Extent of secondary intraventricular hemorrhage is an independent predictor of outcomes in intracerebral hemorrhage: data from the Helsinki ICH Study
BackgroundIntraventricular hemorrhage is a severe subtype of intracerebral hemorrhage associated with high mortality and poor outcome. AimWe analyzed various intraventricular hemorrhage scores at baseline to find common parameters associated with increased mortality. MethodsConsecutive intracerebral hemorrhage patients treated in Helsinki University Central Hospital during 2005–2010 were included in the Helsinki Intracerebral Hemorrhage Study registry and analyzed for three‐month mortality. ResultsAfter excluding lost‐to‐follow‐up patients, 967 intracerebral hemorrhage patients were included, out of whom 398 (41%) had intraventricular hemorrhage. Intraventricular hemorrhage patients, compared with nonintraventricular hemorrhage patients, had lower baseline Glasgow Coma Scale [median 12 (IQR 6–15) vs. 15 (13–15); P
ConclusionsTreatment with tranexamic acid could reduce rebleeding and hematoma expansion in cerebral hemorrhage without an increase in single ischemic adverse events, but it could increase the risk of combined ischemic events; however, the lack of improvement in mortality and the poor functional outcomes limit the value of clinical application. These findings indicate that the most pertinent issue is the risk-to-benefit ratio with tranexamic acid treatment in cerebral hemorrhage.
Authors: Gaberel T, Gakuba C, Fournel F, Le Blanc E, Gaillard C, Saint Paul LP, Chaillot F, Tanguy P, Parienti JJ, Emery E Abstract INTRODUCTION: Aneurysmal subarachnoid hemorrhage (SAH) is a devastating form of stroke, which often causes acute hydrocephalus requiring the insertion of an external ventricular drain (EVD). A major complication of aneurysmal SAH is delayed cerebral ischemia (DCI). As DCI is linked to the presence of blood within the subarachnoid space, it has been hypothesized that removing this blood may decrease the risk of DCI. This could be achieved by injecting a fibrinolytic agent through the EV...
BY GREGORY TAYLOR, DO, &MATTHEW WARPINSKI, DOA 35-year-old man with a history of uncontrolled hypertension and medical noncompliance was brought to the emergency department by EMS complaining of a headache. The family said the patient was watching football and developed an acute headache after he stood up screaming in excitement.His family said he had not taken his blood pressure medication for years. He was afebrile, his blood pressure was 245/129 mm Hg, his respiratory rate was 18 bpm, his heart rate was 68 bpm, and he weighed 340 pounds. The patient was obtunded with a Glasgow Coma Scale score of 4 and was subseq...
ConclusionsCerebral venous sinus thrombosis is an uncommon and tricky condition with unpredictable presentation and prognosis. A physician needs to have a high index of suspicion to diagnose it, especially when the patient presents with uncomplicated complaints. These simple complaints, such as headaches, usually lead to misdiagnosis and delay the appropriate diagnosis and management.
Surgical Practice, EarlyView.
Vertebrobasilar dolichoectasia sometimes presents with symptoms related to mass effect like cranial nerve palsies, or with ischemia or hemorrhage. Symptomatic hydrocephalus as a complication of vertebrobasilar dolichoectasia is extremely uncommon. Furthermore, there are few cases of vertebrobasilar dolichoectasia, in which cerebrospinal fluid flow disorder mechanisms are clearly demonstrated in neuroimaging findings. Here, we describe a patient with vertebrobasilar dolichoectasia who presented with symptomatic hydrocephalus due to direct compression against the third ventricle, which was immediately relieved by ventriculoperitoneal shunt.
Abstract BACKGROUND AND PURPOSE: Inpatient rehabilitation facilities play an integral role in patient progress post-stroke. Cerebellar hemorrhages are an infrequent type of stroke and are therefore less discussed in the literature; however, inpatient rehabilitation continues to be an integral part of patient recovery. The purpose of this case report is to discuss the physical therapy interventions, challenges, and successes for a complex patient with a large cerebellar hemorrhage with obstructive hydrocephalus. CASE DESCRIPTION: The patient is a 32-year-old male admitted to an inpatient rehabilitation facilit...
Our previous studies have demonstrated that hemorrhage-derived iron has a key role in causing brain injury after intraventricular hemorrhage (IVH). Based on this finding, we hypothesized that edaravone, a free-radical scavenger, has the potential to alleviate hydrocephalus and neurological deficits post-IVH by suppressing iron-induced oxidative stress. Thus, this study aimed to investigate the efficacy of edaravone for rats with FeCl3 injection, as well as to explore the related molecular mechanism.
Surgical Practice,Volume 0, Issue ja, -Not available-.
(The Mount Sinai Hospital / Mount Sinai School of Medicine) An artificial intelligence platform designed to identify a broad range of acute neurological illnesses, such as stroke, hemorrhage, and hydrocephalus, was shown to identify disease in CT scans in 1.2 seconds, faster than human diagnosis.