85,388 results match your criteria Intracranial Hemorrhage


The safety and efficacy of pharmaco-mechanical thrombolysis in lower-extremity deep venous thrombosis.

Cardiovasc J Afr 2020 Jun 19;31:1-5. Epub 2020 Jun 19.

Çanakkale Onsekiz Mart University, Çanakkale, Turkey.

Objective: The aim of this study was to investigate the impact of accelerated pharmaco-mechanical thrombolysis (PMT) with low-dose second-generation urokinase for the management of cases with lower-extremity deep venous thrombosis (DVT), and to compare its efficacy in subjects with acute and subacute DVT.

Methods: Thirty-five patients with acute (< 15 days) or subacute (15-30 days) DVT who underwent PMT in a tertiary centre were enrolled in this single-arm, prospective study. Following the placement of a temporary vena cava filter, urokinase (200 000 IU) was administered into the occlusion through a multi-hole catheter for 15 to 20 minutes. Read More

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http://dx.doi.org/10.5830/CVJA-2020-020DOI Listing

Tenecteplase versus alteplase after acute ischemic stroke at high age.

Int J Stroke 2020 Jul 6:1747493020938306. Epub 2020 Jul 6.

Department of Neurology, Division of Medicine, Akershus University Hospital, Lorenskog, Norway.

Background: Stroke prevalence is increasing with age. Alteplase is the only agent approved for thrombolytic treatment for patients with ischemic stroke, including patients ≥80 years. In the present study, the aim was to compare efficacy and safety of tenecteplase and alteplase in patients ≥80 years. Read More

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http://dx.doi.org/10.1177/1747493020938306DOI Listing

Efficacy and Safety of Mechanical Thrombectomy for Acute Mild Ischemic Stroke with Large Vessel Occlusion.

Med Sci Monit 2020 Jul 6;26:e926110. Epub 2020 Jul 6.

Department of Neurology, Wuhan University, Renmin Hospital, Wuhan, Hubei, China (mainland).

BACKGROUND The suitability of mechanical thrombectomy (MT) for patients with acute mild ischemic stroke (AMIS) caused by large vessel occlusion (LVO) is controversial. This study evaluated MT in patients with AMIS and LVO. MATERIAL AND METHODS Forty-seven patients diagnosed as AMIS with LVO received MT or intravenous thrombolysis (IVT). Read More

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http://dx.doi.org/10.12659/MSM.926110DOI Listing

Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Advanced Liver Disease: An Exploratory Meta-Analysis.

Hepatol Commun 2020 Jul 7;4(7):1034-1040. Epub 2020 May 7.

I Clinica Medica Atherothrombosis Center Department of Clinical Internal, Anesthesiologic, and Cardiovascular Sciences Sapienza University of Rome Rome Italy.

Direct oral anticoagulants (DOACs) have had a positive impact in preventing cardioembolic stroke in patients with atrial fibrillation (AF) who were associated with lower bleeding complications; however, data on subjects with concomitant advanced liver diseases (ALDs) are poor. This meta-analysis evaluates bleeding and thromboembolic complications in patients with coexisting AF and ALD who were treated with DOACs or vitamin K antagonists (VKAs). We performed a meta-analysis of randomized controlled trials and observational studies identified by the PubMed and Embase databases using a combination of the following keywords: "direct oral anticoagulants," "advanced liver disease," "cirrhosis," "bleeds," "stroke. Read More

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http://dx.doi.org/10.1002/hep4.1513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327201PMC

Aspiration Thrombectomy Versus Stent Retriever Thrombectomy Alone for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

Cureus 2020 May 31;12(5):e8380. Epub 2020 May 31.

Internal Medicine, John H Stroger J. Hospital of Cook County, Chicago, USA.

Introduction This meta-analysis was conducted to assess the safety and efficacy of aspiration thrombectomy versus stent retriever thrombectomy for acute ischemic stroke (AIS). Methods We queried online databases for original studies comparing aspiration thrombectomy with stent retriever thrombectomy in patients with AIS. After article selection, data were extracted on multiple baseline characteristics and prespecified endpoints. Read More

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http://dx.doi.org/10.7759/cureus.8380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328696PMC

[Successful treatment by switching from activated prothrombin complex concentrate to emicizumab therapy in a hemophilia A patient with inhibitors].

Rinsho Ketsueki 2020 ;61(6):617-620

Center for Postgraduate Education and Training, National Center for Child Health and Development.

