, Erin Case, Ronald D Chervin, Darin B Zahuranec, Lewis B Morgenstern, Nelda M Garcia, Susan Tower, Devin L Brown
OBJECTIVE/BACKGROUND: Limited data are available on sleep-disordered breathing (SDB) following intracerebral hemorrhage (ICH). Our aim was to characterize the objective measures of post-ICH SDB and questionnaire-reported pre-ICH sleep characteristics, overall and by ethnicity. PATIENTS/METHODS: Participants with ICH who were enrolled in the population-based Brain Attack Surveillance in Corpus Christi project (2010-2016) reported their pre-ICH sleep duration and completed the Berlin Questionnaire to characterize pre-ICH risk of SDB...
June 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29773103/-curcumin-alleviates-early-brain-injury-following-subarachnoid-hemorrhage-in-rats-by-inhibiting-jnk-c-jun-signal-pathway
#20
Xia Li, Ji Zhu
Objective To investigate the inhibitory effect of curcumin on early brain injury following subarachnoid hemorrhage (SAH) by inhibiting JNK/ c-Jun signal pathway. Methods Sixty adult male SD rats were randomly divided into four groups: sham operation group (sham group), SAH group, SAH group treated with 100 mg/(kg.d) curcumin and SAH group treated with 200 mg/(kg.d) curcumin, with 15 rats in each group. Endovascular puncture was used to induce SAH model. Nissl staining was used to test whether neurons were broken...
March 2018: Xi Bao Yu Fen Zi Mian Yi Xue za Zhi, Chinese Journal of Cellular and Molecular Immunology
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