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Cerebral perfusion pressure

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https://www.readbyqxmd.com/read/28101162/correlation-between-high-perfusion-syndrome-and-stent-restenosis-after-stent-implantation
#1
Yingyi Li, Lingtao Tang, Dong Qi, Chunlei Wang, Suxia Zhang, Pengfei Hu, Yun Wang, Bogang Zhang, Kunxi Zhang
The present study was conducted to determine the correlation between high perfusion syndrome and stent restenosis after cerebral vascular stent implantation. A total of 146 patients diagnosed with cerebral vascular stenosis and stent implantation were selected. A total of 55 cases (37.67%) of cerebral hyperperfusion syndrome patients were diagnosed by xenon-enhanced computer tomography (Xe-CT) examination and clinical symptoms within 3 days after surgery and were chosen as the observation group. A total of 91 cases were selected as the control group...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28100120/hybrid-stage-i-procedure-as-initial-palliation-for-neonate-with-hypoplastic-left-heart-syndrome-and-right-congenital-diaphragmatic-hernia
#2
Draginja Cvetkovic, Joseph Giamelli, Michael Lyew, Markus Erb, Suvro Sett, Youmna DiStefano
During the past decade, a hybrid procedure has emerged and dramatically evolved as an alternative stage I palliation to the conventional Norwood procedure in neonates with hypoplastic left heart syndrome (HLHS). The hybrid approach avoids the need for cardiopulmonary bypass (CPB) utilizing stenting of the arterial duct and bilateral pulmonary artery banding. Cerebral and coronary perfusion pressure is maintained, and the pulmonary vasculature is protected from higher systemic pressure. Elimination of risks associated with CPB gains vital time to stabilize the patient and correct coexisting noncardiac anomalies and allows growth in preparation for the later stages of the Fontan pathway...
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28097330/electroencephalographic-periodic-discharges-and-frequency-dependent-brain-tissue-hypoxia-in-acute-brain-injury
#3
Jens Witsch, Hans-Peter Frey, J Michael Schmidt, Angela Velazquez, Cristina M Falo, Michael Reznik, David Roh, Sachin Agarwal, Soojin Park, E Sander Connolly, Jan Claassen
Importance: Periodic discharges (PDs) that do not meet seizure criteria, also termed the ictal interictal continuum, are pervasive on electroencephalographic (EEG) recordings after acute brain injury. However, their association with brain homeostasis and the need for clinical intervention remain unknown. Objective: To determine whether distinct PD patterns can be identified that, similar to electrographic seizures, cause brain tissue hypoxia, a measure of ongoing brain injury...
January 9, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28069320/mild-induced-hypothermia-for-patients-with-severe-traumatic-brain-injury-after-decompressive-craniectomy
#4
Chunhai Tang, Yun Bao, Min Qi, Lizhi Zhou, Fan Liu, Jian Mao, Qingmei Lei, Songtao Qi, Binghui Qiu
PURPOSE: To evaluate the efficacy and safety of mild induced hypothermia for intracranial hypertension in patients with traumatic brain injury after decompressive craniectomy. METHODS: A total of 60 adults with intracranial pressure (ICP) of more than 20 mm Hg after decompressive craniectomy were randomly assigned to standard care (control group) or hypothermia (32°C-35°C) plus standard care. Then, ICP, cerebral perfusion pressure, Glasgow Outcome Scale score, and complications were assessed...
