79,349 results match your criteria Intracranial Hemorrhage


[Posterior reversible encephalopathy syndrome in systemic lupus erythematosus: a case report].

Beijing Da Xue Xue Bao Yi Xue Ban 2018 Dec;50(6):1102-1107

Department of Rheumatology and Immunology, Peking University First Hospital, Beijing 100034, China.

This case report concerns a 22-year-old woman who had been diagnosed with systemic lupus erythematosus (SLE). She had intermittent fever, butterfly erythema, photosensitivity, oral ulcers, and multiple arthralgia in the past seven years, but she did not adhere to regular treatments. The edema of the lower extremities and face aggravated in the recent two weeks, so she was admitted to our Department of Rheumatology and Clinical Immunology. Read More

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December 2018

Efficacy and safety of aspirin for primary prevention of cardiovascular events: a meta-analysis and trial sequential analysis of randomized controlled trials.

Eur Heart J 2018 Dec 17. Epub 2018 Dec 17.

Division of Cardiovascular Medicine, Department of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA.

Aims: The role of aspirin in the primary prevention setting is continuously evolving. Recent randomized trials have challenged the role of aspirin in the primary prevention setting.

Methods And Results: Electronic databases were searched for randomized trials that compared aspirin vs. Read More

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http://dx.doi.org/10.1093/eurheartj/ehy813DOI Listing
December 2018

Trevo 2000: Results of a Large Real-World Registry for Stent Retriever for Acute Ischemic Stroke.

J Am Heart Assoc 2018 Dec;7(24):e010867

1 Department of Neurosciences Drexel Neurosciences Institute Philadelphia PA.

Background Recent randomized controlled trials show benefit of thrombectomy for large vessel occlusion in stroke. Real-world data aid in assessing reproducibility of outcomes outside of clinical trials. The Trevo Retriever Registry is a multicenter, international, prospective study designed to assess outcomes in a large cohort of patients. Read More

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http://dx.doi.org/10.1161/JAHA.118.010867DOI Listing
December 2018

Age and Number of Surgeries Increase Risk for Complications in Polytrauma Patients with Operative Maxillofacial Fractures.

World J Plast Surg 2018 Sep;7(3):307-313

Department of Plastic Surgery, University of California, Irvine; Orange, CA, USA.

Background: Poly-trauma patients often sustain complex head/neck injuries requiring prolonged hospitalizations and multiple operations. Few studies have evaluated the associated injury patterns and risk factors for poor clinical outcomes.

Methods: Consecutive poly-trauma patients with operative maxillofacial fractures treated at a level 1 trauma medical center between 1995 and 2013 were evaluated. Read More

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http://dx.doi.org/10.29252/wjps.7.3.307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290318PMC
September 2018

Treatment of bleeding complications in patients on anticoagulant therapy.

Blood 2018 Dec 17. Epub 2018 Dec 17.

Department of Medicine, Division of Hematology and Thromboembolism, and Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada

Anticoagulant therapy is often refrained from due to the fear of hemorrhagic complications. The most frequent type of major bleeding is gastrointestinal but intracranial hemorrhage has the worst prognosis. Management of these complications in patients on anticoagulants should follow the same routines as for non-anticoagulated patients, as described here with the above-mentioned bleeds as examples. Read More

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http://dx.doi.org/10.1182/blood-2018-06-820746DOI Listing
December 2018

Is repeat head CT necessary in patients with mild traumatic intracranial hemorrhage.

Am J Emerg Med 2018 Dec 10. Epub 2018 Dec 10.

Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States of America; Harvard Affiliated Emergency Medicine Residency, Boston, MA 02114, United States of America.

Background: Patients with traumatic intracranial hemorrhage (TIH) frequently receive repeat head CT scans (RHCT) to assess for progression of TIH. The utility of this practice has been brought into question, with some studies suggesting that in the absence of progressive neurologic symptoms, the RHCT does not lead to clinical interventions.

Methods: This was a retrospective review of consecutive patients with CT-documented TIH and GCS ≥ 13 presenting to an academic emergency department from 2009 to 2013. Read More

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http://dx.doi.org/10.1016/j.ajem.2018.12.012DOI Listing
December 2018

Predictors of discharge destination in patients with major traumatic injury: Analysis of Oklahoma Trauma Registry.

Am J Surg 2018 Dec 10. Epub 2018 Dec 10.

Department of Surgery, The University of Oklahoma, College of Medicine, Tulsa, OK, USA. Electronic address:

Background: The ability to predict the need for discharge of trauma patients to a facility may help shorten hospital stay. This study aimed to determine the predictors of discharge to a facility and develop and validate a predictive scoring model, utilizing the Oklahoma Trauma Registry (OTR).

