80,495 results match your criteria Intracranial Hemorrhage


Dose reduction of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: A Danish nationwide cohort study.

Thromb Res 2019 Apr 9;178:101-109. Epub 2019 Apr 9.

Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Kildegaardsvej 28, 2900 Hellerup, Denmark.

Introduction: To investigate the patterns of dose reduction of non-vitamin K antagonist oral anticoagulants (NOAC) in patients with atrial fibrillation (AF).

Materials And Methods: Using Danish nationwide registries, we identified all non-valvular AF patients initiated on standard-dose NOAC during 2011-2017 who were followed until dose reduction. The absolute risk of dose reduction was presented as cumulative incidence both overall and according to baseline characteristics. Read More

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http://dx.doi.org/10.1016/j.thromres.2019.04.007DOI Listing

MRI predicts intracranial hemorrhage in patients who receive long-term oral anticoagulation.

Neurology 2019 Apr 19. Epub 2019 Apr 19.

From the Department of Neurology (J.M.-F., L.P.-S., R.M., R.D.-M., A.M.-D., P.C.-R., E.J.-X.) and Epidemiology (I.G.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona; Departments of Radiology (S.M.-M.) and Neurology (A.R.-C.), Hospital del Mar-Parc de Salut Mar, Barcelona; Unitat RM IDI (E.M.) and Department of Neurosciences (M.H.-P.), Hospital Germans Trias i Pujol, Badalona; Department of Neurology (M.Z.), Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy; Department of Neurology (M.G.-C.), Hospital de Sant Joan Despí Moises Broggi, Sant Joan Despí, Spain; Department of Neurology (L. Lara), Hospital de León; Department of Neurology (A.B.), Hospital Universitari Son Espases, Palma de Mallorca; Department of Neurology (A.C.), Hospital de Valladolid; Department of Neurology (A.M.D.A.-B.), Hospital de Donostia; Department of Neurology (Y.B.), Hospital de Burgos; Department of Neurology (B.F.), Hospital Universitario La Paz, Universidad Autónoma de Madrid, Instituto de Investigación IdiPaz, Madrid; Department of Neurology (D. Cánovas), Hospital Parc Taulí, Sabadell; Department of Neurology (L. Llull), Hospital Clínic, Barcelona; Department of Neurology (B.Z.), Hospital de Navarra, Pamplona; Department of Neurology (M.F.), Hospital de Basurto, Bilbao; Department of Neurology (I.C.-N.), Hospital San Pedro de Alcántara, Cáceres; Department of Neurology (J.S.), Hospital Arnau de Vilanova, Lleida; Department of Neurology (D. Cocho), Hospital de Granollers; Department of Neurology (J.K.), F.Ass. Mutua Terrassa; Department of Neurology (E.P.), Hospital de Mataró; Department of Neurology (A.D.F.), Hospital Ramón y Cajal, Madrid; Department of Neurology (M.S.), Hospital La Rioja, Logroño; Department of Neurology (E.Z.-A.), Hospital Virgen del Rocío, Sevilla; Department of Neurology (J.Z.-B.), Hospital Verge de la Cinta, Tortosa; Department of Neurology (I.D.-M.), Hospital de Albacete; Department of Neurology (J.F.-D.), Centro Médico Asturias, Oviedo; Department of Neurology (A.L.), Hospital La Fe, Valencia; Department of Neurology (J.M.), Hospital Virgen de las Nieves, Granada; and Department of Neurology (M.R.-Y.), Hospital Santiago de Compostela, Santiago de Compostela, Spain.

Objective: We tested the hypothesis that the risk of intracranial hemorrhage (ICH) in patients with cardioembolic ischemic stroke who are treated with oral anticoagulants (OAs) can be predicted by evaluating surrogate markers of hemorrhagic-prone cerebral angiopathies using a baseline MRI.

Methods: Patients were participants in a multicenter and prospective observational study. They were older than 64 years, had a recent cardioembolic ischemic stroke, and were new users of OAs. Read More

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http://dx.doi.org/10.1212/WNL.0000000000007532DOI Listing
April 2019
3 Reads

Examiner Position in Ocular Point-of-Care Ultrasound: A Proposed Technique.

J Emerg Med 2019 Apr 16. Epub 2019 Apr 16.

Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Background: Ocular point-of-care ultrasound (POCUS) is a fast and safe non-invasive procedure used to evaluate the structural integrity and pathology of the eye. Ocular POCUS can be used for evaluation of posterior chamber and orbital pathology, including retinal detachment, vitreous detachment or hemorrhage, foreign body, lens dislocation, and increased intracranial pressure.

Discussion: The purpose of this brief communication is to describe a technique for conducting an ocular POCUS that may in some cases be easier and more comfortable by adjusting the position of the sonographer relative to the patient. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07364679193023
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http://dx.doi.org/10.1016/j.jemermed.2019.03.027DOI Listing
April 2019
2 Reads

Hydrocephalus-induced neurogenic stunned myocardium and cardiac arrest in a child: completely reversed with CSF diversion.

