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hemorrhagic infarction

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https://www.readbyqxmd.com/read/29350603/decision-tree-analysis-in-subarachnoid-hemorrhage-prediction-of-outcome-parameters-during-the-course-of-aneurysmal-subarachnoid-hemorrhage-using-decision-tree-analysis
#1
Isabel Charlotte Hostettler, Carl Muroi, Johannes Konstantin Richter, Josef Schmid, Marian Christoph Neidert, Martin Seule, Oliver Boss, Athina Pangalu, Menno Robbert Germans, Emanuela Keller
OBJECTIVE The aim of this study was to create prediction models for outcome parameters by decision tree analysis based on clinical and laboratory data in patients with aneurysmal subarachnoid hemorrhage (aSAH). METHODS The database consisted of clinical and laboratory parameters of 548 patients with aSAH who were admitted to the Neurocritical Care Unit, University Hospital Zurich. To examine the model performance, the cohort was randomly divided into a derivation cohort (60% [n = 329]; training data set) and a validation cohort (40% [n = 219]; test data set)...
January 19, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29349091/coexistent-ipsilateral-internal-carotid-artery-occlusion-and-cerebral-venous-thrombosis-in-hepatitis-c
#2
Karan Seegobin, Somphanh Khousakhoun, Ryan Crooks, Satish Maharaj, Cherisse Baldeo
A 58-year-old male, known to have hepatitis C virus (HCV), presented with intermittent headaches and left-sided sensorimotor symptoms. There were no focal neurological deficits on examination. Electrocardiogram was unremarkable. Computed tomography angiography head and neck displayed extracranial right internal carotid artery occlusion. Magnetic resonance imaging showed right cortical vein thrombosis, with hemorrhagic infarction. Echocardiography with bubble study was unremarkable. Hypercoagulable workup was significant for protein S deficiency...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29339434/cerebrovascular-outcomes-with-proton-pump-inhibitors-and-thienopyridines-a-systematic-review-and-meta-analysis
#3
Konark Malhotra, Aristeidis H Katsanos, Mohammad Bilal, Muhammad Fawad Ishfaq, Nitin Goyal, Georgios Tsivgoulis
BACKGROUND AND PURPOSE: Pharmacokinetic and prior studies on thienopyridine and proton pump inhibitors (PPI) coadministration provide conflicting data for cardiovascular outcomes, whereas there is no established evidence on the association of concomitant use of PPI and thienopyridines with adverse cerebrovascular outcomes. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials and cohort studies from inception to July 2017, reporting following outcomes among patients treated with thienopyridine and PPI versus thienopyridine alone (1) ischemic stroke, (2) combined ischemic or hemorrhagic stroke, (3) composite outcome of stroke, myocardial infarction (MI), and cardiovascular death, (4) MI, (5) all-cause mortality, and (6) major or minor bleeding events...
January 16, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29335333/predictors-of-in-hospital-death-after-aneurysmal-subarachnoid-hemorrhage-analysis-of-a-nationwide-database-swiss-sos-swiss-study-on-aneurysmal-subarachnoid-hemorrhage
#4
Martin Nikolaus Stienens, Menno Germans, Jan-Karl Burkhardt, Marian C Neidert, Christian Fung, David Bervini, Daniel Zumofen, Michel Röthlisberger, Serge Marbacher, Rodolfo Maduri, Thomas Robert, Martin A Seule, Philippe Bijlenga, Karl Schaller, Javier Fandino, Nicolas R Smoll, Nicolai Maldaner, Sina Finkenstädt, Giuseppe Esposito, Bawarjan Schatlo, Emanuela Keller, Oliver Bozinov, Luca Regli
BACKGROUND AND PURPOSE: To identify predictors of in-hospital mortality in patients with aneurysmal subarachnoid hemorrhage and to estimate their impact. METHODS: Retrospective analysis of prospective data from a nationwide multicenter registry on all aneurysmal subarachnoid hemorrhage cases admitted to a tertiary neurosurgical department in Switzerland (Swiss SOS [Swiss Study on Aneurysmal Subarachnoid Hemorrhage]; 2009-2015). Both clinical and radiological independent predictors of in-hospital mortality were identified, and their effect size was determined by calculating adjusted odds ratios (aORs) using multivariate logistic regression...
