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surgical treatment for intracerebral hemorrhage

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https://www.readbyqxmd.com/read/28424044/emergent-carotid-thromboendarterectomy-for-acute-symptomatic-occlusion-of-the-extracranial-internal-carotid-artery
#1
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
#2
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 10, 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
LiChao Ma, YuanZheng Hou, RuYuan Zhu, XiaoLei Chen
BACKGROUND: Minimally invasive endoscopic hematoma evacuation is a promising treatment option for intracerebral hemorrhage. However, its technique still needs improvement. We report our clinical experience of utilizing this technique to evacuate deep-seated basal ganglia hematomas. METHODS: The frontal approach was used in the majority of patients. The preoperative and postoperative hematoma volumes, Glasgow Coma Scale (GCS), hematoma evacuation rate, 30-day mortality, and long-term outcome defined by the modified Rankin Scale were analyzed retrospectively...
January 29, 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/27899759/perioperative-antihypertensive-treatment-in-patients-with-spontaneous-intracerebral-hemorrhage
#16
Jun Zheng, Hao Li, Sen Lin, Junpeng Ma, Rui Guo, Lu Ma, Yuan Fang, Meng Tian, Ming Liu, Chao You
BACKGROUND: Studies on antihypertensive treatment for surgical patients with spontaneous intracerebral hemorrhage are insufficient. This pilot study was conducted to investigate the safety of the perioperative intensive blood pressure lowering in surgical patients with spontaneous intracerebral hemorrhage. METHODS: This study was a prospective, parallel, randomized, assessor-blinded trial. Patients allocated to the intensive group received perioperative intensive antihypertensive treatment aiming to achieve a target systolic blood pressure between 120 and 140 mm Hg, whereas the patients in the conservative group received conservative treatment aiming to achieve a target systolic blood pressure between 140 and 180 mm Hg for 7 days...
January 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27836703/surgical-treatment-of-traumatic-intracranial-aneurysms-experiences-at-a-single-center-over-30-years
#17
Seung-Hoon Jung, Sung-Hyun Kim, Tae-Sun Kim, Sung-Pil Joo
OBJECTIVE: Traumatic intracranial aneurysm (tIA) is rare and is associated with high rates of morbidity and mortality. We describe our experiences with tIA at our institution. METHODS: We retrospectively reviewed records from patients who underwent treatment for tIA between January 1986 and December 2015. RESULTS: Data from 5532 patients with cerebral aneurysms between January 1986 and December 2015 were reviewed. Of these, 13 cases (0.23%) were tIA...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27832176/recurrent-intracerebral-hemorrhage-associations-with-comorbidities-and-medicine-with-antithrombotic-effects
#18
Linnea Boegeskov Schmidt, Sanne Goertz, Jan Wohlfahrt, Mads Melbye, Tina Noergaard Munch
BACKGROUND: Intracerebral hemorrhage (ICH) is a disease with high mortality and a substantial risk of recurrence. However, the recurrence risk is poorly documented and the knowledge of potential predictors for recurrence among co-morbidities and medicine with antithrombotic effect is limited. OBJECTIVES: 1) To estimate the short- and long-term cumulative risks of recurrent intracerebral hemorrhage (ICH). 2) To investigate associations between typical comorbid diseases, surgical treatment, use of medicine with antithrombotic effects, including antithrombotic treatment (ATT), selective serotonin reuptake inhibitors (SSRI's), and nonsteroidal anti-inflammatory drugs (NSAID's) with recurrent ICH...
2016: PloS One
https://www.readbyqxmd.com/read/27815963/the-management-of-symptomatic-cerebral-developmental-venous-anomalies-a-clinical-experience-of-43-cases
#19
Xin-Guang Yu, Chen Wu, Hui Zhang, Zheng-Hui Sun, Zhi-Qiang Cui
BACKGROUND Developmental venous anomalies (DVAs) are rare vascular diseases becoming more frequently diagnosed. Most patients with DVAs have no clinical symptoms with the exception of a few patients with epilepsy, intracranial hemorrhage, or neuro-function deficit. There is still controversy with respect to treatment strategies for symptomatic DVAs. MATERIAL AND METHODS Forty-three cases of symptomatic DVAs from January 2006 to October 2015 were retrospectively reviewed and the imaging characteristics of DVAs by CT, MRI, and DSA and the treatment modalities for DVAs were studied...
November 5, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27799045/therapeutic-potential-of-drugs-targeting-pathophysiology-of-intracerebral-hemorrhage-from-animal-models-to-clinical-applications
#20
Kuo-Hsing Liao, Chih-Wei Sung, Ya-Ni Huang, Wei-Jiun Li, Po-Chuan Yu, Jia-Yi Wang
BACKGROUND: Intracerebral hemorrhage (ICH) is one of the most common forms of cerebral hemorrhage, the morbidity and death of ICH is high worldwide. ICH can be spontaneous or caused by hypertension, coagulopathy, angiopathy, head trauma, bleeding disorders, tumors, or drug usage. ICH is the most serious and least treatable form of hemorrhagic stroke, with rapidly increasing hematoma size and often resulting in significant brain injury and long term neurological deficits. Surgical hematoma evacuation remains controversial...
October 27, 2016: Current Pharmaceutical Design
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