J Neurosurg Pediatr 2019 Apr 19:1-6. Epub 2019 Apr 19.

Neurogenic stunned myocardium (NSM) is a potentially fatal cause of sudden cardiogenic dysfunction due to an acute neurological event, most commonly aneurysmal subarachnoid hemorrhage in adults. Only two pediatric cases of hydrocephalus-induced NSM have been reported. Here the authors report a third case in a 14-year-old boy who presented with severe headache, decreased level of consciousness, and shock in the context of acute hydrocephalus secondary to fourth ventricular outlet obstruction 3 years after standard-risk medulloblastoma treatment. Read More

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http://dx.doi.org/10.3171/2019.2.PEDS18711DOI Listing

Impact of Intracranial Aneurysm Morphology and Rupture Status on the Particle Residence Time.

J Neuroimaging 2019 Apr 19. Epub 2019 Apr 19.

Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Background And Purpose: Aneurysm hemodynamics play an important role in aneurysm growth and subsequent rupture. Within the available hemodynamic characteristics, particle residence time (PRT) is relatively unexplored. However, some studies have shown that PRT is related to thrombus formation and inflammation. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/jon.12618
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http://dx.doi.org/10.1111/jon.12618DOI Listing
April 2019
1 Read

Utilization and safety of extracranial-intracranial bypass surgery in symptomatic steno-occlusive disorders.

Brain Circ 2019 Jan-Mar;5(1):32-35. Epub 2019 Mar 27.

Department of Neurology, UT Health McGovern School of Medicine, Houston, Texas, USA.

Objective: The objective of this study was to investigate patterns of utilization and safety of extracranial-intracranial (EC-IC) bypass in patients with symptomatic cerebrovascular steno-occlusive disorders.

Methods: Patients with one of the steno-occlusive conditions (defined as symptomatic intracranial stenosis, extracranial stenosis, and moyamoya disease) were identified using all nonfederal hospitalizations in New York (2005-2014) and Florida (2005-2015). EC-IC bypass surgery was defined using the corresponding procedure codes. Read More

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http://dx.doi.org/10.4103/bc.bc_33_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458777PMC

Treatment for ischemic stroke: From thrombolysis to thrombectomy and remaining challenges.

Brain Circ 2019 Jan-Mar;5(1):8-11. Epub 2019 Mar 27.

Department of Neurobiology, Neuroscience Institute, Morehouse School of Medicine, Atlanta, GA, USA.

Stroke is a leading cause of death and long-term disabilities. Despite decades of extensive efforts in search of brain injury mechanisms and therapeutic interventions, pharmacological treatment is limited to the use of thrombolytic agent tissue plasminogen activator, which has limited therapeutic time window and potential side effect of intracranial hemorrhage. Over the past few years, endovascular thrombectomy with stent-retriever devices combined with advanced imaging modalities has transformed the standard of stroke care, offering an opportunity to improve the outcome in selected patients as late as 24 h after the onset of stroke. Read More

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http://www.braincirculation.org/text.asp?2019/5/1/8/255026
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http://dx.doi.org/10.4103/bc.bc_36_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458775PMC
March 2019
1 Read

Clinical Experience with Hemopatch® as a Dural Sealant in Cranial Neurosurgery.

Cureus 2019 Feb 4;11(2):e4013. Epub 2019 Feb 4.

Department of Neurosurgery, University Medical Centre of Regensburg, Regensburg, DEU.

Background: Herein, we report our clinical experience with the novel polyethylene glycol-covered matrix dural onlay, Hemopatch® (Baxter Deutschland GmbH, Unterschleißheim, Germany) for the prevention of postoperative cerebrospinal fluid (CSF) fistulas.

Methods: Retrospectively, 22 consecutive patients (11 females, 11 males, mean age: 49.8 years, range: 15-77 years) with oncological and vascular intracranial lesions were included in this study. Read More

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https://www.cureus.com/articles/17296-clinical-experience-wi
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http://dx.doi.org/10.7759/cureus.4013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450590PMC
February 2019
2 Reads

Intracranial Venous Sinus Stenting: A Review of Idiopathic Intracranial Hypertension and Expanding Indications.

Cureus 2019 Feb 4;11(2):e4008. Epub 2019 Feb 4.

Neurosurgery, Penn State Milton Health S. Hershey Medical Center, Hershey, USA.

Idiopathic intracranial hypertension (IIH) is a functionally limiting disorder secondary to increased intracranial pressures (ICPs) with a prevalence of one per 100,000 persons. It is estimated to cost >$400 million per year in productively. Symptoms classically consist of chronic headaches, papilledema, and visual loss. Read More

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http://dx.doi.org/10.7759/cureus.4008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450594PMC
February 2019

Intracranial Hemorrhage in a Young Woman: An Unusual Initial Presentation of Undiagnosed Choriocarcinoma.

J Neurosci Rural Pract 2019 Apr-Jun;10(2):371-373

Department of Pathology, SMS Medical College, Jaipur, Rajasthan, India.