January 15, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29327997/mechanical-thrombectomy-in-basilar-artery-occlusion-influence-of-reperfusion-on-clinical-outcome-and-impact-of-the-first-line-strategy-adapt-vs-stent-retriever
#5
Benjamin Gory, Mikael Mazighi, Raphael Blanc, Julien Labreuche, Michel Piotin, Francis Turjman, Bertrand Lapergue
OBJECTIVE Several randomized trials have been focused on patients with anterior circulation stroke, whereas few data on posterior circulation stroke are available. Thus, new mechanical thrombectomy (MT) strategies, including a direct-aspiration first-pass technique (ADAPT), remain to be evaluated in basilar artery occlusion (BAO) patients. The authors here assessed the influence of reperfusion on outcome in BAO patients and examined whether ADAPT improves the reperfusion rate compared with stent retriever devices...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29327152/the-prevalence-and-impact-of-status-epilepticus-secondary-to-intracerebral-hemorrhage-results-from-the-us-nationwide-inpatient-sample
#6
Amol Mehta, Benjamin E Zusman, Lori A Shutter, Ravi Choxi, Ahmed Yassin, Arun Antony, Parthasarathy D Thirumala
BACKGROUND: Status epilepticus (SE) has been identified as a predictor of morbidity and mortality in many acute brain injury patient populations. We aimed to assess the prevalence and impact of SE after intracerebral hemorrhage (ICH) in a large patient sample to overcome limitations in previous small patient sample studies. METHODS: We queried the Nationwide Inpatient Sample for patients admitted for ICH from 1999 to 2011, excluding patients with other acute brain injuries...
January 11, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29325982/multiple-cerebral-infarct-with-cerebral-vasculitis-in-a-young-patient-with-ulcerative-colitis
#7
Maeng Real Park, Mun Ki Min, Ji Ho Ryu, Dae Sub Lee, Kang Ho Lee
Ulcerative colitis (UC) is a chronic and debilitating disorder, characterized by inflammation of the colonic mucosa. UC can be considered a systemic disorder but UC-related manifestations in the central nervous system (CNS) are quite rare. A 29-year-old man was admitted to the emergency department with repeated generalized tonic-clonic (GTC) type seizures. Based on brain CT, brain metastasis or hemorrhagic infarct was suspected. Diffusion-weighted image of brain MRI showed high signal in the left thalamus and heterogenous enhancement in the right parietal and left frontal lobes...
January 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29323041/central-post-stroke-pain-due-to-injury-of-the-spinothalamic-tract-in-patients-with-cerebral-infarction-a-diffusion-tensor-tractography-imaging-study
#8
Sung Ho Jang, Jun Lee, Sang Seok Yeo
Many studies using diffusion tensor tractography (DTT) have demonstrated that injury of the spinothalamic tract (STT) is the pathogenetic mechanism of central post-stroke pain (CPSP) in intracerebral hemorrhage; however, there is no DTT study reporting the pathogenetic mechanism of CPSP in cerebral infarction. In this study, we investigated injury of the STT in patients with CPSP following cerebral infarction, using DTT. Five patients with CPSP following cerebral infarction and eight age- and sex-matched healthy control subjects were recruited for this study...
December 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29322704/evaluation-of-cerebral-venous-thrombosis-by-ct-mri-and-mr-venography
#9
Pratibha Issar, Sirasapalli Chinna, Sanjeev Kumar Issar
Objective: To study and compare cerebral parenchymal changes and sinuses involvement in CT with MRI and MRV in Cerebral Venous Thrombosis patients. Method: This study was carried out in the Department of Radiodiagnosis, JLN Hospital and Research Center, Bhilai, Chhattisgarh from October 2012 to Nov 2014 and includes fifty patients of all age groups presenting with clinical symptoms of CVT, admitted in Neurology, Neurosurgery, Medicine, Pediatric, obstetric and Gynecology wards...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29322232/mechanical-thrombectomy-using-the-new-solitaire%C3%A2-platinum-stent-retriever-reperfusion-results-complication-rates-and-early-neurological-outcome
#10
Johannes Pfaff, Stefan Rohde, Tobias Engelhorn, Arnd Doerfler, Martin Bendszus, Markus Alfred Möhlenbruch
BACKGROUND AND PURPOSE: The application of radiopaque markers to the Solitaire™ stent-retriever for better visibility during mechanical thrombectomy (MT) has the potential to alter the well-known characteristics of the device; however, it is uncertain whether this adjustment influences efficacy or safety of the enhanced stent-retriever. METHODS: Retrospective analysis of stroke databases of three comprehensive stroke centers. Our investigation was focused on technical and angiographic parameters, including procedure times, reperfusion results (thrombolysis in cerebral infarction, TICI), periprocedural complications and favorable early neurological recovery at discharge (modified Rankin scale ≤2 or National Institutes of Health Stroke Scale, NIHSS = 0 or ∆NIHSS ≥ 10), from consecutive patients with acute anterior circulation ischemic stroke treated with a Solitaire™ Platinum stent-retriever between October 2016 and March 2017...