A 7-month-old male infant with severe hemophilia A who received on-demand therapy with recombinant factor VIII (rFVIII) vomited because of acute intracranial bleeding. With rFVIII treatment for suppressing bleeding, there was development of high-titer (≤673 BU/ml) inhibitors. The patient was administered bypassing agents followed by immune tolerance induction therapy (ITI) with 50 U/kg of FVIII thrice weekly. Read More

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http://dx.doi.org/10.11406/rinketsu.61.617DOI Listing
January 2020

Transradial access for flow diversion of intracranial aneurysms: Case series.

Interv Neuroradiol 2020 Jul 5:1591019920938961. Epub 2020 Jul 5.

Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.

Background: Transradial access for neurointerventions offers advantages of fewer access-site complications, reduced procedure time, and greater patient comfort over transfemoral access. Data about transradial access for flow diversion are limited. We share our early experience with transradial access for flow diversion in a relatively large case series. Read More

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http://dx.doi.org/10.1177/1591019920938961DOI Listing

Combining visual analytics and case-based reasoning for rupture risk assessment of intracranial aneurysms.

Int J Comput Assist Radiol Surg 2020 Jul 4. Epub 2020 Jul 4.

Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Universitätsplatz 2, D-39106, Magdeburg, Germany.

Purpose: Medical case-based reasoning solves problems by applying experience gained from the outcome of previous treatments of the same kind. Particularly for complex treatment decisions, for example, incidentally found intracranial aneurysms (IAs), it can support the medical expert. IAs bear the risk of rupture and may lead to subarachnoidal hemorrhages. Read More

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http://dx.doi.org/10.1007/s11548-020-02217-9DOI Listing

Population pharmacokinetics-pharmacodynamics of sunitinib in pediatric patients with solid tumors.

Cancer Chemother Pharmacol 2020 Jul 4. Epub 2020 Jul 4.

Pfizer Global Product Development, 10646 Science Center Drive, CB10, La Jolla, CA, 92121, USA.

Purpose: The safety profile of sunitinib in children, including the impact of sunitinib exposure on safety endpoints, was assessed using population pharmacokinetic (PK) and pharmacokinetic-pharmacodynamic (PK-PD) models.

Methods: Data were from two clinical studies in 59 children with solid tumors (age range 2-21 years, 28 male/31 female, body weight range 16.2-100 kg, body surface are [BSA] range 0. Read More

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http://dx.doi.org/10.1007/s00280-020-04106-zDOI Listing

Efficacy and safety of sonothrombolysis in patients with acute ischemic stroke: A systematic review and meta-analysis.

J Neurol Sci 2020 Jun 25;416:116998. Epub 2020 Jun 25.

Department of Ultrasound, Affiliated Xiaolan Hospital, Southern Medical University(Xiaolan People's Hospital), Zhongshan, Guangdong, China.

Background: Accumulating clinical evidence has indicated that sonothrombolysis can aid in the treatment of ischemic stroke; however, these findings remain controversial. The purpose of the present meta-analysis was to assess randomized clinical studies concerning the effects of sonothrombolysis on ischemic stroke to evaluate its safety and efficacy.

Methods: We systematically searched the Cochrane Library, PubMed, and EMBASE databases for literature published between the inception of electronic data and May 2019 regarding sonothrombolysis for acute ischemic stroke. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116998DOI Listing

Angioplasty with a retrievable stent to treat vasospasm secondary to subarachnoid hemorrhage due to an aneurysm: a multicenter study of safety and efficacy.

Radiologia 2020 Jul 1. Epub 2020 Jul 1.

Departmento de Radiología, Neurorradiología Intervencionista, Hospital Universitario Vall d'Hebron, Barcelona, España.

Objective: To determine the safety and efficacy of angioplasty with a retrievable stent in treating vasospasm secondary to subarachnoid hemorrhage (SAH) due to an aneurysm.

Methods: We retrospectively analyzed prospectively collected data from consecutive patients undergoing endovascular angioplasty with a retrievable stent to treat vasospasm related to SAH due to an aneurysm in four neurointerventional radiology departments between January 2018 and July 2019. We included patients aged>18 years with vasospasm>50% of the internal carotid artery (ICA), anterior cerebral artery (ACA), and / or middle cerebral artery (MCA) secondary to SAH due to an aneurysm treated with endovascular angioplasty with a retrievable stent. Read More

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http://dx.doi.org/10.1016/j.rx.2020.04.011DOI Listing

Dual-energy CT for differentiating acute intracranial hemorrhage from contrast staining or calcification: a meta-analysis.

Neuroradiology 2020 Jul 4. Epub 2020 Jul 4.

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.

Purpose: This study aimed to comprehensively evaluate the diagnostic performance of dual-energy CT (DECT) for differentiating acute intracranial hemorrhage (ICH) from contrast staining or small calcifications via a systematic review and meta-analysis.

