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Intraparenchymal hemorrhage

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https://www.readbyqxmd.com/read/28713626/recurrent-hemorrhage-in-hemangioblastoma-involving-the-posterior-fossa-case-report
#1
Eric Marvin, Asad S Akhter, Jeroen R Coppens
BACKGROUND: Hemangioblastomas (HGBs) are the most common primary intra-axial posterior fossa tumor in adults. Although spontaneous hemorrhage of these tumors is exceedingly rare, despite their vascular nature, we describe a case of recurrent hemorrhage with associated tonsillar herniation, and demonstrate that a surgical approach can provide a suitable outcome. CASE DESCRIPTION: A 54-year-old female with von Hippel-Lindau (VHL) syndrome presented with acute loss of consciousness and Glasgow Coma Scale (GCS) was 4...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28710084/neuroprotective-strategies-following-intraparenchymal-hemorrhage
#2
REVIEW
Robin Moshe Babadjouni, Ryan E Radwanski, Brian P Walcott, Arati Patel, Ramon Durazo, Drew M Hodis, Benjamin A Emanuel, William J Mack
Intracerebral hemorrhage and, more specifically, intraparenchymal hemorrhage, are devastating disease processes with poor clinical outcomes. Primary injury to the brain results from initial hematoma expansion while secondary hemorrhagic injury occurs from blood-derived products such as hemoglobin, heme, iron, and coagulation factors that overwhelm the brains natural defenses. Novel neuroprotective treatments have emerged that target primary and secondary mechanisms of injury. Nonetheless, translational application of neuroprotectants from preclinical to clinical studies has yet to show beneficial clinical outcomes...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28693567/protocol-based-invasive-intracranial-pressure-monitoring-in-acute-liver-failure-feasibility-safety-and-impact-on-management
#3
Venkatakrishna Rajajee, Robert J Fontana, Anthony J Courey, Parag G Patil
BACKGROUND: Acute liver failure (ALF) may result in elevated intracranial pressure (ICP). While invasive ICP monitoring (IICPM) may have a role in ALF management, these patients are typically coagulopathic and at risk for intracranial hemorrhage (ICH). Contemporary ICP monitoring techniques and coagulopathy reversal strategies may be associated with a lower risk of hemorrhage. Our objective was to evaluate the safety, feasibility, impact on clinical management and outcomes associated with protocol-directed use of IICPM in ALF...
July 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28680635/prolonged-duration-of-apnea-test-during-brain-death-examination-in-a-case-of-intraparenchymal-hemorrhage
#4
Premkumar Nattanmai, Christopher R Newey, Ishpreet Singh, Keerthivaas Premkumar
OBJECTIVE: Apnea test is required as part of the brain death examination. The duration of the apnea test is variable but typically requires 8-10 min. Prolonged apnea tests have been reported in the setting of hypothermia. Here, we describe a case of prolonged duration of apnea test secondary to a phenomenon called cardiac ventilation. METHODS: The patient presented in coma with brainstem areflexia after having an intracerebral hemorrhage resulting in subfalcine, central, uncal, and tonsillar herniations...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28669878/thresholds-for-volume-and-expansion-in-intraparenchymal-hemorrhage-predictors-of-neurologic-deterioration-and-mortality
#5
Darian R Esfahani, Caitlin A Radnis, Ahmed E Hussein, Sepideh Amin-Hanjani, Fady T Charbel, Ali Alaraj
OBJECTIVE: Spontaneous intraparenchymal hemorrhage (IPH) is a common neurosurgical emergency, with hemorrhage size and expansion associated with poor clinical outcomes. In this study, radiologic risk factors and specific IPH volume thresholds were calculated to identify heightened risk of neurologic deterioration and mortality. METHODS: A consecutive review of all nontraumatic IPH transfer patients to a tertiary academic neurosurgery service was performed over two years...
June 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28612131/three-factor-versus-four-factor-prothrombin-complex-concentrate-for-the-emergent-management-of-warfarin-associated-intracranial-hemorrhage
#6
Daniel Fischer, Jeffrey Sorensen, Gabriel V Fontaine
BACKGROUND: Four-factor prothrombin complex concentrates (PCC) produce a more rapid and complete INR correction compared with 3-factor PCC in patients receiving warfarin. It is unknown if this improves clinical outcomes in the setting of intracranial hemorrhage (ICH). METHODS: This multicenter, retrospective cohort study included patients presenting with warfarin-associated ICH reversed with either 4- or 3-factor PCC. The primary outcome was in-hospital mortality...
