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https://www.readbyqxmd.com/read/29202815/normothermia-after-decompressive-surgery-for-space-occupying-middle-cerebral-artery-infarction-a-protocol-based-approach
#1
Jan Rahmig, Matthias Kuhn, Hermann Neugebauer, Eric Jüttler, Heinz Reichmann, Hauke Schneider
BACKGROUND: Moderate hypothermia after decompressive surgery might not be beneficial for stroke patients. However, normothermia may prove to be an effective method of enhancing neurological outcomes. The study aims were to evaluate the application of a pre-specified normothermia protocol in stroke patients after decompressive surgery and its impact on temperature load, and to describe the functional outcome of patients at 12 months after treatment. METHODS: We analysed patients with space-occupying middle cerebral artery (MCA) infarction treated with decompressive surgery and a pre-specified temperature management protocol...
December 4, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29124813/a-simplified-quantitative-method-to-measure-brain-shifts-in-patients-with-middle-cerebral-artery-stroke
#2
Nina Paletta, Laith Maali, Abdurrehman Zahran, Sankara Sethuraman, Ramon Figueroa, Fenwick T Nichols, Askiel Bruno
BACKGROUND AND PURPOSE: A standardized and validated method to measure brain shifts in malignant middle cerebral artery (MCA) stroke with decompressive hemicraniectomy (DHC) could facilitate clinical decision making, prognostication, and comparison of results between studies. METHODS: We tested for reliability simplified methods to measure transcalvarial herniation, midline brain shift, and the contralateral cerebral ventricular atrium in malignant MCA stroke after DHC...
November 10, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29107638/herniation-despite-decompressive-hemicraniectomy-in-large-hemispherical-ischemic-strokes
#3
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/29103136/a-study-of-the-opinions-of-swedish-healthcare-personnel-regarding-acceptable-outcome-following-decompressive-hemicraniectomy-for-ischaemic-stroke
#4
Magnus Olivecrona, Stephen Honeybul
BACKGROUND: Decompressive hemicraniectomy (DC) is an established lifesaving treatment for malignant infarction of the middle cerebral artery (mMCAI). However, surgical decompression will not reverse the effects of the stroke and many survivors will be left severely disabled. The objective of this study was to assess what neurological outcome would be considered acceptable in these circumstances amongst Swedish healthcare workers. METHOD: Healthcare workers were invited to participate in a presentation that outlined the pathophysiology of mMCAI, the rationale behind DC and outcome data from randomised controlled trials that have investigated efficacy of the procedure...
November 4, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29079663/favorable-revascularization-therapy-in-patients-with-aspects-%C3%A2-5-on-dwi-in-anterior-circulation-stroke
#5
Isabelle Mourand, Eitan Abergel, Daniel Mantilla, Xavier Ayrignac, Tzvika Sacagiu, Omer Faruk Eker, Gregory Gascou, Cyril Dargazanli, Carlos Riquelme, Marinette Moynier, Alain Bonafé, Caroline Arquizan, Vincent Costalat
BACKGROUND: A low baseline Alberta Stroke Programme Early CT Score (ASPECTS) is strongly associated with low rates of favorable outcome in patients with acute stroke. OBJECTIVE: To evaluate the efficacy and safety of revascularization therapy in patient with ASPECTS ≤5 in anterior circulation infarct. METHODS: We retrospectively analyzed 108 consecutive patients presenting low ASPECTS on diffusion-weighted imaging. Sixty patients were treated by mechanical thrombectomy, including 34 patients who received simultaneously intravenous thrombolysis...
October 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28965156/decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction-including-patients-with-additional-involvement-of-the-anterior-and-or-posterior-cerebral-artery-territory-outcome-analysis-and-definition-of-prognostic-factors
#6
Sven Kürten, Christopher Munoz, Kerim Beseoglu, Igor Fischer, Jason Perrin, Hans-Jakob Steiger
BACKGROUND: According to current evidence, adding decompressive craniectomy (DC) to best medical therapy reduces case fatality rate of malignant middle cerebral artery infarction by 50-75%. There is currently little information available regarding the outcome of subgroups, in particular of patients with extensive infarctions exceeding the territory of the middle cerebral artery. METHODS: The records of 101 patients with large hemispheric infarctions undergoing DC were retrospectively reviewed...
