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https://www.readbyqxmd.com/read/28487333/enhanced-detection-of-edema-in-malignant-anterior-circulation-stroke-edema-score-a-risk-prediction-tool
#1
Charlene Jennifer Ong, Jeffrey Gluckstein, Osvaldo Laurido-Soto, Yan Yan, Rajat Dhar, Jin-Moo Lee
BACKGROUND AND PURPOSE: Rapid recognition of those at high risk for malignant edema after stroke would facilitate triage for monitoring and potential surgery. Admission data may be insufficient for accurate triage decisions. We developed a risk prediction score using clinical and radiographic variables within 24 hours of ictus to better predict potentially lethal malignant edema. METHODS: Patients admitted with diagnosis codes of cerebral edema and ischemic stroke, NIHSS score (National Institute of Health Stroke Score) of ≥8 and head computed tomographies within 24 hours of stroke onset were included...
May 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28409051/revisiting-hemicraniectomy-late-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-stroke-and-the-role-of-infarct-growth-rate
#2
Saadat Kamran, Naveed Akhtar, Abdul Salam, Ayman Alboudi, Kainat Kamran, Arsalan Ahmed, Rabia A Khan, Mohsin K Mirza, Jihad Inshasi, Ashfaq Shuaib
Objective and Methods. The outcome in late decompressive hemicraniectomy in malignant middle cerebral artery stroke and the optimal timings of surgery has not been addressed by the randomized trials and pooled analysis. Retrospective, multicenter, cross-sectional study to measure outcome following DHC under 48 or over 48 hours using the modified Rankin scale [mRS] and dichotomized as favorable ≤4 or unfavorable >4 at three months. Results. In total, 137 patients underwent DHC. Functional outcome analyzed as mRS 0-4 versus mRS 5-6 showed no difference in this split between early and late operated on patients [P = 0...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28387620/reoperation-and-readmission-after-clipping-of-an-unruptured-intracranial-aneurysm-a-national-surgical-quality-improvement-program-analysis
#3
Hormuzdiyar H Dasenbrock, Timothy R Smith, Robert F Rudy, William B Gormley, M Ali Aziz-Sultan, Rose Du
OBJECTIVE Although reoperation and readmission have been used as quality metrics, there are limited data evaluating the rate of, reasons for, and predictors of reoperation and readmission after microsurgical clipping of unruptured aneurysms. METHODS Adult patients who underwent craniotomy for clipping of an unruptured aneurysm electively were extracted from the prospective National Surgical Quality Improvement Program registry (2011-2014). Multivariable logistic regression and recursive partitioning analysis evaluated the independent predictors of nonroutine hospital discharge, unplanned 30-day reoperation, and readmission...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28372905/apoe-%C3%AE%C2%B54-positive-patients-suffering-severe-traumatic-head-injury-are-more-prone-to-undergo-decompressive-hemicraniectomy
#4
Zandra Olivecrona, Lars-Owe D Koskinen
OBJECT: In this paper we tested the hypothesis if patients with severe traumatic brain injury and presence of the apolipoprotein E (APOE) ε4 allele are more prone to undergo the surgical procedure decompressive hemicraniectomy (DC) in order to bring the intracranial pressure (ICP) under control. METHODS: In this prospective consecutive study patients with sTBI were enrolled (n=48). Inclusion criteria were arrival to our level one trauma university hospital within 24h after trauma, patient age between 15 and 70years, Glasgow Coma Scale (GCS) score ≤8 at the time of intubation and sedation, an initial cerebral perfusion pressure >10mmHg...
March 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28362968/letter-oracle-stroke-study-opinion-regarding-acceptable-outcome-following-decompressive-hemicraniectomy-for-ischemic-stroke
#5
Marino Muxfeldt Bianchin, Rosane Brondani, Andrea Garcia de Almeida
No abstract text is available yet for this article.
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28362917/in-reply-oracle-stroke-study-opinion-regarding-acceptable-outcome-following-decompressive-hemicraniectomy-for-ischemic-stroke
#6
Stephen Honeybul, Kwok Ming Ho, David J Blacker
No abstract text is available yet for this article.
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28359069/high-risk-of-seizures-and-epilepsy-after-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-stroke%C3%A2
#7
Rosane Brondani, Andrea Garcia de Almeida, Pedro Abrahim Cherubini, Suelen Mandelli Mota, Luiz Carlos de Alencastro, Apio Cláudio Martins Antunes, Marino Bianchin Muxfeldt
BACKGROUND: Decompressive hemicraniectomy (DHC) is a life-saving procedure for treatment of large malignant middle cerebral artery (MCA) strokes. Post-stroke epilepsy is an additional burden for these patients, but its incidence and the risk factors for its development have been poorly investigated. OBJECTIVE: To report the prevalence and risk factors for post-stroke seizures and post-stroke epilepsy after DHC for treatment of large malignant MCA strokes in a cohort of 36 patients...
