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surgical treatment for intracerebral hemorrhage

Kun Liu, Chunxia Yang, Yongna Zhang, Xunhui Yuan, Hang Xiao, Yun'an Bai, Bin Xi
Brain abscess is a rare but potentially lethal infection of brain parenchyma, requiring prompt surgical intervention and high-dose antibiotic therapy. Brain abscess is a known complication of surgically treated intracerebral hemorrhage (ICH), but it is exceptionally rare that it occurs at the same site of a nonoperated ICH. Such cases may result from hematogenous spread from distant foci (pneumonia, infectious endocarditis) or contiguous sites. Herein, the authors report a case of 75-year-old woman presenting with a brain abscess 6 weeks after a nonoperated ICH...
October 14, 2016: Journal of Craniofacial Surgery
Yu Xiao, Jian Zhou, Xiaolong Wei, Yudong Sun, Lei Zhang, Jiaxuan Feng, Rui Feng, Zhiqing Zhao, Zaiping Jing
BACKGROUND: Takayasu's arteritis (TA) is a nonspecific chronic inflammation of the aorta and its branches. This study compared the outcomes of surgical treatments including bypass surgery, cutting balloon angioplasty and conventional balloon angioplasty to TA patients exhibiting supra-aortic arterial (SAA). METHODS: This retrospective study was conducted on 42 TA patients, obtained from hospital database, who underwent surgical therapy due to SAA lesions from January 2010 to March 2015...
September 2016: Journal of Thoracic Disease
P Pardes-Chavanes, M Afanetti, C Boyer, M Poirée
Intracerebral hemorrhage (ICH) remains a cause of death in hematologic malignancies. Asparaginase represents a key agent in the treatment of acute lymphoblastic leukemia (ALL). The toxicity of asparaginase includes coagulopathy such as thrombotic or bleeding tendency. We report a case of fatal cerebral hemorrhage in a 12-year-old girl treated for ALL. Cerebral hemorrhage occurred after three injections of L-asparaginase. The patient presented with hypofibrinogenemia (0.36g/L), associated with thrombocytopenia (24,000/mm(3))...
October 12, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Ryan Hakimi, Ankur Garg
PURPOSE OF REVIEW: Hemorrhagic stroke comprises approximately 15% to 20% of all strokes. This article provides readers with an understanding of the indications and significance of various neuroimaging techniques available for patients presenting with hemorrhagic strokes of distinct causes. RECENT FINDINGS: The most common initial neuroimaging study is a noncontrast head CT, which allows for the identification of hemorrhage. Once an intracranial hemorrhage has been identified, the pattern of blood and the patient's medical history, neurologic examination, and laboratory studies lead the practitioner to pursue further neuroimaging studies to guide the medical, surgical, and interventional management...
October 2016: Continuum: Lifelong Learning in Neurology
Airton Leonardo de Oliveira Manoel, Alberto Goffi, Fernando Godinho Zampieri, David Turkel-Parrella, Abhijit Duggal, Thomas R Marotta, R Loch Macdonald, Simon Abrahamson
Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding...
September 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
Saverio Francesco Retta, Angela J Glading
Cerebral Cavernous Malformation (CCM) is a vascular disease of proven genetic origin, which may arise sporadically or is inherited as an autosomal dominant condition with incomplete penetrance and highly variable expressivity. CCM lesions exhibit a range of different phenotypes, including wide inter-individual differences in lesion number, size, and susceptibility to intracerebral hemorrhage (ICH). Lesions may remain asymptomatic or result in pathological conditions of various type and severity at any age, with symptoms ranging from recurrent headaches to severe neurological deficits, seizures, and stroke...
September 14, 2016: International Journal of Biochemistry & Cell Biology
Terushige Toyooka, Hiroshi Kageyama, Nobusuke Tsuzuki, Shoichiro Ishihara, Kazunari Oka
BACKGROUND: Conventionally, patients suffering a massive intraventricular hemorrhage have undergone external ventricular drainage. However, long-term or repeated drainage increases the risk of complications due to infections or shunt dependency. Neuroendoscopic surgery may offer some advantages over more conventional procedures. METHODS: Thirteen patients suffering intraventricular hematoma associated with intracerebral hemorrhage, treated in our hospital between April 2011 and March 2014, were reviewed retrospectively...
