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https://www.readbyqxmd.com/read/28429859/aneurysms-in-neurofibromatosis-type-2-evidence-for-vasculopathy
#1
Shazia K Afridi, Suki Thomson, Steve E J Connor, Daniel C Walsh, Rosalie E Ferner
There have been anecdotal reports of vasculopathy associated with Neurofibromatosis Type 2 (NF2). Given the increasing use of bevacizumab, a vascular endothelial growth factor inhibitor which results in an increased risk of bleeding, it is important to ascertain if there is a predisposition to vascular abnormalities in NF2. In our unit NF2 patients undergo annual MRI brain and internal auditory meatus imaging. We noted incidental intracranial aneurysms in some patients and sought to determine the prevalence of intracranial aneurysms in our cohort of NF2 patients...
April 21, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28419850/overpressure-blast-injury-induced-oxidative-stress-and-neuroinflammation-response-in-rat-frontal-cortex-and-cerebellum
#2
Hale Z Toklu, Zhihui Yang, Sehkar Oktay, Yasemin Sakarya, Nataliya Kirichenko, Michael K Matheny, Judy Muller-Delp, Kevin Strang, Philip J Scarpace, Kevin K W Wang, Nihal Tümer
BACKGROUND & AIM: Overpressure blast-wave induced brain injury (OBI) and its long-term neurological outcome pose significant concerns for military personnel. Our aim is to investigate the mechanism of injury due to OBI. METHODS: Rats were divided into 3 groups: 1) Control, 2) OBI (exposed 30psi peak pressure, 2-2.5ms), 3) Repeated OBI (r-OBI) (three exposures over one-week period). Lung and brain (cortex and cerebellum) tissues were collected at 24h post injury...
April 15, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28415664/clinical-application-of-the-supraorbital-key-hole-approach-to-the-treatment-of-unilateral-dominant-bilateral-frontal-contusions
#3
Shuguang Zhang, Chunfa Qian, Guan Sun, Xiaoliang Li
We compared the surgical efficacy of the supraorbital key-hole approach (SKA) to conventional unilateral frontotemporal craniotomy (UFTC) for the treatment of patients with unilateral-dominant bilateral frontal contusions (BFCs). A retrospective analysis of 62 patients with unilateral-dominant BFCs who underwent surgery at our institute between 2014 and 2017 was performed. There were 26 patients who underwent SKA (group A) and 36 who underwent UFTC (group B). Postoperative computed tomography scans showed satisfactory evacuation of the frontal cerebral contusions in both groups (p > 0...
March 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28415059/-a-case-of-slowly-progressive-brain-metastasis-with-minor-bleeding-after-removal-of-and-chemotherapy-for-non-small-cell-lung-cancer
#4
Hiroshi Matsufuji, Eri Shiozaki, Yasutaka Nakatake, Koichi Yoshida, Kensaku Kamada, Takayuki Matsuo
Of all brain metastases, the most common primary lesion is derived from the lung. These types of metastases enlarge aggressively with unfavorable prognoses. We report the case of a 75-year-old male patient who had a history of pulmonary resection for Stage IA non-small cell lung cancer(NSCLC), and received chemotherapy. One year after NSCLC surgery, he experienced a cardiogenic cerebral infarction, and anticoagulant therapy was initiated. Mass lesions with hemorrhage were detected bilaterally in the frontal lobes through magnetic resonance imaging three years after the NSCLC surgery...
April 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28412733/prevention-of-tumor-seeding-during-needle-biopsy-by-chemotherapeutic-releasing-gelatin-sticks
#5
Ren-Yuan Bai, Verena Staedtke, Xuewei Xia, Gregory J Riggins
Needle biopsy is an indispensable diagnostic tool in obtaining tumor tissue for diagnostic examination. Tumor cell seeding in the needle track during percutaneous needle biopsies has been reported for various types of cancers. The mechanical force of the biopsy both directly displaces the malignant cells and causes bleeding and fluid movement that can further disseminate cells. To prevent the risk of tumor cell seeding during biopsy, we developed a gelatin stick loaded with chemotherapeutics such as doxorubicin (DXR) that was inserted into the biopsy canal...