December 29, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28067615/intracranial-atherosclerosis-from-anatomy-to-pathophysiology
#5
Yuehua Pu, Linfang Lan, Xinyi Leng, Lawrence Ks Wong, Liping Liu
Background Intracranial atherosclerotic stenosis is an important etiology subtype of ischemic stroke. Stenosis severity was thought to be the main reference index for clinical treatment and research. However, stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation, and perfusion impairment downstream the stenosis are more important. Aims We write this review aimed to summarize novel angiographic methods applied in the evaluation of functional severity of ICAS, and commented on their limitations and prospects in future research...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28057593/mortality-and-outcome-comparison-between-brain-tissue-oxygen-combined-intracranial-pressure-cerebral-perfusion-pressure-guided-therapy-and-intracranial-pressure-cerebral-perfusion-pressure-guided-therapy-in-traumatic-brain-injury-a-meta-analysis
#6
REVIEW
Qiang Xie, Hai-Bing Wu, Yu-Feng Yan, Meng Liu, Er-Song Wang
BACKGROUND: The combination of brain tissue oxygen and standard intracranial pressure/cerebral perfusion pressure (ICP/CPP) guided therapy is thought to improve traumatic brain injury (TBI) prognosis compared with standard ICP/CPP guided therapy. However, related results of previous observational studies and recently published cohort studies and randomized controlled trials (RCTs) remain controversial. The objective was to compare the effect of combined therapy with that of standard ICP/CPP guided therapy on mortality rate, favorable outcome, ICP/CPP, and length of stay (LOS)...
January 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28049382/use-of-intracranial-pressure-monitoring-in-bacterial-meningitis-a-10-year-follow-up-on-outcome-and-intracranial-pressure-versus-head-ct-scans
#7
Lykke Larsen, Frantz R Poulsen, Troels H Nielsen, Carl-Henrik Nordström, Mette K Schulz, Åse B Andersen
BACKGROUND: The aim of this study was to evaluate the clinical outcome of patients with severe bacterial meningitis where intracranial pressure (ICP) monitoring has been performed. METHODS: A retrospective observational study including patients admitted 1st(.) January 2005 to 31st(.) December 2014. Thirty nine patients age 18-89 years were included. All the patients received intensive care with mechanical ventilation, ICP monitoring, sedation, antibiotics and corticosteroids according to current guidelines...
January 3, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28045690/clinical-case-of-the-month-a-49-year-old-man-who-presents-with-left-sided-weakness-an-update-on-ischemic-stroke
#8
Najy Masri, Rikki Weems, Falon Brown, Ben Andres, Fred Lopez
A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28040435/in-vitro-investigation-of-the-hemodynamic-responses-of-the-cerebral-coronary-and-renal-circulations-with-a-rotary-blood-pump-installed-in-the-descending-aorta
#9
M A Rezaienia, G Paul, E J Avital, S Mozafari, M Rothman, T Korakianitis
This study investigates the hemodynamic responses of the cardiovascular system when a rotary blood pump is operating in the descending aorta, with a focus on the cerebral, coronary and renal autoregulation, using our in-house cardiovascular emulator. Several improvements have been made from our previous studies. A novel coronary system was developed to replicate the native coronary perfusion. Three pinch valves actuated by stepper motors were used to simulate the regional autoregulation systems of the native cerebral, coronary and renal circulations...
December 28, 2016: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28033184/effect-of-outflow-graft-size-on-flow-in-the-aortic-arch-and-cerebral-blood-flow-in-continuous-flow-pumps-possible-relevance-to-strokes
#10
Sindhoor Bhat, Jayakala Mathews, Komrakshi R Balakrishnan, Ramarathnam Krishna Kumar
One of the most devastating complications of continuous flow left ventricular devices (CFLVADS) is a stroke, with a higher incidence in Heartware HVAD as compared to HEARTMATE II. The reason for the observed difference in stroke rates is unclear. Since outflow graft diameters are different, we hypothesized that this could contribute to the difference in stroke rates.A Computational fluid structure interaction model was created from the CT scan of a patient. Pressures were used as the boundary condition and the flow through the cerebral vessels was derived as outputs...
