Misconnections in the Critically Ill: Injection of High-Dose Gadolinium into an External Ventricular Drain

We report an unfortunate case of accidental administration of intrathecal gadolinium through an external ventricular drain in a postcraniotomy patient during magnetic resonance imaging of the brain. The incident occurred after the venous contrast line was connected mistakenly to the ventricular drainage catheter. The patient subsequently developed confusion, aphasia, and right facial droop with new computed tomography evidence of diffuse cerebral edema and stroke. Review of the magnetic resonance image revealed the inappropriate presence of subarachnoid gadolinium. Despite all interventions, the patient developed irreversible neurologic disability. We address the clinical sequelae, management strategies, and factors contributing to the catheter misconnection that led to this event.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports: Clinical Care Source Type: research

Related Links:

ConclusionCCDs are highly prevalent and represented the largest subtype of communication disorders in this cohort. FIMFAM scores appear useful in assessing CCDs however they display insufficient sensitivity in capturing change within this population. This audit highlights the need for further interdisciplinary research, education and training into cognitive-communication difficulties with post-stroke populations.
Source: Age and Ageing - Category: Geriatrics Source Type: research
We performed a retrospective, case-control study in consecutive ischemic stroke patients admitted to our stroke rehabilitation unit. Patients were matched for severity of neurological impairment (evaluated with the Canadian Neurological Scale, CNS), age (difference within 1 year) and onset admission interval (difference within 3 days). Participants were divided into two subgroups according to the presence or absence of PSD. Aim was to assess the specific influence of post-stroke depression (PSD) and antidepressant treatment on both basal functional status and rehabilitation outcomes. All PSD patients were treated primarily...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions: Our findings show that disability assessment late in the first week after onset of stroke using NIHSS accurately forecast outcome at one month after onset of stroke. The MMSE too is not expected to change at 1 month. Those with aphasia are expected to have greater disability. Based on or study we recommend that stroke patients should be assessed with NIHSS and MMSE before discharge, to explain the prognosis of the patient. Also more intense counselling on controlling blood pressure and diabetes as well as abstinence from smoking should be undertaken routinely. PMID: 31309796 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Conclusion: This study demonstrates that health professionals are challenged by and limited in managing depression after post-stroke aphasia. Health professionals have the opportunity to improve services through the translation of evidence-based interventions. The integration of mental health care into stroke rehabilitation may be achieved through policy development, leadership and specialist training. Implications for rehabilitation People with aphasia need routine mood screening using aphasia-specific clinical tools and communication support. Stroke health professionals report a need for communication partner training to...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
CONCLUSIONS: Currently there is no evidence of the effectiveness of tDCS (anodal tDCS, cathodal tDCS and Dual-tDCS) versus control (sham tDCS) for improving functional communication in people with aphasia after stroke (low quality of evidence). However, there is limited evidence that tDCS may improve naming performance in naming nouns (moderate quality of evidence), but not verbs (very low quality of evidence) at the end of the intervention period and possibly also at follow-up. Further methodologically rigorous RCTs with adequate sample size calculation are needed in this area to determine the effectiveness of this interv...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Christophe Duret1,2*, Anne-Gaëlle Grosmaire1 and Hermano Igo Krebs3,4,5,6,7,8 1Centre de Rééducation Fonctionnelle Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Neurorééducation, Boissise-Le-Roi, France 2Centre Hospitalier Sud Francilien, Neurologie, Corbeil-Essonnes, France 3Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States 4Department of Neurology, University of Maryland, Baltimore, MD, United States 5Department of Physical Medicine and Rehabilitation, Fujita Health University, Nago...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Wei Li1†, Wei-Min Xiao1†, Yang-Kun Chen1*, Jian-Feng Qu1, Yong-Lin Liu1, Xue-Wen Fang2, Han-Yu Weng1 and Gen-Pei Luo11Department of Neurology, Dongguan People’s Hospital, Dongguan, China2Department of Radiology, Dongguan People’s Hospital, Dongguan, ChinaBackground: Anxiety is prevalent after a stroke. The pathophysiological mechanisms underlying the development of poststroke anxiety (PSA) remain unclear. The aim of this study was to investigate the clinical and neuroimaging risk factors for development of PSA and examine the effects of PSA on activities of daily living (ADL) and quality of life (...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusions: CG-FAST scale could be an effective and simple scale for accurate identification of LVOS among AIS patients. Introduction Large vessel occlusion stroke (LVOS) often leads to severe disability and mortality. Although endovascular therapy (EVT) has been proved to be effective for LVOS patients (1–9), especially in anterior circulation, its benefit is highly time-dependent (10, 11). As hospitals with around-the-clock endovascular capability are scarce in many parts of the world and patients admitted directly to a CSC would have better outcomes than those receiving drip and ship treatment (12, 13), thi...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
CONCLUSIONS: It is clear that aphasia often negatively affects Internet use and proficiency. However, this research clearly demonstrates that it is important to consider the influence of factors such as age, proxy use, education, and previous technology use and experience. Implications for rehabilitation Post-stroke aphasia contributes negatively to Internet use, particularly in the use of online communication tools such as email and messaging services. Sub-groups of people with aphasia are likely to be more vulnerable to exclusion from the benefits of the Internet; specifically, older people and those with lower levels of...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Vincenzo Tigano1, Giuseppe Lucio Cascini2, Cristina Sanchez-Castañeda3, Patrice Péran4 and Umberto Sabatini5* 1Department of Juridical, Historical, Economic and Social Sciences, University of Magna Graecia, Catanzaro, Italy 2Department of Experimental and Clinical Medicine, University of Magna Graecia, Catanzaro, Italy 3Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain 4ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France 5Department of Medical and Surgical Sciences, University of Magna Graecia, Catanzaro, Ita...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
More News: Anesthesiology | Aphasia | Brain | CT Scan | Disability | MRI Scan | Neurology | Stroke