2016: Acta Neurochirurgica. Supplement
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
Roxanna M Garcia, Seungwon Yoon, Matthew B Potts, Michael T Lawton
BACKGROUND: The objective of this study is to classify patients using federally mandated categories of ethnicity and race and to determine if subgroups are associated with patient outcomes and aneurysmal subarachnoid hemorrhage (SAH). METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2013 was utilized to identify patients undergoing treatment of an intracerebral aneurysm. Ethnicity and race were combined to create subgroups...
September 5, 2016: World Neurosurgery
Diaa A Safatli, Albrecht Günther, Peter Schlattmann, Falko Schwarz, Rolf Kalff, Christian Ewald
BACKGROUND: Intracerebral hemorrhage (ICH) is a life threatening entity, and an early outcome assessment is mandatory for optimizing therapeutic efforts. METHODS: We retrospectively analyzed data from 342 patients with spontaneous primary ICH to evaluate possible predictors of 30-day mortality considering clinical, radiological, and therapeutical parameters. We also applied three widely accepted outcome grading scoring systems [(ICH score, FUNC score and intracerebral hemorrhage grading scale (ICH-GS)] on our population to evaluate the correlation of these scores with the 30-day mortality in our study...
2016: Surgical Neurology International
Jian Yu
INTRODUCTION: Traumatic brain injury (TBI) is a common disease for adults, particularly for young people. Most TBI patients have intracerebral hemorrhage, which often to brain edema and toxicity to the neural tissue. Deferoxamine (also known as Deferrioxamine B, Deferoxamine B, DFO-B, DFOA, DFB or desferal, DFX) is a bacterial siderophore produced by the Actinobacteria Streptomyces pilosus. It has medical applications as a chelating agent used to remove excess iron from the body. Animal models indicate that Deferoxamine accelerates intracranial hemorrhage absorption, although its effects on human patients remain unclear...
August 2016: Neurosurgery
Hoon Kim, Nancy J Edwards, Huimahn A Choi, Tiffany R Chang, Kwang Wook Jo, Kiwon Lee
Spontaneous intracerebral hemorrhage (SICH) continues to be a significant cause of neurologic morbidity and mortality throughout the world. Although recent advances in the treatment of SICH have significantly decreased mortality rates, functional recovery has not been dramatically improved by any intervention to date. There are two predominant mechanisms of brain injury from ICH: mechanical injury from the primary hematoma (including growth of that hematoma), and secondary injury from perihematomal inflammation...
June 29, 2016: World Neurosurgery
Vikas Jha, Sanjay Behari, Awadhesh K Jaiswal, Kamlesh Singh Bhaisora, Yogesh P Shende, Rajendra V Phadke
CONTEXT: Concurrent arterial aneurysms (AAs) occurring in 2.7-16.7% patients harboring an arteriovenous malformation (AVM) aggravate the risk of intracranial hemorrhage. AIM: We evaluate the variations of aneurysms simultaneously coexisting with AVMs. A classification-based management strategy and an abbreviated nomenclature that describes their radiological features is also proposed. SETTING: Tertiary care academic institute. STATISTICS: Test of significance applied to determine the factors causing rebleeding in the groups of patients with concurrent AVM and aneurysm and those with only AVMs...
July 2016: Asian Journal of Neurosurgery
Sung Ho Lee, Jong Un Moon, Seok Keun Choi, Man Kyu Choi, Juhie Lee, Ji-Youn Sung
BACKGROUND: Traumatic pseudoaneurysm of the distal posterior inferior cerebellar artery (PICA) is extremely rare. We report our experience of a case of pseudoaneurysm that developed on the PICA after blunt trauma to the head. CASE DESCRIPTION: A 55-year-old woman was transferred to our emergency department presenting with a semicomatose mental status after falling to the floor from a standing position. Computed tomography showed a small intracerebral hemorrhage and subarachnoid hemorrhage in the cerebellum...