Choriocarcinoma is an uncommon tumor. Undiagnosed choriocarcinoma initially presenting with intracranial hemorrhage in an apparently healthy female is rare and presents a diagnostic difficulty. The authors report a case presenting as intracranial hemorrhage of unsuspected choriocarcinoma. Read More

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http://dx.doi.org/10.4103/jnrp.jnrp_307_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454938PMC

Decompression Hemicraniectomy for Refractory Intracranial Hypertension in Reversible Cerebral Vasoconstriction Syndrome.

J Neurosci Rural Pract 2019 Apr-Jun;10(2):355-359

Division of Neurocritical Care, Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Reversible cerebral vasoconstriction syndrome (RCVS) is a disorder of dysregulation of cerebrovascular tone resulting in transient segmental vasoconstriction which resolves in 1-3 months. Cerebral edema is an underrecognized complication in RCVS. It is likely multifactorial. Read More

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http://dx.doi.org/10.4103/jnrp.jnrp_334_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454955PMC

Extended Window for Stroke Thrombectomy.

J Neurosci Rural Pract 2019 Apr-Jun;10(2):294-300

Department of Neurological Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA.

Objective: Mechanical thrombectomy is the standard treatment for large vessel occlusion (LVO) in acute ischemic stroke (AIS) up to 6 h after onset. Recent trials have demonstrated a benefit for wake-up strokes and patients beyond 6 h.

Methods: A systematic literature review was conducted for multicenter randomized clinical trials (RCTs) investigating endovascular stroke treatment using perfusion imaging to identify patients that may benefit from mechanical thrombectomy for AIS beyond 6 h of onset. Read More

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http://www.ruralneuropractice.com/text.asp?2019/10/2/294/254
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http://dx.doi.org/10.4103/jnrp.jnrp_365_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454953PMC
April 2019
1 Read

Pattern of Emergent Head Computed Tomography Findings in a Tertiary Care Hospital during off Working Hours: Retrospective Analysis.

J Neurosci Rural Pract 2019 Apr-Jun;10(2):207-211

Department of Radiodiagnosis, Indian Naval Hospital Ship Asvini, Mumbai, Maharashtra, India.

Introduction: Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient's expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings. Read More

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http://www.ruralneuropractice.com/text.asp?2019/10/2/207/254
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http://dx.doi.org/10.4103/jnrp.jnrp_362_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454959PMC
April 2019
2 Reads

Cost-Effectiveness Analysis of Non-Vitamin K Antagonist Oral Anticoagulants Versus Warfarin in Thai Patients With Non-Valvular Atrial Fibrillation.

Heart Lung Circ 2019 Mar 27. Epub 2019 Mar 27.

Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand. Electronic address:

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) have been recommended as preferred options for stroke prevention in patients with atrial fibrillation (AF) versus warfarin by guidelines worldwide.

Aim: This study aimed to evaluate the cost-effectiveness of each NOAC in a Thai health care environment, a country with upper middle-income economies based on the World Bank's classification.

Method: A lifetime Markov model was created from a Thai societal perspective. Read More

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http://dx.doi.org/10.1016/j.hlc.2019.02.187DOI Listing

The self-reported needs of patients following subarachnoid hemorrhage (SAH).

Disabil Rehabil 2019 Apr 18:1-7. Epub 2019 Apr 18.

b Division of Cardiovascular Sciences , The University of Manchester, Core Technology Facility , Manchester , UK.

Background: Despite advances in the acute care of subarachnoid haemorrhage, longer-term services remain under-developed. Clinical measures are commonly used to assess outcome and quality of life, but patient-reported needs and the extent to which they are met have not been measured. This information is essential to plan and develop evidence-based, patient-centred services. Read More

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http://dx.doi.org/10.1080/09638288.2019.1595748DOI Listing

An experimental study on the early diagnosis of traumatic brain injury in rabbits based on a noncontact and portable system.

PeerJ 2019 12;7:e6717. Epub 2019 Apr 12.

College of Biomedical Engineering, Army Medical University, Chongqing, China.

Closed cerebral hemorrhage (CCH) is a common symptom in traumatic brain injury (TBI) patients who suffer intracranial hemorrhage with the dura mater remaining intact. The diagnosis of CCH patients prior to hospitalization and in the early stage of the disease can help patients get earlier treatments that improve outcomes. In this study, a noncontact, portable system for early TBI-induced CCH detection was constructed that measures the magnetic induction phase shift (MIPS), which is associated with the mean brain conductivity caused by the ratio between the liquid (blood/CSF and the intracranial tissues) change. Read More

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http://dx.doi.org/10.7717/peerj.6717DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463870PMC

[Mechanical thrombectomy treatment in patients with acute ischemic stroke: a single center study].

Beijing Da Xue Xue Bao Yi Xue Ban 2019 Apr;51(2):256-259

Department of Interventional Radiologyand Vascular Surgery, Peking University Third Hospital, Beijing 100191, China.

Objective: To evaluate the effectiveness and safety of mechanical thrombectomy treatment in patients with acute ischemic stroke (AIS),and to explore influential factors of the clinical prognosis preliminarily.