Methods: The PubMed-MEDLINE, EMBASE, and Cochrane Library databases were searched up to November 10, 2019. Original studies (prospective or retrospective cohort studies) with the primary aim of detecting ICH using DECT were selected. Read More

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http://dx.doi.org/10.1007/s00234-020-02486-wDOI Listing

Nuisance bleeding complications in patients with cerebral aneurysm treated with Pipeline embolization device.

J Neurointerv Surg 2020 Jul 3. Epub 2020 Jul 3.

University of South Florida Department of Neurosurgery and Brain Repair, Tampa, Florida, USA

Background: Patients with cerebral aneurysms treated with the Pipeline embolization device (PED) are maintained on dual antiplatelet therapy (DAPT) to prevent thromboembolic complications. Rates of minor, "nuisance" bleeding in these patients remain unknown. We sought to evaluate the frequency and factors associated with this bleeding and its effect on DAPT compliance. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-016245DOI Listing

IV tPA is associated with increase in rates of intracerebral hemorrhage and length of stay in patients with acute stroke treated with endovascular treatment within 4.5 hours: should we bypass IV tPA in large vessel occlusion?

J Neurointerv Surg 2020 Jul 3. Epub 2020 Jul 3.

Zeenat Qureshi Stroke Institute, St. Cloud, Minnesota, USA.

Background: Endovascular treatment (EVT) is a widely proved method to treat patients diagnosed with intracranial large vessel occlusions (LVOs); however, there has been controversy about the safety and efficacy of incorporating intravenous tissue plasminogen activator (IV tPA) as pretreatment for EVT.

Objective: To compare the outcomes of all patients with LVO treated with IV tPA +EVT versus EVT alone within 4.5 hours of stroke onset. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-016045DOI Listing

Pituitary Apoplexy During Hematopoietic Cell Transplantation.

Clin Lymphoma Myeloma Leuk 2020 May 26. Epub 2020 May 26.

Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN. Electronic address:

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http://dx.doi.org/10.1016/j.clml.2020.05.015DOI Listing

Lack of impact of polycystic kidney disease on the outcome of aneurysmal subarachnoid hemorrhage: a matched case-control study.

J Neurosurg 2020 Jul 3:1-8. Epub 2020 Jul 3.

1Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, Kuopio.

Objective: The authors set out to study whether autosomal dominant polycystic kidney disease (ADPKD), an established risk factor for intracranial aneurysms (IAs), affects the acute course and long-term outcome of aneurysmal subarachnoid hemorrhage (aSAH).

Methods: The outcomes of 32 ADPKD patients with aSAH between 1980 and 2015 (median age 43 years; 50% women) were compared with 160 matched (age, sex, and year of aSAH) non-ADPKD aSAH patients in the prospectively collected Kuopio Intracranial Aneurysm Patient and Family Database.

Results: At 12 months, 75% of the aSAH patients with ADPKD versus 71% of the matched-control aSAH patients without ADPKD had good outcomes (Glasgow Outcome Scale score 4 or 5). Read More

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http://dx.doi.org/10.3171/2020.4.JNS20544DOI Listing

Spontaneous Intracranial Hypotension Followed by Intracranial Hypertension.

Neurologist 2020 Jul;25(4):109-111

Departments of Neurology.

Introduction: Spontaneous intracranial hypotension is a secondary cause of headache caused by suspected cerebrospinal fluid leaks. It is associated with vascular changes that may predispose to superficial siderosis. When treated with an epidural blood patch, rebound intracranial hypertension may ensue. Read More

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http://dx.doi.org/10.1097/NRL.0000000000000285DOI Listing

Reversible Cerebral Vasoconstriction Syndrome Following Carotid Endarterectomy: A Case Report.

Neurologist 2020 Jul;25(4):104-105

Lehigh Valley Health Network, Allentown, PA.

Introduction: Reversible cerebral vasoconstriction syndrome (RCVS) is a cerebrovascular disorder associated with multifocal intracranial arterial constriction and dilation that occurs spontaneously or as a result of a stimulant. The authors present a case of RCVS in a patient who presented with a new-onset thunderclap headache a day after carotid endarterectomy (CEA). RCVS has been rarely reported after CEA. Read More

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http://dx.doi.org/10.1097/NRL.0000000000000280DOI Listing

Real-world management of oral factor Xa inhibitor-related bleeds with reversal or replacement agents including andexanet alfa and four-factor prothrombin complex concentrate: a multicenter study.

Future Cardiol 2020 Jul 3. Epub 2020 Jul 3.

Portola Pharmaceuticals Inc. 270 E. Grand Avenue South San Francisco, CA 94080, USA.

