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Intraparenchymal hemorrhage

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https://www.readbyqxmd.com/read/29033772/intraparenchymal-hemorrhage-due-to-brain-metastasis-of-hepatocellular-carcinoma
#1
Rafael Sartori Balbinot, Ana Laura Facco Muscope, Mateus Dal Castel, Silvana Sartori Balbinot, Raul Angelo Balbinot, Jonathan Soldera
Although extrahepatic metastases from hepatocellular carcinoma (HCC) are present in only 5-15% of cases, they are certainly factors associated with poor prognosis. The main sites include lung, lymph nodes, bones, and adrenal glands, in descending order. Metastasis in the central nervous system is extremely rare, and the incidences vary from 0.6 to 1.7%. We report a case of a 54-year-old man previously diagnosed with alcohol-induced cirrhosis of the liver and HCC. The patient was admitted presenting progressive left hemiparesis and headache which started 2 days earlier, with no history of cranioencephalic trauma...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29027857/is-there-added-value-in-obtaining-cervical-spine-mri-in-the-assessment-of-nontraumatic-angiographically-negative-subarachnoid-hemorrhage-a-retrospective-study-and-meta-analysis-of-the-literature
#2
Gelareh Sadigh, Chad A Holder, Jeffrey M Switchenko, Seena Dehkharghani, Jason W Allen
OBJECTIVE Diagnostic algorithms for nontraumatic angiographically negative subarachnoid hemorrhage (AN-SAH) vary, and the optimal method remains subject to debate. This study assessed the added value of cervical spine MRI in identifying a cause for nontraumatic AN-SAH. METHODS Consecutive patients 18 years of age or older who presented with nontraumatic SAH between February 1, 2009, and October 31, 2014, with negative cerebrovascular catheter angiography and subsequent cervical MRI were studied. Patients with intraparenchymal, subdural, or epidural hemorrhage; recent trauma; or known vascular malformations were excluded...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28987840/endovascular-treatment-of-ruptured-vertebrobasilar-dissecting-aneurysms-using-flow-diversion-embolization-devices-single-institution-experience
#3
Waldo R Guerrero, Santiago Ortega-Gutierrez, Minako Hayakawa, Colin P Derdeyn, James D Rossen, David Hasan, Edgar A Samaniego
OBJECTIVE: Treatment of ruptured posterior circulation dissecting aneurysms is technically challenging with potentially high morbidity and mortality. We sought to assess the safety and feasibility of using a flow diversion devices (FDD) and a specific acute antiplatelet aggregation protocol in the management of ruptured dissecting aneurysms. METHODS: Subjects with ruptured dissecting aneurysms treated during a three-year period were retrospectively identified from a prospective registry...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987174/raised-intracranial-pressure-and-brain-edema
#4
Ville Leinonen, Ritva Vanninen, Tuomas Rauramaa
Acutely increased intracranial pressure (ICP) is a life-threatening neurosurgical emergency. Optimal management strategy is selected according to the causative process. Typical causes are intracranial bleeds like traumatic subdural, epidural, or intracerebral hematoma (ICH); spontaneous ICH, intraventricular hemorrhage, subarachnoid hemorrhage, and hydrocephalus. When occurring without significant brain injury and treated effectively before herniation, a full recovery can be expected. In intraparenchymal injuries a full recovery is unlikely since dead cells in the central nervous system leave an "empty hole," to be replaced by cerebrospinal fluid...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28943531/early-diagnosis-of-infective-endocarditis-by-brain-t2-weighted-magnetic-resonance-imaging
#5
Takashi Fujimoto, Yoichi Morofuji, Yuki Matsunaga, Nobutaka Horie, Tsuyoshi Izumo, Yohei Tateishi, Minoru Morikawa, Takashi Miura, Kiyoyuki Eishi, Takayuki Matsuo
BACKGROUND: Because infective endocarditis (IE) carries a high risk of morbidity and mortality, rapid diagnosis and effective treatment are essential to achieving a good patient outcome. However, the diagnosis of IE is often difficult in patients presenting with nonspecific clinical manifestations. An association between IE and hypointense signal spots on brain T2*-weighted magnetic resonance imaging (MRI) has been reported, but the clinical significance remains unclear.Methods and Results:To assess the clinical importance of silent lesions in the brains of IE patients, hypointense signal spots detected on their brain T2*-weighted MRI scans were investigated in a retrospective review of 44 consecutive patients with definite or suspected IE evaluated by MRI between June 2006 and January 2014...