June 13, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28584003/daily-total-physical-activity-and-incident-stroke-the-japan-public-health-center-based-prospective-study
#7
Yasuhiko Kubota, Hiroyasu Iso, Kazumasa Yamagishi, Norie Sawada, Shoichiro Tsugane
BACKGROUND AND PURPOSE: There is limited evidence on the association between total physical activity and stroke in Asian populations experiencing a greater burden of hemorrhagic stroke than Western populations. We aimed to understand their optimal level of physical activity for stroke prevention. METHODS: A total of 74 913 Japanese people 50 to 79 years of age without histories of cardiovascular disease or cancer were followed from 2000 to 2012. RESULTS: During the 698 946 person-years of follow-up, we documented a total of 2738 incident cases of stroke, including 1007 hemorrhagic strokes (747 intraparenchymal and 260 subarachnoid hemorrhages) and 1721 ischemic strokes (1206 nonembolic and 515 embolic infarctions)...
June 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28567488/early-rebleeding-of-intracranial-dural-arteriovenous-fistulas-after-an-intracranial-hemorrhage
#8
Jai Ho Choi, Kyung Il Jo, Keon Ha Kim, Pyoung Jeon, Je Young Yeon, Jong Soo Kim, Seung Chyul Hong
BACKGROUND: The aim of this study was to evaluate the clinical and angiographic characteristics of dural arteriovenous fistulas (DAVF) presenting with intracranial hemorrhage (ICH), with a focus on early rebleeding according to the initial hemorrhage type. METHOD: The clinical and radiologic features of 21 dAVFs that presented with intracranial hemorrhage were retrospectively reviewed. The hemorrhage type was classified as pure intraparenchymal hemorrhage (pIPH) and subarachnoid or subdural hemorrhage with IPH (non-pIPH)...
May 31, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28565988/postprocedural-midterm-and-long-term-results-of-cerebral-aneurysms-treated-with-flow-diverter-devices-7-year-experience-at-a-single-center
#9
Francesco Briganti, Giuseppe Leone, Luigi Cirillo, Oreste de Divitiis, Domenico Solari, Paolo Cappabianca
OBJECTIVE Flow diversion has emerged as a viable treatment option for selected intracranial aneurysms and recently has been gaining traction. The aim of this study was to evaluate the safety and effectiveness of flow-diverter devices (FDDs) over a long-term follow-up period. METHODS The authors retrospectively reviewed all cerebral aneurysm cases that had been admitted to the Division of Neurosurgery of the Università degli Studi di Napoli between November 2008 and November 2015 and treated with an FDD. The records of 60 patients (48 females and 12 males) harboring 69 cerebral aneurysms were analyzed...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28556471/putative-cerebral-microbleeds-in-dogs-undergoing-magnetic-resonance-imaging-of-the-head-a-retrospective-study-of-demographics-clinical-associations-and-relationship-to-case-outcome
#10
S C Kerwin, J M Levine, C M Budke, J F Griffin, C E Boudreau
BACKGROUND: Cerebral microbleeds (CMBs) are focal intraparenchymal signal voids on gradient-echo magnetic resonance imaging (MRI), corresponding to regions of chronic hemorrhage. In humans, they are associated with systemic disease and shorter survival times. Although similar findings have been identified in dogs, their epidemiology and clinical correlations have not been investigated. OBJECTIVE: To determine epidemiological features, clinical associations, and associations with outcome for putative CMB-like foci (putative microbleeds [pMBs]) identified by T2*-weighted MRI in dogs...
July 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28551065/role-of-selective-intra-arterial-embolization-in-benign-liver-tumors
#11
M D Ferrer Puchol, C La Parra Casado, A Cervera Araez, R Sala López, E Esteban Hernández, A Cremades Mira, R Ramiro Gandia
OBJECTIVE: To present cases of symptomatic benign liver tumors diagnosed and treated with intra-arterial embolization before surgery. MATERIAL AND METHODS: We present the cases of 7 patients diagnosed with symptomatic benign liver tumors that required treatment: 1 focal nodular hyperplasia, 2 giant cavernous hemangiomas, 1 hepatic adenomatosis, and 3 hepatic adenomas. Once the feeding arteries were identified, tumors were embolized with polyvinyl alcohol particles (500μm-700μm) and then the feeding artery was plugged with coils if there was an arterial pedicle to ensure the total vascular exclusion of the tumor...
May 24, 2017: Radiología
https://www.readbyqxmd.com/read/28548592/intracranial-pressure-monitoring-in-severe-blunt-head-trauma-does-the-type-of-monitoring-device-matter
#12
Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28531301/a-political-case-of-penetrating-cranial-trauma-the-injury-of-james-scott-brady
#13
Richard Menger, Piyush Kalakoti, Rimal Hanif, Osama Ahmed, Anil Nanda, Bharat Guthikonda
James Brady, the White House press secretary during President Ronald Reagan's first term in office, was 1 of 4 people (including the President) wounded during an attempted assassination attempt on President Reagan's life on March 30, 1981. John Hinckley, Jr. was found not guilty of this attempt by reason of insanity. The assassination attempt was a ploy by Hinckley, Jr. to impress the actress Jodie Foster. Brady was the most seriously injured of the 4 who were wounded. He suffered a gunshot wound to the left forehead that traveled through the left frontal lobe, corpus callosum, and then into the right frontal and temporal lobes...
