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decompressive hemicraniectomy

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https://www.readbyqxmd.com/read/28282456/early-computed-tomography-based-scores-to-predict-decompressive-hemicraniectomy-after-endovascular-therapy-in-acute-ischemic-stroke
#1
Ilko L Maier, Daniel Behme, Marlena Schnieder, Ioannis Tsogkas, Katharina Schregel, Mathias Bähr, Michael Knauth, Jan Liman, Marios-Nikos Psychogios
BACKGROUND: Identification of patients requiring decompressive hemicraniectomy (DH) after endovascular therapy (EVT) is crucial as clinical signs are not reliable and early DH has been shown to improve clinical outcome. The aim of our study was to identify imaging-based scores to predict the risk for space occupying ischemic stroke and DH. METHODS: Prospectively derived data from patients with acute large artery occlusion within the anterior circulation and EVT was analyzed in this monocentric study...
2017: PloS One
https://www.readbyqxmd.com/read/28235642/national-survey-of-neurosurgeons-and-stroke-physicians-on-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction
#2
Pallavi Basu, Harri Jenkins, Kevin Tsang, Vejay N Vakharia
BACKGROUND: Several studies have evaluated the use of decompressive hemicraniectomy (DHC) in malignant middle cerebral artery infarction (MMCAI). In the United Kingdom (UK), the National Institute for Health and Care Excellence (NICE) has set criteria for selection of patients for DHC in MMCAI. We set out to survey the attitudes and practice of neurosurgeons and stroke physicians within the UK towards DHC in MMCAI. METHODS: An electronic survey of questions on management of MMCAI in various clinical scenarios was submitted to the academic committees of the Society of British Neurological Surgeons (SBNS) and the British Association of Stroke Physicians (BASP) for approval, prior to dissemination through the consultant members...
February 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28201629/in-reply-oracle-stroke-study-opinion-regarding-acceptable-outcome-following-decompressive-hemicraniectomy-for-ischemic-stroke
#3
Stephen Honeybul, Kwok Ming Ho, David J Blacker
No abstract text is available yet for this article.
February 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28191384/delayed-temporal-lobe-hemorrhage-after-initiation-of-acyclovir-in-an-immunocompetent-patient-with-herpes-simplex-virus-2-encephalitis-a-case-report
#4
Kyle Mueller, Joshua E Ryan, Alex Tai, Rocco A Armonda
Herpes simplex virus (HSV) is the most common cause of non-epidemic, sporadic, acute focal encephalitis in the United States. Inflammation of the vasculature makes them friable and susceptible to hemorrhage. Massive hemorrhage, though rare, can present in a delayed fashion after initiation of acyclovir and often requires surgical intervention. We report a unique case of delayed temporal lobe hemorrhage after initiation of acyclovir in an immunocompetent patient, specifically for its presentation, virology, and surgical management...
