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Intracerebral hematoma after brain surgery

Kamran A Abid, Oluwaseun A Sobowale, Laura M Parkes, Josephine Naish, Geoff J M Parker, Daniel du Plessis, David Brough, Jack Barrington, Stuart M Allan, Rainer Hinz, Adrian R Parry-Jones
BACKGROUND AND PURPOSE: Studies in animal models suggest that inflammation is a major contributor to secondary injury after intracerebral hemorrhage (ICH). Direct, noninvasive monitoring of inflammation in the human brain after ICH will facilitate early-phase development of anti-inflammatory treatments. We sought to investigate the feasibility of multimodality brain imaging in subacute ICH. METHODS: Acute ICH patients were recruited to undergo multiparametric MRI (including dynamic contrast-enhanced measurement of blood-brain barrier transfer constant (K(trans) ) and PET with [(11) C]-(R)-PK11195)...
October 24, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Yuqian Li, Jiancai Wang, Zhihong Li, Xingye Zhang, Bo Tian, Yanlong Yang, Min Li, Bao Wang, Yi Xia, Tao Ma, Yang Yang, Guodong Gao, Lihong Li
BACKGROUND: Ultra-early surgical clot removal relieves mechanical compression on adjacent normal brain tissue and limits the toxic effects of a hematoma, which might improve the outcomes in patients with intracerebral hemorrhage (ICH); however, hematoma expansion frequently occurs within 20 h after the ictus, and this limits the use of ultra-early surgery. CT-angiography (CTA) spot sign was recently validated as an important predictor of hematoma expansion in ICH patients. METHODS: 59 ICH patients with negative spot sign who received ultra-early stereotactic aspiration (< 6 h after ictus; n = 32 [Ultra-early group]) or routine stereotactic aspiration (≥ 6 h after ictus; n = 27 [Routine group]) were included in retrospective analysis...
September 27, 2017: World Neurosurgery
Aleena Khan, Muhammad Waqas, Waseem M Nizamani, Muhammad E Bari
BACKGROUND: Mycotic aneurysm is a rare potentially life-threatening complication of infective endocarditis (IE). Little data is available on the management and outcomes of ruptured mycotic aneurysms with large intracerebral hematoma. Few cases have been described on the management of mycotic aneurysm in the presence of life-threatening hematoma and mass effect. CASE DESCRIPTION: We are presenting two cases of ruptured mycotic aneurysm with intracerebral hematoma and impending brain herniation...
2017: Surgical Neurology International
Juan Wang, Gaiqing Wang, Jinying Yi, Yi Xu, Shuna Duan, Tong Li, Xin-Gang Sun, Liang Dong
BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) is a particularly devastating form of stroke with high mortality and morbidity. Hematomas are the primary cause of neurologic deficits associated with ICH. The products of hematoma are recognized as neurotoxins and the main contributors to edema formation and tissue damage after ICH. Finding a means to efficiently promote absorption of hematoma is a novel clinical challenge for ICH. Peroxisome proliferator-activated receptor gamma (PPARγ) and nuclear factor erythroid 2-related factor 2 (Nrf2), had been shown that, can take potential roles in the endogenous hematoma clearance...
June 24, 2017: Brain Research Bulletin
Sung Ho Jang, Jeong Pyo Seo
RATIONALE: We report on restoration of the ascending reticular activating system (ARAS), compressed by an intracerebral hematoma and perihematomal edema following a stroke. The restoration of the ARAS was demonstrated by diffusion tensor tractography (DTT). PATIENT CONCERNS: In a 60-year-old male, a brain MRI taken at 2 weeks after the surgery showed a hematoma and perihematomal edema in the left posterolateral pons and cerebellum, which were markedly resolved on a brain MRI after 5 weeks...
February 2017: Medicine (Baltimore)
Guofeng Wu, Fan Wang, Likun Wang, Jing Shi, Hui Yu, Yingjun Zhang
BACKGROUND: Diffusion tensor imaging was used to observe the effects of performing early minimally invasive surgery (MIS) on internal capsule in dog model of intracerebral hemorrhage (ICH). METHODS: Twenty-five male dogs were selected to prepare an ICH model, and then they were randomly distributed into a model control (MC) group (5 dogs) or an MIS group (20 dogs). In the MIS group, the intracerebral hematoma was evacuated by stereotactic minimally invasive procedures over 6 hours (5 dogs), 12 hours (5 dogs), 18 hours (5 dogs), or 24 hours (5 dogs) after successful induction of ICH...
April 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Hongzhi Xu, Zhiyong Qin, Ming Xu, Chunjui Chen, Junjie Zhang, Xiancheng Chen
BACKGROUND: Intraoperative ultrasonography is widely used in neurosurgery for the management of intracerebral hematoma and brain tumor. However, the clinical value of this method in the surgery of cerebral arteriovenous malformations (AVMs) has not been reported. In this study, the application of intraoperative ultrasonography for AVM surgery was evaluated prospectively. METHODS: This prospective clinical study comprised 41 patients who underwent microsurgical resection of cerebral AVMs at our institute...
