89,411 results match your criteria Intracranial Hemorrhage


Quantitative Susceptibility Mapping for Staging Acute Cerebral Hemorrhages: Comparing the Conventional and Multiecho Complex Total Field Inversion magnetic resonance imaging MR Methods.

J Magn Reson Imaging 2021 Jun 11. Epub 2021 Jun 11.

Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Background: The perceived acuity of intracerebral hemorrhage (ICH) impacts the management of patients, both within emergent and outpatient/urgent settings. Morphology enabled dipole inversion (MEDI) quantitative susceptibility imaging (QSM) has improved characterization of ICH acuity, despite outstanding limitations in distinguishing blood products.

Purpose/hypothesis: Using improved susceptibility quantification, novel postprocessing QSM method from multiecho complex total field inversion (mcTFI) may better discriminate between acute and subacute ICH, compared to MEDI. Read More

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A Multicenter Preliminary Study of Cangrelor following Thrombectomy Failure for Refractory Proximal Intracranial Occlusions.

AJNR Am J Neuroradiol 2021 Jun 11. Epub 2021 Jun 11.

Neurology (I.S.), Bordeaux University Hospital, Bordeaux, France.

Background And Purpose: Rescue endovascular and pharmacologic approaches are increasingly being adopted after recanalization failure of acute large-vessel occlusion strokes with mechanical thrombectomy, with encouraging results. The safety and efficacy of glycoprotein IIb/IIIa inhibitors in ischemic stroke have been investigated, though cangrelor, a recent intravenous P2Y12-receptor inhibitor with a rapid onset/offset of action and a short half-life, may be a valuable option. We compared the safety and efficacy of cangrelor with those of glycoprotein IIb/IIIa inhibitors for refractory occlusions. Read More

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Radiosurgery as a microsurgical adjunct: outcomes after microsurgical resection of intracranial arteriovenous malformations previously treated with stereotactic radiosurgery.

J Neurosurg 2021 Jun 11:1-12. Epub 2021 Jun 11.

1Department of Neurosurgery and Stanford Stroke Center, Stanford University Medical Center, Stanford.

Objective: Microsurgical resection of arteriovenous malformations (AVMs) can be aided by staged treatment consisting of stereotactic radiosurgery followed by resection in a delayed fashion. This approach is particularly useful for high Spetzler-Martin (SM) grade lesions because radiosurgery can reduce flow through the AVM, downgrade the SM rating, and induce histopathological changes that additively render the AVM more manageable for resection. The authors present their 28-year experience in managing AVMs with adjunctive radiosurgery followed by resection. Read More

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Correlation of Aneurysmal Wall Enhancement of Unruptured Intracranial Aneurysms on High-Resolution Vessel-Wall Imaging With Clinical Indices and Surgical Findings.

Neurosurgery 2021 Jun 10. Epub 2021 Jun 10.

Department of Neurosurgery, Guro Hospital, Korea University, College of Medicine, Seoul, Republic of Korea.

Background: Many physicians consider aneurysmal wall enhancement (AWE) on high resolution-vessel wall imaging (HR-VWI) as an imaging biomarker of unstable unruptured intracranial aneurysms (UIAs).

Objective: To evaluate the clinical value of different AWE signal intensities (SIs) by assessing the correlation between the AWE SIs and surgical findings and rupture risk assessment tools.

Methods: Twenty-six patients with 34 aneurysms who underwent surgical clipping were included. Read More

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Anterior Inferior Cerebellar Aneurysm Treated by Aneurysm Resection and Intracranial Artery Anastomosis : A Case Report and Literature Review.

Front Surg 2021 25;8:669433. Epub 2021 May 25.

Department of Neurosurgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Anterior inferior cerebellar artery (AICA) aneurysms are relatively rare in clinical practice, accounting for <1% of all intracranial arteries. After the diagnosis and location are confirmed by angiography, magnetic resonance, and other imaging examinations, interventional, or surgical treatment is often used, but some complex aneurysms require reconstructive surgery. An 8-year-old male child was admitted to the hospital due to sudden disturbance of consciousness for 2 weeks. Read More

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Systolic blood pressure variability following endovascular thrombectomy and clinical outcome in acute ischemic stroke: A meta-analysis.

Acta Neurol Scand 2021 Jun 10. Epub 2021 Jun 10.

Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA.