September 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28922367/perihematomal-diffusion-restriction-as-a-common-finding-in-large-intracerebral-hemorrhages-in-the-hyperacute-phase
#6
Tanja Schneider, David Frieling, Julian Schroeder, Jan Regelsberger, Gerhard Schoen, Jens Fiehler, Susanne Gellißen
PURPOSE: There is growing evidence that a perihematomal area of restricted diffusion (PDR) exists in intraparenchymal hemorrhages (IPH) within 1 week of symptom onset (SO). Here, we study characteristics and the clinical impact of the PDR in patients with hyperacute (≤ 6 hours from SO) IPH by means of apparent diffusion coefficient (ADC). METHODS: This monocentric, retrospective study includes 83 patients with first-ever primary IPH from 09/2002-10/2015. 3D volumetric segmentation was performed for the IPH, PDR, and perihematomal edema (PHE) on fluid-attenuated inversion recovery, T2*/susceptibility weighted images, and ADC images...
2017: PloS One
https://www.readbyqxmd.com/read/28919568/robotic-stereotactic-assistance-rosa-utilization-for-minimally-invasive-placement-of-intraparenchymal-hematoma-and-intraventricular-catheters-case-report
#7
Nima Alan, Phillip Lee, Alp Ozpinar, Bradley A Gross, Brian T Jankowitz
BACKGROUND: In patients with supratentorial spontaneous intracerebral hemorrhage, intrahematomal catheter placement may allow for intra-clot thrombolysis and drainage. Robotic assistance may be used for the stereotactic placement of catheters. CASE DESCRIPTION: A 76-year-old male presented with altered mental status and left-sided weakness. Non-contrast CT head showed a right ganglionic intraparenchymal hemorrhage with resultant entrapment of the temporal horn. Using Robotic Stereotactic Assistance (ROSA), an intrahematomal and an intraventricular catheter were placed...
September 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28885094/frontal-and-occipital-horn-ratio-is-associated-with-multifocal-intraparenchymal-hemorrhages-in-neonatal-shunted-hydrocephalus
#8
Soliman Oushy, Jonathon J Parker, Kristen Campbell, Claire Palmer, Corbett Wilkinson, Nicholas V Stence, Michael H Handler, David M Mirsky
OBJECTIVE Placement of a cerebrospinal fluid diversion device (i.e., shunt) is a routine pediatric neurosurgical procedure, often performed in the first weeks of life for treatment of congenital hydrocephalus. In the postoperative period, shunt placement may be complicated by subdural, catheter tract, parenchymal, and intraventricular hemorrhages. The authors observed a subset of infants and neonates who developed multifocal intraparenchymal hemorrhages (MIPH) following shunt placement and sought to determine any predisposing perioperative variables...
September 8, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28882608/-intracranial-hemorrhage-and-oral-anticoagulants-of-patients-treated-between-2011-and-2013-at-the-nancy-regional-university-hospital
#9
A Leblanc, N Petitpain, O Pereira, H El Adssi, C Latarche, P Gillet, S Colnat-Coulbois
OBJECTIVE: To perform a descriptive analysis of intracranial hemorrhages of patients treated with an antivitamin K (fluindione, acenocoumarol or warfarin) or a direct oral anticoagulant (dabigatran, rivaroxaban or apixaban) at the Nancy Regional University Hospital. MATERIAL AND METHOD: The study period was from January 2011 to December 2013 and the computerized data (Programme de Médicalisation des Systèmes d'Information) of our hospital was accessed to identify the patients...