February 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28389927/post-mortem-imaging-of-the-infant-and-perinatal-dura-mater-and-superior-sagittal-sinus-using-optical-coherence-tomography
#6
Emma C Cheshire, Roger D G Malcomson, Shiju Joseph, Asif Adnan, David Adlam, Guy N Rutty
Infants and young children are likely to present with subdural haemorrhage (SDH) if they are the victims of abusive head trauma. In these cases, the most accepted theory for the source of bleeding is the bridging veins traversing from the surface of the brain to the dura mater. However, some have suggested that SDH may result from leakage of blood from a dural vascular plexus. As post-mortem examination of the bridging veins and dura is challenging, and imaging modalities such as magnetic resonance and computed tomography do not have the resolution capabilities to image small blood vessels, we have trialled the use of intravascular and benchtop optical coherence tomography (OCT) systems for imaging from within the superior sagittal sinus (SSS) and through the dura during five infant/perinatal autopsies...
April 7, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28389734/-intensive-care-treatment-of-traumatic-brain-injury-in-multiple-trauma-patients-decision-making-for-complex-pathophysiology
#7
H Trimmel, G Herzer, H Schöchl, W G Voelckel
Traumatic brain injury (TBI) and hemorrhagic shock due to uncontrolled bleeding are the major causes of death after severe trauma. Mortality rates are threefold higher in patients suffering from multiple injuries and additionally TBI. Factors known to impair outcome after TBI, namely hypotension, hypoxia, hypercapnia, acidosis, coagulopathy and hypothermia are aggravated by the extent and severity of extracerebral injuries. The mainstays of TBI intensive care may be, at least temporarily, contradictory to the trauma care concept for multiple trauma patients...
April 7, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28387560/clinical-evaluation-of-the-concussed-athlete-a-view-from-the-sideline
#8
Margot Putukian
CONTEXT: The sideline assessment of concussion is challenging, given its variable presentations, the limited sensitivity and specificity of sideline assessment tools, and how the presentation of the injury evolves over time. In addition, the diagnostic process, as well as the tools used to assess and manage concussion, continue to progress as research and what we know about concussion advance. This paper focuses on the initial assessment on the sideline by reviewing the concussion-evaluation literature, drawing from clinical experience to emphasize a standardized approach, and underscoring the importance of both familiarity with the athlete and clinical judgment...
March 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28387139/intracortical-electrophysiological-correlates-of-blood-flow-after-severe-sah-a-multimodality-monitoring-study
#9
Brandon Foreman, David Albers, J Michael Schmidt, Cristina Maria Falo, Angela Velasquez, E Sander Connolly, Jan Claassen
Subarachnoid hemorrhage (SAH) is a devastating form of stroke. Approximately one in four patients develop progressive neurological deterioration and silent infarction referred to as delayed cerebral ischemia (DCI). DCI is a complex, multifactorial secondary brain injury pattern and its pathogenesis is not fully understood. We aimed to study the relationship between cerebral blood flow (CBF) and neuronal activity at both the cortex and in scalp using electroencephalography (EEG) in poor-grade SAH patients undergoing multimodality intracranial neuromonitoring...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28386283/rare-gingival-metastasis-by-hepatocellular-carcinoma
#10
Li-Jun Xue, Xiao-Bei Mao, Jian Geng, Ya-Nan Chen, Qian Wang, Xiao-Yuan Chu
Hepatocellular carcinoma (HCC) uncommonly metastasizes to the gingiva, which always means a poor outcome. We reported a rare HCC case with multiple metastases to gingiva, lungs, and brain. A 60-year-old man was initially diagnosed as HCC with metastases to double lungs. He was subjected to a transarterial chemoembolization (TACE) (5-fluorouracil, 750 mg) and two cycles of intravenous chemotherapy (gemcitabine 1.8 g at days 1 and 8, oxaliplatin 200 mg at day 2, every 4 weeks). However, the volume of liver tumor still increased...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28384878/a-rare-collision-tumour-of-uterus-squamous-cell-carcinoma-and-endometrial-stromal-sarcoma
#11
Nadeem Tanveer, Bindiya Gupta, Abhishek Pathre, Shalini Rajaram, Neerja Goyal