Blood pressure variability (BPV) has been linked with the outcome of acute ischemic stroke (AIS) after endovascular thrombectomy (EVT). However, the association of the stroke outcome with specific short-term BPV parameters is unclear. We did a systematic literature search for studies published from January 2010 to September 2020. Read More

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[Chronic-phase chronic myeloid leukemia with intracranial hemorrhage complicated with tumor lysis syndrome].

Rinsho Ketsueki 2021 ;62(5):346-351

Department of Hematology/Oncology, Saitama Children's Medical Center.

A 14-year-old male with autism was admitted to our hospital owing to altered consciousness and gait disturbance. Blood tests showed a white blood cell (WBC) count of 728,600/µl, and brain computed tomography revealed intracranial hemorrhage and a midline shift of the brain. The chronic phase of chronic myeloid leukemia (CML) was confirmed as per bone marrow aspiration findings. Read More

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Flow diversion via telescoping stent with Low-profile Visualized Intraluminal Support Junior for treatment of ruptured dissecting aneurysm located at proximal posterior inferior cerebellar artery.

J Cerebrovasc Endovasc Neurosurg 2021 Jun 10. Epub 2021 Jun 10.

Department of Neurosurgery, Uijeongbu Eulji Medical Center, Eulji University College of Medicine, Uijeongbu, Korea.

Dissecting aneurysm involving the posterior inferior cerebellar artery (PICA) are challenging because of its nature and anatomic relationship to medulla and lower cranial nerve. We introduce a case of ruptured dissecting aneurysm located at the proximal PICA treated with telescoping stents for flow diversion and dissection healing. A 49 years old female visited to the emergency room for ruptured dissecting aneurysm at right proximal PICA. Read More

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Transvenous Pressure Monitoring Guides Endovascular Treatment of Vein of Galen Malformation: A Technical Note.

Pediatr Neurosurg 2021 Jun 9:1-6. Epub 2021 Jun 9.

Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Introduction: Vein of Galen malformations (VGMs) are complex congenital arteriovenous malformations that generally require serial endovascular treatment sessions to slowly correct the high-flow fistulous connections that cause increased venous pressures and ultimately lead to the classic presentations of heart failure, hydrocephalus, and intracranial hemorrhages. Despite the advances in endovascular technology and embolic materials, the resolution of embolization is often limited to the subjective view of diminished flow on angiograms.

Case Report: An 8-month-old patient with a VGM developed clinical signs of heart failure and growing head circumference with ventriculomegaly. Read More

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Anticoagulation Protocol for Secondary Prevention of Acute Ischemic Stroke Associated with Nonvalvular Atrial Fibrillation.

J Stroke Cerebrovasc Dis 2021 Jun 6;30(8):105893. Epub 2021 Jun 6.

Department of Stroke Medicine and Neurosurgery, Nayoro General Hospital, Nayoro City, Japan.

Objectives: There is no clear evidence regarding when to initiate oral anticoagulants (OACs) for secondary prevention of recurrent stroke in patients with atrial fibrillation (AF). Therefore, this study aimed to evaluate the safety and efficacy of a novel OAC initiation protocol for secondary prevention of acute ischemic stroke associated with AF.

Materials And Methods: In this multicenter prospective study 597 consecutive Japanese patients with acute ischemic stroke associated with nonvalvular AF received post-stroke OACs according to a protocol based on severity (clinical (NIHSS) and radiological (ASPECTS + W)), rt-PA use, reperfusion, and hemorrhagic transformation (HT). Read More

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Rescue balloon-assisted remodeling technique for protrusion of coil loop: A case report.

Authors:
Hak Cheol Ko

Medicine (Baltimore) 2021 May;100(19):e25783

Department of Neurosurgery, Stroke and Neurological Disorders Centre, Kyung Hee University Hospital at Gangdong.

Rationale: Among the possible complications during endovascular embolization of intracranial aneurysms, coil protrusion into the parent artery is associated with parent artery occlusion or thromboembolic of the distal arteries. There is no clearly established management strategy for coil protrusion. This report demonstrates our experience with balloon-assisted remodeling to reposition a protruded coil loop. Read More

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[Amyloid angiopathy brain hemorrhage].

