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Ischemic malignant infarct

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https://www.readbyqxmd.com/read/29458183/age-dependent-attitudes-of-ischemic-patients-towards-disability-after-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction
#1
Byoung-Joon Kim, Yeon Ran Hong, Youngmin Han, Yang-Ha Hwang, Boram Ohk, Jaechan Park
OBJECTIVE: To improve the process of surgical informed consent, patient attitudes towards acceptable levels of disability after decompressive surgery for malignant middle cerebral artery infarction are investigated, including the impact of patient age. METHODS: Patients who had experienced a recent minor stroke were asked to complete a questionnaire comprised of 2 parts: 1) demographic information, including patient age, gender, years of education, working status, religion, and economic status and 2) acceptable level of disability based on a modified Rankin Scale (mRS) with corresponding illustrations to explain the mRS levels...
February 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29422364/glioblastoma-arising-within-sites-of-encephalomalacia-from-cerebrovascular-insult-two-cases-and-a-review-of-the-literature
#2
Emily A Ferenczi, Altaf Saadi, Shamik Bhattacharyya, Aaron L Berkowitz
Glioblastoma is the most common primary parenchymal brain malignancy, with median survival of less than one year. While there are likely multiple predisposing genetic and environmental factors in glioblastoma formation, chronic inflammation resulting from non-traumatic vascular brain injury is one proposed risk factor for oncogenesis. Here, we report two instances of glioblastoma arising within areas of encephalomalacia caused by remote vascular insults (one following aneurysmal subarachnoid hemorrhage and one following ischemic infarction), review the literature associating glioblastoma with prior brain injury, and discuss potential mechanisms for malignant transformation in injured brain tissue...
February 5, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29410497/the-neuroprotective-effect-of-thalidomide-against-ischemia-through-the-cereblon-mediated-repression-of-ampk-activity
#3
Naoya Sawamura, Mariko Yamada, Miku Fujiwara, Haruka Yamada, Hideki Hayashi, Norio Takagi, Toru Asahi
Thalidomide was originally used as a sedative and found to be a teratogen, but now thalidomide and its derivatives are widely used to treat haematologic malignancies. Accumulated evidence suggests that thalidomide suppresses nerve cell death in neurologic model mice. However, detailed molecular mechanisms are unknown. Here we examined the molecular mechanism of thalidomide's neuroprotective effects, focusing on its target protein, cereblon (CRBN), and its binding protein, AMP-activated protein kinase (AMPK), which plays an important role in maintaining intracellular energy homeostasis in the brain...
February 6, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29317364/early-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction-in-asian-patients-a-single-center-study
#4
Prakash Paliwal, Farasat Kazmi, Hock Luen Teoh, Leonard L L Yeo, Raymond C S Seet, Tseng Tsai Yeo, Lwin Sein, Ning Chou, Thomas Tan, Bernard P L Chan, Vijay K Sharma
INTRODUCTION: Early decompression craniectomy (within 48 hours of stroke onset) in acute and malignant middle cerebral artery (MCA) ischemic stroke (IS) reduces mortality and increases the proportion of patients with favorable functional outcome. Various cultural and social issues among Asians lead to some differences in clinical practice, especially when surgical interventions are involved. Accordingly, decompressive craniectomy in Asian patients with stroke is often delayed. MATERIALS AND METHODS: Data for all patients with acute IS hospitalized in our center were entered into a prospectively maintained registry...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29262431/decompressive-craniectomy-for-malignant-middle-cerebral-artery-stroke
#5
Mark M Landreneau, Kevin N Sheth
Advancements in the treatment of ischemic stroke have led to a recent decline in overall stroke mortality, but patients with hemispheric infarcts remain at high risk for death. Recent advances in the approach to this devastating disease include early identification of patients at high risk for swelling and standardized approaches to medical therapy. However, surgical decompression continues to be the most effective treatment for malignant edema from large hemispheric strokes. Patient selection in the past had been strictly limited to younger ages and the nondominant hemisphere...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29113853/hyperkinetic-transient-ischemic-attacks-preceding-deep-ganglionic-infarction-in-a-patient-with-a-treated-parasellar-chondrosarcoma
#6
Michael W Ruff, Adip G Bhargav, Stephen W English, James P Klaas
A 44-year-old right-handed female with a past medical history of parasellar chondrosarcoma status post-surgical debulking and proton beam therapy (70 Gy) three years prior to presentation experienced several hours of brief, repetitive episodes of transient hemiballism and dystonia; this was followed by abrupt onset of fixed hemiparesis and dysarthria weeks later, ipsilateral to her prior hyperkinetic movements. She was found to have total occlusion of the right middle cerebral artery with focal stenosis of the proximal right A-1 segment of the anterior cerebral artery adjacent to the remnants of the chondrosarcoma...
November 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29107638/herniation-despite-decompressive-hemicraniectomy-in-large-hemispherical-ischemic-strokes
#7
Archana Hinduja, Rohan Samant, Dongxia Feng, Yousef Hannawi
BACKGROUND: Despite decompressive hemicraniectomy (DHC), progressive herniation resulting in death has been reported following middle cerebral artery (MCA) strokes. We aimed to determine the surgical parameters measured on brain computed tomography (CT) scan that are associated with progressive herniation despite DHC in large MCA strokes. METHODS: Retrospective chart review of medical records of patients with malignant hemispheric infarction who underwent DHC for cerebral edema was performed...
