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https://www.readbyqxmd.com/read/28929294/neurologic-complications-of-infective-endocarditis-recent-findings
#1
REVIEW
Marie Cantier, Mikael Mazighi, Isabelle Klein, J P Desilles, Michel Wolff, J F Timsit, Romain Sonneville
PURPOSE OF REVIEW: The purpose of this paper is to provide recent insights in management of neurologic complications of left-sided infective endocarditis (IE). RECENT FINDINGS: Cerebral lesions observed in IE patients are thought to involve synergistic pathophysiological mechanisms including thromboembolism, sepsis, meningitis, and small-vessel cerebral vasculitis. Brain MRI represents a major tool for the detection of asymptomatic events occurring in the majority of patients...
September 19, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28920537/magnetic-resonance-imaging-and-brain-injury-in-the-chronic-phase-after-aneurysmal-subarachnoid-hemorrhage-a-systematic-review
#2
Bertine L Stehouwer, Lisa A van der Kleij, Jeroen Hendrikse, Gabriel Je Rinkel, Jill B De Vis
Background Case-fatality rates after aneurysmal subarachnoid hemorrhage have decreased over the past decades. However, many patients who survive an aneurysmal subarachnoid hemorrhage have long-term functional and cognitive impairments. Aims We sought to review all data on conventional brain MRI obtained in the chronic phase after aneurysmal subarachnoid hemorrhage to (1) analyze the proportion of patients with cerebral infarction or brain volume changes; (2) investigate baseline determinants predictive of MRI-detected damage; and (3) assess if brain damage is predictive of patient outcome...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28919227/asymptomatic-ischemic-risks-in-microsurgical-clipping-for-unruptured-intracranial-aneurysms-in-anterior-circulation
#3
Katsuhiro Shinagawa, Toshinori Matsushige, Takahito Okazaki, Daizo Ishii, Nobuhiko Ichinose, Shigeyuki Sakamoto, Kaoru Kurisu
BACKGROUND: The ischemic risk in prophylactic treatments of unruptured intracranial aneurysms (UIAs) is a serious health concern. OBJECTIVE: The aim of this study was to elucidate the incidence and characteristics of ischemic events in microsurgical clipping (MC) of anterior circulation UIAs. METHODS: Ischemic events were prospectively evaluated before and after surgery between April 2011 and March 2017. The location, volume, minimum value of apparent diffusion coefficient (ADCMIN) in high-intensity spots (HIS) on 3T MR Diffusion-weighted imaging (DWI), and radiographic outcomes were analyzed...
September 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28913704/impact-of-etiology-age-and-gender-on-onset-and-severity-of-hyponatremia-in-patients-with-hypopituitarism-retrospective-analysis-in-a-specialised-endocrine-unit
#4
Dragana Miljic, Mirjana Doknic, Marko Stojanovic, Marina Nikolic-Djurovic, Milan Petakov, Vera Popovic, Sandra Pekic
BACKGROUND: Hyponatremia can unmask hypopituitarism and secondary adrenal insufficiency. This is important, since the need to screen for steroid deficiency, in patients with hyponatremia is often neglected. PATIENTS AND METHODS: In a retrospective study, twenty-five patients (13f/12m, age 58.9 ± 18.6 years) with hyponatremia (119.7 ± 10.5 mmol/L) were identified among 260 in-patients treated for hypopituitarism in our specialized endocrine unit, over the last decade...
September 14, 2017: Endocrine
https://www.readbyqxmd.com/read/28900857/endovascular-biopsy-in-vivo-cerebral-aneurysm-endothelial-cell-sampling-and-gene-expression-analysis
#5
Daniel L Cooke, David B McCoy, Van V Halbach, Steven W Hetts, Matthew R Amans, Christopher F Dowd, Randall T Higashida, Devon Lawson, Jeffrey Nelson, Chih-Yang Wang, Helen Kim, Zena Werb, Charles McCulloch, Tomoki Hashimoto, Hua Su, Zhengda Sun
There is limited data describing endothelial cell (EC) gene expression between aneurysms and arteries partly because of risks associated with surgical tissue collection. Endovascular biopsy (EB) is a lower risk alternative to conventional surgical methods, though no such efforts have been attempted for aneurysms. We sought (1) to establish the feasibility of EB to isolate viable ECs by fluorescence-activated cell sorting (FACS), (2) to characterize the differences in gene expression by anatomic location and rupture status using single-cell qPCR, and (3) to demonstrate the utility of unsupervised clustering algorithms to identify cell subpopulations...