Authors:
Jorge Tapia

Rev Med Chil 2021 Jan;149(1):76-87

Departamento de Neurología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Amyloid angiopathy (AA) is a selective deposition of amyloid in the walls of the brain vessels. It is a form of sporadic and localized amyloidosis, constituted by the Aβ4 protein, the same of Alzheimer's disease senile plaques. The most consistent clinical effect of AA is spontaneous brain hemorrhage (BH). Read More

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January 2021

Predictors of mortality for acute vertebrobasilar artery occlusion receiving endovascular treatment.

Acta Neurol Scand 2021 Jun 8. Epub 2021 Jun 8.

Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China.

Objectives: Acute vertebrobasilar artery occlusion (VBAO) is a devastating type of stroke with a high mortality rate. This study aimed to investigate the predictors of 3-month and 1-year mortality in VBAO patients receiving endovascular treatment (EVT).

Materials & Methods: Consecutive acute VBAO patients undergoing EVT between January 2014 and December 2019 were retrospectively analyzed in a prospectively maintained database. Read More

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Thrombectomy for ischemic stroke with large vessel occlusion and concomitant subarachnoid hemorrhage.

J Thromb Thrombolysis 2021 Jun 8. Epub 2021 Jun 8.

Department of Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.

To report our experience in treating one patient with nontraumatic subarachnoid hemorrhage (SAH) and concurrent acute ischemic stroke (AIS) due to large vessels occlusion (LVO). A man in his 50 s presented with acute right hemiparesis and aphasia. Brain CT showed a SAH in the left central sulcus; CT-angiography revealed a tandem occlusion of the left internal carotid artery and homolateral middle cerebral artery. Read More

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Hemorrhage and venous thromboembolism in critically ill patients with COVID-19.

SAGE Open Med 2021 31;9:20503121211020167. Epub 2021 May 31.

Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Objective: The majority of patients with COVID-19 showed mild symptoms. However, approximately 5% of them were critically ill and require intensive care unit admission for advanced life supports. Patients in the intensive care unit were high risk for venous thromboembolism and hemorrhage due to the immobility and anticoagulants used during advanced life supports. Read More

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Cerebrospinal fluid hemoglobin drives subarachnoid hemorrhage-related secondary brain injury.

J Cereb Blood Flow Metab 2021 Jun 8:271678X211020629. Epub 2021 Jun 8.

Division of Internal Medicine, Universitätsspital and University of Zurich; Zurich, Switzerland.

Secondary brain injury after aneurysmal subarachnoid hemorrhage (SAH-SBI) contributes to poor outcomes in patients after rupture of an intracranial aneurysm. The lack of diagnostic biomarkers and novel drug targets represent an unmet need. The aim of this study was to investigate the clinical and pathophysiological association between cerebrospinal fluid hemoglobin (CSF-Hb) and SAH-SBI. Read More

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Decreased Basal Ganglia Volume in Cerebral Amyloid Angiopathy.

J Stroke 2021 May 31;23(2):223-233. Epub 2021 May 31.

Department of Neurology, J.P. Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background And Purpose: Cerebral amyloid angiopathy (CAA) is a common pathology of the leptomeningeal and cortical small vessels associated with hemorrhagic and non-hemorrhagic brain injury. Given previous evidence for CAA-related loss of cortical thickness and white matter volume, we hypothesized that CAA might also cause tissue loss in the basal ganglia.

Methods: We compared basal ganglia volumes expressed as a percentage of total intracranial volume (pBGV) of non-demented patients with sporadic and hereditary CAA to age-matched healthy control (HC) and Alzheimer's disease (AD) cohorts. Read More

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Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke Guidelines.

Authors:
Jong S Kim

J Stroke 2021 May 31;23(2):149-161. Epub 2021 May 31.

Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Hyperlipidemia is an important risk factor for ischemic stroke; the Stroke Prevention by Aggressive Reduction in Cholesterol Level and Treat Stroke to Target studies have shown that statins are beneficial for patients with stroke and that a low target for low-density lipoprotein cholesterol (LDL-C) concentration may maximize this benefit. Based on these results, recent guidelines have emphasized the application of "high-intensity statins" and "low LDL-C target" strategies in patients with stroke. However, it should be kept in mind that the role of blood lipids as a risk factor and benefit of lipid-lowering therapy are different among patients with different levels of cerebral arterial diseases. Read More

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Expression and methylation status of vascular endothelial growth factor and thrombospondin-1 genes in congenital factor XIII-deficient patients with intracranial hemorrhage.

