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surgical treatment for intracerebral hemorrhage

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https://www.readbyqxmd.com/read/28611838/endovascular-embolization-of-intracranial-infectious-aneurysms-in-patients-undergoing-open-heart-surgery-using-n-butyl-cyanoacrylate
#1
Esteban Cheng-Ching, Seby John, Mark Bain, Gabor Toth, Thomas Masaryk, Ferdinand Hui, Muhammad Shazam Hussain
INTRODUCTION: Mycotic aneurysms are a serious complication of infective endocarditis with increased risk of intracranial hemorrhage. Patients undergoing open heart surgery for valve repair or replacement are exposed to anticoagulants, increasing the risk of aneurysm bleeding. These patients may require endovascular or surgical aneurysm treatment prior to heart surgery, but data on this approach are scarce. METHODS: Retrospective review of consecutive patients with infectious endocarditis and mycotic aneurysms treated endovascularly with Trufill n-butyl cyanoacrylate (n-BCA) at the Cleveland Clinic between January 2013 and December 2015...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28600011/direct-versus-indirect-bypass-for-moyamoya-disease
#2
REVIEW
Jonathan J Liu, Gary K Steinberg
Moyamoya disease is a progressive occlusive vasculopathy that involves the supraclinoid internal carotid arteries and Circle of Willis, and results in the formation of collateral vessels at the skull base. The progressive nature of this disease leads to cerebral ischemia and sometimes intracerebral hemorrhage. The treatment of moyamoya disease is mainly surgical revascularization, using revascularization techniques that include direct, indirect, and combined strategies. Here we discuss the available options for revascularization as well as our opinions regarding the surgical management of patients with moyamoya disease...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28579600/incidence-management-and-short-term-outcome-of-stroke-in-a-general-population-of-1-4-million-japanese%C3%A3-shiga-stroke-registry
#3
Naoyuki Takashima, Hisatomi Arima, Yoshikuni Kita, Takako Fujii, Naomi Miyamatsu, Masaru Komori, Yoshihisa Sugimoto, Satoru Nagata, Katsuyuki Miura, Kazuhiko Nozaki
BACKGROUND: This study determined the current status of the incidence, management, and prognosis of stroke in Japan using a population-based stroke registry.Methods and Results:Shiga Stroke Registry is an ongoing population-based registry that covers approximately 1.4 million residents of Shiga Prefecture. Cases of acute stroke were identified using standard definitions through surveillance of both all acute-care hospitals with neurology/neurosurgery facilities and death certificates in 2011...
June 3, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28578111/surgical-evacuation-of-spontaneous-supratentorial-lobar-intracerebral-hemorrhage-comparison-of-safety-and-efficacy-of-stereotactic-aspiration-endoscopic-surgery-and-craniotomy
#4
Yuqian Li, Ruixin Yang, Zhihong Li, Yanping Yang, Bo Tian, Xingye Zhang, Bao Wang, Dan Lu, Shaochun Guo, Minghao Man, Yang Yang, Tao Luo, Guodong Gao, Lihong Li
BACKGROUND: The safety and efficacy of craniotomy, endoscopic surgery, and stereotactic aspiration for surgical evacuation of spontaneous supratentorial lobar intracerebral hemorrhage (ICH) is yet uncertain. The present study analyzed the clinical and radiographical data from 99 patients with spontaneous supratentorial lobar ICH, retrospectively, to address this issue. METHODS: Patients who underwent craniotomy, endoscopy surgery, or stereotactic aspiration were assigned to the craniotomy group (n = 31), endoscopy surgery group (n = 32), or stereotactic aspiration group (n = 36), respectively...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28484927/ethical-and-legal-considerations-in-the-management-of-an-unbefriended-patient-in-a-vegetative-state
#5
Alexandra Lloyd-Smith Sequeira, Ariane Lewis
BACKGROUND: Patients without surrogates are referred to as "unbefriended." Because these patients do not have representatives to assist with medical decision-making, patient autonomy and self-determination, fundamental concepts of American healthcare, are jeopardized. METHODS: We present a case of an unbefriended patient in a vegetative state and discuss the ethical and legal complications associated with management of unbefriended patients. RESULTS: An unbefriended patient was admitted to our hospital with a cardiac arrest in the setting of an intracerebral hemorrhage...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28424044/emergent-carotid-thromboendarterectomy-for-acute-symptomatic-occlusion-of-the-extracranial-internal-carotid-artery
#6
Igor Gunka, Dagmar Krajickova, Michal Lesko, Stanislav Jiska, Jan Raupach, Miroslav Lojik, Radovan Maly
BACKGROUND: Strokes secondary to acute internal carotid artery (ICA) occlusion are associated with an extremely poor prognosis. The best treatment approach in this setting is still unknown. The aim of our study was to evaluate the efficacy, safety, and outcomes of emergent surgical revascularization of acute extracranial ICA occlusion in patients with minor to severe ischemic stroke. METHODS: A retrospective analysis was performed using prospectively collected data of consecutive patients who underwent carotid thromboendarterectomy for symptomatic acute ICA occlusion during the period from January 2013 to December 2015...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28408264/single-session-hematoma-removal-and-transcranial-coil-embolization-for-a-cavernous-sinus-dural-arteriovenous-fistula-a-technical-case-report
#7
Yosuke Akamatsu, Kenichi Sato, Hidenori Endo, Yasushi Matsumoto, Teiji Tominaga
BACKGROUND: Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. CASE DESCRIPTION: We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein...
