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Intraparenchymal hemorrhage

Jacob R Joseph, Brandon W Smith, Hugh J L Garton
Blunt prenatal trauma is known to have consequences to the developing brain, and can result in subdural hematoma (SDH) or epidural hematoma (EDH). The authors present a case of blunt prenatal trauma resulting in a fetal SDH, intraparenchymal hematoma, and intraventricular hemorrhage, and perform a systematic review of the literature. This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Relevant studies (up to April 2016) that reported on cases of fetal SDH or EDH after blunt prenatal trauma were identified from the PubMed database...
October 14, 2016: Journal of Neurosurgery. Pediatrics
Sophia F Shakur, Victor A Aletich, Sepideh Amin-Hanjani, Ahmed E Hussein, Fady T Charbel, Ali Alaraj
BACKGROUND: Pipeline embolization devices (PEDs) are commonly used for endovascular treatment of cerebral aneurysms but can be associated with delayed ipsilateral intraparenchymal hemorrhage. Although intra-aneurysmal hemodynamic changes have been studied, parent vessel and intracranial hemodynamics after PED use are unknown. We examine the impact of flow diversion on parent artery and distal intracranial hemodynamics. METHOD: Patients with internal carotid cerebral aneurysms treated with PED who had flow volume rate, flow velocities, pulsatility index, resistance index, Lindegaard ratio, and wall shear stress (WSS) obtained after treatment using quantitative magnetic resonance angiography were reviewed...
October 4, 2016: Interventional Neuroradiology
Mohammad Fazel Bakhsheshi, Yong Wang, Lynn Keenliside, Ting-Yim Lee
BACKGROUND: Target temperature management is the single most effective intervention and the gold standard in post-resuscitation care today. However, cooling the whole body below 33-34 °C can cause severe complications. Therefore, developing a selective brain cooling (SBC) approach which can be initiated early to induce rapid cooling and maintain the target temperature over 12-24 h before slowly rewarming brain temperature by itself alone would be advantageous. Vortex tubes are simple mechanical devices generating cold air from a stream of compressed air without applied chemical or energy...
December 2016: Intensive Care Medicine Experimental
Tanja Schneider, Tobias Mahraun, Julian Schroeder, Andreas Frölich, Philip Hoelter, Marlies Wagner, Jean Darcourt, Christophe Cognard, Alain Bonafé, Jens Fiehler, Susanne Siemonsen, Jan-Hendrik Buhk
PURPOSE: The presence of intraparenchymal hyperattenuations (IPH) on flat-panel computed tomography (FP-CT) after endovascular recanalization in stroke patients is a common phenomenon. They are thought to occur in ischemic areas with breakdown of the blood-brain barrier but previous studies that investigated a mutual interaction are scarce. We aimed to assess the relationship of IPH localization with prethrombectomy diffusion-weighted imaging (DWI) lesions. METHODS: This retrospective multicenter study included 27 acute stroke patients who underwent DWI prior to FP-CT following mechanical thrombectomy...
September 16, 2016: Clinical Neuroradiology
Nitin Agarwal, Giulio Zuccoli, Geoffrey Murdoch, Brian T Jankowitz, Stephanie Greene
INTRODUCTION: Developmental venous anomalies (DVAs) are cited as the most common cerebral vascular malformations. Still, intracerebral hematomas are rarely thought to be caused by DVAs. In this report, the authors present a unique case of a DVA that hemorrhaged spontaneously, rather than hemorrhaging into a venous infarction following DVA thrombosis as has been more commonly reported. CLINICAL PRESENTATION: A 22-year-old previously healthy male presented to the emergency department with a severe headache, confusion, and progressive hemiparesis...
September 9, 2016: Neuroradiology Journal
Mario Teo, Jeremiah N Johnson, Teresa E Bell-Stephens, Michael P Marks, Huy M Do, Robert L Dodd, Michael B Bober, Gary K Steinberg
OBJECTIVE Majewski osteodysplastic primordial dwarfism Type II (MOPD II) is a rare genetic disorder. Features of it include extremely small stature, severe microcephaly, and normal or near-normal intelligence. Previous studies have found that more than 50% of patients with MOPD II have intracranial vascular anomalies, but few successful surgical revascularization or aneurysm-clipping cases have been reported because of the diminutive arteries and narrow surgical corridors in these patients. Here, the authors report on a large series of patients with MOPD II who underwent surgery for an intracranial vascular anomaly...