We describe the real-world utilization and outcomes associated with managing oral factor Xa inhibitor (FXai)-related major bleeds. Electronic records from 45 US hospitals were queried (ICD-10-CM billing codes D68.32, T45. Read More

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http://dx.doi.org/10.2217/fca-2020-0073DOI Listing

Benefit of dual antithrombotic therapy with direct oral anticoagulants in patients with atrial fibrillation undergoing percutaneous coronary intervention: a systematic review and metaanalysis of randomized clinical trials.

Intern Emerg Med 2020 Jul 2. Epub 2020 Jul 2.

Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.

Antithrombotic treatment in patients with atrial fibrillation undergoing percutaneous coronary intervention is still debated. We conducted a meta-analysis of recent randomized controlled trials to evaluate the benefit of different antithrombotic strategies. Data were analyzed between May and September 2019. Read More

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http://dx.doi.org/10.1007/s11739-020-02402-3DOI Listing

Perioperative mannitol intensive use may avoid the early complication of cerebral venous sinus stenting.

Ann Transl Med 2020 Jun;8(11):672

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Background: Cerebral venous sinus (CVS) stenting has been widely applied for correcting CVS stenosis. However, there are still some potential complications. The purpose of this study is to investigate the impact of perioperative management on avoiding complications of CVS stenting. Read More

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http://dx.doi.org/10.21037/atm-20-3021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327372PMC

Intravenous Thrombolysis Guided by Perfusion CT with Alteplase in >4.5 Hours from Stroke Onset.

Cerebrovasc Dis 2020 Jul 2:1-6. Epub 2020 Jul 2.

Stroke Unit, University Hospital Virgen del Rocío, Sevilla, Spain,

Introduction: The benefit of intravenous thrombolysis (IVT) in wake-up stroke (WUS), stroke of unknown time of onset (SUKO), or when time exceeds 4.5 h from last-seen-normal (LSN) guided by CT perfusion (CTP) or MRI has been recently suggested. However, there is limited information of IVT in those patients in real-world studies. Read More

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http://dx.doi.org/10.1159/000509013DOI Listing

Intravenous Thrombolysis Is Not Associated with Increased Time to Endovascular Treatment.

Cerebrovasc Dis 2020 Jul 2:1-7. Epub 2020 Jul 2.

Department of Neurology, St. Antonius Hospital, Nieuwegein, The Netherlands.

Background: Endovascular treatment (EVT) with or without intravenous thrombolysis (IVT) is effective and safe in is-chemic stroke caused by large vessel occlusion, but IVT might delay time to EVT or increase risk of intracranial hemorrhage (ICH). We assessed the influence of prior IVT on time to treatment and risk of ICH in patients treated with EVT.

Methods: We analyzed data from the MR CLEAN Registry and included patients with an anterior circulation occlusion treated with EVT who presented directly to an intervention center, between 2014 and 2017. Read More

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http://dx.doi.org/10.1159/000508898DOI Listing

Unusual Periventricular Hemorrhage as the initial manifestation of Central Nervous System Tuberculosis: A case report.

World Neurosurg 2020 Jun 29. Epub 2020 Jun 29.

Neurology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address:

Background: Intracranial hemorrhage (ICH) is a rare complication of central nervous system (CNS) tuberculosis, and intra-tuberculoma hemorrhage is even rarer. Periventricular hemorrhage caused by CNS tuberculosis has not been reported so far. In this paper, we exhibited the peculiar neuroradiological manifestations of periventricular hemorrhage secondary to CNS tuberculosis and discussed possible mechanisms of intra-tuberculoma hemorrhage supported by neuroradiological findings. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.193DOI Listing

Risk stratification and outcomes of intracranial hemorrhage in patients with immune thrombocytopenia under 60 years of age.

Platelets 2020 Jul 2:1-9. Epub 2020 Jul 2.

Peking University People's Hospital, Peking University Institute of Hematology , Beijing, China.

Intracranial hemorrhage (ICH) is a devastating complication of immune thrombocytopenia (ITP). However, information on ICH in ITP patients under the age of 60 years is limited, and no predictive tools are available in clinical practice. A total of 93 adult patients with ITP who developed ICH before 60 years of age were retrospectively identified from 2005 to 2019 by 27 centers in China. Read More

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http://dx.doi.org/10.1080/09537104.2020.1786042DOI Listing

Is Optic Nerve Sheath Diameter a Reliable Proxy for Intracranial Pressure in Patients with Subarachnoid Hemorrhage?

Neurocrit Care 2020 Jul 1. Epub 2020 Jul 1.

Neuroanesthesia Division, Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.