Collision tumours are defined by co-existence of two tumours in the same or adjacent organs which are topographically and histologically distinct with minimal or no histological admixture. Collision tumours have been described in many organs notably thyroid, brain, adrenal gland, stomach and rarely uterus. Most of the collision tumours reported in uterus have two components; an adenocarcinoma and a sarcoma. We report a case of a 60-year-old lady who presented with complaints of post-menopausal bleeding. A cervical biopsy was performed which showed a non-keratinizing squamous cell carcinoma of cervix...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28381928/prevalence-of-shunt-dependency-and-clinical-outcome-in-patients-with-massive-intraventricular-haemorrhage-treated-with-endoscopic-washout-and-external-ventricular-drainage
#12
Jason Raj Johnson, Zamzuri Idris, Jafri Malin Abdullah, Azmi Alias, Mohammad Saffari Mohammad Haspani
BACKGROUND: Intraventricular haemorrhage (IVH) causes blockage of ventricular conduits leading to hydrocephalus, increased intracranial pressure (ICP), and a reduced level of consciousness. The current standard management of IVH is insertion of an external ventricular drainage (EVD) catheter. However, this procedure addresses only the problems of acute hydrocephalus and raised ICP. Endoscopic washout allows for a more complete removal of the intraventricular clot. This study compared these two types of treatment in terms of shunt dependency and relevant clinical outcomes...
March 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28381238/homozygous-germ-line-mutation-of-the-pms2-mismatch-repair-gene-a-unique-case-report-of-constitutional-mismatch-repair-deficiency-cmmrd
#13
N C Ramchander, N A J Ryan, E J Crosbie, D G Evans
BACKGROUND: Constitutional mismatch repair deficiency syndrome results from bi-allelic inheritance of mutations affecting the key DNA mismatch repair genes: MLH1, MSH2, MSH6 or PMS2. Individuals with bi-allelic mutations have a dysfunctional mismatch repair system from birth; as a result, constitutional mismatch repair deficiency syndrome is characterised by early onset malignancies. Fewer than 150 cases have been reported in the literature over the past 20 years. This is the first report of the founder PMS2 mutation - NM_000535...
April 5, 2017: BMC Medical Genetics
https://www.readbyqxmd.com/read/28378693/hematoma-expansion-following-intracerebral-hemorrhage-mechanisms-targeting-the-coagulation-cascade-and-platelet-activation
#14
Sherrefa R Burchell, Jiping Tang, John H Zhang
Hematoma expansion (HE), defined as a greater than 33% increase in intracerebral hemorrhage (ICH) volume within the first 24 hours, results in significant neurological deficits, and enhancement of ICH-induced primary and secondary brain injury. An escalation in the use of oral anticoagulants has led to a surge in the incidences of oral anticoagulation-associated ICH (OAT-ICH), which has been associated with a greater risk for HE and worse functional outcomes following ICH. The oral anticoagulants in use include vitamin K antagonists, and direct thrombin and factor Xa inhibitors...
March 29, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28377258/cavernoma-new-insights-from-an-unusual-case
#15
G Sokratous, I Ughratdar, R Selway, Safa Al-Sarraj, K Ashkan
Rapid growth in cerebral cavernous malformation is rare. We present the case of a 71 year old patient with known multiple cavernomas over many years in whom one lesion showed rapid expansion in size. Histological examination revealed co-existence of glioblastoma within the cavernoma. We review the literature for similar cases and discuss the potential mechanisms underlying this phenomenon. Review of the literature revealed four cases with known cerebral cavernous malformations that have later developed, at the same site, a high grade glioma...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28367945/a-case-of-superficial-siderosis-ameliorated-after-closure-of-dural-deficit-detected-by-mri-ciss-constructive-interference-in-steady-state-imaging
#16
Ayako Sakoda, Ken-Ichiro Yamashita, Mitsumasa Hayashida, Yukihide Iwamoto, Ryo Yamasaki, Jun-Ichi Kira
A 64-year-old male developed headache, dizziness, and difficulty hearing, two years after an operation for chronic subdural hematoma due to head injury. These symptoms gradually worsened over the following 15 years. As he showed bloody cerebrospinal fluid (CSF) and marginal hypointensity on the surface of the brain and spinal cord on T2/T2*-weighted MRI, he was diagnosed with superficial siderosis (SS), although the source of the bleeding was unclear and anti-hemorrhagic drugs were ineffective. When he was admitted to our hospital, neurological examination disclosed horizontal gaze-evoked nystagmus, severe bilateral hearing loss, scanning speech, and limb and truncal ataxia...