Methods: A multivariate analysis of the OTR 2005-2013 determined independent predictors of discharge to a facility. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2018.11.045DOI Listing
December 2018

Eosinophilic cerebrospinal fluid pleocytosis associated with neural Angiostrongylus vasorum infection in a dog.

Vet Clin Pathol 2018 Dec 17. Epub 2018 Dec 17.

Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, UK.

A 1-year-old, female intact Pug dog was presented to the Small Animal Teaching Hospital of the University of Liverpool with a 4-week history of progressive multifocal intracranial signs. Magnetic resonance imaging (MRI) detected multiple hemorrhagic lesions in the brain. The Baermann and zinc sulfate flotation tests with centrifugation, performed on fecal samples, were positive for lungworm larvae and an antigenic test confirmed Angiostrongylus vasorum infection. Read More

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http://dx.doi.org/10.1111/vcp.12684DOI Listing
December 2018

Intracranial Hemorrhage in Children With Inherited Bleeding Disorders: A Single Center Study in China.

J Pediatr Hematol Oncol 2018 Dec 14. Epub 2018 Dec 14.

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Background: Intracranial hemorrhage (ICH) is a life-threatening condition in children. Inherited bleeding disorders (IBD) have high risk of ICH.

Aim: This single center study aims to identify the incidence, risk factors, and neurological outcome of ICH in children who suffer from IBD. Read More

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http://dx.doi.org/10.1097/MPH.0000000000001358DOI Listing
December 2018

Real-time Imaging of an Experimental Intracranial Aneurysm in Rats.

Neurol Med Chir (Tokyo) 2018 Dec 15. Epub 2018 Dec 15.

Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center.

Subarachnoid hemorrhage due to rupture of a pre-existing intracranial aneurysm has quite a poor outcome in spite of intensive medical care. Hemodynamic stress loaded on intracranial arterial walls is considered as a trigger and a regulator of formation and progression of the disease, but how intracranial arterial walls or intracranial aneurysm walls behave under hemodynamic stress loading remains unclear. The purpose of this study was to visualize and analyze the wall motion of intracranial aneurysms to detect a pathological flow condition. Read More

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http://dx.doi.org/10.2176/nmc.oa.2018-0197DOI Listing
December 2018

Management of Cerebral Microbleeds in Clinical Practice.

Transl Stroke Res 2018 Dec 15. Epub 2018 Dec 15.

Stroke Program, Department of Medicine, University of Alberta, Edmonton, T6G 2G3, Canada.

Cerebral microbleeds (CMBs) are very frequent diagnoses with MRI imaging in the elderly or in patients with cerebral infarction, intracranial hemorrhage (ICH), and dementia. The mechanisms for CMBs are not fully understood but may be secondary to injury to the vascular wall from long-standing hypertension or amyloid deposition in the tissue. The presence of CMB increases the risk for stroke, dementia, and death. Read More

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http://link.springer.com/10.1007/s12975-018-0678-z
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http://dx.doi.org/10.1007/s12975-018-0678-zDOI Listing
December 2018
2 Reads

Imaging in neurointerventional stroke treatment: review of the recent trials and what your neurointerventionalist wants to know from emergency radiologists.

Emerg Radiol 2018 Dec 14. Epub 2018 Dec 14.

Department of Radiology and Biomedical Imaging, University of California San Francisco School of Medicine, 550 16th. Street, San Francisco, CA, 94158, USA.

Stroke is one of the leading causes of death and disability worldwide. Standard treatment for stroke is intravenous (IV) injection of tissue plasminogen activator (t-PA) rapidly after symptom onset. However, there are limitations of IV t-PA treatment, such as a short time window for administration and risk for hemorrhage. Read More

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http://dx.doi.org/10.1007/s10140-018-01662-zDOI Listing
December 2018

Hybrid operation to revascularize long-segment occluded internal carotid artery prevent further ischemic events.

Neuroradiology 2018 Dec 14. Epub 2018 Dec 14.

Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.

Purpose: The effects and complications of hybrid procedure (combined carotid endarterectomy and carotid stenting) to revascularize chronic long-segment occlusion of internal carotid artery (ICA) are currently unknown and the purpose of this study.

Methods: Sixty-five patients with long-segment occlusion of ICA were prospectively enrolled and divided into two groups of revascularization with hybrid operation (n = 30) and medication group (n = 35), and clinical and angiographic data were analyzed.

Results: The duration from symptom onset to revascularization ranged 17-120 days (mean 40. Read More

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http://dx.doi.org/10.1007/s00234-018-2145-7DOI Listing
December 2018

Pipeline shield with single antiplatelet therapy in aneurysmal subarachnoid haemorrhage: multicentre experience.

J Neurointerv Surg 2018 Dec 14. Epub 2018 Dec 14.

Institute of Neurological Sciences, Prince of Wales Hospital, Randwick, New South Wales, Australia.