September 9, 2016: Journal of Neurosurgery. Pediatrics
Ha Son Nguyen, Ninh Doan, Saman Shabani, Michael Gelsomino, Osama Zaidat
BACKGROUND: Pure subdural hematoma (without subarachnoid, intraventricular, or intraparenchymal hemorrhage) due to a ruptured intracranial aneurysm is rare. Most reported cases involve an aneurysm along the internal carotid artery, posterior communicating artery, or middle cerebral artery. No reports have described an aneurysm along the transmastoid branches of the occipital artery. CASE DESCRIPTION: A 70-year-old female presented with sudden-onset, excruciating headaches, associated with dizziness, nausea, and emesis...
2016: Surgical Neurology International
Aasheen Munshey, Justin Moore, Catriona Maclean, Anthony Longano, Tony Goldschlager
BACKGROUND: Pilocytic astrocytoma (PA) is a benign neoplasm that typically occurs in the brain within the pediatric and adolescent age groups and is uncommon in adults. It rarely occurs within the ventricles and the overall prognosis is favourable. A pilocytic astrocytoma of the brain with spinal metastasis at presentation has never been reported in an adult. CASE DESCRIPTION: We report a case of a 47-year-old male presenting with sudden onset frontal headache associated with nausea and lethargy...
August 12, 2016: World Neurosurgery
Xiao-Hui Zhang, Qian-Ming Wang, Huan Chen, Yu-Hong Chen, Wei Han, Feng-Rong Wang, Jing-Zhi Wang, Yuan-Yuan Zhang, Xiao-Dong Mo, Yao Chen, Yu Wang, Ying-Jun Chang, Lan-Ping Xu, Kai-Yan Liu, Xiao-Jun Huang
Intracranial hemorrhage (ICH) is one of the most life-threatening neurological complications after allogeneic hematopoietic stem cell transplantation. Although cerebral complications and its causes after allo-HSCT are well documented, assessment of the incidence and risk factors of intracranial hemorrhage following allo-HSCT are less discussed. A nested case-control study was conducted involving 160 subjects drawn from 2169 subjects who underwent HSCT at Peking University People's Hospital between 2004 and 2014...
October 2016: Annals of Hematology
Marco Felipe Silva, Ana Raquel Feitosa, José A Paz, Nádia Emi Aikawa, Clovis A Silva
Childhood primary angiitis of the central nervous system (cPACNS) is a rare inflammatory brain disease of unknown etiology. Of note, brain hemorrhage has been rarely reported in cPACNS patients, generally associated with a delayed clinical diagnosis, or with a diagnosis only at necropsy. We present the case of a boy with cPACNS that previously suffered an ischemic stroke. At the age of 7 years and 10 months, he presented a sudden and severe headache, vomiting and reduction in consciousness level (Glasgow coma scale 7), requiring prompt tracheal intubation...
July 2016: Revista Brasileira de Reumatologia
S A Abudeev, K A Popugaev, N M Kruglyakov, K A Belousova, D A Terekhov, K Yu Leushin, M S Aronov, O V Karpova, A V Zelenkov, K V Kiselev, A B Fedin, M V Zabelin, A S Samoylov
Aneurysmal subarachnoid hemorrhage is a serious medical and social problem. The main physiological mechanisms that determine secondary brain damage in this patients are intracranial hypertension, cerebral vasospasm, dysfunction of autoregulation mechanisms, violation of liquorodynamics and delayed cerebral ischemia. The multimodal neuromonitoring for prevention and timely correction ofsecondary brain injury factors has become routine practice in neuroICU. Measurement of oxygen tension in the brain parenchyma is one of neuromonitoring options...
March 2016: Anesteziologiia i Reanimatologiia
Faiz I Syed, Daniel R Couriel, David Frame, Ashok Srinivasan
Hematopoietic stem cell transplantation (SCT) is now commonly used to treat several hematologic and nonhematologic diseases. Central nervous system (CNS) complications post-transplantation occur commonly in the first year and result in increased mortality from infectious, toxic, metabolic, or vascular causes. Infections secondary to aspergillus, toxoplasma and viruses cause many of the complications. Drug-related toxicities arising from conditioning regimens and graft-versus-host disease prophylaxis, as well as intraparenchymal hemorrhage, are not uncommon and can result in increased morbidity...
August 2016: Hematology/oncology Clinics of North America
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...
