Unexpected Intracranial Hemorrhage and Death After Cranioplasty in a Patient With Massive Hemispheric Infarction

The benefits and common complications of cranioplasty are often mentioned, but fatal complications are rarely documented. Here, the authors report a patient of intracranial hemorrhage and death after cranioplasty and discussed the possible mechanism. A 42-year-old man was admitted with the diagnosis of massive cerebral infarction in left fronto-temporo- parietal lobe, emergency surgery for decompressive large craniotomy and Encephalo-Myo-Synangiosis were performed. One year after surgery, cranioplasty was performed using a titanium mesh plate. Intraoperative cerebrospinal fluid leakage was occurred and dura mater was repaired using pieces of silk. During the postoperative anesthesia emergence, the patient had epileptic seizures and did not wake after surgery. The authors also observed about 150 mL bloody cerebrospinal fluid (CSF) in the subcutaneous vacuum drainage system within 2 hours. Emergency computed tomography of the brain showed epidural, subdural, subarachnoid hemorrhages in the postischemic area, the middle line left, and the brain stem swelling. The patient's family refused to immediately remove the titanium mesh plate. Finally, nonoperative treatment is invalid and the patient's neurological condition did not recover and he died 3 days after the surgery. In the authors’ mind, patients with previous massive cerebral infarction and Encephalo-Myo-Synangiosis undergoing cranioplasty might be at heightened risk of a fatal event than other cranioplasty. Therefor...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Brief Clinical Studies Source Type: research

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ConclusionsThese CDEs would allow the development of best practice guidelines to standardize the assessment and reporting of observations concerning UIA and SAH.
Source: Neurocritical Care - Category: Neurology Source Type: research
Conclusions: The rate of seizure and epilepsy in patients with FES is low when compared with rates in all hospitalized patients or in patients with other causes of acute neurological injury such as intracerebral hemorrhage, subarachnoid hemorrhage, and traumatic brain injury. Further studies are needed to provide recommendations for antiepileptic medication use in FES.
Source: The Neurologist - Category: Neurology Tags: Original Article Source Type: research
Shanshan Zhang1, Dongli Yuan2 and Ge Tan1* 1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China 2The Institute of Medical Information, Chongqing Medical University, Chongqing, China Primary systemic vasculitis can affect every structure in both the central and peripheral nervous system, causing varied neurological manifestations of neurological dysfunction. Early recognition of the underlying causes of the neurological symptoms can facilitate timely treatment and improve the prognosis. This review highlights the clinical manifestations of primary systemic vasc...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Hongye Zhao1,2, Tiezheng Zheng1, Xiaohan Yang1, Ming Fan3, Lingling Zhu3, Shuhong Liu3, Liying Wu3 and Changkai Sun1,4* 1Department of Physiology and Key Laboratory of Brain Diseases of Liaoning Province, School of Basic Medical Sciences, Dalian Medical University, Dalian, China 2Department of Physiology, School of Basic Medical Sciences, Qiqihar Medical University, Qiqihar, China 3Department of Brain Protection and Plasticity, Institute of Basic Medical Sciences, Academy of Military Medical Sciences, Beijing, China 4Department of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineerin...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions Stroke comprises ischemic stroke and ICH. The immuno-inflammatory process is involved in neural plasticity following events such as a hemorrhage or ischemic stroke. After ischemia, astrocytes, microglia, and MDMs play important roles during rehabilitation with the modulation of cytokines or chemokines, such as TNF-α and IL-1. Moreover, MiRNAs are also important posttranscriptional regulators in these glial mitochondrial responses to cerebral ischemia. ICH involves processes similar and different to those seen in ischemia, including neuronal injury, astrocytic and microglial/macrophage activation, and neu...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Publication date: Available online 5 December 2018Source: MitochondrionAuthor(s): Shafqat Rasul Chaudhry, Stilla Frede, Gerald Seifert, Thomas Mehari Kinfe, Mika Niemelä, Alf Lamprecht, Sajjad MuhammadAbstractAneurysmal subarachnoid hemorrhage (aSAH) is a highly complex disease. Majority of aSAH survivors confront post-SAH complications including cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) that mainly influence the clinical outcome. Tissue damage during early brain injury may lead to release of damage associated molecular pattern molecules (DAMPs) that may initiate and sustain inflammation during the ...
Source: Mitochondrion - Category: Biochemistry Source Type: research
ConclusionsThe incidence of epilepsy was high and increased with age in elderly patients followed in general practices in Germany. Addressing identified risk factors may help reduce the risk of developing epilepsy.
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
CONCLUSIONS: The incidence of epilepsy was high and increased with age in elderly patients followed in general practices in Germany. Addressing identified risk factors may help reduce the risk of developing epilepsy. PMID: 30529258 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
Publication date: Available online 22 October 2018Source: Neurología (English Edition)Author(s): C. Avellaneda-Gómez, A. Rodríguez Campello, E. Giralt Steinhauer, A. Gómez González, M. Serra Martínez, P. de Ceballos Cerrajería, A. Zabalza de Torres, E. Cuadrado-Godia, A. Ois Santiago, J. Jiménez-Conde, J. RoquerAbstractIntroductionA considerable percentage of events initially diagnosed as ischaemic stroke have non-cerebrovascular causes; these are called stroke mimics (SM). Currently available evidence about these events is heterogeneous and comes from studies with sm...
Source: Neurologia - Category: Neurology Source Type: research
ConclusionsThis analysis of nationally representative US data suggests that although readmission after RS for MMD is not uncommon, cerebral hemorrhagic events during the 90-day postoperative period are rare.
Source: Journal of Neurology - Category: Neurology Source Type: research
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