January 2017: World Neurosurgery
Yu A Grigoryan, A R Sitnikov, A V Timoshenkov, G Yu Grigoryan
UNLABELLED: The mediobasal temporal region (MTR) is located near the brain stem and surrounded by the eloquent neurovascular structures. The supracerebellar transtentorial approach (STA) is safe access to the posterior MTR structures, however its use for resection of anterior MTR lesions still remains controversial. The article describes the technique and outcome of surgery for different MTR structures using STA. MATERIAL AND METHODS: The paramedian STA was used in 18 patients (13 females and 5 males) for 7 years...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Raimund Helbok, Alois Josef Schiefecker, Christian Friberg, Ronny Beer, Mario Kofler, Paul Rhomberg, Iris Unterberger, Elke Gizewski, John Hauerberg, Kirsten Möller, Peter Lackner, Gregor Broessner, Bettina Pfausler, Martin Ortler, Claudius Thome, Erich Schmutzhard, Martin Fabricius
Pathophysiologic mechanisms of secondary brain injury after intracerebral hemorrhage and in particular mechanisms of perihematomal-edema progression remain incompletely understood. Recently, the role of spreading depolarizations in secondary brain injury was established in ischemic stroke, subarachnoid hemorrhage and traumatic brain injury patients. Its role in intracerebral hemorrhage patients and in particular the association with perihematomal-edema is not known. A total of 27 comatose intracerebral hemorrhage patients in whom hematoma evacuation and subdural electrocorticography was performed were studied prospectively...
May 2017: Journal of Cerebral Blood Flow and Metabolism
Radek Frič, John K Hald, Ellen-Ann Antal
BACKGROUND AND STUDY OBJECT: We report an unusual case of a benign lateral sphenoid wing meningioma that presented with, and was masked by, an acute intracerebral hemorrhage. CASE REPORT: A 68-year-old woman was admitted after sudden onset of coma. Computed tomography (CT) revealed an intracerebral hemorrhage, without any underlying vascular pathology on CT angiography. During the surgery, we found a lateral sphenoid wing meningioma with intratumoral bleeding that extended into the surrounding brain parenchyma...
2016: Journal of Central Nervous System Disease
Guofeng Wu, Junjie Wu, Likun Wang, Yu Jiao, Houguang Zhou, Zhouping Tang
OBJECTIVES: To observe the effects of minimally invasive surgery (MIS) for intracerebral hematoma (ICH) evacuation followed by rosiglitazone infusion therapy on peroxisome proliferator-activated receptor-gamma (PPARγ), blood-brain barrier (BBB) permeability, and neurological function. METHODS: A total of 75 male rabbits (2.8-3.4 kg) were randomly assigned to a normal control group (NC group), a model control group (MC group), a rosiglitazone group (RSG group), a minimally invasive treatment group (MIS group) or a MIS combined with rosiglitazone group (MIS+RSG group)...
March 2016: Neurological Research
Jun Zheng, Hao Li, He-Xiang Zhao, Rui Guo, Sen Lin, Wei Dong, Lu Ma, Yuan Fang, Meng Tian, Ming Liu, Chao You
Spontaneous intracerebral hemorrhage (sICH) is one of the most dangerous cerebrovascular diseases, especially when in deep brain. The treatment of spontaneous deep supratentorial intracerebral hemorrhage is still controversial. We conducted a retrospective case-control study using propensity score matching to compare the efficacy of surgery and conservative treatment for patients with deep surpatentorial hemorrhage. We observed the outcomes of consecutive patients with spontaneous deep supratentorial hemorrhage retrospectively from December 2008 to July 2013...
March 2016: Medicine (Baltimore)
Sun-Chul Hwang, Dong-Gyu Yeo, Dong-Seong Shin, Bum-Tae Kim
BACKGROUND: Although the functional efficacy of surgical evacuation of an intracerebral hematoma (ICH) remains controversial, it has a valuable role for managing ICHs. Endoscopic surgery is increasingly used to evacuate ICHs; however, the narrow rigid sheath may be limiting. We report the usefulness of a soft plastic membrane sheath for endoscopic evacuation of ICHs. METHODS: The 20 × 100-mm flat membrane sheath was made of polyester film. Before introducing the sheath into the ICH cavity under navigation, one side was tucked into the opposite side to make a narrow four-layered tube...
June 2016: World Neurosurgery
Christian Fung, Michael Murek, Pascal P Klinger-Gratz, Michael Fiechter, Werner J Z'Graggen, Oliver P Gautschi, Marwan El-Koussy, Jan Gralla, Karl Schaller, Martin Zbinden, Marcel Arnold, Urs Fischer, Heinrich P Mattle, Andreas Raabe, Jürgen Beck
BACKGROUND: Perihematomal edema contributes to secondary brain injury in the course of intracerebral hemorrhage. The effect of decompressive surgery on perihematomal edema after intracerebral hemorrhage is unknown. This study analyzed the course of PHE in patients who were or were not treated with decompressive craniectomy. METHODS: More than 100 computed tomography images from our published cohort of 25 patients were evaluated retrospectively at two university hospitals in Switzerland...