Blood Coagul Fibrinolysis 2021 Jun 7. Epub 2021 Jun 7.

Hematology Department, Faculty of Paramedicine, AJA University of Medical Sciences Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine (IBTO), Tehran Ali Ebne Abitaleb Hospital, School of Medicine, Zahedan University of Medical Sciences, Zahedan Hematology Department, Allied Medical School, Iran University of Medical Sciences, Tehran Department of Paramedical Sciences, Qazvin University of Medical Sciences, Qazvin Hematology Department, Allied Medical School, Tehran University of Medical Sciences, Tehran, Iran.

Congenital factor XIII (FXIII) deficiency is one of the rarest bleeding disorders, with an incidence of one per 2 million persons. Intracranial hemorrhage (ICH), a major cause of mortality in FXIII deficiency, is reported to be associated with vascular endothelial growth factor (VEGF) and thrombospondin-1 (TSP-1). Therefore, we investigated the association of VEGF and TSP-1 expression and methylation patterns with ICH in congenital FXIII deficiency patients. Read More

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Golf cart injuries in children: the experience of trauma centers in a single state in the USA.

J Pediatr Orthop B 2021 Jun 7. Epub 2021 Jun 7.

Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh Penn State University College of Medicine, Penn State College of Medicine, Hershey Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh Division of Pediatric Surgery, Penn State Hershey Children's Hospital Department of Orthopaedic Surgery, Penn State Hershey Medical Center Department of Orthopaedic Surgery, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania, USA.

Golf carts remain a source of morbidity in children. We aimed to establish the incidence and injury characteristics of pediatric patients injured due to golf cart usage over an 11-year period. This is a retrospective study using a single state trauma database of patients ages 0-17 years admitted to a trauma center and who sustained injures while a golf cart was in use. Read More

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Andexanet alfa and four-factor prothrombin complex concentrate for reversal of apixaban and rivaroxaban in patients diagnosed with intracranial hemorrhage.

J Thromb Thrombolysis 2021 Jun 8. Epub 2021 Jun 8.

Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.

Limited data exists regarding the clinical outcomes of andexanet alfa and four factor prothrombin complex concentrate (4F-PCC) for reversal of apixaban or rivaroxaban in the setting of intracranial hemorrhage (ICH). The objective of this study was to evaluate clinical outcomes of 4F-PCC and andexanet alfa for reversal of ICH associated with oral factor Xa inhibitors. This was a retrospective, single-center, case series evaluating hemostatic efficacy of patients receiving andexanet alfa) or 4F-PCC for reversal of apixaban or rivaroxaban after ICH. Read More

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Ocular Trauma with Ophthalmic Artery Injury as a Rare Cause of Subarachnoid Hemorrhage: a Case Report and Review of the Literature.

J Neurol Surg A Cent Eur Neurosurg 2021 Jun 7. Epub 2021 Jun 7.

Department of Neurosurgery, Universitätsklinikum Aachen, RWTH Aachen University, Aachen, Germany.

Background And Importance:  Traumatic avulsion of the ophthalmic artery is a rare cause of subarachnoid hemorrhage (SAH). In this case, a relative minor fall with isolated ocular trauma caused bulbar dislocation and rupture of the ophthalmic artery in its intracranial segment resulting in subarachnoid bleeding.

Clinical Presentation:  In a female patient in her 70s, a direct penetrating trauma to the orbit by a door handle resulted in basal SAH with blood dispersion into both Sylvian fissures. Read More

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Low-dose thrombolysis for submassive pulmonary embolism.

J Investig Med 2021 Jun 7. Epub 2021 Jun 7.

Pulmonary Medicine, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.

The role of thrombolysis in submassive pulmonary embolism (PE) is controversial due to the high risk of hemorrhage. This study aimed to evaluate the role of half-dose tissue-type plasminogen activator (rt-PA) in preventing death/hemodynamic decompensation in submassive (intermediate-risk) PE without increasing the risk of bleeding. In a prospective, non-randomized, open-label, single-center trial, we compared 50 mg rt-PA plus low molecular weight heparin (LMWH) with LMWH in submassive (intermediate-risk) PE. Read More

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Letter to the editor: Vascular endothelial growth factor in the pathogenesis of chronic spontaneous subdural hematoma.