September 13, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28899830/simple-lateral-suboccipital-approach-and-modification-for-vertebral-artery-aneurysms-a-study-of-52-cases-over-10-years
#6
Mardjono Tjahjadi, Behnam Rezai-Jahromi, Joseph Serrone, Ville Nurminen, Joham Choque-Velasquez, Riku Kivisaari, Hanna Lehto, Mika Niemelä, Juha Hernesniemi
INTRODUCTION: Complex skull base approaches are frequently used to treat intracranial vertebral artery (VA) and proximal posterior inferior cerebellar artery (PICA) aneurysms. These complex procedures are associated with higher risk of neurovascular injury. Hence, a less invasive surgical approach is needed to improve treatment's efficacy and safety. MATERIAL AND METHODS: A retrospective analysis was conducted on clinical and radiological data from surgeries where simple lateral suboccipital and "lateral enough" approaches were used to clip VA aneurysms in the Department of Neurosurgery at Helsinki University Central Hospital from 2000 - 2009...
September 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28894586/a-pilot-study-on-the-impact-of-dopamine-serotonin-and-brain-derived-neurotrophic-factor-genotype-on-long-term-functional-outcomes-after-subarachnoid-hemorrhage
#7
Ansley Stanfill, Claire Simpson, Paula Sherwood, Samuel Poloyac, Elizabeth Crago, Hyungsuk Kim, Yvette Conley
OBJECTIVES: Many that survive an aneurysmal subarachnoid hemorrhage experience lasting physical disability, which might be improved by medications with effects on the dopaminergic, serotonergic, and brain-derived neurotrophic factor neurotransmitter systems. But it is not clear which patients are most likely to benefit from these therapies. The purpose of this pilot study was to explore the relationship of genetic polymorphisms in these pathways with 12-month functional outcomes after aneurysmal subarachnoid hemorrhage...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28892213/evaluation-of-longitudinal-and-radial-left-ventricular-functions-using-two-and-three-dimensional-echocardiography-before-and-after-intravenous-immunoglobulin-administration-in-patients-with-acute-kawasaki-disease
#8
Ikuo Hashimoto, Yu Saitou, Nao Sakata, Ko Shibata
BACKGROUND: The relationship between left ventricular (LV) function and longitudinal or radial contraction has not yet been elucidated in patients with acute Kawasaki disease (KD), especially before and after intravenous immunoglobulin (IVIG) administration. METHODS: We studied 28 KD patients without coronary aneurysms (average 3.2 years). The LV end-diastolic volume (LVEDV), end-systolic volume (LVESV), stroke volume (LVSV), and ejection fraction (LVEF) were assessed using three-dimensional echocardiography before IVIG, after IVIG administration, and in the convalescent phase...
September 11, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28887082/clinical-outcomes-after-craniotomy-for-unruptured-intracranial-aneurysm-in-patients-with-coronary-artery-disease
#9
Akira Nakamizo, Toshiyuki Amano, Satoshi Matsuo, Yuhei Michiwaki, Yutaka Fujioka, Yousuke Kawano
BACKGROUND: Coronary artery disease (CAD) patients receiving antiplatelet agents occasionally undergo craniotomy. We aimed to clarify clinical outcomes after craniotomy for unruptured intracranial aneurysm (UIA) in patients with CAD. We also aimed to identify the possible predictive factors for morbidity and surgical complications in patients on antiplatelet treatment. METHODS: We retrospectively analyzed 401 consecutive patients who had undergone craniotomy for UIA at our institution between January 2006 and December 2016...
September 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28882865/prevalence-of-intracranial-aneurysms-in-patients-with-aortic-dissection
#10
W S Jung, J H Kim, S J Ahn, S-W Song, B M Kim, K-D Seo, S H Suh
BACKGROUND AND PURPOSE: There is an uncertainty about the association between intracranial aneurysms and aortic dissection. We aimed to determine the prevalence of intracranial aneurysms in patients with aortic dissection and evaluate the independent risk factors for the presence of intracranial aneurysms in these patients. MATERIALS AND METHODS: Seventy-one patients with a confirmed aortic dissection who underwent additional brain imaging were enrolled as the aortic dissection group, and 2118 healthy individuals with brain imaging, as controls...