April 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28402516/surgical-performance-in-minimally-invasive-surgery-plus-recombinant-tissue-plasminogen-activator-for-intracerebral-hemorrhage-evacuation-phase-iii-clinical-trial
#8
Maged D Fam, Daniel Hanley, Agnieszka Stadnik, Hussein A Zeineddine, Romuald Girard, Michael Jesselson, Ying Cao, Lynn Money, Nichol McBee, Amanda J Bistran-Hall, W Andrew Mould, Karen Lane, Paul J Camarata, Mario Zuccarello, Issam A Awad
BACKGROUND: Minimally invasive thrombolytic evacuation of intracerebral hematoma is being investigated in the ongoing phase III clinical trial of Minimally Invasive Surgery plus recombinant Tissue plasminogen activator for Intracerebral hemorrhage Evacuation (MISTIE III). OBJECTIVES: To assess the accuracy of catheter placement and efficacy of hematoma evacuation in relation to surgical approach and surgeon experience. METHODS: We performed a trial midpoint interim assessment of 123 cases that underwent the surgical procedure...
April 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28391022/reliable-the-value-of-early-postoperative-magnetic-resonance-imaging-after-ccm-surgery
#9
Bixia Chen, Sophia Göricke, Karsten Wrede, Ramazan Jabbarli, Max Jaegersberg, Ulrich Sure, Philipp Dammann
BACKGROUND: Cerebral cavernous malformations (CCM) can cause intracerebral hemorrhage. The lesions themselves are frequently associated with perifocal hemosiderin deposits due to repetitive microhemorrhages. Main indications for a surgical treatment are recurrent symptomatic hemorrhages or cavernoma-related epilepsy (CRE). After surgical resection, follow-up MR-imaging is usually performed to confirm a) the complete resection of the CCM and, especially in cases of CRE, b) the complete resection of the hemosiderin deposits...
April 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28187799/management-of-intracerebral-hemorrhage
#10
REVIEW
A M Thabet, M Kottapally, J Claude Hemphill
Intracerebral hemorrhage (ICH) is a potentially devastating neurologic injury representing 10-15% of stroke cases in the USA each year. Numerous risk factors, including age, hypertension, male gender, coagulopathy, genetic susceptibility, and ethnic descent, have been identified. Timely identification, workup, and management of this condition remain a challenge for clinicians as numerous factors can present obstacles to achieving good functional outcomes. Several large clinical trials have been conducted over the prior decade regarding medical and surgical interventions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28182164/minimal-invasive-puncture-and-drainage-versus-endoscopic-surgery-for-spontaneous-intracerebral-hemorrhage-in-basal-ganglia
#11
Zhihong Li, Yuqian Li, Feifei Xu, Xi Zhang, Qiang Tian, Lihong Li
Two prevalent therapies for the treatment of spontaneous intracerebral hemorrhage (ICH) in basal ganglia are, minimally invasive puncture and drainage (MIPD), and endoscopic surgery (ES). Because both surgical techniques are of a minimally invasive nature, they have attracted greater attention in recent years. However, evidence comparing the curative effect of MIPD and ES has been uncertain. The indication for MIPD or ES has been uncertain till now. In the present study, 112 patients with spontaneous ICH in basal ganglia who received MIPD or ES were reviewed retrospectively...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28178413/spontaneous-intracerebral-hemorrhage-management
#12
REVIEW
Jun Yup Kim, Hee-Joon Bae
Spontaneous non-traumatic intracerebral hemorrhage (ICH) remains a significant cause of mortality and morbidity throughout the world. To improve the devastating course of ICH, various clinical trials for medical and surgical interventions have been conducted in the last 10 years. Recent large-scale clinical trials have reported that early intensive blood pressure reduction can be a safe and feasible strategy for ICH, and have suggested a safe target range for systolic blood pressure. While new medical therapies associated with warfarin and non-vitamin K antagonist oral anticoagulants have been developed to treat ICH, recent trials have not been able to demonstrate the overall beneficial effects of surgical intervention on mortality and functional outcomes...
