Posterior Reversible Encephalopathy Syndrome Triggered by Vertebral Artery Angiogram
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Conclusions: Diverse cases of medical procedure-related TGA have been reported in the literature. Valsalva-associated activities, emotional stress with anxiety, and acute pain were predisposing conditions. An understanding of medical procedure-related TGA may be important for clinicians who perform such medical procedures.Eur Neurol 2018;80:42 –49
We present a 36-year-old female patient who underwent transradial cerebrovascular angiography because of acute putaminal hemorrhage. Catheter entrapment occurred with severe pain in the right upper arm proximal to the elbow. A subclavian artery angiogram by way of a transfemoral crossover catheter revealed severe vasospasm in the axillary artery distal to the branch point between it and the posterior brachial circumflex artery. Diazepam 5 mg intravenously (IV) through a peripheral catheter, lidocaine 0.5% 5 mL injected subcutaneously, and lidocaine 2% 4 mL IV isosorbide dinitrate 2 mg IV through the angiograp...
CONCLUSIONS: A supporting angiography via microsheath in confirming the absence of hemorrhage, stenosis, dissection, and distal embolization may be worthwhile to selectively use for cases of PEVAR. PMID: 30168307 [PubMed - as supplied by publisher]
CONCLUSIONManagement of cardiac phaeochromocytoma is complex and demands careful perioperative planning and management. Perioperative morbidity is common and anaethetists play an important role in achieving a successful outcome for patients who present for excision of cardiac phaeochromocytoma.
We presented three cases of transient cortical blindness secondary to contrast medium toxicity after endovascular procedures for intracranial aneurysms. Two patients noted bilateral blindness 5 or 6 hours respectively of awakening from general anesthesia for aneurysm treatment. The other one noted bilateral blindness during vertebral angiography under local anesthesia. Immediate angiography was performed in one case (Case 1), showing no arterial occlusion. CT was performed in one case that showed brain edema (Case 2).
Cerebral vasospasm is the most important cause of morbidity after an aneurysm clipping in the early postoperative period. The aim of this retrospective study was to evaluate whether the incidence of vasospasms differs when using propofol or desflurane for an emergent aneurysm clipping. The data from 102 patients (50 in the propofol group, 52 in the desflurane group) were analyzed. The occurrence of vasospasm based on daily transcranial Doppler, angiography, and cerebral infarction during 14 days after surgery were compared by anesthetic agents. Postoperative data including Glasgow Coma Scale (GCS) score on day 14 after su...
The aim of this study was to compare general and local anesthesia techniques in patients treated with elective endovascular aortic aneurysm repair (EVAR) for infrarenal aortic aneurysms. In this single-center, observational cohort study, in all, 259 consecutive patients who underwent elective EVAR was included; 144 patients (55.6%, 126 men, mean age 72.8 years) operated on under general anesthesia (GA group) and 115 (44.4%, 100 men, mean age 72.3 years) operated on under local anesthesia (LA group). A retrospective analysis regarding technical feasibility, endoleaks, length of hospital stay, and 30-day clinical outcomes w...
ConclusionCut wounds in the face should not be repaired in the primary care without detailed history, systematic examination and proper investigations.
Conclusioncut wounds in the face should not be repaired in the primary care without detailed history, systematic examination and proper investigations.
CONCLUSIONS: Computed tomography may replace cardiac catheterization in identification of great vessel stenosis/hypoplasia before bidirectional cavopulmonary connection when no intervention before surgery is required. Computed tomography carries lower morbidity, can be performed without sedation and may be associated with less radiation. PMID: 30041863 [PubMed - as supplied by publisher]