September 30, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28887767/management-of-spontaneous-intracerebral-hemorrhage
#7
REVIEW
Roland Veltkamp, Jan Purrucker
PURPOSE OF REVIEW: We review the current evidence for medical and surgical treatments of spontaneous intracerebral hemorrhage (ICH). RECENT FINDINGS: Therapy with hemostatic agents (e.g. factor VIIa and tranexamic acid) if started early after bleeding onset may reduce hematoma expansion, but their clinical effectiveness has not been shown. Rapid anticoagulation reversal with prothrombin concentrates (PCC) plus vitamin K is the first choice in vitamin K antagonist-related ICH...
September 8, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28885045/duret-hemorrhage-complicating-a-sinking-skin-flap-syndrome
#8
Mickael Cardinale, Eric Meaudre, Pierre-Julien Cungi, Cédric Nguyen, Pierre Esnault, Christophe Joubert
Duret hemorrhage has always been reported during an episode of increased intracranial pressure with transtentorial herniation. We reported a Duret hemorrhage occurring during an episode of intracranial hypotension resulted in sinking skin flap syndrome which was responsible for acute paradoxal descending transtentorial herniation and Duret hemorrhage, 10 days after large hemicraniectomy which could indicate early cranioplasty.
September 8, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28873989/decompressive-hemicraniectomy-in-the-setting-of-poststroke-cerebral-edema-a-case-for-early-intervention
#9
Rami James N Aoun, Aman Gupta, Matthew E Welz, Bernard R Bendok
No abstract text is available yet for this article.
July 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28847114/single-stage-surgery-avoiding-cranioplasty-at-a-later-date-following-decompressive-hemicraniectomy
#10
LETTER
Sudip Kumar Sengupta
No abstract text is available yet for this article.
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28806209/refractory-intracranial-hypertension-the-role-of-decompressive-craniectomy
#11
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...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28790400/prediction-of-infarction-volume-and-infarction-growth-rate-in-acute-ischemic-stroke
#12
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/28698088/microsurgical-repair-of-ruptured-aneurysms-associated-with-moyamoya-pattern-collateral-vessels-of-the-middle-cerebral-artery-a-report-of-two-cases
#13
Min Lang, Nina Z Moore, Alex M Witek, Varun R Kshettry, Mark D Bain
BACKGROUND: Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe 2 cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. CASE DESCRIPTION: The first patient was a 61-year-old man who presented with right frontal and intraventricular hemorrhage...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28695244/-diagnostic-and-treatment-standards-for-cerebral-sinus-venous-thrombosis-results-of-an-online-survey-of-german-stroke-units
#14
C Geisbüsch, P A Ringleb, O Busse, G F Hamann, S Nagel
BACKGROUND AND PURPOSE: The aim of this survey was to characterize the current diagnostic and therapeutic strategies for thrombosis of the cerebral sinus and veins (CVT) performed in German stroke units (SU). METHODS: Between September 2015 and January 2016 all clinical heads of certified SUs in Germany were invited to participate in a standardized online survey. The survey concentrated on the basic characteristics of SUs, diagnostic and therapeutic procedures and was made anonymous if so desired...