January 15, 2017: Curēus
https://www.readbyqxmd.com/read/28187804/decompressive-craniectomy-in-acute-brain-injury
#5
REVIEW
D A Brown, E F M Wijdicks
Decompressive surgery to reduce pressure under the skull varies from a burrhole, bone flap to removal of a large skull segment. Decompressive craniectomy is the removal of a large enough segment of skull to reduce refractory intracranial pressure and to maintain cerebral compliance for the purpose of preventing neurologic deterioration. Decompressive hemicraniectomy and bifrontal craniectomy are the most commonly performed procedures. Bifrontal craniectomy is most often utilized with generalized cerebral edema in the absence of a focal mass lesion and when there are bilateral frontal contusions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187798/critical-care-in-acute-ischemic-stroke
#6
REVIEW
M McDermott, T Jacobs, L Morgenstern
Most ischemic strokes are managed on the ward or on designated stroke units. A significant proportion of patients with ischemic stroke require more specialized care. Several studies have shown improved outcomes for patients with acute ischemic stroke when neurocritical care services are available. Features of acute ischemic stroke patients requiring intensive care unit-level care include airway or respiratory compromise; large cerebral or cerebellar hemisphere infarction with swelling; infarction with symptomatic hemorrhagic transformation; infarction complicated by seizures; and a large proportion of patients require close management of blood pressure after thrombolytics...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28185018/efficacy-and-safety-of-durotomy-after-decompressive-hemicraniectomy-in-traumatic-brain-injury
#7
R B Moringlane, N Keric, F B Freimann, D Mielke, R Burger, D Duncker, V Rohde, K L V Eckardstein
Decompressive hemicraniectomy (DH) plus duroplasty was demonstrated to be effective for treating critically elevated intracranial pressure (ICP). In order to shorten operation time and to avoid the use of autologous or heterologous material, durotomy has been introduced as an alternative to duroplasty. Only limited data is available on the effect of DH and durotomy on the increased ICP in traumatic brain injury (TBI). Therefore, we collected consecutive intraoperative ICP readings during the different steps of DH and durotomy in TBI patients...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28163065/a-standardized-method-to-measure-brain-shifts-with-decompressive-hemicraniectomy
#8
Askiel Bruno, Abdurrehman Zahran, Nina Paletta, Laith Maali, Fenwick T Nichols, Ramon Figueroa
BACKGROUND: A standardized, reliable, and practical method for measuring decompressive hemicraniectomy (DHC) defects and brain shifts in malignant middle cerebral artery (MCA) territory infarction is needed for reliable comparisons between computed tomography (CT) scans. Such a method could facilitate further studies on the effects of DHC. NEW METHOD: We describe and apply a method for measuring DHC defects and brain shifts on CT scans in 25 patients with malignant MCA territory infarction...
February 2, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28108618/timing-of-decompressive-hemicraniectomy-for-stroke-a-nationwide-inpatient-sample-analysis
#9
Hormuzdiyar H Dasenbrock, Faith C Robertson, Henrikas Vaitkevicius, M Ali Aziz-Sultan, Donovan Guttieres, Ian F Dunn, Rose Du, William B Gormley
BACKGROUND AND PURPOSE: Previous clinical trials were not designed to discern the optimal timing of decompressive craniectomy for stroke, and the ideal surgical timing in patients with space-occupying infarction who do not exhibit deterioration within 48 hours is debated. METHODS: Patients undergoing decompressive craniectomy for stroke were extracted from the Nationwide Inpatient Sample (2002-2011). Multivariable logistic regression evaluated the association of surgical timing with mortality, discharge to institutional care, and poor outcome (a composite end point including death, tracheostomy and gastrostomy, or discharge to institutional care)...
January 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28070645/middle-cerebral-artery-aneurysms-with-intracerebral-hematoma-the-impact-of-side-and-volume-on-final-outcome
#10
Ondrej Navratil, Kamil Duris, Vilem Juran, Eduard Neuman, Karel Svoboda, Martin Smrcka
BACKGROUND: Middle cerebral artery aneurysms (MCA aneurysms) belong to the most frequent type of intracranial aneurysms forming an intracerebral hematoma. The consequences of the hematoma-the laterality, the impact of ICH volume and size of the aneurysm with the final outcome of these patients had not been studied in detail in this location, and we focused on the analysis of these factors. METHODS: Patients with MCA aneurysms and associated intracerebral hematomas with a volume ≥10 ml were studied; these were treated from January 2006 to December 2015...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28024976/neurologic-functional-outcomes-of-decompressive-hemicraniectomy-versus-conventional-treatment-for-malignant-middle-cerebral-artery-infarction-a-systematic-review-and-meta-analysis