May 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#14
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28499787/motocross-associated-head-and-spine-injuries-in-adult-patients-evaluated-in-an-emergency-department
#15
Lucas Oliveira J E Silva, M Fernanda Bellolio, Elisa M Smith, David J Daniels, Christine M Lohse, Ronna L Campbell
BACKGROUND: Motor vehicle-related injuries (including off-road) are the leading cause of traumatic brain injury (TBI) and acute traumatic spinal cord injury in the United States. OBJECTIVES: To describe motocross-related head and spine injuries of adult patients presenting to an academic emergency department (ED). METHODS: We performed an observational cohort study of adult ED patients evaluated for motocross-related injuries from 2010 through 2015...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28489610/invasive-and-noninvasive-means-of-measuring-intracranial-pressure-a-review
#16
Xuan Zhang, Joshua Medow, Bermans Iskandar, Fa Wang, Mehdi Shokoueinejad, Joyce Koueik, John Webster
Measurement of intracranial pressure (ICP) can be invaluable in the management of critically ill patients. Cerebrospinal fluid (CSF) is produced by the choroid plexus in the brain ventricles (a set of communicating chambers), after which it circulates through the different ventricles and exits into the subarachnoid space (SAS) around the brain, where it is reabsorbed into the venous system. If the fluid does not drain out of the brain or get reabsorbed, the ICP increases, which may lead to brain damage or death...
May 10, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28484546/postoperative-hematoma-involving-brainstem-peduncles-cerebellum-deep-subcortical-white-matter-cerebral-hemispheres-following-chronic-subdural-hematoma-evacuation
#17
Mohana Rao Patibandla, Amit K Thotakura, Dinesh Shukla, Anirudh K Purohit, Gokul Chowdary Addagada, Manisha Nukavarapu
Among the intracranial hematomas, chronic subdural hematomas (CSDH) are the most benign with a mortality rate of 0.5-4.0%. The elderly and alcoholics are commonly affected by CSDH. Even though high percentage of CSDH patients improves after the evacuation, there are some unexpected potential complications altering the postoperative course with neurological deterioration. Poor outcome in postoperative period is due to complications like failure of brain to re-expand, recurrence of hematoma and tension pneumocephalus...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28465403/middle-cerebral-artery-flow-velocity-increases-more-in-patients-with-delayed-intraparenchymal-hemorrhage-after-pipeline
#18
Denise Brunozzi, Sophia F Shakur, Ahmed E Hussein, Fady T Charbel, Ali Alaraj
OBJECTIVE: Pipeline Embolization Devices (PED) are commonly used for endovascular treatment of cerebral aneurysms but can be associated with delayed ipsilateral intraparenchymal hemorrhage (DIPH). The role that altered intracranial hemodynamics may play in the pathophysiology of DIPH is poorly understood. We assess middle cerebral artery (MCA) flow velocity changes after PED deployment. MATERIALS AND METHODS: Patients with aneurysms located proximal to the internal carotid artery terminus treated with PED at our institution between 2015 and 2016 were retrospectively reviewed...
May 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28430295/multiple-cerebral-fusiform-aneurysms-involving-the-posterior-and-anterior-circulation-including-the-anterior-cerebral-artery-a-case-report
#19
Sumit Das, Tibor Valyi-Nagy
<i>Multiple fusiform aneurysms occurring in a single patient are very uncommon. Fusiform aneurysms affecting the anterior circulation are extremely rare and reported cases involve the middle cerebral artery and internal carotid artery. We report here a case of a 55-year-old African American male who had a history of multiple strokes and who was found unresponsive prior to his latest hospital admission. Neuroimaging was remarkable for multiple fusiform aneurysms involving segments of the anterior, middle and posterior cerebral arteries as well as subarachnoid and intraparenchymal hemorrhage...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28393415/the-insertion-of-electrodes-in-the-brain-for-electrophysiological-recording-or-chronic-stimulation-is-not-associated-with-any-biochemically-detectable-neuronal-injury
#20
Marios S Themistocleous, Damianos E Sakas, Efstathios Boviatsis, George Tagaris, Andreas Kouyialis, Christina Psachoulia, Pantelis Stathis
OBJECTIVE: The aim of this study was to evaluate the degree of brain tissue injury that could be potentially induced by the introduction of a) microrecording electrodes, b) macrostimulation electrodes, or c) chronic stimulation electrodes. We aimed to evaluate whether the use of five simultaneous microrecording tracks is associated with any brain injury not detectable by conventional imaging such as CT or MRI. MATERIALS AND METHODS: The study included 61 patients who underwent surgery for implantation of 121 DBS leads...
April 10, 2017: Neuromodulation: Journal of the International Neuromodulation Society
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