January 10, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29321395/-hmgb1-as-a-representative-damp-and-anti-hmgb1-antibody-therapy
#11
Masahiro Nishibori
High mobility group box-1 (HMGB1), a representative damage-associated molecular patterns (DAMPs), has been reported to be involved in many inflammatory diseases. To validate HMGB1 as a target molecule of inflammatory diseases and to examine the effects of inhibition of HMGB1 on the diseases, we raised anti-HMGB1 monoclonal antibody (mAb) neutralizing extracellular HMGB1 and characterized it. We report the effects of anti-HMGB1 mAb on brain infarction, brain hemorrhage, brain trauma, epilepsy and neuropathic pain using animal models...
2018: Nihon Yakurigaku Zasshi. Folia Pharmacologica Japonica
https://www.readbyqxmd.com/read/29313183/predictors-of-unknown-cancer-in-patients-with-ischemic-stroke
#12
Sonia Quintas, Jacobo Rogado, Pedro Gullón, Vilma Pacheco-Barcia, Julio Dotor García-Soto, Gemma Reig-Roselló, Rebeca Mondéjar, Ramón Colomer, Jose Vivancos
Stroke is the second most frequent neurologic finding in postmortem studies of cancer patients. It has also been described as the first expression of an occult cancer. We have studied patients diagnosed with cancer after an ischemic stroke (IS) and we analyze differences with non-tumor patients. Single cohort longitudinal retrospective study of patients admitted to our center with IS diagnosis from 1 January 2012 to 12 December 2014. All patients were followed for 18 months. Patients with transient ischemic infarction or cerebral hemorrhage, active cancer or in the last 5 years, inability to follow-up or absence of complete complementary study (holter-EKG, echocardiogram, and dupplex/angiography-CT) were excluded...
January 8, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29311290/impact-of-clopidogrel-therapy-on-mortality-and-cancer-in-patients-with-cardiovascular-and-cerebrovascular-disease-a-patient-level-meta-analysis
#13
Sammy Elmariah, Gheorghe Doros, Oscar R Benavente, Deepak L Bhatt, Stuart J Connolly, Salim Yusuf, Steven R Steinhubl, Yuyin Liu, Wen-Hua Hsieh, Robert W Yeh, Laura Mauri
BACKGROUND: Clinical trial data associate extended clopidogrel therapy with increased mortality and cancer. We sought to determine the impact of continued clopidogrel use on mortality and cancer within a patient-level meta-analysis of randomized clinical trials. METHODS AND RESULTS: Meta-analytic clinical event rates for all-cause, cardiovascular, noncardiovascular, and cancer-related mortality; cancer; myocardial infarction; stroke; and fatal and major nonfatal bleeding were generated using patient-level data from 6 randomized trials comparing prolonged versus no or short-duration clopidogrel on a background of aspirin in patients with cardiovascular and cerebrovascular disease...
January 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29311264/starting-sich-nomogram-to-predict-symptomatic-intracerebral-hemorrhage-after-intravenous-thrombolysis-for-stroke
#14
Manuel Cappellari, Gianni Turcato, Stefano Forlivesi, Cecilia Zivelonghi, Paolo Bovi, Bruno Bonetti, Danilo Toni
BACKGROUND AND PURPOSE: Symptomatic intracerebral hemorrhage (sICH) is a rare but the most feared complication of intravenous thrombolysis for ischemic stroke. We aimed to develop and validate a nomogram for individualized prediction of sICH in intravenous thrombolysis-treated stroke patients included in the multicenter SITS-ISTR (Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register). METHODS: All patients registered in the SITS-ISTR by 179 Italian centers between May 2001 and March 2016 were originally included...
January 8, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29305915/intraventricular-hemorrhage-due-to-subarachnoid-hemorrhage-does-the-severity-matter
#15
Marvin Darkwah Oppong, Oliver Gembruch, Annika Herten, Roman Frantsev, Mehdi Chihi, Philipp Dammann, Nicolai El Hindy, Michael Forsting, Ulrich Sure, Ramazan Jabbarli
OBJECT: Aneurysm rupture might be accompanied by intraventricular hemorrhage (IVH) that is associated with poor outcome of subarachnoid hemorrhage (SAH). The aim of this study was to analyze risk factors and clinical impact of IVH severity. MATERIAL AND METHODS: 995 consecutive SAH patients treated at our institution between January 2003 and June 2016 were eligible for this study. Clinical and radiological findings were correlated with the presence and severity of IVH assessed with the original Graeb score...