March 30, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28353064/radiological-imaging-features-of-the-basal-ganglia-that-may-predict-progression-to-hemicraniectomy-in-large-territory-middle-cerebral-artery-infarct
#8
Asim Z Mian, David Edasery, Osamu Sakai, M Mustafa Qureshi, James Holsapple, Thanh Nguyen
PURPOSE: Predicting which patients are at risk for hemicraniectomy can be helpful for triage and can help preserve neurologic function if detected early. We evaluated basal ganglia imaging predictors for early hemicraniectomy in patients with large territory anterior circulation infarct. METHODS: This retrospective study evaluated patients with ischemic infarct admitted from January 2005 to July 2011. Patients with malignant cerebral edema refractory to medical therapy or with herniating signs such as depressed level of consciousness, anisocoria, and contralateral leg weakness were triaged to hemicraniectomy...
March 28, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28350280/no-benefits-of-hypothermia-in-patients-treated-with-hemicraniectomy-for-large-ischemic-stroke
#9
Hauke Schneider, Philipp Krüger, Ale Algra, Jeannette Hofmeijer, H Bart van der Worp, Eric Jüttler, Katayoun Vahedi, Gabriele Schackert, Heinz Reichmann, Volker Puetz
Background Space-occupying middle cerebral artery brain infarcts are associated with the development of brain edema, which may lead to cerebral herniation and death despite early hemicraniectomy. Aims To evaluate the benefit of therapeutic hypothermia in patients with space-occupying cerebral infarction treated with hemicraniectomy within 48 h of stroke onset. Methods Patients aged 18-60 years with space-occupying cerebral infarction treated with hemicraniectomy within 48 h and hypothermia (33-34°C) were selected from a single university hospital between 2001 and 2010 (n = 53)...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28314516/impact-of-an-intrahospital-mobile-thrombolysis-team-on-3-month-clinical-outcomes-in-patients-benefiting-from-intravenous-thrombolysis-for-acute-ischemic-stroke
#10
B Hebant, A Triquenot-Bagan, E Guegan-Massardier, O Ozkul-Wermester, L Grangeon, D Maltête
INTRODUCTION/OBJECTIVE: The benefits of thrombolysis in patients presenting with acute ischemic stroke (IS) are highly time-dependent. The aim of our study was to evaluate the clinical benefit, after 3 months, of an intrahospital mobile thrombolysis team (MTT) for thrombolysis in IS. PATIENTS AND METHODS: A total of 95 consecutive patients treated with IV tPA for acute IS at the neurology department of Rouen University Hospital between 1 January and 31 December 2015 were retrospectively identified...
March 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28282456/early-computed-tomography-based-scores-to-predict-decompressive-hemicraniectomy-after-endovascular-therapy-in-acute-ischemic-stroke
#11
Ilko L Maier, Daniel Behme, Marlena Schnieder, Ioannis Tsogkas, Katharina Schregel, Mathias Bähr, Michael Knauth, Jan Liman, Marios-Nikos Psychogios
BACKGROUND: Identification of patients requiring decompressive hemicraniectomy (DH) after endovascular therapy (EVT) is crucial as clinical signs are not reliable and early DH has been shown to improve clinical outcome. The aim of our study was to identify imaging-based scores to predict the risk for space occupying ischemic stroke and DH. METHODS: Prospectively derived data from patients with acute large artery occlusion within the anterior circulation and EVT was analyzed in this monocentric study...
2017: PloS One
https://www.readbyqxmd.com/read/28235642/national-survey-of-neurosurgeons-and-stroke-physicians-on-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction
#12
Pallavi Basu, Harri Jenkins, Kevin Tsang, Vejay N Vakharia
BACKGROUND: Several studies have evaluated the use of decompressive hemicraniectomy (DHC) in malignant middle cerebral artery infarction (MMCAI). In the United Kingdom (UK), the National Institute for Health and Care Excellence (NICE) has set criteria for selection of patients for DHC in MMCAI. We set out to survey the attitudes and practice of neurosurgeons and stroke physicians within the UK towards DHC in MMCAI. METHODS: An electronic survey of questions on management of MMCAI in various clinical scenarios was submitted to the academic committees of the Society of British Neurological Surgeons (SBNS) and the British Association of Stroke Physicians (BASP) for approval, prior to dissemination through the consultant members...
February 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28201629/in-reply-oracle-stroke-study-opinion-regarding-acceptable-outcome-following-decompressive-hemicraniectomy-for-ischemic-stroke
#13
Stephen Honeybul, Kwok Ming Ho, David J Blacker
No abstract text is available yet for this article.