December 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28008305/magnesium-sulfate-prevents-placental-ischemia-induced-increases-in-brain-water-content-and-cerebrospinal-fluid-cytokines-in-pregnant-rats
#11
Linda W Zhang, Junie P Warrington
Magnesium sulfate (MgSO4) is the most widely used therapy in the clinic to prevent the progression of preeclampsia, a hypertensive disorder of pregnancy, to eclampsia. Eclampsia, manifested as unexplained seizures and/or coma during pregnancy or postpartum, accounts for ~13% of maternal deaths worldwide. While MgSO4 continues to be used in the clinic, the mechanisms by which it exerts its protective actions are not well understood. In this study, we tested the hypothesis that MgSO4 protects against placental ischemia-induced increases in brain water content and cerebrospinal fluid cytokines...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27998650/identification-of-hemodynamically-compromised-regions-by-means-of-cerebral-blood-volume-mapping-utilizing-computed-tomography-perfusion-imaging
#12
Satoshi Takahashi, Yoshio Tanizaki, Kazunori Akaji, Hiroaki Kimura, Takehiro Katano, Kentaro Suzuki, Yoichi Mochizuki, Satoka Shidoh, Masaki Nakazawa, Kazunari Yoshida, Ban Mihara
The aim of the study was to evaluate the potential role of computed tomography perfusion (CTP) imaging in identifying hemodynamically compromised regions in patients with occlusive cerebrovascular disease. Twelve patients diagnosed with either occlusion or severe stenosis of the internal carotid artery or the M1 portion of the middle cerebral artery underwent CTP imaging. The data was analyzed by an automated ROI-determining software. Patients were classified into two subgroups: an asymptomatic group consisting of three patients in whom perfusion pressure distal to the site of occlusion/stenosis (PPdis) could be maintained in spite of the arterial occlusion/stenosis, and a symptomatic group consisting of nine patients in whom PPdis could not be maintained enough to avoid watershed infarction...
December 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27989737/association-of-brain-metabolites-with-blood-lactate-and-glucose-levels-with-respect-to-neurological-outcomes-after-out-of-hospital-cardiac-arrest-a-preliminary-microdialysis-study
#13
Toru Hifumi, Kenya Kawakita, Takeshi Yoda, Tomoya Okazaki, Yasuhiro Kuroda
AIM: Out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Cerebral microdialysis (CMD) is an efficient sampling technique to detect neurochemical changes in brain interstitial tissue. In this retrospective study, we hypothesised that there are different CMD levels between patients with favourable and unfavourable neurological outcomes. METHODS: Data of patients with OHCA admitted to Kagawa University Hospital and administered therapeutic hypothermia (TH) were collected...
October 27, 2016: Resuscitation
https://www.readbyqxmd.com/read/27984152/association-of-brain-metabolites-with-blood-lactate-and-glucose-levels-with-respect-to-neurological-outcomes-after-out-of-hospital-cardiac-arrest-a-preliminary-microdialysis-study
#14
Toru Hifumi, Kenya Kawakita, Takeshi Yoda, Tomoya Okazaki, Yasuhiro Kuroda
AIM: Out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Cerebral microdialysis (CMD) is an efficient sampling technique to detect neurochemical changes in brain interstitial tissue. In this retrospective study, we hypothesised that there are different CMD levels between patients with favourable and unfavourable neurological outcomes. METHODS: Data of patients with OHCA admitted to Kagawa University Hospital and administered therapeutic hypothermia (TH) were collected...
January 2017: Resuscitation
https://www.readbyqxmd.com/read/27982772/deliberate-employment-of-postoperative-hypotension-for-brain-arteriovenous-malformation-surgery-and-the-incidence-of-delayed-postoperative-hemorrhage-a-prospective-cohort-study
#15
Michael Kerin Morgan, Markus Karl Hermann Wiedmann, Nazih N A Assaad, Michael J A Parr, Gillian Z Heller
OBJECTIVE The aim of this study was to examine the impact of deliberate employment of postoperative hypotension on delayed postoperative hemorrhage (DPH) for all Spetzler-Ponce Class (SPC) C brain arteriovenous malformations (bAVMs) and SPC B bAVMs ≥ 3.5 cm in diameter (SPC B 3.5+). METHODS A protocol of deliberate employment of postoperative hypotension was introduced in June 1997 for all SPC C and SPC B 3.5+ bAVMs. The aim was to achieve a maximum mean arterial blood pressure (BP) ≤ 70 mm Hg (with cerebral perfusion pressure > 50 mm Hg) for a minimum of 7 days after resection of bAVMs (BP protocol)...