2016: PloS One
Hyuk Jin Choi, Jae Il Lee, Kyoung Hyup Nam, Jun Kyeung Ko
Acute subdural hematoma (SDH) of arterial origin is rare, especially SDH associated with an arteriovenous malformation (AVM) is extremely rare. The authors report a case of acute spontaneous SDH due to rupture of a tiny cortical AVM. A 51-year-old male presented with sudden onset headache and mentality deterioration without a history of trauma. Brain CT revealed a large volume acute SDH compressing the right cerebral hemisphere with subfalcine and tentorial herniation. Emergency decompressive craniectomy was performed to remove the hematoma and during surgery a small (5 mm sized) conglomerated aciniform mass with two surrounding enlarged vessels was identified on the parietal cortex...
December 2015: Journal of Korean Neurosurgical Society
U R Krause-Titz, N Warneke, S Freitag-Wolf, H Barth, H M Mehdorn
After performing a decompressive craniectomy, a cranioplastic surgery is usually warranted. The complications of this reconstructive procedure may differ from the initial operation. The authors of this study report on their experience to define patient-specific and procedural risk factors for possible complications following cranioplasty influencing the outcome (Glasgow Outcome Scale (GOS)), mobility, shunt dependency, and seizures. A retrospective analysis of 263 patients of all ages and both sexes who had undergone cranioplasty after craniectomy for traumatic brain injury (including chronic subdural hematoma), subarachnoidal hemorrhage (including intracerebral hemorrhage), ischemic stroke, and tumor surgery in one single center in 12 years from January 2000 to March 2012 has been carried out...
January 2016: Neurosurgical Review
Clarissa Nóbrega Gambarra Nascimento, Robson Luis Amorim, Maurício Mandel, Marcelo Prudente do Espírito Santo, Wellingson Silva Paiva, Almir Ferreira Andrade, Manoel Jacobsen Teixeira
The endoscopic technique has been described as a minimally invasive method for spontaneous hematoma evacuation, as a safe and effective treatment. Nevertheless, to our knowledge, there is no description of a technical report of traumatic intracerebral hematoma removal using the neuroendoscope. A 47-year-old man was admitted sustaining 13 points in Glasgow coma scale with brain computed tomography (CT) scan showing a temporal contusion. Guided by a 3D reconstructed CT, using the program OsiriX®, the posterior limit of the hematoma was identified...
2015: Journal of Surgical Case Reports
Frédéric Rossi-Mossuti, Urs Fisch, Patrick Schoettker, Marinella Gugliotta, Marc Morard, Philippe Schucht, Bawarjan Schatlo, Marc Levivier, Bernhard Walder, Javier Fandino
OBJECTIVE: Since the introduction of modern surgical techniques and monitoring tools for the treatment of severe traumatic brain injury (TBI) in Switzerland, standardized nationwide operative procedures are still lacking. This study aimed to assess surgical management and monitoring strategies in patients admitted throughout Switzerland with severe TBI. METHODS: Demographic, clinical, and radiologic data from a prospective national cohort study on severe brain-injured patients (Patient-relevant Endpoints after Brain Injury from Traumatic Accidents [PEBITA]) were collected during a 3-year period...
January 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Long Chen, Xue-Gang Jin, Jian-Fang Zhu, Hui-Juan Li, Yan-Ping Wang, You-Xin Zhou, Jian Wang, Wen-Hua Wang
OBJECTIVE: To explore the expression of transferrin (Tf) and transferrin receptor (TfR) in hematoma brain tissue at different stage after intracerebral hemorrhage (ICH) in rats. METHODS: ICH rats model were established by collagenase method, and rats were sacrificed at 24 h, 72 h, 7 d and 14 d after operation. The levels of Tf and TfR in different periods of rats were detected by immunohistochemical method, and correlation between two groups was analyzed. RESULTS: Tf, TfR-positive cells at each time after operation in observation group were significantly higher than that in control group (P < 0...
July 2015: Asian Pacific Journal of Tropical Medicine
Xi-Chang Liu, Li-Yan Jing, Ming-Feng Yang, Kun Wang, Yuan Wang, Xiao-Yan Fu, Jie Fang, Ya-Jun Hou, Jing-Yi Sun, Da-Wei Li, Zong-Yong Zhang, Lei-Lei Mao, You-Mei Tang, Xiao-Ting Fu, Cun-Dong Fan, Xiao-Yi Yang, Bao-Liang Sun
Hypothermia treatment is one of the neuroprotective strategies that improve neurological outcomes effectively after brain damage. Minimally invasive surgery (MIS) has been an important treatment of intracerebral hemorrhage (ICH). Herein, we evaluated the neuroprotective effect and mechanism of MIS joint local cooling lavage (LCL) treatment on ICH via detecting the inflammatory responses, oxidative injury, and neuronal apoptosis around the hematoma cavity in rats. ICH model was established by type IV collagenase caudatum infusion...
July 2016: Cellular and Molecular Neurobiology
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