October 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29054315/cord-topographical-anatomy-and-its-role-in-evaluating-intramedullary-lesions
#8
REVIEW
James Andrew Spain, Scott Cressman, Horia Marin, Suresh C Patel, John J Corrigan, Brent Griffith
Intramedullary spinal lesions present a wide differential diagnosis including infectious, inflammatory, traumatic, ischemic, benign, or malignant neoplastic etiologies. Using knowledge of anatomy and physiology within the spinal cord, many similar appearing entities can be parsed into a prioritized differential. The purpose of this article is to review anatomy and pathophysiology of the spinal cord, with subsequent discussion of how this knowledge can be used to differentiate several similar appearing intramedullary pathologic processes...
September 18, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28989934/takotsubo-cardiomyopathy-with-a-rapidly-resolved-left-ventricular-thrombus
#9
Abdel Anabtawi, Paola C Roldan, Carlos A Roldan
This article presents the case of a 53-year-old man who presented with acute right superficial femoral and popliteal arterial thrombosis for which he underwent an emergent uncomplicated thrombectomy. He denied preceding cardiovascular or neurologic symptomatology and had no history of coronary or peripheral arterial disease, trauma, hypercoagulability, or malignancy. However, he reported having several days of intense emotional stress prior to presentation. His cardiac exam was normal, his electrocardiogram showed normal sinus rhythm and nonspecific ST-T wave abnormalities, and his troponin levels were normal...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28963681/decompressive-craniectomy-icp-monitoring-and-secondary-necrosectomy-as-treatment-options-in-patients-presenting-with-malignant-ischemic-infarctions-extending-beyond-the-middle-cerebral-artery-territory
#10
EDITORIAL
https://www.readbyqxmd.com/read/28962946/mitochondrial-dna-common-deletion-in-post-fna-infarcted-oncocytic-thyroid-tumors
#11
Luca Conti, Simona Vatrano, Luca Bertero, Lavinia Masu, Donatella Pacchioni, Lorenzo Daniele, Giovanni De Rosa, Paola Cassoni, Marco Volante, Mauro Papotti
Thyroid fine needle aspiration (FNA) can rarely induce morphological changes potentially hindering the histopathological diagnosis, especially in Hurthle cell tumors (HCT), which may easily undergo post-FNA infarction or necrosis. HCTs contain mitochondrion (mt)-rich cells that may bear mtDNA mutations, the most frequent being the so-called "common deletion" (CD). The aim of this study was to determine the presence and extent of the mtDNA CD in a series of thyroid HCT that underwent extensive infarction following FNA procedure, in comparison with a control series of HCT lacking post-FNA ischemic/hemorrhagic alterations...
September 26, 2017: Human Pathology
https://www.readbyqxmd.com/read/28855390/tissue-selective-salvage-of-the-white-matter-by-successful-endovascular-stroke-therapy
#12
Justus F Kleine, Mirjam Kaesmacher, Benedikt Wiestler, Johannes Kaesmacher
BACKGROUND AND PURPOSE: White matter (WM) is less vulnerable to ischemia than gray matter. In ischemic stroke caused by acute large-vessel occlusion, successful recanalization might therefore sometimes selectively salvage the WM, leading to infarct patterns confined to gray matter. This study examines occurrence, determinants, and clinical significance of such effects. METHODS: Three hundred twenty-two patients with acute middle cerebral artery occlusion subjected to mechanical thrombectomy were included...
October 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28806209/refractory-intracranial-hypertension-the-role-of-decompressive-craniectomy
#13
REVIEW
Martin Smith
Raised intracranial pressure (ICP) is associated with worse outcomes after acute brain injury, and clinical guidelines advocate early treatment of intracranial hypertension. ICP-lowering therapies are usually administered in a stepwise manner, starting with safer first-line interventions, while reserving higher-risk options for patients with intractable intracranial hypertension. Decompressive craniectomy is a surgical procedure in which part of the skull is removed and the underlying dura opened to reduce brain swelling-related raised ICP; it can be performed as a primary or secondary procedure...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28798267/pretreatment-predictors-of-malignant-evolution-in-patients-with-ischemic-stroke-undergoing-mechanical-thrombectomy
#14
Alessandro Davoli, Caterina Motta, Giacomo Koch, Marina Diomedi, Simone Napolitano, Angela Giordano, Marta Panella, Daniele Morosetti, Sebastiano Fabiano, Roberto Floris, Roberto Gandini, Fabrizio Sallustio
BACKGROUND: Few data exist on malignant middle cerebral artery infarction (MMI) among patients with acute ischemic stroke (AIS) after endovascular treatment (ET). Numerous predictors of MMI evolution have been proposed, but a comprehensive research of patients undergoing ET has never been performed. Our purpose was to find a practical model to determine robust predictors of MMI in patients undergoing ET. METHODS: Patients from a prospective single-center database with AIS secondary to large intracranial vessel occlusion of the anterior circulation, treated with ET, were retrospectively analyzed...