Background: The Pipeline Embolisation Device with Shield technology (PED-Shield) is suggested to have reduced thrombogenicity. This reduced thrombogenicity may make it possible to use safely in the acute treatment of aneurysmal subarachnoid haemorrhage (aSAH) on single antiplatelet therapy (SAPT).

Objective: To evaluate the safety and efficacy of the off-label use of PED-Shield with SAPT for the acute treatment of aSAH. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014363DOI Listing
December 2018

Clipping of Basilar Perforator Pure Arterial Malformation Aneurysm: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2018 Dec 14. Epub 2018 Dec 14.

University of Miami, Department of Neurosurgery, Miami, Florida.

Pure arterial malformations are rarely-encountered intracranial lesions, often mistaken for arteriovenous malformations. A minority of these lesions may harbor associated aneurysms. In a recent series of 12 patients with pure arterial malformations, 3 patients had associated aneurysms. Read More

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http://dx.doi.org/10.1093/ons/opy382DOI Listing
December 2018

[The surgical management of upper parapharyngeal regions].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018 Dec;32(23):1804-1809

Department of Otorhinolaryngology, the First Affiliated Hospital, Bengbu Medical College, Bengbu, 233004, China.

To find proper the surgical approval and evaluate clinical efficacy to treat the tumor of upper parapharyngeal space involving the base of skull and intracranial skull. The data of 9 cases from June 2013 and June 2018 were analyzed retrospectively including schwannoma in 6 cases, pleomorphic adenoma in 2 cases and hemangioma in 1 case. All cases received preoperative high resolution CT and MRI, some cases also did the DSA examination. Read More

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http://www.cnki.net/kcms/doi/10.13201/j.issn.1001-1781.2018.
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http://dx.doi.org/10.13201/j.issn.1001-1781.2018.23.009DOI Listing
December 2018
3 Reads

Systematic review and meta-analysis on the role of prenatal magnetic resonance imaging in the era of fetal neurosonography: mild and moderate ventriculomegaly.

Ultrasound Obstet Gynecol 2018 Dec 14. Epub 2018 Dec 14.

Women´s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway.

Objectives: To report the rate of additional anomalies detected exclusively on prenatal MRI in fetuses affected by isolated mild or moderate ventriculomegaly (VM) according to the type of ultrasound protocol adopted (dedicated neurosonography vs standard assessment of fetal brain) and to explore whether the diagnostic performance of fetal MRI in detecting such anomalies is affected by gestational age at scan and laterality of ventricular dilatation.

Methods: The primary aim was to report the rate of additional anomalies detected exclusively on prenatal MRI in fetuses affected by isolated mild and moderate VM (ventricular dilatation between 10-15 mm) undergoing compared to those not undergoing dedicated neurosonography, defined as a detail assessment of fetal brain according to the International Society of Ultrasound in Obstetrics and Gynecology guidelines. Medline, Embase, Cinahl and Clinicaltrials. Read More

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http://dx.doi.org/10.1002/uog.20197DOI Listing
December 2018

Basal ganglia hemorrhage in a case report following spinal surgery.

BMC Neurol 2018 Dec 14;18(1):204. Epub 2018 Dec 14.

Neurosurgery and Radiology, Neurology Department, University of Minnesota, Minneapolis, MN, USA.

Background: Intracranial hemorrhage is a rare but potentially severe complication of spinal surgery. Most reported post-operative ICH cases consist of cerebellar hemorrhage. There are fewer reported cases of supratentorial ICH following spinal surgery. Read More

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http://dx.doi.org/10.1186/s12883-018-1218-xDOI Listing
December 2018

Cost Effectiveness of Biomarker Screening for Traumatic Brain Injury.

J Neurotrauma 2018 Dec 14. Epub 2018 Dec 14.

UPenn, Neurosurgery , 310 Spruce St , Philadelphia, Pennsylvania, United States , 19106 ;

Intracranial hemorrhage after traumatic brain injury (TBI) can be life threatening and requires prompt diagnosis. CT scans are a rapid and accurate way to evaluate for hemorrhage. However, in patients with mild and moderate TBI, in whom the incidence of intracranial pathology is low, scanning every patient with CT can be costly. Read More

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http://dx.doi.org/10.1089/neu.2018.6020DOI Listing
December 2018

Nutrition, Energy Expenditure, Dysphagia, and Self-Efficacy in Stroke Rehabilitation: A Review of the Literature.

Brain Sci 2018 Dec 7;8(12). Epub 2018 Dec 7.

Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.

