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https://www.readbyqxmd.com/read/28431870/the-effect-of-hypertonic-saline-and-mannitol-on-coagulation-in-moderate-traumatic-brain-injury-patients
#1
Haifeng Wang, Hongshi Cao, Xiaohong Zhang, Liang Ge, Li Bie
BACKGROUND: Hyperosmolar therapy, using either hypertonic saline (HTS) or mannitol (MT), is considered the treatment of choice for intracranial hypertension, a disorder characterized by high intracranial pressure (ICP). However, hyperosmolar agents have been postulated to impair coagulation and platelet function. The aim of this study was to identify whether HTS and MT could affect coagulation in moderate traumatic brain injury (TBI) patients. METHODS: In this prospective and randomized double-blind study, we included adult patients with moderate TBI...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28342705/comparison-of-20-mannitol-and-3-hypertonic-saline-on-intracranial-pressure-and-systemic-hemodynamics
#2
Navdeep Sokhal, Girija Prasad Rath, Arvind Chaturvedi, Manmohan Singh, Hari Hara Dash
Mannitol and hypertonic saline (HS) are most commonly used hyperosmotic agents for intraoperative brain relaxation. We compared the changes in ICP and systemic hemodynamics after infusion of equiosmolar solutions of both agents in patients undergoing craniotomy for supratentorial tumors. Forty enrolled adults underwent a standard anesthetic induction. Apart from routine monitoring parameters, subdural ICP with Codmann catheter and cardiac indices by Vigileo monitor, were recorded. The patients were randomized to receive equiosmolar solutions of either 20% mannitol (5ml/kg) or 3% HS (5...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28319185/real-time-monitoring-of-human-blood-brain-barrier-disruption
#3
Vesa Kiviniemi, Vesa Korhonen, Jukka Kortelainen, Seppo Rytky, Tuija Keinänen, Timo Tuovinen, Matti Isokangas, Eila Sonkajärvi, Topi Siniluoto, Juha Nikkinen, Seppo Alahuhta, Osmo Tervonen, Taina Turpeenniemi-Hujanen, Teemu Myllylä, Outi Kuittinen, Juha Voipio
Chemotherapy aided by opening of the blood-brain barrier with intra-arterial infusion of hyperosmolar mannitol improves the outcome in primary central nervous system lymphoma. Proper opening of the blood-brain barrier is crucial for the treatment, yet there are no means available for its real-time monitoring. The intact blood-brain barrier maintains a mV-level electrical potential difference between blood and brain tissue, giving rise to a measurable electrical signal at the scalp. Therefore, we used direct-current electroencephalography (DC-EEG) to characterize the spatiotemporal behavior of scalp-recorded slow electrical signals during blood-brain barrier opening...
2017: PloS One
https://www.readbyqxmd.com/read/28285405/the-effects-of-blood-and-blood-products-on-the-arachnoid-cell
#4
Eric A Hansen, Liudmila Romanova, Christopher Janson, Cornelius H Lam
After traumatic brain injury (TBI), large amounts of red blood cells and hemolytic products are deposited intracranially creating debris in the cerebrospinal fluid (CSF). This debris, which includes heme and bilirubin, is cleared via the arachnoid granulations and lymphatic systems. However, the mechanisms by which erythrocytes and their breakdown products interfere with normal CSF dynamics remain poorly defined. The purpose of this study was to model in vitro how blood breakdown products affect arachnoid cells at the CSF-blood barrier, and the extent to which the resorption of CSF into the venous drainage system is mechanically impaired following TBI...
March 11, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28258418/comparison-of-equiosmolar-hypertonic-saline-and-mannitol-for-brain-relaxation-during-craniotomies-a-meta-analysis-of-randomized-controlled-trials
#5
REVIEW
Jingxue Fang, Yanzhang Yang, Wei Wang, Yang Liu, Tong An, Meijuan Zou, Gang Cheng
There is a controversy about the effects of hypertonic saline (HS) used for brain relaxation in patients requiring craniotomies. We conducted a meta-analysis to compare the efficacy of equiosmolar hypertonic saline with mannitol on intraoperative brain relaxation in patients undergoing craniotomies. We searched PubMed, EMBASE, Cochrane Library databases, and Web of Science for randomized controlled trials (RCTs). The outcome indicators included brain relaxation, hemodynamic status, fluid volume, and blood chemistry...