#11
Yu-Ping Li, Meng-Zhuo Hou, Guang-Yu Lu, Natalia Ciccone, Xing-Dong Wang, Lun Dong, Chen Cheng, Heng-Zhu Zhang
OBJECTIVE: The aims of this study were to evaluate decompressive hemicraniectomy (DHC) versus conventional treatment (CT) for patients with malignant middle cerebral artery (MCA) infarction and to investigate the impact of age and surgical timing on neurologic function and mortality. METHODS: We searched English and Chinese databases for randomized controlled trials or observational studies published before August 2016. Outcomes included good functional outcome (GFO), mortality, and National Institutes of Health Stroke Scale and Barthel index scores...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28012353/impact-of-timing-of-cranioplasty-on-hydrocephalus-after-decompressive-hemicraniectomy-in-malignant-middle-cerebral-artery-infarction
#12
Tobias Finger, Vincent Prinz, Evelyn Schreck, Alexandra Pinczolits, Simon Bayerl, Thomas Liman, Johannes Woitzik, Peter Vajkoczy
OBJECTIVE: Patients with malignant middle cerebral artery infarction frequently develop hydrocephalus after decompressive hemicraniectomy. Hydrocephalus itself and known shunt related complications after ventriculo-peritoneal shunt implantation may negatively impact patientś outcome. Here, we aimed to identify factors associated with the development of hydrocephalus after decompressive hemicraniectomy in malignant middle cerebral artery infarction. PATIENTS AND METHODS: A total of 99 consecutive patients with the diagnosis of large hemispheric infarctions and the indication for decompressive hemicraniectomy were included...
February 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27968912/decompressive-craniectomy-for-severe-middle-cerebral-artery-infarction-a-meta-analysis-of-randomised-controlled-trials
#13
Yuping Li, Mengzhuo Hou, Guangyu Lu, Natalia Ciccone, Lun Dong, Zhengcun Yan, Chen Cheng, Xingdong Wang, Hengzhu Zhang
BACKGROUND: Severe middle cerebral artery infarction is defined as an acute infarction in the entire middle cerebral artery territory. Several case series have indicated that decompressive hemicraniectomy for severe middle cerebral artery infarction is lifesaving. However, data concerning the long-term functional outcome are insufficient. We did a systematic review and meta-analysis to assess the efficacy of decompressive hemicraniectomy for patients with severe middle cerebral artery infarction...
October 2016: Lancet
https://www.readbyqxmd.com/read/27966092/attitudes-of-patients-and-relatives-toward-disability-and-treatment-in-malignant-mca-infarction
#14
Hermann Neugebauer, Matthias Schnabl, Dorothée Lulé, Peter U Heuschmann, Eric Jüttler
BACKGROUND: Attitudes among patients and relatives toward the degree of acceptable disability and the importance of aphasia are critical in deciding on decompressive hemicraniectomy (DHC) in malignant middle cerebral artery infarction (MMI). However, most MMI patients are not able to communicate their will. Furthermore, attitudes of healthy individuals and relatives may not correspond to those of stroke patients. METHODS: This is a multicenter survey among 355 patients and 199 relatives during treatment for acute minor or moderate severe ischemic stroke in Germany...
December 13, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27884858/hemicraniectomy-versus-medical-treatment-with-large-mca-infarct-a-review-and-meta-analysis
#15
Paul Alexander, Diane Heels-Ansdell, Reed Siemieniuk, Neera Bhatnagar, Yaping Chang, Yutong Fei, Yuqing Zhang, Shelley McLeod, Kameshwar Prasad, Gordon Guyatt
OBJECTIVE: Large middle cerebral artery stroke (space-occupying middle-cerebral-artery (MCA) infarction (SO-MCAi)) results in a very high incidence of death and severe disability. Decompressive hemicraniectomy (DHC) for SO-MCAi results in large reductions in mortality; the level of function in the survivors, and implications, remain controversial. To address the controversy, we pooled available randomised controlled trials (RCTs) that examined the impact of DHC on survival and functional ability in patients with large SO-MCAi and cerebral oedema...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27858578/severe-cerebral-edema-following-nivolumab-treatment-for-pediatric-glioblastoma-case-report
#16
Xiao Zhu, Michael M McDowell, William C Newman, Gary E Mason, Stephanie Greene, Mandeep S Tamber
Nivolumab is an immune checkpoint inhibitor (ICI) currently undergoing Phase III clinical trials for the treatment of glioblastoma. The authors present the case of a 10-year-old girl with glioblastoma treated with nivolumab under compassionate-use guidelines. After the first dose of nivolumab the patient developed hemiparesis, cerebral edema, and significant midline shift due to severe tumor necrosis. She was managed using intravenous dexamethasone and discharged on a dexamethasone taper. The patient's condition rapidly deteriorated after the second dose of nivolumab, demonstrating hemiplegia, seizures, and eventually unresponsiveness with a fixed and dilated left pupil...