December 16, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27982555/how-to-manage-blood-pressure-after-brain-injury
#16
Laurent Carteron, Fabio S Taccone, Mauro Oddo
Manipulation of blood pressure (BP) is a mainstay of therapy in patients with acute brain injury (ABI). In the early emergent phase (first hours from injury), depending on intracranial pathology, BP manipulation aims to 1) limit the progression of parenchymal hematomas or hemorrhagic transformation (in patients with ischemic/hemorrhagic stroke and aneurysmal subarachnoid hemorrhage [SAH]), and 2) attenuate hypoperfusion and secondary cerebral ischemic insults (in patients with traumatic brain injury [TBI])...
December 16, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27974985/anomalous-origin-of-the-left-common-carotid-artery-from-the-main-pulmonary-artery-a-rare-association-in-an-infant-with-charge-syndrome
#17
Onyekachukwu Osakwe, Blaise Jones, Russel Hirsch
Case Report. Isolated carotid artery originating from the pulmonary trunk is an exceedingly rare anomalous origin of head and neck vessels. We present this finding, along with a persistent embryonic trigeminal artery, in a male infant with multiple cardiac defects and other congenital anomalies associated with CHARGE syndrome. After extensive investigations, cardiac catheterization revealed the anomalous left common carotid artery arising from the cranial aspect of the main pulmonary artery. There was retrograde flow in this vessel, resulting from the lower pulmonary pressure, essentially stealing arterial supply from the left anterior cerebral circulation...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27929741/cerebral-microvascular-dysfunction-and-inflammation-are-improved-by-centrally-acting-antihypertensive-drugs-in-metabolic-syndrome
#18
Vanessa Estato, Alessandro Nascimento, Barbara Antunes, Fabiana Gomes, Laura Coelho, Raquel Rangel, Luciana Garzoni, Anissa Daliry, Pascal Bousquet, Eduardo Tibiriçá
BACKGROUND: We aimed to investigate the effects of chronic oral treatment with centrally acting antihypertensive drugs, such as clonidine (CLO), an α2-adrenoceptor agonist, or LNP599, a selective I1 imidazoline receptor agonist, on brain microvascular function in rats with high-fat diet (HFD)-induced metabolic syndrome. METHODS: Male Wistar Kyoto rats were maintained on a normal diet (CON) or a HFD for 20 weeks. After this period, the HFD group received oral CLO (0...
December 8, 2016: Metabolic Syndrome and related Disorders
https://www.readbyqxmd.com/read/27923226/intraoperative-tumoral-bleeding-of-hypervascular-medulloblastoma-after-ventricular-drainage-a-case-report
#19
Han-Seung Ryu, Tae-Young Jung, Moon-Soo Han, Seul-Ki Kim, Kyung-Hwa Lee
We report a rare case of intraoperative tumoral bleeding of a hypervascular medulloblastoma. A 12-year-old girl presented with dizziness and nausea. Brain magnetic resonance (MR) images revealed an approximately 4.2-cm enhanced mass on the cerebellar vermis associated with mild perilesional edema and increased cerebral blood volume. Angiography showed tumoral staining and developed occipital and circular dural sinuses in the venous phase. A suboccipital craniotomy was performed. To relieve the intracranial pressure, cerebrospinal fluid (CSF) was drained via a lateral ventricular catheter in the occipital horn...
December 7, 2016: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#20
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
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