March 3, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28187815/principles-of-intracranial-pressure-monitoring-and-treatment
#6
REVIEW
M Czosnyka, J D Pickard, L A Steiner
Intracranial pressure (ICP) is governed by volumes of intracranial blood, cerebrospinal fluid, and brain tissue. Expansion of any of these volumes will trigger compensatory changes in the other compartments, resulting in initially limited change in ICP. Due to the rigid skull, once compensatory mechanisms are exhausted, ICP rises very rapidly. Intracranial hypertension is associated with unfavorable outcome in brain-injured patients. This chapter discusses the pathophysiology of raised ICP, as well as typical waveforms, monitoring techniques, and clinical management...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28175535/376%C3%A2-the-salt-versus-sugar-debate-urinary-sodium-losses-following-hypertonic-saline-administration-curtails-its-superior-osmolar-effect-in-comparison-to-mannitol-in-severe-traumatic-brain-injury
#7
Aniruddha Tekkatte Jagannatha, Sriganesh Kamath, Indira Devi, Umamaheswara G S Rao
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28103265/rabbit-model-of-human-gliomas-implications-for-intra-arterial-drug-delivery
#8
Huamin Qin, Miroslaw Janowski, Monica S Pearl, Izabela Malysz-Cymborska, Shen Li, Charles G Eberhart, Piotr Walczak
The prognosis for malignant brain tumors remains poor despite a combination of surgery, radiotherapy, and chemotherapy. This is partly due to the blood-brain barrier, a major obstacle that prevents therapeutic agents from effectively reaching the tumor. We have recently developed a method for precise and predictable opening of the blood-brain barrier via the intra-arterial administration of mannitol, a hyperosmolar agent, in a rabbit model, whose vascular anatomy facilitates the use of standard interventional neuroradiology techniques and devices...
2017: PloS One
https://www.readbyqxmd.com/read/28065791/neuroprotective-strategies-for-patients-with-acute-myocardial-infarction-combined-with-hypoxic-ischemic-encephalopathy-in-the-icu
#9
Weiwei Hu, Yali Chao, Xiaojuan Geng
BACKGROUND: We investigated neuroprotective treatment strategies for patients with acute myocardial infarction (AMI) complicated with hypoxic ischemic encephalopathy (HIE) in the ICU. METHODS: The 83 cases diagnosed with secondary AMI were, for the first time, divided into an observation group (n = 43) and control group (n = 40). All of the patients underwent emergency or elective PCI. Patients in the control group were treated with mannitol to reduce intracranial pressure and cinepazide maleate to improve microcirculation in the brain as well as given a comprehensive treatment with oxygen inhalation, fluid infusion, acid-base imbalance correction and electrolyte disturbance...
January 5, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28017126/recent-advances-in-transcranial-focused-ultrasound-fus-triggered-brain-delivery
#10
Nidhi Nainwal
Successful delivery of therapeutic agents in the brain is very challenging, which makes treatment of various brain disorders very difficult. One of the major causes of this difficulty is the presence of physiological barriers in the brain like blood brain barrier (BBB) and blood cerebro-spinal fluid (CSF) barrier. These barriers are very specific and restrict the entry of water soluble agents and ionized molecule. Only lipid soluble and small molecular size agents are allowed to enter into the brain. But there are several serious brain diseases in which the use of only conventional small molecular mass lipophilic drug is not effective...