While significant research has been performed regarding the use of thrombolytic agents and thrombectomy in the setting of acute stroke, other factors, such as nutritional status of stroke patients, is a less explored topic. The topic of nutrition is critical to the discussion of stroke, as up to half of stroke survivors may be considered malnourished at discharge. Dysphagia, old age, restricted upper limb movement, visuospatial impairment, and depression are all important risk factors for malnutrition in this cohort. Read More

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http://dx.doi.org/10.3390/brainsci8120218DOI Listing
December 2018

Effect of glycated hemoglobin index and mean arterial pressure on acute ischemic stroke prognosis after intravenous thrombolysis with recombinant tissue plasminogen activator.

Medicine (Baltimore) 2018 Dec;97(49):e13216

Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, China.

To determine whether glycated hemoglobin and mean arterial pressure (MAP) during thrombolysis are prognostic factors of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) for acute ischemic stroke (AIS).A total of 125 AIS patients, who received rt-PA intravenous thrombolysis in our hospital, were included into the present study, and divided into good prognosis group and poor prognosis group. Univariate and multivariate logistic regression analyses were used to determine the prognostic factors of AIS treated by rt-PA thrombolysis, Spearman correlation analysis was used to analyze the correlation of the accumulated cigarette consumption in the smoking subgroup and glycated hemoglobin in the diabetic subgroup with the prognosis after intravenous thrombolysis and the symptomatic intracranial hemorrhage (sICH). Read More

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http://dx.doi.org/10.1097/MD.0000000000013216DOI Listing
December 2018

Terminal spreading depolarizations causing electrocortical silencing prior to clinical brain death: case report.

Authors:

J Neurosurg 2018 Dec 1:1-7. Epub 2018 Dec 1.

The authors report on a 57-year-old woman in whom progression to brain death occurred on day 9 after aneurysmal subarachnoid hemorrhage without evidence of significant brain edema or vasospasm. Neuromonitoring demonstrated that brain death was preceded by a series of cortical spreading depolarizations that occurred in association with progressive hypoxic episodes. The depolarizations induced final electrical silence in the cortex and ended with a terminal depolarization that persisted > 7 hours. Read More

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http://dx.doi.org/10.3171/2018.7.JNS181478DOI Listing
December 2018

High prevalence of KRAS/BRAF somatic mutations in brain and spinal cord arteriovenous malformations.

Brain 2018 Dec 12. Epub 2018 Dec 12.

State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Brain and spinal arteriovenous malformations are congenital lesions causing intracranial haemorrhage or permanent disability especially in young people. We investigated whether the vast majority or all brain and spinal arteriovenous malformations are associated with detectable tumour-related somatic mutations. In a cohort of 31 patients (21 with brain and 10 with spinal arteriovenous malformations), tissue and paired blood samples were analysed with ultradeep next generation sequencing of a panel of 422 common tumour genes to identify the somatic mutations. Read More

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http://dx.doi.org/10.1093/brain/awy307DOI Listing
December 2018

Limitations of Cerebral Oximetry in a Patient With an Intracerebral Hemorrhage and Brain Edema on Extracorporeal Membrane Oxygenation: A Case Report.

A A Pract 2018 Dec 11. Epub 2018 Dec 11.

From the Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, General Hospital Vienna, Medical University of Vienna, Vienna, Austria.

Regional cerebral tissue saturation monitoring is frequently used in patients on mechanical cardiac assist devices with the intention to promptly detect critical imbalances between cerebral oxygen delivery and oxygen extraction and ultimately circumvent permanent brain injury. We report a case where an intraparenchymal bleed in the supply zone of the middle cerebral artery-followed by severe hemispherical brain edema, leading to life-threatening intracranial hypertension-escaped cerebral oximetry monitoring using near-infrared spectroscopy. Potential explanations for our observation, as well as the specific limitations of these devices, are discussed. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000940DOI Listing
December 2018

Pretreatment cerebral microbleeds and symptomatic intracerebral hemorrhage post-thrombolysis: a systematic review and meta-analysis.

J Neurol 2018 Dec 12. Epub 2018 Dec 12.

Department of Neurology, Cerebrovascular Disease Center, People's Hospital, China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People's Republic of China.

Background And Purpose: Cerebral microbleeds (CMBs) are a possible predictor of symptomatic intracranial hemorrhage (sICH) and poor function outcome (PFO). We aimed to investigate the presence of CMBs on increased incidence of sICH and PFO in acute ischemic stroke patients receiving intravenous thrombolysis (IVT) treatment.

Methods: We searched PubMed, EMBASE, and Cochrane Library from 1 January 1997 to 13 May 2018, for relevant studies and calculated the pooled relative risk (RR) for the incidence of sICH and PFO in patients with CMBs versus those without after IVT. Read More

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http://dx.doi.org/10.1007/s00415-018-9156-5DOI Listing
December 2018

Stents and Stent Mimickers in Endovascular Management of Wide-neck Intracranial Aneurysms.