July 21, 2016: Pediatric and Developmental Pathology
Francesco Briganti, Giuseppe Leone, Lorenzo Ugga, Mariano Marseglia, Antonio Macera, Andrea Manto, Luigi Delehaye, Maurizio Resta, Mariachiara Resta, Nicola Burdi, Nunzio Paolo Nuzzi, Ignazio Divenuto, Ferdinando Caranci, Mario Muto, Domenico Solari, Paolo Cappabianca, Francesco Maiuri
BACKGROUND: Experience with the endovascular treatment of cerebral aneurysms using the p64 Flow Modulation Device is still limited. This study discusses the results and complications of this new flow diverter device. METHODS: 40 patients (30 women, 10 men) with 50 cerebral aneurysms treated in six Italian neurointerventional centers with the p64 Flow Modulation Device between April 2013 and September 2015 were retrospectively reviewed. RESULTS: Complete occlusion was obtained in 44/50 aneurysms (88%) and partial occlusion in 3 (6%)...
July 20, 2016: Journal of Neurointerventional Surgery
Javier M Romero, Jonathan Rosand
Primary or nontraumatic spontaneous intracerebral hemorrhage (ICH) accounts for 10-15% of all strokes, and has a poor prognosis. ICH has a mortality rate of almost 50% when associated with intraventricular hemorrhage within the first month, and 80% rate of dependency at 6 months from onset. Neuroimaging is critical in identifying the underlying etiology and thus assisting in the important therapeutic decisions. There are several imaging modalities available in the workup of patients who present with ICH, including computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA)...
2016: Handbook of Clinical Neurology
V R Ferraz, G B Aguiar, J L Vitorino-Araujo, G L Badke, J C E Veiga
Low-energy penetrating nail injury to the brain is an extremely rare neurosurgical emergency. The most common cause of nail gun injury is work related accidents; other causes result from accidental firing of a nail gun, suicide attempts by firing nail guns into the brain, and bomb blasts containing pieces of nails. Neurosurgical treatment performed by craniotomy still seems to be the safest one; there are reports of complications such as subdural hematoma and intraparenchymal hemorrhages following the blind removal of foreign bodies leading to suggestions that all penetrating foreign bodies should be removed under direct vision...
2016: Case Reports in Neurological Medicine
Filippo Flavio Angileri, Felice Esposito, Stefano Maria Priola, Giovanni Raffa, Daniele Marino, Rosaria Viola Abbritti, Maria Giusa, Antonino Germanò, Francesco Tomasello
OBJECTIVE: A modification of other reported endoscopic Intracerberal clot evacuation is reported. METHODS: From January 2014 to December 2014 we operated on 6 patients harboring a spontaneous supratentorial intracerebral hemorrhage (ICH) using a fully endoscopic free hand technique. The surgical technique is described and illustrated. Clinical chart and surgical videos were analyzed. Volumetric evaluation of the clot preoperatively and the residual hematoma post-operatively was performed...
July 13, 2016: World Neurosurgery
Virendra R Desai, Robert Grossman, Harlan Sparrow
OBJECTIVE: To describe the characteristics of patients who underwent a cranial operation and postoperatively suffered an intracranial hemorrhage significant enough to require evacuation. MATERIALS & METHODS : 3,109 cranial operations were performed at Houston Methodist Hospital (Texas Medical Center campus) between January 2009 and December 2013. Of these, 59 cases required a second operation for evacuation of an intracranial hemorrhage. The information gathered included the patients' age, gender, past medical history, medications and laboratory data, initial diagnosis, date/type of first and second operations, duration of hospitalization, discharge condition, and discharge destination...
2016: Curēus
Guilherme Dabus, Jonathan A Grossberg, C Michael Cawley, Jacques E Dion, Ajit S Puri, Ajay K Wakhloo, Douglas Gonsales, Pedro Aguilar-Salinas, Eric Sauvageau, Italo Linfante, Ricardo A Hanel
BACKGROUND: The off-label use of flow diverters in the treatment of distal aneurysms continues to be debated. OBJECTIVE: To report our multicenter experience in the treatment of complex anterior cerebral artery aneurysms with the Pipeline embolization device (PED). METHODS: The neurointerventional databases of the four participating institutions were retrospectively reviewed for aneurysms treated with PED between October 2011 and January of 2016...
July 5, 2016: Journal of Neurointerventional Surgery
Vijay M Ravindra, Michael Karsy, Richard H Schmidt, Philipp Taussky, Min S Park, Robert J Bollo
The authors report the case of a previously healthy 6-month-old girl who presented with right arm and leg stiffening consistent with seizure activity. An initial CT scan of the head demonstrated acute subarachnoid hemorrhage in the basal cisterns extending into the left sylvian fissure. Computed tomography angiography demonstrated a 7 × 6 × 5-mm saccular aneurysm of the inferior M2 division of the left middle cerebral artery. The patient underwent left craniotomy and microsurgical clip ligation with wrapping of the aneurysm neck because the vessel appeared circumferentially dysplastic in the region of the aneurysm...
July 1, 2016: Journal of Neurosurgery. Pediatrics
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