Posttraumatic subgaleal herniation of an intracranial cerebral arterial segment.

Posttraumatic subgaleal herniation of an intracranial cerebral arterial segment. Proc (Bayl Univ Med Cent). 2019 Apr;32(2):271-273 Authors: Bhalla M, Ulmer JL, Klein AP, McAvoy KE, Bhalla NM Abstract A rare case of extracranial herniation of an intracranial arterial segment is described in an elderly patient presenting with loss of consciousness following mild head trauma. Cross-sectional imaging of the brain revealed a temporal skull fracture with associated intra-axial and extra-axial bleeding, and a computed tomography angiogram of the head and cerebral digital subtraction angiogram performed a few hours later displayed a rare finding. A small segment of a parietal branch of the right middle cerebral artery (M4 segment) herniated through the skull fracture, which coursed into the extracranial subgaleal space overlying the fracture site, before coursing back into the intracranial compartment. There was no evidence of cerebral ischemia or vascular compromise. The presence of a subgaleal artery on computed tomography angiogram may point to herniation of intracranial artery. In the absence of knowledge of this entity, even basic routine emergency care such as application of a scalp bandage or suturing of a scalp laceration could potentially result in devastating complications of vascular compromise and stroke. PMID: 31191151 [PubMed]
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research

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Background: To determine the clinical outcomes of perimesencephalic subarachnoid hemorrhages based on the computed tomography (CT) bleeding patterns. Methods: This retrospective cohort study included: (1) patients ( ≥18 years) admitted to a comprehensive stroke center (January 2015-May 2018), (2) with angiography-negative, nontraumatic subarachnoid hemorrhage in a perimesencephalic or diffuse bleeding pattern, and (3) had CT imaging performed in less than rqual to 72 hours of symptom onset. Patients were stra tified by location of bleeding on CT: Peri-1: focal prepontine hemorrhage; Peri-2: prepontine with suprasellar c...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Authors: Campbell BC Abstract In recent years, reperfusion therapies such as intravenous thrombolysis and endovascular thrombectomy for ischaemic stroke have dramatically reduced disability and revolutionised stroke management. Thrombolysis with alteplase is effective when administered to patients with potentially disabling stroke, who are not at high risk of bleeding, within 4.5 hours of the time the patient was last known to be well. Emerging evidence suggests that other thrombolytics such as tenecteplase may be even more effective. Treatment may be possible beyond 4.5 hours in patients selected using brain imagi...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
HeartFlow said yesterday that it won reimbursement coverage from the Japanese Ministry of Health, Labor and Welfare for its HeartFlow FFRct fractional flow reserve analysis. The Redwood City, Calif.-based company said that it has already received approval from the Japanese Pharmaceuticals and Medical Devices Agency, and that reimbursement will go into effect beginning on December 1. “When a patient presents with symptoms suggesting CAD, we want to be able to quickly and effectively diagnose patients while reducing the need for unnecessary tests or invasive procedures. In clinical studies, we were able to see fir...
Source: Mass Device - Category: Medical Devices Authors: Tags: Business/Financial News Cardiovascular Featured Imaging Software / IT HeartFlow Source Type: news
AbstractBackgroundThe presence of the spot sign on computed tomography angiogram (CTA) is considered a sign of active bleeding, and studies have shown it can predict hematoma expansion in intraparenchymal hemorrhage (IPH). The spot sign in intraventricular hemorrhage (IVH) has not been explored yet. The purpose of this study is to estimate the prevalence of the intraventricular-spot sign, and its prediction of hematoma expansion and clinical outcomes.MethodsWe retrieved data of hemorrhagic stroke patients seen at our medical center from January 2013 to January 2018. A total of 321 subjects were filtered for the prevalence ...
Source: Journal of Neurology - Category: Neurology Source Type: research
ConclusionsManagement of a retroperitoneal hematoma can commence with recognition of the warning signs of bleeding and neurological impairment, and consulting the appropriate services in case the need for intervention arises. A conservative approach of volume resuscitation and blood transfusion can be used initially, with the need for pausing or reversing anticoagulation being assessed on an individual basis with expert consultation. If intervention becomes necessary, other interventional radiology-based modalities can be used to identify and stop the bleeding source, and interventional radiology-guided drainage can be per...
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
​BY NOURA MAHDI; DARRON LEWIS; JEREMY OSBORNE; &AHMED RAZIUDDIN, MDA 73-year-old man was brought to the emergency department from his nursing home for rectal bleeding and anemia. The patient mentioned he had had episodes of bright red rectal bleeding and constipation for a few months. A colonoscopy had been done prior to the visit, which revealed a large intestine tumor and biopsy confirming adenocarcinoma. He was awaiting an appointment with his surgeon.The patient reported bloody rectal leakage, and a CBC done at the nursing home showed a hemoglobin level of 7.2. He also complained of dyspnea but denied any other s...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Conclusion: MIDCAB is a safe procedure with low postoperative morbidity and mortality and favorable mid-term MACCE-free survival. PMID: 29430423 [PubMed]
Source: Korean Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Korean J Thorac Cardiovasc Surg Source Type: research
Conclusion: Defining the vascular pathology by CTA directly at the emergency site may be beneficial in triaging patients with various cerebrovascular diseases to the most appropriate target hospital and specialized treatment.Cerebrovasc Dis 2017;44:338 –343
Source: Cerebrovascular Diseases - Category: Neurology Source Type: research
cute;pez Medina A Abstract In stroke code patients, multimodal imaging workup encompasses various imaging techniques, including baseline computed tomography (CT), magnetic resonance (MR) imaging, diffusion MR imaging, CT or MR perfusion studies, and CT or MR angiography, that are used to rule out bleeding, confirm arterial occlusion, establish tissue viability, and help select candidates for endovascular treatment as early as possible. Five recently published relevant clinical trials have demonstrated the efficacy of mechanical thrombectomy in proximal arterial occlusions; all these trials used different imaging t...
Source: Radiologia - Category: Radiology Authors: Tags: Radiologia Source Type: research
We describe a case of acute oculomotor nerve palsy caused by a ruptured middle cerebral artery (MCA) aneurysm. A 59-year-old female presenting with headache and nausea was admitted to our hospital. Her consciousness was alert, and had no other neurological deficit without left oculomotor nerve palsy. A computed tomography (CT) showed SAH extending from left sylvian cistern to basal cistern. CT angiography revealed a left MCA aneurysm which protruded toward internal carotid artery. The patient was successfully treated with surgical clipping. The oculomotor nerve palsy resolved immediately after the surgery. Perioperative ra...
Source: Journal of Medical Investigation - Category: Journals (General) Tags: J Med Invest Source Type: research
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