Cureus 2018 Oct 5;10(10):e3420. Epub 2018 Oct 5.

Radiology, The Aga Khan University, Karachi, PAK.

Subarachnoid hemorrhage due to a ruptured cerebral aneurysm is a disastrous event accounting for approximately 5%-15% of all stroke cases and has a high mortality rate. One of the major goals in the management of these patients is to prevent rebleeding by securing the aneurysm either surgically or by endovascular means. Endovascular treatment is considered the first line of treatment for intracranial aneurysms; however, wide-neck aneurysms (WNAs) are specifically difficult to treat by endovascular means due to the difficulty in achieving a stable coil mass inside the aneurysm sac. Read More

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http://dx.doi.org/10.7759/cureus.3420DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284878PMC
October 2018

Collagen COL22A1 maintains vascular stability and mutations in are potentially associated with intracranial aneurysms.

Dis Model Mech 2018 Dec 12;11(12). Epub 2018 Dec 12.

Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA

Collagen XXII (COL22A1) is a quantitatively minor collagen, which belongs to the family of fibril-associated collagens with interrupted triple helices. Its biological function has been poorly understood. Here, we used a genome-editing approach to generate a loss-of-function mutant in zebrafish Homozygous mutant adults exhibit increased incidence of intracranial hemorrhages, which become more prominent with age and after cardiovascular stress. Read More

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http://dx.doi.org/10.1242/dmm.033654DOI Listing
December 2018

Complications of Decompressive Craniectomy.

Front Neurol 2018 20;9:977. Epub 2018 Nov 20.

Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India.

Decompressive craniectomy (DC) has become the definitive surgical procedure to manage medically intractable rise in intracranial pressure due to stroke and traumatic brain injury. With incoming evidence from recent multi-centric randomized controlled trials to support its use, we could expect a significant rise in the number of patients who undergo this procedure. Although one would argue that the procedure reduces mortality only at the expense of increasing the proportion of the severely disabled, what is not contested is that patients face the risk of a large number of complications after the operation and that can further compromise the quality of life. Read More

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http://dx.doi.org/10.3389/fneur.2018.00977DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256258PMC
November 2018
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Functional Outcome and Safety of Intracranial Thrombectomy After Emergent Extracranial Stenting in Acute Ischemic Stroke Due to Tandem Occlusions.

Front Neurol 2018 20;9:940. Epub 2018 Nov 20.

Klinik für Neuroradiologie, Klinikum Stuttgart, Stuttgart, Germany.

Various endovascular approaches to treat acute ischemic stroke caused by extra- intracranial tandem occlusions (TO) exist: percutaneous transluminal angioplasty with or without emergent extracranial carotid stenting (ECS) due to high-grade stenosis preceded or followed by intracranial mechanical and/or aspiration thrombectomy (MT). Which treatment strategy to use is still a matter of debate. From our ongoing prospective stroke registry we retrospectively analyzed 1,071 patients with anterior circulation stroke getting endovascular treatment within 6 h of symptom onset. Read More

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http://dx.doi.org/10.3389/fneur.2018.00940DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256428PMC
November 2018

Statistical weights for model-based reconstruction in cone-beam CT with electronic noise and dual-gain detector readout.

Phys Med Biol 2018 Dec 14;63(24):245018. Epub 2018 Dec 14.

Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, United States of America.

Cone-beam CT (CBCT) systems commonly incorporate a flat-panel detector (FPD) with multiple-gain readout capability to reduce electronic noise and extend dynamic range. In this work, we report a penalized weighted least-squares (PWLS) method for CBCT image reconstruction with a system model that includes the electronic noise characteristics of FPDs, including systems with dynamic-gain or dual-gain (DG) readout in which the electronic noise is spatially varying. Statistical weights in PWLS were modified to account for the contribution of the electronic noise (algorithm denoted [Formula: see text]), and the method was combined with a certainty-based approach that improves the homogeneity of spatial resolution (algorithm denoted [Formula: see text]). Read More

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http://dx.doi.org/10.1088/1361-6560/aaf0b4DOI Listing
December 2018

Angiographic Features of Intracranial Aneurysms in Ecuador.

J Stroke Cerebrovasc Dis 2018 Dec 3. Epub 2018 Dec 3.

University of Iowa School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador, USA.

Background: Most of the literature describing morphological features of intracranial aneurysms (IAs) is from North-America, East-Asia, and Europe. There is limited data from South-America. We describe the epidemiologic and angiographic features of ruptured and unruptured IAs in a cohort of patients from Ecuador. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.11.020DOI Listing
December 2018

Comparison of PED and FRED Flow Diverters for Internal Carotid Artery Aneurysms: A Propensity Score-Matched Cohort Study.

Neurosurgery 2018 Dec 12. Epub 2018 Dec 12.