January 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28154550/peri-hemorrhagic-edema-and-secondary-hematoma-expansion-after-intracerebral-hemorrhage-from-benchwork-to-practical-aspects
#13
REVIEW
Marc-Alain Babi, Michael L James
Spontaneous intracerebral hemorrhage (SICH) is the most lethal type of stroke. Half of these deaths occur within the acute phase. Frequently observed deterioration during the acute phase is often due to rebleeding or peri-hematomal expansion. The exact pathogenesis that leads to rebleeding or peri-hemorrhagic edema remains under much controversy. Numerous trials have investigated potential predictor of peri-hemorrhagic edema formation or rebleeding but have yet to come with consistent results. Unfortunately, almost all of the "classical" approaches have failed to show a significant impact in regard of significant clinical outcome in randomized clinical trials...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28147238/endoscopic-evacuation-of-basal-ganglia-hematoma-surgical-technique-outcome-and-learning-curve
#14
Lichao Ma, Yuanzheng Hou, Ruyuan Zhu, Xiaolei Chen
BACKGROUND: Minimally invasive endoscopic hematoma evacuation is a promising treatment option for intracerebral hemorrhage. However, the technique still needs improvement. We report our clinical experience of using this technique to evacuate deep-seated basal ganglia hematomas. METHODS: The frontal approach was used in most patients. The preoperative and postoperative hematoma volumes, Glasgow Coma Scale, hematoma evacuation rate, 30-day mortality, and long-term outcome defined by the modified Rankin Scale were analyzed retrospectively...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28070645/middle-cerebral-artery-aneurysms-with-intracerebral-hematoma-the-impact-of-side-and-volume-on-final-outcome
#15
Ondrej Navratil, Kamil Duris, Vilem Juran, Eduard Neuman, Karel Svoboda, Martin Smrcka
BACKGROUND: Middle cerebral artery aneurysms (MCA aneurysms) belong to the most frequent type of intracranial aneurysms forming an intracerebral hematoma. The consequences of the hematoma-the laterality, the impact of ICH volume and size of the aneurysm with the final outcome of these patients had not been studied in detail in this location, and we focused on the analysis of these factors. METHODS: Patients with MCA aneurysms and associated intracerebral hematomas with a volume ≥10 ml were studied; these were treated from January 2006 to December 2015...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28034814/outcome-prognostic-factors-and-follow-up-results-after-subarachnoid-hemorrhage-from-pericallosal-artery-aneurysms
#16
Nazife Dinc, Stephanie Lescher, Johanna Quick-Weller, Joachim Berkefeld, Johannes Platz, Christian Senft, Volker Seifert, Juergen Konczalla
OBJECTIVE: Pericallosal artery aneurysms (PAAs) are usually rare (2%-5%), and treatment is challenging for both surgical and endovascular modalities. We performed this analysis to determine the outcome and prognostic factors after subarachnoidal hemorrhage (SAH) caused by ruptured PAAs. METHODS: A total of 32 patients with ruptured PAA were admitted to our hospital between 1999 and 2014, added to our prospective database, and analyzed retrospectively. Outcome was measured based on the modified Rankin Scale (mRS) at 6 months after ictus (favorable mRS score, 0-2 vs...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28024977/external-ventricular-drain-related-infection-in-spontaneous-intracerebral-hemorrhage
#17
Samir Cezimbra Dos Santos, Telmo Tiburcio Fortes Lima, Luciano Werle Lunardi, Marco Antonio Stefani
OBJECTIVE: We aimed to analyze infection rates in patients with spontaneous intracranial hemorrhage who underwent surgical external ventricular drain (EVD) placement. METHODS: This prospective study included 94 consecutive patients who required an EVD for spontaneous intracranial hemorrhage at the Neurosurgery Department of Hospital Cristo Redentor, Porto Alegre, Rio Grande do Sul, Brazil. RESULTS: The mean duration of EVD use was 7 days. Overall sample mortality was 45%, and overall infection rate was 36%...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28005820/brain-abscess-following-intracerebral-hemorrhage-in-a-patient-with-pneumonia
#18
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...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27907957/surgical-strategies-for-spontaneous-intracerebral-hemorrhage
#19
Wendy Ziai, J Ricardo Carhuapoma, Paul Nyquist, Daniel F Hanley
In recent decades, the medical and surgical treatment of intracerebral hemorrhage (ICH) have become the focus of a number of scientific investigations. This effort has been led by an international group of neurologists and neurosurgeons with the goal of studying functional recovery and developing new medical and surgical treatments to facilitate improved clinical outcomes. Currently, two of the most pressing ICH investigational goals are (1) early blood pressure control, and (2) safe hematoma volume reduction...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906525/the-clinical-utility-of-qsm-disease-diagnosis-medical-management-and-surgical-planning
#20
REVIEW
Sarah Eskreis-Winkler, Yan Zhang, Jingwei Zhang, Zhe Liu, Alexey Dimov, Ajay Gupta, Yi Wang
Quantitative susceptibility mapping (QSM) is an MR technique that depicts and quantifies magnetic susceptibility sources. Mapping iron, the dominant susceptibility source in the brain, has many important clinical applications. Herein, we review QSM applications in the diagnosis, medical management, and surgical treatment of disease. To assist in early disease diagnosis, QSM can identify elevated iron levels in the motor cortex of amyotrophic lateral sclerosis patients, in the substantia nigra of Parkinson's disease (PD) patients, in the globus pallidus, putamen, and caudate of Huntington's disease patients, and in the basal ganglia of Wilson's disease patients...
December 1, 2016: NMR in Biomedicine
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