March 30, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28362883/use-of-aspirin-and-p2y12-response-assays-in-detecting-reversal-of-platelet-inhibition-with-platelet-transfusion-in-patients-with-traumatic-brain-injury-on-antiplatelet-therapy
#17
Phillip A Choi, Phillip V Parry, Joshua S Bauer, Benjamin E Zusman, David M Panczykowski, Ava M Puccio, David O Okonkwo
BACKGROUND: At present, guidelines are lacking on platelet transfusion in patients with a traumatic intracranial bleed and history of antiplatelet therapy. The aspirin and P2Y 12 response unit (ARU and PRU, respectively) assays detect the effect of aspirin and P2Y 12 inhibitors in the cardiac population. OBJECTIVE: To describe the reversal of platelet inhibition after platelet transfusion using the ARU and PRU assays in patients with traumatic brain injury. METHODS: Between 2010 and 2015, we conducted a prospective comparative cohort study of patients presenting with a positive head computed tomography and a history of antiplatelet therapy...
January 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28360248/transfusion-of-red-blood-cells-in-patients-with-traumatic-brain-injuries-admitted-to-canadian-trauma-health-centres-a-multicentre-cohort-study
#18
Amélie Boutin, Lynne Moore, François Lauzier, Michaël Chassé, Shane English, Ryan Zarychanski, Lauralyn McIntyre, Donald Griesdale, Dean A Fergusson, Alexis F Turgeon
BACKGROUND: Optimisation of healthcare practices in patients sustaining a traumatic brain injury is of major concern given the high incidence of death and long-term disabilities. Considering the brain's susceptibility to ischaemia, strategies to optimise oxygenation to brain are needed. While red blood cell (RBC) transfusion is one such strategy, specific RBC strategies are debated. We aimed to evaluate RBC transfusion frequency, determinants of transfusions and associated clinical outcomes...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28358264/the-absence-of-the-cd163-receptor-has-distinct-temporal-influences-on-intracerebral-hemorrhage-outcomes
#19
Jenna L Leclerc, Andrew S Lampert, Claudia Loyola Amador, Brandon Schlakman, Terrie Vasilopoulos, Pia Svendsen, Søren K Moestrup, Sylvain Doré
Hemoglobin (Hb) toxicity precipitates secondary brain damage following intracerebral hemorrhage (ICH). CD163 is an anti-inflammatory Hb scavenger receptor and CD163-positive macrophages/microglia locally accumulate post-bleed, yet no studies have investigated the role of CD163 after ICH. ICH was induced in wildtype and CD163(-/-) mice and various anatomical and functional outcomes were assessed. At 3 d, CD163(-/-) mice have 43.4 ± 5.0% (p = 0.0002) and 34.8 ± 3.4% (p = 0.0003) less hematoma volume and tissue injury, respectively...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28351447/near-infrared-spectroscopy-a-promising-prehospital-tool-for-management-of-traumatic-brain-injury
#20
Joost Peters, Bas Van Wageningen, Nico Hoogerwerf, Edward Tan
Introduction Early identification of traumatic brain injury (TBI) is essential. Near-infrared spectroscopy (NIRS) can be used in prehospital settings for non-invasive monitoring and the diagnosis of patients who may require surgical intervention. METHODS: The handheld NIRS Infrascanner (InfraScan Inc.; Philadelphia, Pennsylvania USA) uses eight symmetrical scan points to detect intracranial bleeding. A scanner was tested in a physician-staffed helicopter Emergency Medical Service (HEMS)...
March 29, 2017: Prehospital and Disaster Medicine
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