Department of Neurology, Paracelsus Medical University, Salzburg, Austria.

Background: Flow diversion has become an accepted endovascular treatment modality for intracranial aneurysms. Studies comparing different types of flow diverters are currently lacking.

Objective: To perform a propensity score-matched cohort study comparing the Pipeline Embolization Device (PED; Medtronic, Dublin, Ireland) and Flow Redirection Endoluminal Device (FRED; MicroVention, Aliso Viejo, California). Read More

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https://academic.oup.com/neurosurgery/advance-article/doi/10
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http://dx.doi.org/10.1093/neuros/nyy572DOI Listing
December 2018
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Design and rationale of the Edoxaban Treatment in routiNe clinical prActice for patients with Atrial Fibrillation in Europe (ETNA-AF-Europe) study.

J Cardiovasc Med (Hagerstown) 2018 Dec 11. Epub 2018 Dec 11.

Institute of Cardiovascular Sciences, University of Birmingham, SWBH and UHB NHS Trusts, Birmingham, UK.

Aim: Edoxaban, a nonvitamin K antagonist oral anticoagulant, is an oral factor Xa inhibitor approved for the prevention of stroke and systemic embolism in adult patients with atrial fibrillation and for the treatment and secondary prevention in adult patients with venous thromboembolism (VTE). This study details the design of the Edoxaban Treatment in routiNe clinical prActice for patients with Atrial Fibrillation in Europe (ETNA-AF-Europe) study - a postauthorization observational study, which is part of the postapproval plan for edoxaban agreed with the European Medicines Agency.

Methods: The ETNA-AF-Europe study (Clinicaltrials. Read More

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http://dx.doi.org/10.2459/JCM.0000000000000737DOI Listing
December 2018
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Selective and super-selective C-arm based cone beam CT angiography (CBCTA) with DynaCT for CyberKnife radiosurgery planning of intracranial arteriovenous malformations (AVMs).

J Radiosurg SBRT 2018 ;5(4):305-313

Division of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada.

Background: Successful radiosurgery for intracranial arteriovenous malformations (AVMs) requires accurate delineation of the nidus in 3D. Exact targeting and precise equipment is needed to achieve obliteration of the nidus while minimizing toxicity to the surrounding brain. In some micro-AVMs and poorly visible AVMs we have used cone beam CT angiography (CBCTA) with selective and super-selective angiography where a micro-catheter is advanced into the feeding arteries- to assist with nidus definition for CyberKnife radiosurgery planning. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255721PMC
January 2018
1 Read

Predictors of cognitive function in the acute phase after aneurysmal subarachnoid hemorrhage.

Acta Neurochir (Wien) 2018 Dec 8. Epub 2018 Dec 8.

Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, P.B. 4950, Nydalen, 0424, Oslo, Norway.

Background: Cognitive dysfunction is the most common form of neurological impairment after aneurysmal subarachnoid hemorrhage (aSAH) in the chronic phase. Cognitive deficits in the acute phase after aSAH, however, remain scarcely investigated. The aim of the present study was to test cognitive function and to identify medical predictors of cognitive deficits in the acute phase of aSAH. Read More

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http://link.springer.com/10.1007/s00701-018-3760-0
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http://dx.doi.org/10.1007/s00701-018-3760-0DOI Listing
December 2018
2 Reads

Early Intracranial Aneurysm Recurrence after Microsurgical Clip Ligation: Case Report and Review of the Literature.

J Neurol Surg Rep 2018 Oct 7;79(4):e93-e97. Epub 2018 Dec 7.

Department of Neurosurgery, Kantonsspital Aarau (KSA), Aarau, Switzerland.

Microsurgical clip ligation is considered a definitive treatment for intracranial aneurysms (IAs), resulting in low rates of local recurrence that range from 0.2 to 0.5% and a latency period that averages about a decade. Read More

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http://dx.doi.org/10.1055/s-0038-1676454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286179PMC
October 2018

Delayed diagnosis of post-traumatic aneurysm of distal anterior cerebral artery.

Surg Neurol Int 2018 1;9:222. Epub 2018 Nov 1.

Department of Neurosurgery, Regina Elena National Cancer Institute, Neurosurgery Department, Via Elio Chianesi 53, 00144, Rome, Italy.

Background: Traumatic intracranial aneurysms (TICA) are often associated with poor prognosis and should be diagnosed as soon as possible to prevent delayed intracranial hemorrhage and high rates of morbidity/mortality related to bleeding. Diagnosis requires a high index of suspicion. The goal of treatment is to exclude the aneurysm issue with surgical or endovascular methods. Read More

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http://dx.doi.org/10.4103/sni.sni_252_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238328PMC
November 2018

Utility of Various Ultrafast Magnetic Resonance Sequences in the Detection of Fetal Intracranial Hemorrhage.