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http://dx.doi.org/10.1007/s12028-020-01038-7DOI Listing

Safety and Efficacy of Tirofiban in Rescue Treatment for Acute Intracranial Intraprocedural Stent Thrombosis.

Front Neurol 2020 16;11:492. Epub 2020 Jun 16.

Department of Neurology, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

The incidence of acute intraprocedural stent thrombosis (AIST) during stenting of intracranial atherosclerotic stenosis (ICAS) has seldom been reported and evidence regarding the treatment of AIST is lacking. We aim to investigate the incidence of AIST during stenting of ICAS in our institute, assess the preliminary efficacy and safety of rescue treatment of tirofiban for these patients. From September 2016 to May 2019, all symptomatic ICAS patients who underwent intracranial stenting in our institute were prospectively registered into this study, of which patients with AIST were retrospectively reviewed to extract baseline characteristics, perioperative management, procedural details, angiographic, and clinical outcomes. Read More

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http://dx.doi.org/10.3389/fneur.2020.00492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308481PMC

Treatment for Geriatric Traumatic Brain Injury: A Nationwide Cohort Study.

J Nippon Med Sch 2020 Jun 30. Epub 2020 Jun 30.

Department of Emergency and Critical Care Medicine, Nippon Medical School.

Background: Due to aging of the Japanese population, traumatic brain injuries (TBI) in elderly individuals have increased. However, the effectiveness and prognosis of intensive treatment in geriatric TBI have not yet been determined. Thus, we analyzed the prognostic factors of intensive and aggressive treatments using nationwide data from Japan Neurotrauma Data Bank (JNTDB) projects. Read More

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http://dx.doi.org/10.1272/jnms.JNMS.2021_88-404DOI Listing

Who may benefit from lower dosages of intravenous tissue plasminogen activator? Results from a cluster data analysis.

Stroke Vasc Neurol 2020 Jul 1. Epub 2020 Jul 1.

Department of Neurology, Huashan Hospital Fudan University, Shanghai, Shanghai, China

Background: The risk of symptomatic intracranial haemorrhage (sICH) after thrombolysis is low but severe. Lower dose of alteplase may reduce the risk of sICH. We aim to identify subsets of patients who could benefit from lower dose of alteplase compared with standard dose. Read More

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http://dx.doi.org/10.1136/svn-2020-000388DOI Listing

White Matter Atrophy in Cerebral Amyloid Angiopathy.

Neurology 2020 Jul 1. Epub 2020 Jul 1.

Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA, USA

Objective: We postulated that Cerebral Amyloid Angiopathy (CAA) is associated with white matter atrophy (WMA) and that WMA can be related to cognitive changes in CAA.

Methods: White matter volume expressed as percent of intracranial volume (pWMV) of prospectively enrolled non-demented patients diagnosed with probable CAA was compared to age-matched healthy controls (HC) and patients with Alzheimer's disease (AD). Cognitive scores were also sought to understand the potential effects of WMA on cognitive function. Read More

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http://dx.doi.org/10.1212/WNL.0000000000010017DOI Listing

Paramedic utilization of Vision, Aphasia, Neglect (VAN) stroke severity scale in the prehospital setting predicts emergent large vessel occlusion stroke.

J Neurointerv Surg 2020 Jul 1. Epub 2020 Jul 1.

Emergency Health Sciences, UTHSC at San Antonio, San Antonio, Texas, USA.

Background: Numerous stroke severity scales have been published, but few have been studied with emergency medical services (EMS) in the prehospital setting. We studied the Vision, Aphasia, Neglect (VAN) stroke assessment scale in the prehospital setting for its simplicity to both teach and perform. This prospective prehospital cohort study was designed to validate the use and efficacy of VAN within our stroke systems of care, which includes multiple comprehensive stroke centers (CSCs) and EMS agencies. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-016054DOI Listing

Association between draining vein diameters and intracranial arteriovenous malformation hemorrhage: a multicentric retrospective study.

Neuroradiology 2020 Jun 30. Epub 2020 Jun 30.

Division of Interventional Neuroradiology, Medical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14048-090, Brazil.

Purpose: Intracranial arteriovenous malformations (AVMs) cause hemorrhage, and the role of draining vein diameters in rupture risk is controversial. The aims of the present study were to investigate the variables related with intracranial AVM rupture and to examine the association of draining vein diameters and AVM hemorrhage.

Methods: Two hundred three patients were included in this study, of which 117 (57%) had unruptured AVMs, and 86 (43%) had ruptured AVMs. Read More

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http://dx.doi.org/10.1007/s00234-020-02484-yDOI Listing

Use of intracranial stent as rescue therapy after mechanical thrombectomy failure-9-year experience in a comprehensive stroke centre.