August 2016: World Neurosurgery
Joji Inamasu, Keisuke Ito, Natsuki Hattori, Yuichi Hirose
Intracerebral hemorrhage is a well-known complication resulting from warfarin use. By contrast, warfarin-associated intraspinal hematoma is very rare. The intraspinal hematoma may exhibit delayed progression and patients may present with atypical symptoms, occasionally resulting in diagnostic delay. A 65-year-old man with non-valvular atrial fibrillation, arterial hypertension and benign prostatic hyperplasia who used warfarin for prevention of systemic embolism, visited our emergency department (ED) with a complaint of acute urinary retention...
May 26, 2016: Keio Journal of Medicine
Wendy Ziai, Paul Nyquist, Daniel F Hanley
In recent decades, the surgical treatment of intracerebral hemorrhage (ICH) has become a focus of scientific inquest. This effort has been led by an international group of neurologists and neurosurgeons with the goal of studying functional recovery and developing new surgical techniques to facilitate improved clinical outcomes. Currently, the two most pressing ICH investigational goals are (1) early blood pressure control, and (2) safe hematoma volume reduction. Achieving these goals would support decision-making, level-of-care choices, and the global research strategy of developing biologically informed treatments...
June 2016: Seminars in Neurology
Junhui Chen, Jun Zhu, Jianqing He, Yuhai Wang, Lei Chen, Chunlei Zhang, Jingxu Zhou, Likun Yang
Spontaneous subarachnoid hemorrhage (SAH) is the most common cerebrovascular disease. The conventional treatment for SAH is usually associated with high mortality. The present study aims to assess the prognosis of microsurgical treatment for patients with poor-grade aneurysm (Hunt and Hess grades IV-V) associated with intracerebral hematoma. A total of 18 consecutive patients who were diagnosed with poor-grade aneurysm accompanied with intracerebral hematoma were retrospectively recruited. All patients underwent microsurgical treatment between April 2010 and June 2013 at The 101st Hospital of Chinese People's Liberation Army (Wuxi, China)...
May 2016: Oncology Letters
Nishant Ganesh Kumar, Scott L Zuckerman, Imad S Khan, Michael C Dewan, Peter J Morone, Jay Mocco
Intracerebral hemorrhage (ICH) is a devastating disease. Sixty percent of survivors do not function independently at one year. Treatment of ICH costs approximately $12.7 billion annually. To date no intervention has demonstrated clear efficacy in improving outcomes. The goal of this selective review is to provide an understanding of current treatment and discuss future directions. After a discussion of pathophysiology and societal impact, a synopsis of treatment options is reviewed, including: 1) open craniotomy, 2) catheter based thrombolytic therapy, 3) endoscopic evacuation, and 4) ultrasonic lysis...
March 18, 2016: Journal of Neurosurgical Sciences
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)
Ricardo Rivera-Fernández, Francisco Guerrero-López, David Rodríguez-Rubio, Francisco Javier Gómez-Jiménez, Francisco Rodríguez-Vilanova, Juan Mora-Ordóñez, Victoria Olea-Jiménez, María Dolores Arias-Verdú, Guillermo Quesada-García, Faustino Acebal-Blanco, Encarnación Castillo-Lorente, Miguel Ángel Arráez-Sánchez
OBJECTIVE: To conduct a survival study and evaluation of surgical treatment in a cohort of patients with diagnosis of supratentorial spontaneous intracerebral hemorrhage (ICH). MATERIALS AND METHODS: The study included all consecutive patients with supratentorial ICH admitted to the Intensive Care Units of three Spanish hospitals with Neurosurgery Department between 2009 and 2012. DATA COLLECTED: age, APACHE-II, Glasgow Coma Score (GCS), and pupillary anomalies on admission, intracerebral hemorrhage (ICH) score, location/volume of hematoma, intraventricular hemorrhage (IVH), surgical evacuation alone or with additional external ventricular drain, and 30-days survival and at hospital discharge RESULTS: A total of 263 patients were included...
September 2016: Neurocirugía
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