September 4, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28812942/acute-hypertensive-response-in-patients-with-intracerebral-hemorrhage-pathophysiology-and-treatment
#10
Adnan I Qureshi, Mushtaq H Qureshi
Acute hypertensive response is a common systemic response to occurrence of intracerebral hemorrhage which has gained unique prominence due to high prevalence and association with hematoma expansion and increased mortality. Presumably, the higher systemic blood pressure predisposes to continued intraparenchymal hemorrhage by transmission of higher pressure to the damaged small arteries and may interact with hemostatic and inflammatory pathways. Therefore, intensive reduction of systolic blood pressure has been evaluated in several clinical trials as a strategy to reduce hematoma expansion and subsequent death and disability...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28812469/placental-pathologic-associations-with-morbidly-adherent-placenta-potential-insights-into-pathogenesis
#11
Linda M Ernst, Rebecca L Linn, Lucy Minturn, Emily S Miller
Background The pathology that underlies morbidly adherent placenta (MAP) is poorly understood. The objective of this study was to describe the placental pathology, especially implantation site pathology, associated with MAP. Methods This was a single institution, retrospective case-control study design examining placentas of patients who delivered between January 2008 and September 2013. MAP cases were defined by the need for clinical intervention at delivery beyond spontaneous placental delivery or simple manual extraction of the placenta...
September 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28754118/anticoagulation-with-warfarin-and-rivaroxaban-ameliorates-experimental-autoimmune-encephalomyelitis
#12
Leonie Stolz, Amin Derouiche, Kavi Devraj, Frank Weber, Robert Brunkhorst, Christian Foerch
BACKGROUND: In multiple sclerosis, coagulation factors have been shown to modulate inflammation. In this translational study, we investigated whether long-term anticoagulation with warfarin or rivaroxaban has beneficial effects on the course of autoimmune experimental encephalomyelitis (EAE). METHODS: Female SJL/J mice treated with anticoagulants namely warfarin or rivaroxaban were immunized with PLP139-151. Stable anticoagulation was maintained throughout the entire experiment...
July 28, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28730501/the-pseudo-sah-sign-an-imaging-pitfall-in-postmortem-computed-tomography
#13
Go Shirota, Wataru Gonoi, Masako Ikemura, Masanori Ishida, Yukako Shintani, Hiroyuki Abe, Masashi Fukayama, Tomohiko Higashida, Hidemi Okuma, Osamu Abe
Postmortem computed tomography (PMCT) of the brain has an important role in detection of subarachnoid hemorrhage (SAH), which has a high mortality rate. However, a phenomenon known as "pseudo-SAH," or high-attenuation areas along the cisterns mimicking SAH, may be seen on CT. The aim of this study was to evaluate the diagnostic accuracy of brain PMCT for SAH and to identify the characteristics of pseudo-SAH. Findings on PMCT (sulcal effacement, asymmetry, maximum thickness of SAH signs, presence of acute/subacute intraventricular/intraparenchymal hemorrhage) and clinical history (left ventricular assist device [LVAD] implantation, anticoagulation therapy/coagulation disorder, global ischemia) were compared between subjects with true SAH and those with pseudo-SAH...
July 20, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28720528/postoperative-dilatation-of-superficial-temporal-artery-associated-with-transient-neurologic-symptoms-after-direct-bypass-surgery-for-moyamoya-angiopathy
#14
Daizo Ishii, Takahito Okazaki, Toshinori Matsushige, Katsuhiro Shinagawa, Nobuhiko Ichinose, Shigeyuki Sakamoto, Kaoru Kurisu
OBJECTIVE: In moyamoya angiopathy, transient neurologic symptoms (TNS) are occasionally observed after superficial temporal artery (STA)-middle cerebral artery direct bypass surgery. The purpose of this study was to investigate the correlation between TNS and postoperative magnetic resonance imaging as well as perform a perfusion study. METHODS: We reviewed 52 hemispheres in 33 consecutive patients with moyamoya angiopathy. TNS were defined as reversible neurologic dysfunction without any apparent intracranial infarction or hemorrhage...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28713626/recurrent-hemorrhage-in-hemangioblastoma-involving-the-posterior-fossa-case-report
#15
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
#16
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
#17
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
#18
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
#19
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 patients with nontraumatic IPH transferred to a tertiary academic neurosurgery service was performed over 2 years...
October 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
#20
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
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