Neuroradiology 2020 Jun 30. Epub 2020 Jun 30.

Interventional Neuroradiology, Hospital Clínico San Carlos, Calle del Prof Martín Lagos s/n, 28040, Madrid, Spain.

Purpose: There is no established rescue treatment in patients with mechanical thrombectomy (MT) failure. Our aim is to analyse whether the use of an intracranial stent improves prognosis in these patients.

Methods: Retrospective analysis of a prospective cohort of patients with ischemic stroke due to middle cerebral artery occlusion (MCA) or distal intracranial carotid artery (ICA) occlusion, from September 2009 to April 2019 in our comprehensive stroke care centre. Read More

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http://dx.doi.org/10.1007/s00234-020-02487-9DOI Listing

Classification of Intracranial Hemorrhage Subtypes Using Deep Learning on CT Scans.

Stud Health Technol Inform 2020 Jun;272:370-373

Laboratory of Biomedical Informatics and Artificial Intelligence, National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation.

Intracranial hemorrhage is a pathological condition that requires fast diagnosis and decision making. Recently, a neural network model for classification of different intracranial hemorrhage types was proposed by a member of our research group Konstantin Kotik as part of the machine learning competition at Kaggle. Our current pilot study aimed to test this model on real-world CT scans from patients with intracranial hemorrhage treated at N. Read More

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http://dx.doi.org/10.3233/SHTI200572DOI Listing

Facial fractures and associated injuries in high- versus low-energy trauma: all are not created equal.

Maxillofac Plast Reconstr Surg 2020 Dec 24;42(1):22. Epub 2020 Jun 24.

Santa Barbara Cottage Hospital, Santa Barbara, California USA.

Introduction: Facial fractures (FFs) occur after high- and low-energy trauma; differences in associated injuries and outcomes have not been well articulated.

Objective: To compare the epidemiology, management, and outcomes of patients suffering FFs from high-energy and low-energy mechanisms.

Methods: We conducted a 6-year retrospective local trauma registry analysis of adults aged 18-55 years old that suffered a FF treated at the Santa Barbara Cottage Hospital. Read More

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http://dx.doi.org/10.1186/s40902-020-00264-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312115PMC
December 2020

Endovascular Treatment of Giant Intracranial Aneurysms.

Cureus 2020 May 26;12(5):e8290. Epub 2020 May 26.

Radiology, Miami Cardiac & Vascular Institute/Miami Neuroscience Institute, Miami, USA.

Objective Giant intracranial aneurysms (GIAs) are associated with a high risk of rupture and have a high mortality rate when they rupture (65-100%). The traditional microsurgical approach to secure these lesions is challenging, and as such endovascular embolization has been increasingly selected as a treatment option. Methods We performed a retrospective analysis of consecutive patients with ruptured and unruptured GIAs at three medical centers from October 2008 to April 2016. Read More

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http://dx.doi.org/10.7759/cureus.8290DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317134PMC

Extensive spontaneous cerebral haemorrhage after Russell's viper bite.

BMJ Case Rep 2020 Jun 29;13(6). Epub 2020 Jun 29.

Post Graduate Institute of Medical Education and Research, Chandigarh, India

A 30-year-old man presented with altered sensorium following Russell's viper bite, which was found to be secondary to intracranial hemorrhage secondary to venom-induced consumptive coagulopathy. He was managed conservatively with blood component transfusion and antivenom injection, and successfully discharged. Read More

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http://dx.doi.org/10.1136/bcr-2019-233200DOI Listing

Angioplasty with the scepter C dual lumen balloon catheter and postprocedural result evaluation in patients with subarachnoid hemorrhage related vasospasms.

BMC Neurol 2020 Jun 29;20(1):260. Epub 2020 Jun 29.

Department of Neuroradiology, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Gottingen, Germany.

Background: Delayed cerebral ischemia is one of the leading causes of death and disability in patients with subarachnoid hemorrhage (SAH). Transluminal balloon angioplasty (TBA) is a therapeutic option for vasospasms affecting proximal intracranial arteries.

Methods: Aim of this study was to report our experience using the Scepter C balloon catheter in the treatment of cerebral vasospasms due to SAH and evaluate the postprocedural result with the iFlow tool. Read More

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http://dx.doi.org/10.1186/s12883-020-01792-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322884PMC

Intraventricular hemorrhage as clinical presentation of herpes simplex virus encephalitis. A case report and review of the literature.

Int J Neurosci 2020 Jul 7:1-6. Epub 2020 Jul 7.

Stroke Unit, Cova da Beira University Hospital, Covilhã, Portugal.