Methods: Clinical data of 26 patients with acute cerebral arterial occlusion treated with mechanical thrombectomy in Peking University Third Hospital from January 2014 to June 2017 were retrospectively collected. The immediate effects of the 26 patients in this group after mechanical thrombectomy treatment were analyzed,The national institutes of health stroke scale (NIHSS) scores between preoperative and at discharge of the 26 patients in this group were compared,and modified Rankin scale (mRS) scores of 90 days post operation were analyzed to assess the prognosis of the 26 patients in this group. Read More

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April 2019
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Intracellular Fe accumulation in endothelial cells and pericytes induces blood-brain barrier dysfunction in secondary brain injury after brain hemorrhage.

Sci Rep 2019 Apr 17;9(1):6228. Epub 2019 Apr 17.

Molecular Pharmacology, Department of Biofunctional Evaluation, Gifu Pharmaceutical University, Gifu, 501-1196, Japan.

After intracranial hemorrhage (ICH), iron is released from the hematoma and induces secondary brain injury. However, the detail effect of iron on blood-brain barrier (BBB) function is still unknown. We investigated whether hemoglobin (Hb), ferrous ammonium sulfate (FAS) or hemin which contains iron have the detrimental effect on both human brain microvascular endothelial cells and pericytes by cellular function analysis in vitro. Read More

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http://dx.doi.org/10.1038/s41598-019-42370-zDOI Listing

Protease-independent action of tissue plasminogen activator in brain plasticity and neurological recovery after ischemic stroke.

Proc Natl Acad Sci U S A 2019 Apr 17. Epub 2019 Apr 17.

Pittsburgh Institute of Brain Disorders and Recovery, University of Pittsburgh, Pittsburgh, PA 15213;

Emerging evidence suggests that tissue plasminogen activator (tPA), currently the only FDA-approved medication for ischemic stroke, exerts important biological actions on the CNS besides its well-known thrombolytic effect. In this study, we investigated the role of tPA on primary neurons in culture and on brain recovery and plasticity after ischemic stroke in mice. Treatment with recombinant tPA stimulated axonal growth in culture, an effect independent of its protease activity and achieved through epidermal growth factor receptor (EGFR) signaling. Read More

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http://dx.doi.org/10.1073/pnas.1821979116DOI Listing
April 2019
1 Read

Intractable Medial Anastomotic Branches from the Lenticulostriate Artery Causing Recurrent Hemorrhages in Moyamoya Disease: A Case Report.

World Neurosurg 2019 Apr 14. Epub 2019 Apr 14.

Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Background: While superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis is a beneficial treatment for hemorrhagic moyamoya disease, indeterminate mechanisms can cause rebleeding even after successful bypass surgery. The authors describe a case with a prominent collateral from the lenticulostriate artery (LSA) causing multiple recurrent hemorrhages after successful STA-MCA anastomosis.

Case: Description: A 49-year-old Japanese woman with moyamoya disease was referred to our institution after suffering intracranial hemorrhage on two occasions. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.066DOI Listing

Early prediction of neurological outcome after barbiturate coma therapy in patients undergoing brain tumor surgery.

PLoS One 2019 17;14(4):e0215280. Epub 2019 Apr 17.

Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

After a difficult brain tumor surgery, refractory intracranial hypertension (RICH) may occur due to residual tumor or post-operative complications such as hemorrhage, infarction, and aggravated brain edema. We investigated which predictors are associated with prognosis when using barbiturate coma therapy (BCT) as a second-tier therapy to control RICH after brain tumor surgery. The study included adult patients who underwent BCT after brain tumor surgery between January 2010 and December 2016. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215280PLOS
April 2019
1 Read

Comparison of different types of endovascular mechanical embolectomy in acute ischemic stroke.

Authors:
Yuan Pu

Rev Assoc Med Bras (1992) 2019 Mar 11;65(3):342-347. Epub 2019 Apr 11.

Department of Neurosurgery, Suqian People' hospital of Nanjing Durm Tower hospital Group, Suqian, Jiangsu, China.

Background: To compare the treatment efficacy of different types of endovascular mechanical embolectomy in acute ischemic stroke (AIS).

Material And Methods: A total of 89 patients with AIS were selected in our hospital from January 2014 to January 2016 and divided into tPA group (n=27), tPA+Trevo group (n=30) and tPA+Solitaire FR group (n=32) for different treatments. Treatment effectiveness was evaluated using NIHSS and mRS system. Read More

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http://www.scielo.br/scielo.php?script=sci_arttext&pid=S
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http://dx.doi.org/10.1590/1806-9282.65.3.342DOI Listing
March 2019
2 Reads

Medium-term results of undersized angioplasty and stenting for symptomatic high-grade intracranial atherosclerotic stenosis with Enterprise.

Interv Neuroradiol 2019 Apr 16:1591019919832244. Epub 2019 Apr 16.

1 Department of Radiology, University of Health Sciences, Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Purpose: The aim of this retrospective study is to evaluate medium-term results of undersized balloon angioplasty and stenting for symptomatic high-grade (70-99%) stenosis of a major intracranial artery with Enterprise stent.