Ann Indian Acad Neurol 2018 Oct-Dec;21(4):275-279

Department of Sonography, Mediscan Systems, Chennai, Tamil Nadu, India.

Objective: The aim of this study is to compare the images obtained from standard ultrafast magnetic resonance (MR) imaging sequences with gradient (GRE) sequence images in identifying fetal intracranial hemorrhage (ICH).

Materials And Methods: MR images of fetal brains with ICH done between October 2012 and September 2015 were reviewed. The images obtained from four ultrafast MR sequences- Turbo Fast Low Angle Shot (Turbo FLASH) T1-weighted images, Half Fourier Acquisition single-shot turbo spin echo (HASTE) T2-weighted images, b0 images of diffusion-weighted imaging (DWI) and b800 images of DWI were compared with images obtained from GRE sequence in depicting fetal ICH. Read More

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http://dx.doi.org/10.4103/aian.AIAN_431_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238567PMC
December 2018
3 Reads

Posterior reversible encephalopathy syndrome.

Curr Opin Neurol 2019 Feb;32(1):25-35

Center for Stroke Research Berlin (CSB).

Purpose Of Review: Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by acute cerebral endotheliopathy with consecutive disruption of the blood-brain barrier and vasogenic edema. Since its first description in 1996, PRES is increasingly recognized. However, many aspects of this syndrome with its wide spectrum of clinical and radiological features are still incompletely understood. Read More

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http://dx.doi.org/10.1097/WCO.0000000000000640DOI Listing
February 2019

Cortical surface intracranial electrodes identify clinically relevant seizures missed on scalp EEG after traumatic intracranial hemorrhage.

Epileptic Disord 2018 Dec 10. Epub 2018 Dec 10.

Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.

Seizures and other electrophysiological disturbances are an under-recognized cause of coma, focal deficits, and prolonged encephalopathy following subdural hematoma evacuation. In these patients, it is possible that seizures remain unrecognized on scalp EEG. It has been shown that a high burden of seizures and other electrophysiological disturbances exist following surgical evacuation and underlie the encephalopathy commonly seen in this patient population, predisposing them to medical complications and confounding estimates of prognosis. Read More

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http://dx.doi.org/10.1684/epd.2018.1015DOI Listing
December 2018

Incidence of epilepsy and associated factors in elderly patients in Germany.

Epilepsy Behav 2018 Dec 4;90:107-111. Epub 2018 Dec 4.

Epidemiology, IQVIA, Frankfurt, Germany. Electronic address:

Aims: Little is known about the recent epidemiology of epilepsy in the elderly in Germany. Therefore, the goal of this study was to analyze the incidence of epilepsy and associated factors in elderly patients followed in general practices in this country.

Methods: The incidence of epilepsy was estimated using data from all patients aged ≥60 years who were followed in 1203 general practices in Germany in 2017 (IQVIA Disease Analyzer database). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15255050183081
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http://dx.doi.org/10.1016/j.yebeh.2018.10.035DOI Listing
December 2018
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Use of Anti-coagulation Agents after Traumatic Intracranial Hemorrhage.

World Neurosurg 2018 Dec 5. Epub 2018 Dec 5.

Vivian L. Smith Department of Neurosurgery, University of Texas Health Science Center at Houston, Texas USA. Electronic address:

Objectives: Anticoagulant therapy (ACT) after traumatic intracranial hemorrhage may lead to progression of hemorrhage, but in the presence of thromboembolic events the clinician must decide if the benefits outweigh the risks. Currently, no data exist to guide therapy in the acute setting.

Patients And Methods: We retrospectively identified all patients admitted to our institution with traumatic intracranial hemorrhage that received intravenous heparin, full dose enoxaparin, or warfarin during their initial hospitalization over a three-year period. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.10.173DOI Listing
December 2018

Post-thrombolysis rupture of small lenticulostriate aneurysms: A report of 2 consecutive cases.

J Clin Neurosci 2018 Oct 24. Epub 2018 Oct 24.

Department of Neurology, National Neuroscience Institute, Singapore.

The 2018 American Heart Association/American Stroke Association (AHA/ASA) guidelines stated that the administration of intravenous recombinant tissue-type plasminogen activator (rTPA) for acute ischaemic stroke is probably safe for patients with small (i.e. <10 mm) unruptured intracranial aneurysms. Read More

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http://dx.doi.org/10.1016/j.jocn.2018.10.087DOI Listing
October 2018

Interventions affecting blood pressure variability and outcomes after intubating patients with spontaneous intracranial hemorrhage.

Am J Emerg Med 2018 Nov 29. Epub 2018 Nov 29.

Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States of America; R Adams Cowley Shock Trauma Center, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States of America. Electronic address:

Introduction: Spontaneous intracranial hemorrhage (sICH) that increases intracranial pressure (ICP) is a life-threatening emergency often requiring intubation in Emergency Departments (ED). A previous study of intubated ED patients found that providing ≥5 interventions after initiating mechanical ventilation (pMVI) reduced mortality rate. We hypothesized that pMVIs would lower blood pressure variability (BPV) in patients with sICH and thus improve survival rates and neurologic outcomes. Read More

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http://dx.doi.org/10.1016/j.ajem.2018.11.041DOI Listing
November 2018

Intravenous Thrombolysis After Idarucizumab Application in Acute Stroke Patients-A Potentially Increased Sensitivity of Thrombi to Lysis?

J Stroke Cerebrovasc Dis 2018 Dec 6. Epub 2018 Dec 6.

Department for Vascular Neurology and Intensive Neurological Therapy, University Ljubljana, Faculty of Medicine, Department of Neurology, Ljubljana, Slovenia.

Background: Rapid inactivation of dabigatran by its specific inhibitor idarucizamab allows intravenous thrombolysis (IVT) in patients suffering ischemic stroke while being treated with dabigatran. Only limited data of this approach is available and numerous questions regarding efficacy/safety remain to be answered. Herein, we present the findings from the Slovenian national cohort study. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.11.019DOI Listing
December 2018

Safety and Outcome of Endovascular Treatment for Minor Ischemic Stroke: Results From the Multicenter Clinical Registry of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands.

J Stroke Cerebrovasc Dis 2018 Dec 6. Epub 2018 Dec 6.

Maastricht University Medical Center, Department of Neurology, Maastricht, Limburg, The Netherlands. Electronic address:

Goal: Insufficient data is available about safety and efficacy of endovascular treatment (EVT) in patients with minor stroke symptoms because these patients were excluded from most randomized trials. We aimed to compare characteristics, functional outcome, and complications in patients with minor ischemic stroke National Institutes of Health Stroke Scale score ≤5 (NIHSS score ≤5) and moderate to severe ischemic stroke (NIHSS score ≥6) due to intracranial proximal artery occlusion of the anterior circulation who underwent EVT.

Materials And Methods: We report patients with an anterior circulation occlusion who were included between March 2014 and June 2016 in the multicenter randomized clinical trial of EVT of acute ischemic stroke in the Netherlands Registry, a prospective, multicenter, observational study for stroke centers that perform EVT in the Netherlands. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.10.029DOI Listing
December 2018

Stroke Outcomes With Vorapaxar Versus Placebo in Patients With Acute Coronary Syndromes: Insights From the TRACER Trial.

J Am Heart Assoc 2018 Dec;7(24):e009609

2 Department of Medicine Duke Clinical Research Institute Durham NC.

Background Vorapaxar, a protease-activated receptor-1 antagonist, is approved for secondary prevention of cardiovascular events but is associated with increased intracranial hemorrhage. Methods and Results TRACER (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome) was a trial of vorapaxar versus placebo among patients with acute coronary syndrome. Strokes were adjudicated by a central events committee. Read More

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https://www.ahajournals.org/doi/10.1161/JAHA.118.009609
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http://dx.doi.org/10.1161/JAHA.118.009609DOI Listing
December 2018
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Left Atrial Appendage Closure Device Implantation in Patients with Prior Intracranial Hemorrhage.

Heart Rhythm 2018 Nov 19. Epub 2018 Nov 19.

Section of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH. Electronic address:

Background: The Watchman™ device (Boston Scientific, MN), used for left atrial appendage closure (LAAC) was approved for stroke prevention in patients with atrial fibrillation (AF) and an appropriate rationale to avoid long-term oral anticoagulation. Patients with AF and prior intracranial hemorrhage (ICH) were excluded from clinical trials due to perceived risks of peri-operative anticoagulation.

Objective: We studied the efficacy and safety of LAAC using Watchman™ in patients with AF and prior ICH. Read More

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http://dx.doi.org/10.1016/j.hrthm.2018.11.022DOI Listing
November 2018
2 Reads

Platelet transfusion practices in immune thrombocytopenia related hospitalizations.

Transfusion 2018 Dec 5. Epub 2018 Dec 5.

Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Department of Pediatrics, Division of Hematology/Oncology, Emory University School of Medicine, Atlanta, Georgia.

Background: The role of platelet transfusions in management of Immune Thrombocytopenia (ITP) remains controversial. Current guidelines recommend that platelet transfusions in ITP be reserved for catastrophic hemorrhage or invasive surgical procedures. This study assesses the nationwide platelet transfusion practices in hospitalized children and adults with ITP. Read More

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http://doi.wiley.com/10.1111/trf.15069
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http://dx.doi.org/10.1111/trf.15069DOI Listing
December 2018
5 Reads