September 7, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28877576/unusual-location-of-hydatid-cysts-report-of-two-cases-in-the-heart-and-hip-joint-of-romanian-patients
#11
Simona Gurzu, Marius Alexandru Beleaua, Emeric Egyed-Zsigmond, Ioan Jung
Hydatid cyst is usually located in the liver and lungs, rare cases showing localization in other organs or tissues. In the unusual location, echinococcosis is an excluding diagnosis that is established only after microscopic evaluation. Our first case occurred in a 67-year-old female previously diagnosed with pulmonary tuberculosis and hospitalized with persistent pain in the hip joint. The clinical diagnosis was tuberculosis of the joint, but the presence of the specific acellular membrane indicated a hydatid cyst of the synovial membrane, without bone involvement...
August 2017: Korean Journal of Parasitology
https://www.readbyqxmd.com/read/28876566/a-survey-of-selected-key-areas-of-management-of-south-african-neurosurgical-patients
#12
C H Daniel, M D du Trevou
BACKGROUND: Previous surveys of neurosurgical patient management, including a South African (SA) survey conducted in 2001, confirmed the existence of significant dissimilarities in management on national and international levels. This survey aimed to determine current SA neurosurgical patient management and to compare this with international trends. METHOD: Questionnaires in multiple choice question (MCQ) and free text entry format covering key areas of neurosurgical practice were emailed to SA neurosurgeons following ethics approval...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28870111/the-anatomical-variation-of-the-circulus-arteriosus-cerebri-in-a-cadaver-cohort-representing-the-population-dynamics-of-the-western-cape
#13
Karen Cilliers, Willie Vorster, Benedict John Page
The literature revealed a connection between the variations of the Circulus arteriosus cerebri (CAC) and cerebrovascular disease, ischemia, stroke, aneurysms and atherosclerosis. The diameters of the vessels forming the CAC have been classified into 22 types by previous authors. The aim of this study was to assess the variation of the CAC (diameter, length and anomalies) in a cadaver cohort representing the population of the Western Cape. Thirty-nine subjects (female n = 11, male n = 28) who had died of causes unrelated to brain trauma, were obtained from Stellenbosch University...
September 5, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28867358/radiation-induced-large-vessel-cerebral-vasculopathy-in-pediatric-patients-with-brain-tumors-treated-with-proton-radiation-therapy
#14
Stephen F Kralik, Gordon A Watson, Chie-Schin Shih, Chang Y Ho, Whitney Finke, Jeffrey Buchsbaum
PURPOSE: The purpose of this research was to evaluate the incidence, time to development, imaging patterns, risk factors, and clinical significance of large vessel cerebral vasculopathy in pediatric patients with brain tumors treated with proton radiation therapy. METHODS AND MATERIALS: A retrospective study was performed on 75 consecutive pediatric patients with primary brain tumors treated with proton radiation therapy. Radiation-induced large vessel cerebral vasculopathy (RLVCV) was defined as intracranial large vessel arterial stenosis or occlusion confirmed on magnetic resonance angiography, computed tomographic angiography, catheter angiography, or a combination of these within an anatomic region with previous exposure to proton beam therapy and not present before radiation therapy...
July 12, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28865323/impact-of-antithrombotic-treatment-on-clinical-outcomes-after-craniotomy-for-unruptured-intracranial-aneurysm
#15
Akira Nakamizo, Yuhei Michiwaki, Yousuke Kawano, Toshiyuki Amano, Satoshi Matsuo, Yutaka Fujioka, Tomoyuki Tsumoto, Masahiro Yasaka, Yasushi Okada
OBJECTIVE: Patients receiving antithrombotic treatment occasionally undergo craniotomy. We aimed to explore the impact of perioperative use of antithrombotic agents on the occurrence of surgical complications and clinical outcomes in patients with unruptured intracranial aneurysm (UIA). PATIENTS AND METHODS: We retrospectively analyzed 401 consecutive patients who had undergone craniotomy for UIA at our institution between January 2006 and December 2016. Patients were divided into two groups: those who received oral antiplatelet and/or anticoagulant agents during the perioperative period (antithrombotic treatment group, n=45); and those who did not (no antithrombotic treatment group, n=356)...