Methods: This study included 68 consecutive symptomatic (recurrent transient ischemic attack (TIA) or ischemic stroke under dual antiplatelet treatment) patients with high-grade (70-99%) stenosis of a major intracranial artery who were endovascularly treated with undersized balloon angioplasty and Enterprise stent deployment between July 2012 and December 2017. Primary outcomes were any stroke or death within 30 days after procedure. Read More

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http://dx.doi.org/10.1177/1591019919832244DOI Listing

Phantom-based evaluation of near-infrared intracranial hematoma detector performance.

J Biomed Opt 2019 Apr;24(4):1-10

U.S. Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, Maryla, United States.

Near-infrared spectroscopy (NIRS) is emerging as a rapid, low-cost approach for point-of-care triage of hematomas resulting from traumatic brain injury. However, there remains a lack of standardized test methods for benchtop performance assessment of these devices and incomplete understanding of relevant light-tissue interactions. We propose a phantom-based test method for systems operating near the 800-nm oxy-/deoxy-hemoglobin isosbestic point and implement it to evaluate a clinical system. Read More

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http://dx.doi.org/10.1117/1.JBO.24.4.045001DOI Listing
April 2019
2 Reads

[Intracranial hemorrhage masquerading as STEMI].

Med Klin Intensivmed Notfmed 2019 Apr 15. Epub 2019 Apr 15.

Allgemeine Intensivstation, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Auenbruggerplatz 15, 8036, Graz, Österreich.

A 56-year-old woman was found unconscious and promptly intubated. The electrocardiogram showed ST elevations in I, aVL, V1-V4. Thus, lysis therapy was performed. Read More

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http://dx.doi.org/10.1007/s00063-019-0584-5DOI Listing
April 2019
1 Read

Stent-retriever assisted vacuum-locked extraction (SAVE) versus a direct aspiration first pass technique (ADAPT) for acute stroke: data from the real-world.

BMC Neurol 2019 Apr 15;19(1):65. Epub 2019 Apr 15.

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

Background: Embolectomy is the standard of care in acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). Aim of this study was to compare two techniques: A Direct Aspiration First Pass Technique (ADAPT) and Stent-retriever Assisted Vacuum-locked Extraction (SAVE) stratified by the occluded vessel.

Methods: One hundred seventy-one patients (71 male) treated between January 2014 and September 2017 with AIS due to LVO of the anterior circulation (55 carotid T, 94 M1, 22 M2) were included. Read More

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https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-
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http://dx.doi.org/10.1186/s12883-019-1291-9DOI Listing
April 2019
4 Reads

Clinical Features of Patients With Spontaneous Intracranial Hypotension Complicated With Bilateral Subdural Fluid Collections.

Headache 2019 Apr 15. Epub 2019 Apr 15.

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

Background: Subdural hygromas are often found bilaterally in spontaneous intracranial hypotension (SIH). They frequently progress to chronic subdural hematomas (CSDHs), and if the hematomas are formed, it is difficult to consider SIH as an underlying cause. Whether SIH is underlying or not among the patients presenting bilateral subdural fluid collections (hygromas or CSDHs) is clinically important because the treatment strategy should be different between them. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/head.13525
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http://dx.doi.org/10.1111/head.13525DOI Listing
April 2019
2 Reads

Safety and Efficacy of Heparinization During Mechanical Thrombectomy in Acute Ischemic Stroke.

Front Neurol 2019 29;10:299. Epub 2019 Mar 29.

Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

The benefits of heparization during mechanical thrombectomy (MT) with newer generation thrombectomy devices, and if it is counterbalanced by the increased risk of intracranial hemorrhage (ICH) remain unknown. We included eligible patients who underwent MT from the ANGEL registry study (2015-2017) in China. Subjects in the current analysis were dichotomized into two groups according to whether adequate heparinization during MT was performed. Read More

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https://www.frontiersin.org/article/10.3389/fneur.2019.00299
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http://dx.doi.org/10.3389/fneur.2019.00299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450216PMC
March 2019
2 Reads

A Low-Dose 4F-PCC Protocol for DOAC-Associated Intracranial Hemorrhage.

J Intensive Care Med 2019 Apr 14:885066619840992. Epub 2019 Apr 14.

3 Department of Pharmacy, NewYork-Presbyterian Hospital, The Allen Hospital, New York, NY, USA.

Purpose: Current guidelines favor 4F-PCC over plasma for reversal of warfarin. Uncertainty remains on the hemostatic effectiveness and thrombotic risk of 4F-PCC for direct-acting oral anticoagulants (DOACs), particularly in patients with intracranial hemorrhage (ICH). This study sought to evaluate the effectiveness and safety of a lower dose protocol of 25 units/kg 4F-PCC for the management of DOAC-associated ICH in a real-world setting. Read More

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http://dx.doi.org/10.1177/0885066619840992DOI Listing
April 2019
4 Reads

Clinical decision rule for non-traumatic computed tomography of the brain.

Emerg Med Australas 2019 Apr 14. Epub 2019 Apr 14.

Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.