February 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28191384/delayed-temporal-lobe-hemorrhage-after-initiation-of-acyclovir-in-an-immunocompetent-patient-with-herpes-simplex-virus-2-encephalitis-a-case-report
#14
Kyle Mueller, Joshua E Ryan, Alex Tai, Rocco A Armonda
Herpes simplex virus (HSV) is the most common cause of non-epidemic, sporadic, acute focal encephalitis in the United States. Inflammation of the vasculature makes them friable and susceptible to hemorrhage. Massive hemorrhage, though rare, can present in a delayed fashion after initiation of acyclovir and often requires surgical intervention. We report a unique case of delayed temporal lobe hemorrhage after initiation of acyclovir in an immunocompetent patient, specifically for its presentation, virology, and surgical management...
January 15, 2017: Curēus
https://www.readbyqxmd.com/read/28187804/decompressive-craniectomy-in-acute-brain-injury
#15
REVIEW
D A Brown, E F M Wijdicks
Decompressive surgery to reduce pressure under the skull varies from a burrhole, bone flap to removal of a large skull segment. Decompressive craniectomy is the removal of a large enough segment of skull to reduce refractory intracranial pressure and to maintain cerebral compliance for the purpose of preventing neurologic deterioration. Decompressive hemicraniectomy and bifrontal craniectomy are the most commonly performed procedures. Bifrontal craniectomy is most often utilized with generalized cerebral edema in the absence of a focal mass lesion and when there are bilateral frontal contusions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187798/critical-care-in-acute-ischemic-stroke
#16
REVIEW
M McDermott, T Jacobs, L Morgenstern
Most ischemic strokes are managed on the ward or on designated stroke units. A significant proportion of patients with ischemic stroke require more specialized care. Several studies have shown improved outcomes for patients with acute ischemic stroke when neurocritical care services are available. Features of acute ischemic stroke patients requiring intensive care unit-level care include airway or respiratory compromise; large cerebral or cerebellar hemisphere infarction with swelling; infarction with symptomatic hemorrhagic transformation; infarction complicated by seizures; and a large proportion of patients require close management of blood pressure after thrombolytics...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28185018/efficacy-and-safety-of-durotomy-after-decompressive-hemicraniectomy-in-traumatic-brain-injury
#17
R B Moringlane, N Keric, F B Freimann, D Mielke, R Burger, D Duncker, V Rohde, K L V Eckardstein
Decompressive hemicraniectomy (DH) plus duroplasty was demonstrated to be effective for treating critically elevated intracranial pressure (ICP). In order to shorten operation time and to avoid the use of autologous or heterologous material, durotomy has been introduced as an alternative to duroplasty. Only limited data is available on the effect of DH and durotomy on the increased ICP in traumatic brain injury (TBI). Therefore, we collected consecutive intraoperative ICP readings during the different steps of DH and durotomy in TBI patients...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28163065/a-standardized-method-to-measure-brain-shifts-with-decompressive-hemicraniectomy
#18
Askiel Bruno, Abdurrehman Zahran, Nina Paletta, Laith Maali, Fenwick T Nichols, Ramon Figueroa
BACKGROUND: A standardized, reliable, and practical method for measuring decompressive hemicraniectomy (DHC) defects and brain shifts in malignant middle cerebral artery (MCA) territory infarction is needed for reliable comparisons between computed tomography (CT) scans. Such a method could facilitate further studies on the effects of DHC. NEW METHOD: We describe and apply a method for measuring DHC defects and brain shifts on CT scans in 25 patients with malignant MCA territory infarction...
February 2, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28108618/timing-of-decompressive-hemicraniectomy-for-stroke-a-nationwide-inpatient-sample-analysis
#19
Hormuzdiyar H Dasenbrock, Faith C Robertson, Henrikas Vaitkevicius, M Ali Aziz-Sultan, Donovan Guttieres, Ian F Dunn, Rose Du, William B Gormley
BACKGROUND AND PURPOSE: Previous clinical trials were not designed to discern the optimal timing of decompressive craniectomy for stroke, and the ideal surgical timing in patients with space-occupying infarction who do not exhibit deterioration within 48 hours is debated. METHODS: Patients undergoing decompressive craniectomy for stroke were extracted from the Nationwide Inpatient Sample (2002-2011). Multivariable logistic regression evaluated the association of surgical timing with mortality, discharge to institutional care, and poor outcome (a composite end point including death, tracheostomy and gastrostomy, or discharge to institutional care)...
March 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28070645/middle-cerebral-artery-aneurysms-with-intracerebral-hematoma-the-impact-of-side-and-volume-on-final-outcome
#20
Ondrej Navratil, Kamil Duris, Vilem Juran, Eduard Neuman, Karel Svoboda, Martin Smrcka
BACKGROUND: Middle cerebral artery aneurysms (MCA aneurysms) belong to the most frequent type of intracranial aneurysms forming an intracerebral hematoma. The consequences of the hematoma-the laterality, the impact of ICH volume and size of the aneurysm with the final outcome of these patients had not been studied in detail in this location, and we focused on the analysis of these factors. METHODS: Patients with MCA aneurysms and associated intracerebral hematomas with a volume ≥10 ml were studied; these were treated from January 2006 to December 2015...
March 2017: Acta Neurochirurgica
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