Portable gamma-camera for the diagnosis of brain death diagnosis

ConclusionsA portable gamma-camera could be a useful and feasible tool for the diagnosis of BD.ResumenObjetivoEvaluar la factibilidad del empleo de la minigammacámara portátil Sentinella®, para el diagnóstico de muerte encefálica (ME).DiseñoEstudio observacional, prospectivo, de factibilidad.ÁmbitoUnidad de cuidados intensivos de un hospital de tercer nivel.PacientesDesde enero a diciembre de 2017 se registraron de forma consecutiva los pacientes mayores de edad que tras su ingreso en unidad de cuidados intensivos fueron diagnosticados de ME según criterios clínicos.IntervencionesEl procedimiento se realizó a la cabecera del paciente tras la administración intravenosa de tecnecio 99 metaestable-hexametil-propilen-amino-oxima. La ausencia de perfusión a nivel de hemisferios cerebrales y fosa posterior se describía como patrón compatible con ME. Se correlacionó el diagnóstico con doppler transcraneal y/o electroencefalograma.ResultadosCincuenta y seis pacientes presentaron exploración física compatible con ME. Un 66,1% fueron hombres con una mediana de edad de 60 (RIQ: 51-72) años. La causa más frecuente que precipitó la ME fue el ictus hemorrágico en el 48,2% (27) seguido por traumatismo craneoencefálico grave en el 30,4% (17), ictus isquémico en el 10,7% (6) y encefalopatía anóxica tras parada cardio...
Source: Medicina Intensiva - Category: Intensive Care Source Type: research

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Written by Meyers, edits by SmithA 50-ish year old man was working construction when he suddenly collapsed. Coworkers started CPR within 1 minute of collapse. EMS arrived within 10 minutes and continued CPR and ACLS, noting alternating asystole and sinus bradycardia during rhythm checks. He received various ACLS medications and arrived at the ED with a perfusing rhythm.Initial vitals included heart rate around 100 bpm and BP 174/96. Here is his initial ECG, very soon after ROSC:What do you think?Sinus tachycardia.  There is incomplete RBBB (QRS duration less than 120 ms).  There is diffuse STD, maximal in V4-V5 a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Publication date: Available online 16 October 2019Source: Epilepsy &BehaviorAuthor(s): Giada Pauletto, Francesco Bax, Gian Luigi Gigli, Simone Lorenzut, Lorenzo Verriello, Elisa Corazza, Mariarosaria ValenteAbstractAim of the studyThe aim of the study was to evaluate the clinical characteristics of patients with previous stroke (either ischemic or hemorrhagic), who developed status epilepticus (SE) mimicking a stroke relapse.Materials and methodsWe performed a retrospective cohort study of patients brought to hospital by the emergency service between December 2016 and January 2018 with a stroke code as possible candida...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Abstract AIM OF THE STUDY: The aim of the study was to evaluate the clinical characteristics of patients with previous stroke (either ischemic or hemorrhagic), who developed status epilepticus (SE) mimicking a stroke relapse. MATERIALS AND METHODS: We performed a retrospective cohort study of patients brought to hospital by the emergency service between December 2016 and January 2018 with a stroke code as possible candidates for intravenous thrombolysis and who had already have a previous stroke. Among them, patients admitted for negative symptoms and finally discharged with a diagnosis of SE mimicking stroke...
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
Publication date: Available online 11 October 2019Source: Life SciencesAuthor(s): Jenq-Lin Yang, Yun-Ru Yang, Shang-Der ChenAbstractStroke is the major cause of adult disability and the second or third leading cause of death in developed countries. The treatment options for stroke (thrombolysis or thrombectomy) are restricted to a small subset of patients with acute ischemic stroke because of the limited time for an efficacious response and the strict criteria applied to minimize the risk of cerebral hemorrhage. Attempts to develop new treatments, such as neuroprotectants, for acute ischemic stroke have been costly and tim...
Source: Life Sciences - Category: Biology Source Type: research
Conclusion: This case report suggests that further randomized studies may evaluate whether repeated IVtPA may be safe and effective in ERS occurring shortly after a previous stroke when patients experience a period of complete neurological regression, minor disability, and a small infarct volume. Should the hypothesis be confirmed, small volume core and wide volume penumbra at perfusion CT may support the decision of adopting IVtPA repetition.
Source: The Neurologist - Category: Neurology Tags: Case Report/Case Series Source Type: research
Abstract BACKGROUND: Given the increasing worldwide prevalence of chronic kidney disease (CKD), it is critical to decrease the associated risk of debilitating vascular complications, including stroke, congestive heart failure, myocardial infarction, and peripheral vascular disease. Treatment options for reducing the risk of all subtypes of stroke in patients with CKD remain limited. For patients with end-stage kidney disease (ESKD), novel applications of noninvasive imaging may help personalize the type of dialysis and dialysis prescription for patients at high-risk. SUMMARY: This manuscript reviews the heigh...
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research
In this study, we tried to translate this concept, the initiation of intraventricular NO application on top of continuous Molsidomine infusion, from awake to comatose patients who lack neurological –clinical monitoring but are primarily monitored using frequently applied transcranial Doppler (TCD).MethodsIn this observational, retrospective, nonrandomized feasibility study, 18 consecutive aSAH comatose/intubated patients (Hunt and Hess IV/V with/without pupil dilatation) whose poor clinical status precluded clinical monitoring received standard neuro-intensive care, frequent TCD monitoring, continuous intravenous Mol...
Source: Neurocritical Care - Category: Neurology Source Type: research
CONCLUSIONS: The single-cross technique appears to be a safe and effective option for treating tandem occlusive lesions in the setting of ELVO. PMID: 31311374 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
AbstractPurpose of ReviewUrgent reperfusion treatment with intravenous thrombolysis or mechanical thrombectomy reduces disability after ischaemic stroke. Imaging plays an important role in identifying patients who benefit, particularly in extended time windows. However, the role of post-treatment neuroimaging is less well established. We review recent advances in neuroimaging after reperfusion treatment and provide a practical guide to the options and management implications.Recent FindingsPost-treatment imaging is critical to identify patients with reperfusion-related haemorrhage and oedema requiring intervention. It also...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
ConclusionAlthough various perfusion CT parameters have been used across studies, the current evidence supports the use of perfusion CT to predict hemorrhagic transformation in acute ischemic stroke.Key Points•High blood-brain barrier permeability and hypoperfusion status derived from perfusion CT were associated with hemorrhagic transformation.•Perfusion CT has moderate diagnostic performance for the prediction of hemorrhagic transformation in acute ischemic stroke.•The pooled sensitivity was 84%, and the pooled specificity was 74%.
Source: European Radiology - Category: Radiology Source Type: research
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