Objective: The aims of the present study were to derive and validate a clinical decision rule (CDR) to rule out the need for computed tomography of the brain (CTB) in non-traumatic patients who present to the ED.

Methods: This is a retrospective review of non-traumatic patients who presented to the EDs in two urban hospitals and received CTB from January 2014 to December 2016. Data from one hospital were used to develop a CDR for clinically significant CTB findings. Read More

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http://dx.doi.org/10.1111/1742-6723.13292DOI Listing
April 2019
1 Read

Economic Comparison Between Endovascular Coiling vs Neurosurgical Clipping for Ruptured and Unruptured Intracranial Aneurysms in Austria.

Neurosurgery 2019 May;84(5):E272-E273

Introduction: Subarachnoid hemorrhage from a ruptured intracranial aneurysm poses a significant health hazard due to its high rates of mortality and disability. The 2 most commonly used treatment modalities of intracranial aneurysms are neurosurgical clipping and endovascular coiling. Through the decision on which treatment option should be chosen in every case is made based on medical indication, nevertheless, due to high socioeconomic burden of subarachnoid hemorrhage, it is also important to compare the healthcare expenditures, caused by clipping and coiling. Read More

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https://academic.oup.com/neurosurgery/article/84/5/E272/5418
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http://dx.doi.org/10.1093/neuros/nyz001.NV1DOI Listing
May 2019
2 Reads

Freehand Insertion of External Ventricular Drainage Catheter-Evaluation of Accuracy in a Single Centre.

Neurosurgery 2019 May;84(5):E271

Introduction: External ventricular drain (EVD) placement is the gold standard for managing acute hydrocephalus. Freehand EVD, using surface anatomical landmarks is performed for ventricular cannulation due to its simplicity and efficiency. This study evaluates accuracy and reason(s) for misplacements as few studies have analyzed the accuracy of freehand EVD insertion. Read More

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https://academic.oup.com/neurosurgery/article/84/5/E271/5418
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http://dx.doi.org/10.1093/neuros/nyz001.TN2DOI Listing
May 2019
4 Reads

Meta-Analysis of Direct-Acting Oral Anticoagulants Compared With Warfarin in Patients >75 Years of Age.

Am J Cardiol 2019 Mar 18. Epub 2019 Mar 18.

Division of Cardiology, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York.

Older patients with atrial fibrillation (AF) are at higher risk of thromboembolic events and oral anticoagulant (OAC)-related bleeding complications. This meta-analysis evaluates the efficacy and safety of direct-acting OACs (DOACs) compared with warfarin in older patients with nonvalvular AF. PubMed, Embase, and Cochrane Central databases were searched for randomized controlled trials assessing the efficacy and safety of DOACs compared with warfarin in AF patients who were >75 years old. Read More

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http://dx.doi.org/10.1016/j.amjcard.2019.02.060DOI Listing
March 2019
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Number of Stentriever Passes and Outcome after Thrombectomy in Stroke.

J Neuroradiol 2019 Apr 11. Epub 2019 Apr 11.

Departments of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address:

Background And Purposes: Stroke secondary to emergent large vessel occlusions (ELVO) involving the anterior circulation can be treated with intravenous tissue plasminogen activator (IV-tPA) or thrombectomy. Data regarding the influence of the number of stentriever passes needed for vessel recanalization on outcome is lacking.

Patients And Methods: We prospectively accrued data on consecutive patients with ELVO that were treated with thrombectomy. Read More

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http://dx.doi.org/10.1016/j.neurad.2019.03.014DOI Listing
April 2019
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Angiographical Jaggy Sign of Remnant M2 Occlusion during Acute Mechanical Thrombectomy.

J Stroke Cerebrovasc Dis 2019 Apr 10. Epub 2019 Apr 10.

Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Background And Purpose: During mechanical thrombectomy for acute main trunk occlusion, we sometimes encounter difficult situation; 1 M2 branch of the middle cerebral artery is successfully recanalized, while the other remains occluded. In this study, we focused on the angiographical findings of remnant occlusion.

Methods: Among 83 patients who underwent mechanical thrombectomy for the acute internal carotid artery or proximal middle cerebral artery (M1) occlusion, 25 patients (30%) intraoperatively exhibited the remnant M2 occlusion, in spite of the recanalization of the other M2. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10523057193013
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.03.043DOI Listing
April 2019
4 Reads

Endovascular Thrombectomy, Platelet Count and Intracranial Hemorrhage.

World Neurosurg 2019 Apr 10. Epub 2019 Apr 10.

University of Pittsburgh Medical Center, Departments of Neurology, Pittsburgh PA; Neurosurgery, Pittsburgh PA. Electronic address:

Background: Intracranial hemorrhage (ICH) can be a devastating complication of endovascular thrombectomy (ET) following acute ischemic stroke increasing disability and mortality. Patients with low platelet count were excluded from major ET trials. This study explores the association between platelet count and ICH after ET. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.036DOI Listing
April 2019
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Endovascular mechanical thrombectomy for cerebral venous sinus thrombosis: a single center experience.