August 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28859027/subarachnoid-hemorrhage-revealing-moyamoya-syndrome-in-a-patient-with-may-hegglin-anomaly
#16
Yannick Béjot, José-Luis Barnay, Adrien Chavent, Benoit Daubail, Agnès Jacquin, Apolline Kazemi, Frédéric Ricolfi, Maurice Giroud
INTRODUCTION: Moyamoya syndrome is a rare progressive cerebrovascular occlusive disease for which several associated conditions have been described. CASE REPORT: We report the case of a 76-year-old woman with a history of May-Hegglin anomaly who presented with an isolated unusual diffuse headache. Initial laboratory investigations showed only thrombocytopenia (platelet count 95000/μL). Unenhanced brain computed tomography scan revealed a small subarachnoid hemorrhage in the left frontal lobe...
September 2017: Neurologist
https://www.readbyqxmd.com/read/28858905/electroencephalogram-abnormalities-during-positional-changes-in-brain-sagging-syndrome
#17
Benziger Bensam, Heustein L Sy, Nadia Sotudeh, Paulomi K Bhalla, Sean T Hwang, David E LeDoux
PURPOSE: Brain sagging after craniotomy and clipping of a ruptured aneurysm is a rare complication. Clinical and electrographic changes in patients with a final diagnosis of intracranial hypotension are not well described, and can be mistaken on rare occasions for other entities such as nonconvulsive status epilepticus. There may be resulting delay in the diagnosis and treatment of this potentially life-threatening disorder. METHODS: Case report and imaging. RESULTS: We present a case of intracranial hypotension in which concerning continuous electroencephalogram (cEEG) and quantitative EEG (qEEG) findings were noted during active sagging of the brain, which resolved with supine positioning...
August 30, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28856460/late-onset-pompe-disease-a-genetic-radiological-correlation-on-cerebral-vascular-anomalies
#18
A Pichiecchio, S Sacco, P De Filippi, E Caverzasi, S Ravaglia, S Bastianello, C Danesino
Pompe disease is an autosomal recessive disorder in which deficiency of the lysosomal enzyme acid alpha-glucosidase results in the accumulation of glycogen mostly in muscle tissues. Several reports suggest a higher incidence of intracranial vascular abnormalities (IVAs) in this condition, as well as brain microbleeds and cerebral vasculopathy. The aim of our study was to evaluate through neuroimaging studies the incidence of these anomalies in our cohort of late-onset Pompe disease (LOPD) patients asymptomatic for cerebrovascular disease, looking for correlations with clinical and genetic data...
August 30, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28841123/optic-neuropathy-after-anterior-communicating-artery-aneurysm-clipping-3-cases-and-techniques-to-address-a-correctable-pitfall
#19
Joseph R Linzey, Kevin S Chen, Luis Savastano, B Gregory Thompson, Aditya S Pandey
Brain shifts following microsurgical clip ligation of anterior communicating artery (ACoA) aneurysms can lead to mechanical compression of the optic nerve by the clip. Recognition of this condition and early repositioning of clips can lead to reversal of vision loss. The authors identified 3 patients with an afferent pupillary defect following microsurgical clipping of ACoA aneurysms. Different treatment options were used for each patient. All patients underwent reexploration, and the aneurysm clips were repositioned to prevent clip-related compression of the optic nerve...
August 25, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28840087/posterior-inferior-cerebellar-artery-thrombosed-aneurysm-associated-with-persistent-primitive-hypoglossal-artery-successfully-treated-with-condylar-fossa-approach
#20
Norihiro Saito, Rokuya Tanikawa, Toshiyuki Tsuboi, Kosmo Noda, Nakao Ota, Shirou Miyata, Hidetoshi Matsukawa, Takeshi Yanagisawa, Fumihiro Sakakibara, Yu Kinoshita, Takanori Miyazaki, Hiroyasu Kamiyama, Sadahisa Tokuda
A 68-year-old woman presented with generalized seizure due to the left internal carotid artery (ICA) aneurysmal compression of the ipsilateral medial temporal lobe. Computed tomography angiography (CTA) revealed multiple aneurysms of the right persistent primitive hypoglossal artery (PPHA), the right ICA, and the right anterior cerebral artery (ACA). The right PPHA originated from the ICA at the level of the C1 and C2 vertebral bodies and passed through the hypoglossal canal (HC). The PPHA aneurysm was large and thrombosed, which was located at the bifurcation of the right PPHA and the right posterior inferior cerebellar artery (PICA), projecting medially to compress the medulla oblongata...
July 2017: NMC Case Rep J
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