Objective: Herpes simplex virus encephalitis (HSVE) represents the most common cause of sporadic encephalitis in humans. The development of intracerebral hematomas is rare and late during the course of HSVE. To report a case of a patient with HSVE who initially presented a diffuse intracranial hemorrhage with predominant intraventricular bleeding. Read More

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http://dx.doi.org/10.1080/00207454.2020.1787409DOI Listing

Antiplatelet therapy within 24 hours of tPA: lessons learned from patients requiring combined thrombectomy and stenting for acute ischemic stroke.

J Cerebrovasc Endovasc Neurosurg 2020 Mar 31;22(1):1-7. Epub 2020 Mar 31.

Department of Neurosurgery, University of California, San Diego, La Jolla, CA, USA.

Objective: Although stroke guidelines recommend antiplatelets be started 24 hours after tissue plasminogen activator (tPA), select mechanical thrombectomy (MT) patients with luminal irregularities or underlying intracranial atherosclerotic disease may benefit from earlier antiplatelet administration.

Methods: We explore the safety of early (<24 hours) post-tPA antiplatelet use by retrospectively reviewing patients who underwent MT and stent placement for acute ischemic stroke from June 2015 to April 2018 at our institution.

Results: Six patients met inclusion criteria. Read More

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http://dx.doi.org/10.7461/jcen.2020.22.1.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307608PMC

Cerebral Venous Thrombosis in a Patient with Immune Thrombocytopenia, an Apparent Paradox.

Case Rep Oncol 2020 May-Aug;13(2):588-594. Epub 2020 Jun 4.

Department of Medical Oncology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.

We present a paradoxical case of immune thrombocytopenia (ITP) that presented with cerebral venous thrombosis. A 39-year-old female patient diagnosed with chronic ITP, who failed treatment on multiple-line agents, was started on eltrombopag (thrombopoietin receptor agonist), which she was not compliant to. The patient later developed extensive cerebral venous thrombosis, along with venous infarcts, and intracranial and subarachnoid hemorrhage. Read More

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http://dx.doi.org/10.1159/000507389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315189PMC

A novel case of reverse Takotsubo cardiomyopathy following brain biopsy.

Echocardiography 2020 Jun 28. Epub 2020 Jun 28.

Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.

Reverse Takotsubo cardiomyopathy (rTTC) is a variant of Takotsubo cardiomyopathy (TTC) or stress-induced cardiomyopathy. TTC is a transient cardiomyopathy resulting in a heart failure syndrome, triggered by emotional and/or physical stressors, that is usually self-limited. rTTC is characterized by basal wall hypokinesis and apical wall hyperkinesis, the opposite of TTC. Read More

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http://dx.doi.org/10.1111/echo.14700DOI Listing

A New Scoring System for Prediction of Underlying Vascular Pathology in Patients with Intracerebral Hemorrhage: The Modified Secondary Intracerebral Hemorrhage Score (mSICH).

World Neurosurg 2020 Jun 25. Epub 2020 Jun 25.

Department of Neurosurgery, University of Illinois at Chicago, Chicago, Il, USA; Department of Neurosurgery, Stony Brook University, Stony Brook, NY, USA.

Background: Secondary intracerebral hemorrhage (SICH) score is used to predict risk of intracranial hemorrhage (ICH) associated vascular lesions. However, it has low clinical utility in identifying patients without need for neurovascular imaging.

Objective: This study aims to develop a modified scoring system to capture patients with low risk of underlying vascular pathology, thereby decreasing need for vascular imaging and its associated morbidity. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.139DOI Listing

CT window trainable neural network for improving intracranial hemorrhage detection by combining multiple settings.

Artif Intell Med 2020 Jun 20;106:101850. Epub 2020 May 20.

Department of Emergency Medicine, College of Medicine of Yeungnam University, Daegu, South Korea. Electronic address:

Window settings to rescale and contrast stretch raw data from radiographic images such as Computed Tomography (CT), X-ray and Magnetic Resonance images is a crucial step as data pre-processing to examine abnormalities and diagnose diseases. We propose a distant-supervised method for determining automatically the best window settings by attaching a window estimator module (WEM) to a deep convolutional neural network (DCNN)-based lesion classifier and training them in conjunction. Aside from predicting a flexible window setting for each raw image, we statistically identify the top four window settings by calculating the mean and standard deviations for the entire dataset. Read More

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http://dx.doi.org/10.1016/j.artmed.2020.101850DOI Listing

Neuromonitoring Using Neurosonography and Pupillometry in A Weaning and Early Neurorehabilitation Unit.

J Neuroimaging 2020 Jun 27. Epub 2020 Jun 27.