World Neurosurg 2019 Apr 10. Epub 2019 Apr 10.

Department of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Robert-Koch-Straße 40, 37075 Goettingen, Germany.

Background: Cerebral venous thrombosis (CVT) is a rare entity with a potentially fatal outcome. Especially patients who do not respond to standard medical therapy alone may benefit from endovascular treatment options. We evaluate the angiographic and clinical results of mechanical thrombectomy (MT) in patients with severe CVT. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193104
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http://dx.doi.org/10.1016/j.wneu.2019.04.049DOI Listing
April 2019
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What is the best therapeutic approach to a pediatric patient with a deep-seated brain AVM?

Neurosurg Rev 2019 Apr 13. Epub 2019 Apr 13.

Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland.

Although brain arteriovenous malformations (bAVMs) account for a very small proportion of cerebral pathologies in the pediatric population, they are the cause of roughly 50% of spontaneous intracranial hemorrhages. Pediatric bAVMs tend to rupture more frequently and seem to have higher recurrence rates than bAVMs in adults. Thus, the management of pediatric bAVMs is particularly challenging. Read More

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http://link.springer.com/10.1007/s10143-019-01101-8
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http://dx.doi.org/10.1007/s10143-019-01101-8DOI Listing
April 2019
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Rivaroxaban in cervical and "cervico-cerebral" artery dissections: a new therapeutic option?

Neurol Sci 2019 Apr 12. Epub 2019 Apr 12.

Department of Medicine, Maggiore Hospital, Bologna, BO, Italy.

Antiplatelet agents and vitamin K antagonists (VKA) are usually used in the treatment of cervical (carotid or vertebral) artery dissections (CADs); however, data about the use of direct oral anticoagulants (DOACs) in these conditions are very limited. DOACs have proven to be effective in stroke reduction in non-valvular atrial fibrillation and, when possible, they are preferred to warfarin because of their better safety profile. We describe four cases of CADs and, firstly in literature, cervico-cerebral (CCADs) in young patients (average age of 42 years) treated with rivaroxaban 20 mg daily. Read More

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http://dx.doi.org/10.1007/s10072-019-03882-8DOI Listing
April 2019
2 Reads

Early post-Humanitarian Device Exemption experience with the Neuroform Atlas stent.

J Neurointerv Surg 2019 Apr 12. Epub 2019 Apr 12.

Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.

Introduction: The low-profile Neuroform Atlas stent received FDA Humanitarian Device Exemption status (HDE) in January 2018 for stent-assisted coil embolization of wide-necked saccular aneurysms. We review and report our results with the Atlas stent in our institution within the first year after its HDE approval.

Methods: Our retrospective chart review identified patients treated with the Atlas stent. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014874DOI Listing
April 2019
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Impact of aneurysm shape and neck configuration on cerebral infarction during microsurgical clipping of intracranial aneurysms.

J Neurosurg 2019 Apr 12:1-9. Epub 2019 Apr 12.

1Center for Neurosurgery and.

OBJECTIVECerebral infarction is a significant cause of morbidity and mortality related to microsurgical clipping of intracranial aneurysms. The objective of this study was to determine the impact of aneurysm shape and neck configuration on cerebral infarction after aneurysm surgery.METHODSThe authors retrospectively reviewed consecutive cases of ruptured and unruptured aneurysms treated with microsurgical clipping at their institution between 2010 and 2018. Read More

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http://dx.doi.org/10.3171/2019.1.JNS183193DOI Listing
April 2019
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Molecular diagnosis of asparagine synthetase (ASNS) deficiency in two Indian families and literature review of 29 ASNS deficient cases.

Gene 2019 Apr 9;704:97-102. Epub 2019 Apr 9.

Sandor Speciality Diagnostics Pvt Ltd, Banjara Hills, Road No.3, Hyderabad, India.

In the current study, we report three cases of Asparagine Synthetase (ASNS) Deficiency from two consanguineous families. Family 1 had two early neonatal deaths due to a novel mutation in the ASNS gene c.788C > T (p. Read More

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http://dx.doi.org/10.1016/j.gene.2019.04.024DOI Listing
April 2019
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Comparison between in-hospital stroke and community-onset stroke treated with endovascular thrombectomy.

PLoS One 2019 12;14(4):e0214883. Epub 2019 Apr 12.

Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.

Objective: In-hospital stroke (IHS) is an uncommon but serious medical emergency. Early recanalization through endovascular thrombectomy (EVT) may offer a vital therapeutic choice. This study compared the clinical features and outcomes between IHS and community-onset stroke (COS). Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214883PLOS
April 2019
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Cerebral Venous Sinus Thrombosis with an Intracranial Haemorrhage: A Case Report.

Open Access Maced J Med Sci 2019 Mar 28;7(6):1029-1031. Epub 2019 Mar 28.

King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Department of Family Medicine, Jeddah, Saudi Arabia.