February 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27733025/reduction-of-midline-shift-following-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction
#17
Sang-Beom Jeon, Sun U Kwon, Jung Cheol Park, Deok Hee Lee, Sung-Cheol Yun, Yeon-Jung Kim, Jae-Sung Ahn, Byung-Duk Kwun, Dong-Wha Kang, H Alex Choi, Kiwon Lee, Jong S Kim
BACKGROUND AND PURPOSE: Hemicraniectomy is a decompressive surgery used to remove a large bone flap to allow edematous brain tissue to bulge extracranially. However, early indicators of the decompressive effects of hemicraniectomy are unclear. We investigated whether reduction of midline shift following hemicraniectomy is associated with improved consciousness and survival in patients with malignant middle cerebral artery infarctions. METHODS: We studied 70 patients with malignant middle cerebral artery infarctions (MMI) who underwent hemicraniectomies...
September 2016: Journal of Stroke
https://www.readbyqxmd.com/read/27649670/size-of-bone-flap-and-bone-window-area-may-impact-the-outcome-of-decompressive-craniectomy-using-standard-bone-flap
#18
Y-S Wang, Y Wang, X-W Shi, J-D Zhang, Y-Y Ma
OBJECTIVE: To verify if the size of the bone flap and the bone window area may have an impact on the outcome of decompressive craniectomy. PATIENTS AND METHODS: From February 2012 to February 2014, 42 patients with acute intracranial hypertension were enrolled in this study. We conducted standard craniotomy and decompressive hemicraniectomy on all patients. The intracranial pressure was measured before the hemicraniectomy operation, at the time of bone flap removal, at the time of the incision of the dura mater and 24 hours after the operation...
September 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27637622/surgical-management-of-aneurysmal-hematomas-prognostic-factors-and-outcome
#19
P Meneghelli, F Cozzi, A Hasanbelliu, F Locatelli, Alberto Pasqualin
From 1991 until 2013, 304 patients with intracranial hematomas from aneurysmal rupture were managed surgically in our department, constituting 17 % of all patients with aneurysmal rupture. Of them, 242 patents presented with isolated intracerebral hematomas (in 69 cases associated with significant intraventricular hemorrhage), 50 patients presented with combined intracerebral and subdural hematomas (in 11 cases associated with significant intraventricular hemorrhage), and 12 presented with an isolated subdural hematoma...
2016: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/27591100/volume-of-brain-herniation-in-ischemic-stroke-patients-following-decompressive-craniectomy
#20
Kirsten E Stoner, Kingsley O Abode-Iyamah, Nicole M Grosland, Matthew A Howard
BACKGROUND: Decompressive craniectomy procedures are performed in patients with malignant intracranial hypertension. A bone flap is removed to relieve pressure. Later a second operation is performed to reconstruct the skull after brain swelling has resolved. This surgical treatment would be improved if it were possible to perform a single operation that decompressed the brain acutely while eliminating the need for a second operation. In order to design a device and procedure that achieves this objective it is essential to understand how the brain swells following a craniectomy procedure...
August 30, 2016: World Neurosurgery
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