December 22, 2016: Current Drug Targets
https://www.readbyqxmd.com/read/27923631/the-influence-of-fibroblast-on-the-arachnoid-leptomeningeal-cells-in-vitro
#11
Cornelius H Lam, Liudmila Romanova, Allison Hubel, Christopher Janson, Eric A Hansen
OBJECTIVE: Fibroblast is pervasive in the setting of injury. Its invasion into the arachnoid tissue causes scarring, cortical adhesion of the brain, and obstruction of cerebrospinal fluid outflow. The purpose of this study is to determine the phenotypic and physiologic effects of fibroblasts on arachnoid in culture. METHODS: We studied the effects of fibroblast on the arachnoid cell growth, motility, phenotypic changes, and transport properties. Immortalized rat (Rattus norvegicus, Sprague Dawley breed) arachnoid cells were grown with fibroblast on opposite sides of polyethylene membranes or co-cultured in plastic wells...
December 3, 2016: Brain Research
https://www.readbyqxmd.com/read/27923162/comparison-of-different-osmotic-therapies-in-a-mouse-model-of-traumatic-brain-injury
#12
COMPARATIVE STUDY
Vinoth K M Khandelwal, Prabhakar Singh, Tatiana Ravingerova, Marslin Gregory, Hardik Gandhi, Manu Chaudhary
BACKGROUND: Inflammation in the affected region, increased intracranial pressure, consequent oedema and congestion contribute to the negative outcome of traumatic brain injury. Osmotic therapies are recommended for improvement in cognitive and motor functions. Aim of the present study was to evaluate the effect of osmotic therapies in a mice model of traumatic brain injury. METHODS: Experimental closed head injury was performed in adult Swiss albino mice by the weight-drop method...
February 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/27867922/palliative-resection-of-metastatic-brain-tumors-previously-treated-by-stereotactic-radiosurgery
#13
Yoo Sung Jeon, Young-Cho Koh, Sang Woo Song, Joon Cho, So Dug Lim
BACKGROUND: Therapeutic approaches to brain metastases include surgery, whole-brain radiotherapy, stereotactic radiosurgery (SRS), and combination therapy. Recently, postoperative or preoperative SRS draws more attention to reduce postoperative recurrence in brain metastases. The goal of this study is to review surgical outcome of patients who had been treated by SRS, and to discuss the effectiveness of preoperative SRS. METHODS: From 2009 to 2015, 174 patients were treated by SRS for brain metastases, and among these 50 patients underwent surgery...
October 2016: Brain Tumor Research and Treatment
https://www.readbyqxmd.com/read/27857907/clinical-outcome-of-acute-epidural-hematoma-in-korea-preliminary-report-of-285-cases-registered-in-the-korean-trauma-data-bank-system
#14
Young Ha Jeong, Ji Woong Oh, Sungmin Cho
OBJECTIVE: The aim of this preliminary collaborative study was to assess the clinical characteristics, management, and outcome of epidural hematoma (EDH) based on the data collected and registered in the Korean Trauma Data Bank System (KTDBS). METHODS: Of 2,698 patients registered in the KTDBS between September 2010 and March 2014, 285 patients with EDH were analyzed. Twenty-three trauma centers participated in the study voluntarily to collect data. We subcategorized the patients into two groups with good and poor outcomes...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27854097/optimizing-the-delivery-of-antineoplastic-therapies-to-the-central-nervous-system
#15
REVIEW
Jarushka Naidoo, Hardik Panday, Sadhana Jackson, Stuart A Grossman
Despite significant advances in the treatment of systemic cancers, progress in the treatment of primary brain tumors has been quite modest. In addition, an increasing proportion of patients with systemic cancers are presenting with brain-only metastases. These observations highlight the critical role that the blood-brain barrier plays in preventing antineoplastic therapies from reaching the central nervous system in therapeutic concentrations. This review describes the anatomy of the blood-brain barrier and currently available methods to quantify the entry of therapeutic compounds into the brain...
November 15, 2016: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/27851869/intracerebral-synthesis-of-glutamine-from-hyperpolarized-glutamate
#16
Leslie Mazuel, Rolf F Schulte, Aurélie Cladière, Claudine Spéziale, Marie Lagrée, Martin Leremboure, Betty Jean, Franck Durif, Carine Chassain
PURPOSE: Changes in glutamate (Glu) levels occur in a number of neurodegenerative diseases. We proposed the use of (13)C spectroscopy and the highly amplified signal generated by hyperpolarization to achieve spatial and temporal resolutions adequate for in vivo studies of Glu metabolism in the healthy rat brain. Thus, we investigated uptake of hyperpolarized [1(-13C)]Glu after a temporary blood-brain barrier (BBB) disruption protocol and its conversion to glutamine (Gln) in the brain...
