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What Are the Classifications of Perinatal Stroke?
Discussion Perinatal stroke occurs in about 1:1000 live births and is a “focal vascular injury from the fetal period to 28 days postnatal age.” Perinatal stroke is the most common cause of hemiparetic cerebral palsy and causes other significant morbidity including cognitive deficits, learning disabilities, motor problems, sensory problems including visual and hearing disorders, epilepsy, and behavioral and psychological problems. Family members are also affected because of the potential anxiety and guilt feelings that having a child with a stroke presents, along with the care that may be needed over the child&#...
Source: PediatricEducation.org - May 1, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Patients on NOACs in the Emergency Room
AbstractPurpose of ReviewDespite the increasing use of NOACs, there is still uncertainty on how to treat NOAC patients presenting with neurological emergencies. Initial assessment of coagulation status is challenging but essential in these patients to provide best-possible treatment in case of ischemic or hemorrhagic stroke. Meanwhile, anticoagulation reversal strategies have been suggested; yet, the optimal management is still unestablished. The current review aims to provide up-to-date information on (i) how to identify patients with NOAC intake, (ii) which therapies are feasible in the setting of ischemic and hemorrhagi...
Source: Current Neurology and Neuroscience Reports - May 28, 2019 Category: Neuroscience Source Type: research

Atypical presentation of Sturge-Weber Syndrome. (P3.289)
Conclusions:This is an unusual presentation of SWS. Commonly, patients present at early age with seizure and unlike our case patient presented with SAH and stroke like symptoms.Disclosure: Dr. Lee has nothing to disclose. Dr. E-Ghanmh has nothing to disclose. Dr. Said Said has nothing to disclose. Dr. Wu has nothing to disclose. Dr. Muhammad has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Lee, A., E-Ghanmh, M., Said, S. S., Wu, N., Muhammad, I. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Real-life experience with the specific reversal agent idarucizumab for the management of emergency situations in dabigatran-treated patients: a series of 11 cases
We report 11 real-life clinical cases in which idarucizumab was used after multidisciplinary consultation in a variety of emergency situations including severe postoperative bleeding, emergency high-bleeding-risk surgery (hip/spine surgery and neurosurgery), invasive diagnostic testing (lumbar puncture), intracranial bleeding (pre-pontine subarachnoid hemorrhage and lobar intracerebral hemorrhage) and thrombolysis with recombinant tissue plasminogen activator for acute ischemic stroke. This case series illustrates the role of idarucizumab in improving patient safety in rare emergency situations requiring rapid reversal of ...
Source: Journal of Thrombosis and Thrombolysis - February 15, 2017 Category: Hematology Source Type: research

Treatment With Prothrombin Complex Concentrate to Enable Emergency Lumbar Puncture in Patients Receiving Vitamin K Antagonists
Conclusion Reversing the effect of vitamin K antagonist with prothrombin complex concentrates to enable emergency lumbar puncture appears effective and safe, particularly in regard to bleeding events.
Source: Annals of Emergency Medicine - April 14, 2016 Category: Emergency Medicine Source Type: research

The zebra sign
A 65 year old female was transferred to the Hyperacute Stroke Unit after a routine L5/S1 laminectomy. She suffered a small dural tear. 3 hours post procedure, her GCS dropped to 3. CT scan showed a bi-cerebellar haemorrhage and MRI brain the next day revealed a convexity subarachoid haemorrhage. Imaging was reviewed with neuroradiologists and neurosurgeons. They recognised this as a typical case of post-dural puncture remote cerebellar haemorrhage. In surgical literature there are many cases reported since 1981 of "the Zebra sign". Patients can become obtunded up to 72 hours after the injury. The mechanism of the haemorrha...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Patel, B., Nagendran, A., Khan, U. Tags: Brain stem / cerebellum, Stroke, Radiology, Radiology (diagnostics) Thur 21, Parallel session 5: Therapeutics Source Type: research

MRI spot sign
A 47-year-old woman presented with fever and acute right subdural hematoma. Her neurologic examination was normal, but she experienced persistent severe headache and repeat CT showed increasing mass effect. Lumbar puncture was deferred for risk of herniation. MRI was performed to evaluate for septations, abnormal enhancement, or other atypical features that would suggest an alternative diagnosis such as subdural empyema. An area of active contrast extravasation was seen on MRI (figure) and corresponded, at surgical evacuation, to a small bleeding artery that was ablated with bipolar cautery. Despite extensive evaluation, n...
Source: Nature Clinical Practice - December 8, 2014 Category: Neurology Authors: Cutsforth-Gregory, J. K., Black, D. F., Hoffman, E. M., Datar, S. V., Wijdicks, E. F. Tags: MRI, All Cerebrovascular disease/Stroke, Critical care Cases Source Type: research