Clin Neurol Neurosurg 2021 Jun 2:106718. Epub 2021 Jun 2.

Colombian Clinical Research Group in Neurocritical Care, School of Medicine, University of Cartagena, Cra. 50 #24-120, Cartagena, Colombia. Electronic address:

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Pipeline Embolization Devices for the Treatment of Intracranial Aneurysms, Single-Center Registry: Long-Term Angiographic and Clinical Outcomes from 1000 Aneurysms.

Neurosurgery 2021 Jun 7. Epub 2021 Jun 7.

Department of Interventional Neuroradiology and Neurosurgery, Instituto Médico ENERI-Clínica La Sagrada Familia, Buenos Aires, Argentina.

Background: Prospective studies have established the safety and efficacy of the PipelineTM Embolization Device (PED; Medtronic) for treatment of intracranial aneurysms (IA).

Objective: To investigate long-term outcomes from the Pipeline Embolization Devices for the Treatment of Intracranial Aneurysms (PEDESTRIAN) Registry.

Methods: The PEDESTRIAN Registry data were retrospectively reviewed, which included patients (March 2006 to July 2019) with complex IAs treated with PED. Read More

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Microsurgical Clip Trapping of Dorsal Internal Carotid Artery Blister Ruptured Aneurysm: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 Jun 7. Epub 2021 Jun 7.

Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

Dorsal internal carotid artery (ICA) blister aneurysms are an uncommon aneurysm variant constituting 0.3% to 1% of intracranial aneurysms and can be due to ulceration, atherosclerosis, or dissection.1-3 Despite its rarity, it carries a high risk of rupture with an estimation of 0. Read More

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Impact of a pharmacist driven anticoagulation reversal program at a large academic medical center.

J Thromb Thrombolysis 2021 Jun 7. Epub 2021 Jun 7.

Department of Pharmacy, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ, 07601, USA.

In major/life-threatening bleeding, administration of timely and appropriate reversal agents is imperative to reduce morbidity and mortality. Due to complexities associated with the use of reversal agents, a clinical pharmacist-driven anticoagulation reversal program (ARP) was developed. The goal of this program was to ensure appropriateness of reversal agents based on the clinical scenario, optimize selection and avoid unintended consequences. Read More

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WSO EXPRESS: Thrombolysis outcomes according to arterial characteristics of acute ischemic stroke by alteplase dose and blood pressure target.

Int J Stroke 2021 Jun 7:17474930211025436. Epub 2021 Jun 7.

The George Institute for Global Health, Sydney, Australia.

Background: We explored the influence of low-dose intravenous alteplase and intensive blood pressure (BP) lowering on outcomes of acute ischemic stroke (AIS) according to status/location of vascular obstruction in participants of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED).

Methods: ENCHANTED was a multicenter, quasi-factorial, randomized trial to determine efficacy and safety of low- versus standard-dose intravenous alteplase and intensive- versus guideline-recommended BP lowering in AIS patients. In those who had baseline CT or MRI angiography, the degree of vascular occlusion was grouped according to being no (NVO), medium (MVO), or large (LVO). Read More

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Molecular Epidemiology and Drug Resistant Mechanism of Carbapenem-Resistant in Elderly Patients With Lower Respiratory Tract Infection.

Front Public Health 2021 20;9:669173. Epub 2021 May 20.

Intensive Care Department of Taian City Central Hospital, Shandong, China.

Infection by carbapenem-resistant (CRKp) hampers the treatment of elderly patients with lower respiratory tract infection (LRTI); however, relevant data with respect to the characteristics of CRKp in elderly patients with LRTIs are limited. In the present study, isolated from elderly patients with LRTIs was collected and identified by VITEK-MS. VITEK 2 compact was used for drug sensitivity test to screen CRKps, and broth dilution method was used for drug sensitivity of tigecycline and colistin. Read More

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Blind Exchange With Mini-Pinning Technique Using the Tron Stent Retriever for Middle Cerebral Artery M2 Occlusion Thrombectomy in Acute Ischemic Stroke.

Front Neurol 2021 19;12:667835. Epub 2021 May 19.

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.

The usefulness of the blind exchange with mini-pinning (BEMP) technique has recently been reported for mechanical thrombectomy in patients with stroke owing to medium vessel occlusion (MeVO). The Tron stent retriever can be delivered and deployed through a 0.0165-inch microcatheter. Read More

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