August 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28790400/prediction-of-infarction-volume-and-infarction-growth-rate-in-acute-ischemic-stroke
#15
Saadat Kamran, Naveed Akhtar, Ayman Alboudi, Kainat Kamran, Arsalan Ahmad, Jihad Inshasi, Abdul Salam, Ashfaq Shuaib, Uvais Qidwai
The prediction of infarction volume after stroke onset depends on the shape of the growth dynamics of the infarction. To understand growth patterns that predict lesion volume changes, we studied currently available models described in literature and compared the models with Adaptive Neuro-Fuzzy Inference System [ANFIS], a method previously unused in the prediction of infarction growth and infarction volume (IV). We included 67 patients with malignant middle cerebral artery [MMCA] stroke who underwent decompressive hemicraniectomy...
August 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28746427/decompressive-craniotomy-for-the-treatment-of-malignant-infarction-of-the-middle-cerebral-artery-mortality-and-outcome
#16
Gianise Toboliski Bongiorni, Marjeane Cristina Jaques Hockmuller, Cristini Klein, Ápio Cláudio Martins Antunes
Objective: To assess, by Rankin scale, the functional disability of patients who had a malignant middle cerebral artery (MCA) ischemic stroke, who underwent decompressive craniotomy (DC) within the first 30 days. Methods: A cross-sectional study in a University hospital. Between June 2007 and December 2014, we retrospectively analyzed the records of all patients submitted to DC due to a malignant MCA infarction. The mortality rate was defined during the hospitalization period...
July 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28694110/predictors-of-in-hospital-mortality-after-decompressive-hemicraniectomy-for-malignant-ischemic-stroke
#17
Saadat Kamran, Abdul Salam, Naveed Akhtar, Aymen Alboudi, Arsalan Ahmad, Rabia Khan, Rashed Nazir, Muhammad Nadeem, Jihad Inshasi, Ahmed ElSotouhy, Ghanim Al Sulaiti, Ashfaq Shuaib
OBJECTIVE: The purpose of this retrospective multicenter, pooled-data analysis was to determine the factors associated with in-hospital mortality in decompressive hemicraniectomy (DHC) for malignant middle cerebral artery (MMCA) stroke. PATIENTS AND METHODS: The authors reviewed pooled DHC database from 3 countries for patients with MMCA with hospital mortality in spite of DHC to identify factors that predicted in-hospital mortality after DHC. The identified factors were applied to the group of patients who were selected for DHC but either refused surgery and died or stabilized and did not undergo DHC...
September 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28687640/early-imaging-prediction-of-malignant-cerebellar-edema-development-in-acute-ischemic-stroke
#18
Matthias P Fabritius, Kolja M Thierfelder, Felix G Meinel, Ahmed E Othman, Franziska Dorn, Bastian O Sabel, Pierre Scheffler, Birgit Ertl-Wagner, Wieland H Sommer, Wolfgang G Kunz
BACKGROUND AND PURPOSE: Malignant cerebellar edema (MCE) is a life-threatening complication of acute ischemic stroke that requires timely diagnosis and management. Aim of this study was to identify imaging predictors in initial multiparametric computed tomography (CT), including whole-brain CT perfusion (WB-CTP). METHODS: We consecutively selected all subjects with cerebellar ischemic WB-CTP deficits and follow-up-confirmed cerebellar infarction from an initial cohort of 2635 patients who had undergone multiparametric CT because of suspected stroke...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28545277/-effect-of-the-ischemic-post-conditioning-on-the-prevention-of-the-cardio-renal-damage-in-patients-with-acute-st-segment-elevation-myocardial-infarction-after-primary-percutaneous-coronary-intervention
#19
RANDOMIZED CONTROLLED TRIAL
Y Y Wang, T Li, Y W Liu, B J Liu, X M Hu, Y Wang, W Q Gao, P Wu, L Huang, X Li, W J Peng, M Ning
Objective: To evaluate the effect of the ischemic post-conditioning (IPC) on the prevention of the cardio-renal damage in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI). Methods: A total of 251 consecutive STEMI patients underwent PPCI in the heart center of Tianjin Third Central Hospital from January 2012 to June 2014 were enrolled in this prospective, randomized, control, single-blinded, clinical registry study. Patients were randomly divided into IPC group (123 cases) and control group (128 cases) with random number table...
April 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28518124/direct-re-implantation-of-left-coronary-artery-into-the-aorta-in-adults-with-anomalous-origin-of-left-coronary-artery-from-the-pulmonary-artery-alcapa
#20
Reza Tavakoli, Peiman Jamshidi, Nassrin Yamani, Max Gassmann
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ischemia and infarction in children. If left untreated, it results in a 90% mortality rate in the first year of life. In patients who survive to the adulthood, the coronary steal phenomenon and retrograde left-sided coronary flow provide a substrate for chronic subendocardial ischemia, which may lead to left ventricular dysfunction, ischemic mitral regurgitation, malignant ventricular arrhythmias, and sudden cardiac death...
April 24, 2017: Journal of Visualized Experiments: JoVE
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