Department of Neurology, University of Regensburg, Center for Vascular Neurology and Intensive Care, Regensburg, Germany.

Background And Purpose: Long-term surveillance of intracranial pressure (ICP) in neurological/neurosurgical patients during ventilator weaning and early neurorehabilitation currently relies on clinical observation because neuroimaging is rarely readily available. In this prospective study, multimodal neurosonography and pupillometry are evaluated for follow-up monitoring.

Methods: Sonographic neuromonitoring was used to noninvasively examine patients' ICP during weaning and early neurorehabilitation. Read More

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http://dx.doi.org/10.1111/jon.12742DOI Listing

Multimodal non-invasive assessment of intracranial hypertension: an observational study.

Crit Care 2020 Jun 26;24(1):379. Epub 2020 Jun 26.

Department of Intensive Care Medicine, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070, Brussels, Belgium.

Background: Although placement of an intra-cerebral catheter remains the gold standard method for measuring intracranial pressure (ICP), several non-invasive techniques can provide useful estimates. The aim of this study was to compare the accuracy of four non-invasive methods to assess intracranial hypertension.

Methods: We reviewed prospectively collected data on adult intensive care unit (ICU) patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), or intracerebral hemorrhage (ICH) in whom invasive ICP monitoring had been initiated and estimates had been simultaneously collected from the following non-invasive indices: optic nerve sheath diameter (ONSD), pulsatility index (PI), estimated ICP (eICP) using transcranial Doppler, and the neurological pupil index (NPI) measured using automated pupillometry. Read More

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http://dx.doi.org/10.1186/s13054-020-03105-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318399PMC

Bilateral pediatric pial arteriovenous fistulas accompanying a giant arachnoid cyst with torticollis: A case report.

Medicine (Baltimore) 2020 Jun;99(26):e20991

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.

Rationale: Pial arteriovenous fistula (PAVF) occurs when intracranial arteries communicate directly with veins. PAVFs are very rare congenital vascular lesions that are commonly seen in infants and children. Arachnoid cysts are congenital cavitation often filled with cerebrospinal fluid. Read More

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http://dx.doi.org/10.1097/MD.0000000000020991DOI Listing
June 2020
5.723 Impact Factor

Comment on "Bilirubin: a novel predictor of hemorrhagic transformation and symptomatic intracranial hemorrhage after mechanical thrombectomy".

Neurol Sci 2020 Jun 25. Epub 2020 Jun 25.

Department of Biochemistry, Private Practice, Istanbul, Turkey.

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http://dx.doi.org/10.1007/s10072-020-04532-0DOI Listing

Circulating TIMP-1 is associated with hematoma volume in patients with spontaneous intracranial hemorrhage.

Sci Rep 2020 Jun 25;10(1):10329. Epub 2020 Jun 25.

Laboratory of Atherothrombosis, CIMA, Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra, IdisNA, Pamplona, Spain.

Matrix metalloproteinases (MMPs) are proteolytic zinc-endopeptidases regulated by tissue Inhibitors of matrix metalloproteinases (TIMPs). We evaluated the potential of MMPs and TIMPs as clinical tools for Intracranial Haemorrhage (ICH). Spontaneous non-traumatic ICH patients were recruited from two hospitals: Complejo Hospitalario de Navarra (CHN = 29) and Vall d´Hebron (VdH = 76). Read More

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http://dx.doi.org/10.1038/s41598-020-67250-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316718PMC

A prospective, randomized, controlled study assessing vagus nerve stimulation using the gammaCore®-Sapphire device for patients with moderate to severe CoViD-19 Respiratory Symptoms (SAVIOR): A structured summary of a study protocol for a randomised controlled trial".

Trials 2020 Jun 26;21(1):576. Epub 2020 Jun 26.

Hospital Clínico Universitario de Valencia, Anaesthesia, Critical Care and Pain Management Unit, Valencia, Spain.

Objectives: Primary Objective: The primary objective is to reduce initiation of mechanical ventilator dependency in patients with moderate to severe CoViD- 19. This will be measured as the difference between the control group and active group for subjects admitted to the hospital for CoViD-19. Secondary Objectives: • To evaluate cytokine trends / Prevent cytokine storms • To evaluate supplemental oxygen requirements • To decrease mortality of CoViD-19 patients • Delay onset of ventilation TRIAL DESIGN: The study is a single centre, 2-arm, prospective, randomized (ratio 1:1), controlled trial with parallel groups design to compare the reduction of respiratory distress in a CoViD-19 population, using the intervention of the gammaCore®-Sapphire device plus standard of care (active) vs. Read More

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http://dx.doi.org/10.1186/s13063-020-04486-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316576PMC