October 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28694110/predictors-of-in-hospital-mortality-after-decompressive-hemicraniectomy-for-malignant-ischemic-stroke
#15
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/28678213/decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction-experience-from-the-western-province-of-saudi-arabia
#16
Haifa M Algethamy, Afnan Samman, Saleh S Baeesa, Mohammed A Almekhlafi, Yousef A Al Said, Ahmed Hassan
OBJECTIVE: To describe our experience implementing decompressive hemicraniectomy (DH) for eligible patients with malignant middle cerebral artery (MCA) infarcts. METHODS: We retrospectively collected data of malignant MCA infarction patients requiring DH at King Abdulaziz University Hospital & King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia between October 2010 and July 2015. Clinical outcome was assessed immediately postoperatively using Glasgow Coma Score (GCS), and at 12 months using the modified Rankin scale (mRS) and Barthel index...
July 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/28665171/infarct-volume-predicts-outcome-after-decompressive-hemicraniectomy-for-malignant-hemispheric-stroke
#17
Nils Hecht, Hermann Neugebauer, Ingo Fiss, Alexandra Pinczolits, Peter Vajkoczy, Eric Jüttler, Johannes Woitzik
The decision to perform decompressive hemicraniectomy (DHC) by default in malignant hemispheric stroke (MHS) remains controversial. Even under ideal conditions, DHC usually results in moderate to severe disability. The present study for the first time uses neuroimaging to identify independent outcome predictors in a prospective cohort of 96 MHS patients undergoing DHC. The primary outcome was functional status according to the modified Rankin Scale (mRS) at 12 months and categorized as favorable (mRS 0-3) or unfavorable (mRS 4-6)...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28621627/factors-associated-with-shunt-dependent-hydrocephalus-after-decompressive-craniectomy-for-traumatic-brain-injury
#18
Aditya Vedantam, Jose-Miguel Yamal, Hyunsoo Hwang, Claudia S Robertson, Shankar P Gopinath
OBJECTIVE Posttraumatic hydrocephalus (PTH) affects 11.9%-36% of patients undergoing decompressive craniectomy (DC) and is an important cause of morbidity after traumatic brain injury (TBI). Early diagnosis and treatment of PTH can prevent further neurological compromise in patients who are recovering from TBI. There is limited data on predictors of shunting for PTH after DC for TBI. METHODS Prospectively collected data from the erythropoietin severe TBI randomized controlled trial were studied. Demographic, clinical, and imaging data were analyzed for enrolled patients who underwent a DC...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28620567/a-retrospective-cohort-study-to-assess-patient-and-physician-reported-outcome-measures-after-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-stroke
#19
Sanjay Budhdeo, Angelos G Kolias, David J Clark, Aswin Chari, Peter J Hutchinson, Elizabeth A Warburton
INTRODUCTION: Decompressive hemicraniectomy for malignant middle cerebral artery (MCA) infarction is known to reduce mortality. However, there are on-going concerns in terms of the quality of life in survivors. We aimed to examine the correlation between patient and physician reported outcome measures in decompressive hemicraniectomy. PATIENTS AND METHODS: We analyzed outcomes in 21 patients who underwent decompressive hemicraniectomy for malignant MCA infarction between September 2003 and August 2013 within a regional health system...
May 10, 2017: Curēus
https://www.readbyqxmd.com/read/28600010/hemicraniectomy-for-ischemic-and-hemorrhagic-stroke-facts-and-controversies
#20
REVIEW
Aman Gupta, Mithun G Sattur, Rami James N Aoun, Chandan Krishna, Patrick B Bolton, Brian W Chong, Bart M Demaerschalk, Mark K Lyons, Jamal McClendon, Naresh Patel, Ayan Sen, Kristin Swanson, Richard S Zimmerman, Bernard R Bendok
Malignant large artery stroke is associated with high mortality of 70% to 80% with best medical management. Decompressive craniectomy (DC) is a highly effective tool in reducing mortality. Convincing evidence has accumulated from several randomized trials, in addition to multiple retrospective studies, that demonstrate not only survival benefit but also improved functional outcome with DC in appropriately selected patients. This article explores in detail the evidence for DC, nuances regarding patient selection, and applicability of DC for supratentorial intracerebral hemorrhage and posterior fossa ischemic and hemorrhagic stroke...
July 2017: Neurosurgery Clinics of North America
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