Background: Cerebral venous sinus thrombosis (CVST) is a rare, life-threatening disorder. It has an annual incidence of approximately two to four per million people per year. Nearly 70-80% of all cases of CVST are located in the superior sagittal sinus (SSS). Read More

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http://dx.doi.org/10.3889/oamjms.2019.229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454179PMC
March 2019
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'Real-world' comparison of first-line direct aspiration and stent retriever mechanical thrombectomy for the treatment of acute ischemic stroke in the anterior circulation: a multicenter international retrospective study.

J Neurointerv Surg 2019 Apr 11. Epub 2019 Apr 11.

Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.

Background: Thrombectomy for anterior large vessel occlusion less than 24 hours since last known well is now standard of care. Certain aspects of clinical trials may limit generalizability to 'real-world' practice.

Objective: To compare revascularization rates and outcomes for direct aspiration (ADAPT) and stent retriever thrombectomy following anterior acute ischemic stroke (AIS) in a real-life setting. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014624DOI Listing
April 2019
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Flow diversion treatment of aneurysms of the complex region of the anterior communicating artery: which stent placement strategy should 'I' use? A single center experience.

J Neurointerv Surg 2019 Apr 11. Epub 2019 Apr 11.

NEURI, Hopital Bicetre, Le Kremlin-Bicetre, France.

Background: Aneurysms of the anterior communicating artery (ACoA) are difficult to treat with coiling or clipping because of the anatomical variation in this region. Flow diversion represents a feasible treatment, but no consensus exists as to which stent deployment technique is more suitable.

Methods: All patients with ACoA aneurysms treated with flow diverters between April 2014 and November 2018 were retrospectively analyzed. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014858DOI Listing
April 2019
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Proposal of modification in management strategy for intracranial hemorrhage in low- and middle-income countries.

Clin Neurol Neurosurg 2019 Apr 1;181:21-23. Epub 2019 Apr 1.

Neurosurgery Unit, Department of Surgery, Lagoon Hospitals, Lagos, Nigeria. Electronic address:

This brief communication describes the challenges faced by neurosurgeons in Low- or middle-income countries to treat neurosurgical emergencies from intracranial bleeds (whether traumatic or spontaneous). The authors point out that in low- or middle-income countries and Africa in particular, resources, facilities, and personnel are lacking to follow the guidelines proposed for treating these conditions in high-income countries. The proposal offered here is to move to early surgical intervention because algorithms to monitor patients under conservative management guidelines are often not possible. Read More

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http://dx.doi.org/10.1016/j.clineuro.2019.03.026DOI Listing
April 2019
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1.248 Impact Factor

Comparison of Frame-based vs Frameless Intracranial Stereotactic Biopsy: Systematic Review and Meta-Analysis.

World Neurosurg 2019 Apr 8. Epub 2019 Apr 8.

Department of Neurosurgery, University of Minnesota, MN, USA. Electronic address:

Background: Frame-based stereotaxy is generally considered the gold standard for brain biopsies while frameless stereotaxy may expedite efficiency of clinical work flow. There are conflicting reports in the literature that studied the relative efficacy and safety of frame-based and frameless needle biopsy of brain lesions.

Objective: We performed a meta-analysis of the published literature to compare the relative efficacy, safety, and time-efficiency of frame-based and frameless stereotactic needle biopsy. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.016DOI Listing
April 2019
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Carotid artery stenting in acute stroke using a microporous stent device: a single centre experience.

World Neurosurg 2019 Apr 8. Epub 2019 Apr 8.

Interventional Radiology Service - Department of Radiology, Austin Hospital, Melbourne, Australia; Department of Neurology, Austin Health, Melbourne, Australia; Department of Imaging - Monash Health, Melbourne, Australia; Interventional Neuroradiology Service - Department of Radiology, Austin Hospital, Melbourne, Australia; School of Medicine - Faculty of Health, Deakin University, Waurn Ponds, Australia.

Background: Carotid artery stenting (CAS) is an established treatment for carotid artery stenosis, typically in a semi-elective or elective setting. The growth of mechanical thrombectomy for acute stroke has led to an increased use of emergent carotid artery stenting (eCAS). This single-centre retrospective case series evaluates the safety and efficacy of eCAS using a dual-layer micromesh nitinol stent to treat carotid artery stenosis in the acute stroke setting. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.04.024DOI Listing
April 2019
3 Reads
2.417 Impact Factor

Neurostereologic Lesion Volumes and Spreading Depolarizations in Severe Traumatic Brain Injury Patients: A Pilot Study.

Neurocrit Care 2019 Apr 9. Epub 2019 Apr 9.

Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, and UC Gardner Neuroscience Institute, Cincinnati, OH, USA.

Background: Spreading depolarizations (SDs) occur in 50-60% of patients after surgical treatment of severe traumatic brain injury (TBI) and are independently associated with unfavorable outcomes. Here we performed a pilot study to examine the relationship between SDs and various types of intracranial lesions, progression of parenchymal damage, and outcomes.

Methods: In a multicenter study, fifty patients (76% male; median age 40) were monitored for SD by continuous electrocorticography (ECoG; median duration 79 h) following surgical treatment of severe TBI. Read More

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http://dx.doi.org/10.1007/s12028-019-00692-wDOI Listing
April 2019
1 Read