January 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29303459/multimodal-treatment-approach-in-a-patient-with-multiple-intracranial-myxomatous-aneurysms
#16
David L Penn, Arianna B Lanpher, Jennifer M Klein, Harry P W Kozakewich, Kristopher T Kahle, Edward R Smith, Darren B Orbach
The most common primary cardiac tumor is myxoma, typically originating in the left atrium. Emboli to the central nervous system can cause cerebral infarction or, rarely, seed tumor growth within vessel walls, causing myxomatous aneurysms. Fewer than 60 myxomatous aneurysms have been reported, including 2 cases in children. Here, the authors describe 2 different growing myxomatous aneurysms in a child successfully managed using a combined multidisciplinary approach. A 12-year-old boy developed a sudden headache, diplopia, gait instability, and speech difficulty...
January 5, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29288496/cha2-ds2-vasc-scores-for-outcomes-prediction-in-acute-ischemic-stroke
#17
Chun-Hung Su, Teng-Fu Tsao, An-Chih Chen, Kai-Wei Chang, Yi-Sun Yang, Kwo-Chang Ueng, Chin-Feng Tsai
BACKGROUND: The CHADS2 and CHA2 DS2 -VASc scores are clinical risk stratification instruments that are used clinically to assess the risk of stroke in patients with atrial fibrillation (AF). The aim of this study was to evaluate whether the pre-stroke CHADS2 and CHA2 DS2 -VASc scores could be useful for predicting infarction severity and long-term outcomes in patients of acute ischemic stroke. MATERIALS AND METHODS: This prospective study included all 1494 patients who had acute ischemic stroke without hemorrhagic transformation which were evidenced with magnetic resonance (MR) imaging during hospitalization...
December 29, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29288487/association-between-hemorrhagic-transformation-after-endovascular-therapy-and-poststroke-seizures
#18
Arthur Thevathasan, Jillian Naylor, Leonid Churilov, Peter J Mitchell, Richard J Dowling, Bernard Yan, Patrick Kwan
OBJECTIVE: Endovascular therapy has recently become standard therapy for select patients with acute ischemic stroke. Infarcted brain tissue may undergo hemorrhagic transformation (HT) after endovascular therapy. We investigated the association between HT and occurrence of poststroke seizures in patients treated with endovascular therapy. METHODS: Consecutive patients treated with endovascular therapy for acute anterior circulation ischemic stroke were included. HT was assessed with computed tomography/magnetic resonance imaging (CT/MRI) at 24 h after stroke onset...
December 30, 2017: Epilepsia
https://www.readbyqxmd.com/read/29288194/increased-middle-cerebral-artery-mean-blood-flow-velocity-index-after-stroke-thrombectomy-indicates-increased-risk-for-intracranial-hemorrhage
#19
Markus Kneihsl, Kurt Niederkorn, Hannes Deutschmann, Christian Enzinger, Birgit Poltrum, Renate Fischer, Daniela Thaler, Christina Hermetter, Gerit Wünsch, Franz Fazekas, Thomas Gattringer
BACKGROUND AND PURPOSE: Cerebral hyperperfusion has been related to the risk of intracranial hemorrhage (ICH) in stroke patients after vessel recanalization therapy. We hypothesized that after successful mechanical thrombectomy for acute anterior circulation stroke, hemodynamics detectable by transcranial Duplex (TCD) sonography would vary, and that increased blood flow velocities would be associated with ICH. METHODS: We retrospectively identified all ischemic stroke patients with successful endovascular recanalization for anterior circulation vessel occlusion (Thrombolysis in Cerebral Infarction 2b-3) between 2010 and 2017...
December 28, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29284735/contact-aspiration-versus-stent-retriever-in-patients-with-acute-ischemic-stroke-with-m2-occlusion-in-the-aster-randomized-trial-contact-aspiration-versus-stent-retriever-for-successful-revascularization
#20
Benjamin Gory, Bertrand Lapergue, Raphael Blanc, Julien Labreuche, Malek Ben Machaa, Alain Duhamel, Gautier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin
BACKGROUND AND PURPOSE: Middle cerebral artery M2-segment occlusions represent an important subgroup of patients with acute stroke with large-vessel occlusion. The safety of mechanical thrombectomy, especially contact aspiration (CA), in such distal intracranial occlusions is still under debate. We compared reperfusion, adverse events, neurological recovery, and functional outcome of patients with isolated M2 occlusions according to the first-line strategy mechanical thrombectomy devices (CA versus stent retriever [SR])...
December 28, 2017: Stroke; a Journal of Cerebral Circulation
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