November 8, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/27849336/durability-of-single-dose-intra-arterial-bevacizumab-after-blood-brain-barrier-disruption-for-recurrent-glioblastoma
#17
Shamik Chakraborty, Christopher G Filippi, Jan-Karl Burkhardt, Sherese Fralin, Ashley Ray, Tamika Wong, Rafael Ortiz, David J Langer, John A Boockvar
BACKGROUND: Bevacizumab (BV) has been used to treat recurrent glioblastoma with a progression free survival of approximately 3-3.5 months. Typically, it is administered intravenously every 2-3 weeks at dosages ranging from 5-15 mg/kg. Serious side effects include GI tract perforations, hematologic disorders, intracranial hemorrhage, and malignant hypertension. We hypothesized that selective intracranial intra-arterial infusion (SIACI) of BV following blood/brain barrier disruption (BBBD) with mannitol may allow for reduced dosage, lower toxicity, and equivalent or superior progression free survival (PFS)...
November 2016: Journal of Experimental Therapeutics & Oncology
https://www.readbyqxmd.com/read/27777397/evaluation-of-the-maintained-effect-of-3-hypertonic-saline-solution-in-an-animal-model-of-intracranial-hypertension
#18
Leonardo M Sousa, Almir F de Andrade, Alessandro R Belon, Matheus S Soares, Robson Luis Amorim, Jose Pinhata Otochi, Manoel J Teixeira, Wellingson S Paiva
BACKGROUND Current clinical treatment methods for refractory intracranial hypertension include elevation of the decubitus, ventilation adjustment, and use of hypertonic solutions such as hypertonic saline and mannitol solutions. Previous studies have shown that hypertonic solutions are particularly effective. Although several concentrations of saline solution have been proposed, a 3% solution is the most widely used. The aim of this study was to evaluate the maintained efficacy of a 3% hypertonic saline solution in an experimental model of intracranial hypertension...
October 25, 2016: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/27626493/review-traumatic-brain-injury-and-hyperglycemia-a-potentially-modifiable-risk-factor
#19
REVIEW
Jia Shi, Bo Dong, Yumin Mao, Wei Guan, Jiachao Cao, Rongxing Zhu, Suinuan Wang
Hyperglycemia after severe traumatic brain injury (TBI) occurs frequently and is associated with poor clinical outcome and increased mortality. In this review, we highlight the mechanisms that lead to hyperglycemia and discuss how they may contribute to poor outcomes in patients with severe TBI. Moreover, we systematically review the proper management of hyperglycemia after TBI, covering topics such as nutritional support, glucose control, moderated hypothermia, naloxone, and mannitol treatment. However, to date, an optimal and safe glycemic target range has not been determined, and may not be safe to implement among TBI patients...
October 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/27593830/the-effects-of-stereotactic-cerebroventricular-administration-of-albumin-mannitol-hypertonic-sodium-chloride-glycerin-and-dextran-in-rats-with-experimental-brain-edema
#20
Tuncay Ateş, Yurdal Gezercan, Güner Menekşe, Yusuf Türköz, Hakan Parlakpinar, Ali İhsan Ökten, Yener Akyuva, Selami Çağatay Önal
AIM: We aimed to evaluate the effects of cerebroventricular administration of hyperoncotic/hyperosmotic agents on edematous tissue in rats with experimental head trauma. MATERIAL AND METHODS: The study included 54 female Sprague-Dawley rats with weights ranging between 200-250 g. Six experimental groups were examined with each group containing 9 rats. All rats were exposed to head trauma, and treatment groups were administered 2 microliters of one of the drugs (albumin, mannitol, hypertonic sodium chloride (NaCl),glycerin and dextran) 6, 12 and 24 hours after the trauma via the cerebroventricular route and using a stereotactic device...
May 25, 2016: Turkish Neurosurgery
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