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Natural Course of Dissecting Vertebrobasilar Artery Aneurysms without Stroke FELLOWS' JOURNAL CLUB
CONCLUSIONS: The natural course of these lesions suggests that acute intervention is not always required and close follow-up without antithrombotic therapy is reasonable. Patients with symptoms due to mass effect or aneurysms of >10 mm may require treatment.
Source: American Journal of Neuroradiology - July 15, 2014 Category: Radiology Authors: Kobayashi, N., Murayama, Y., Yuki, I., Ishibashi, T., Ebara, M., Arakawa, H., Irie, K., Takao, H., Kajiwara, I., Nishimura, K., Karagiozov, K., Urashima, M. Tags: FELLOWS ' JOURNAL CLUB Source Type: research

The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers
During the last 10 years, reversible cerebral vasoconstriction syndrome (RCVS) has emerged as the most frequent cause of thunderclap headache (TCH) in patients without aneurysmal subarachnoid hemorrhage, and as the most frequent cause of recurrent TCHs. The typical TCHs of RCVS are multiple, recurring over a few days to weeks, excruciating, short‐lived, and brought up by exertion, sexual activities, emotion, Valsalva maneuvers, or bathing, among other triggers. All these triggers induce sympathetic activation. In a minority of cases with RCVS, TCH heralds stroke and rarely death. Early diagnosis of RCVS in patients who p...
Source: Headache: The Journal of Head and Face Pain - March 25, 2016 Category: Neurology Authors: Anne Ducros, Valérie Wolff Tags: Review Article Source Type: research

E-027 Matricidal cavernous aneurysms: a multicenter case series
Conclusion Matricidal aneurysms require careful consideration and planning. The restricted anatomy of the cavernous sinus can make successful execution of endovascular interventions difficult. Direct elastic compression of the parent artery does not respond to angioplasty and stenting the way that atherosclerotic stenosis does. Because of this, planning for possible parent vessel sacrifice is important. Abstract E-027 Table 1 Intended Treatments and Outcomes n Intended Treatment Failed Treatment (rate) All Patients 37 10 (27%) Flow Diversion 18 5 (28%) Parent Vessel Sacrifice 11 With Bypass 4 2 (50%) Without Bypass 7 0 ...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Roberts, M., Nickele, C., Welch, B., Ban, V., Ringer, A., Kim, L., Levitt, M., Lanzino, G., Kan, P., Shallwani, H., Siddiqui, A., Elijovich, L., Arthur, A. Tags: Electronic Poster Abstracts Source Type: research

Successful Treatment of Growing Basilar Artery Dissecting Aneurysm by Pipeline Flow Diversion Embolization Device
We describe a case of successful management of a growing basilar artery dissecting aneurysm by the Pipeline flow diversion embolization device (PED). A 48-year-old woman presented with severe headache, neck pain, and altered consciousness. Computed tomography showed subarachnoid hemorrhage located in basal cisterns, with a pontine infarct shown on magnetic resonance imaging. Digital subtraction angiography showed dissecting aneurysm of the trunk of the basilar artery, with growth over time on repeated imaging. Repeated imaging demonstrated growth in size of the aneurysm. The aneurysm was treated with PED with complete obl...
Source: Journal of Stroke and Cerebrovascular Diseases - January 6, 2014 Category: Neurology Authors: Dasen Gong, Bernard Yan, Richard Dowling, Peter Mitchell Tags: Case Reports Source Type: research

Puerperal Extracranial Vertebral Artery Dissection and Nonaneurysmal Subarachnoid Hemorrhage
Previously reported only a few times before, we present a case of extracranial vertebral dissection and spontaneous frontoparietal subarachnoid hemorrhage (SAH) in the puerperium, discussing possible mechanisms and difficulties in management. A 35-year-old woman presented 10 days postcaesarean section with neck pain and vertigo with normal initial investigations. Following recurrent vertigo, headache, and ataxia, imaging revealed a frontoparietal SAH and vertebral artery dissection. The patient was consequently treated with aspirin, and then following a return of symptoms 3 weeks later, warfarin therapy was continued for 6 months.
Source: Journal of Stroke and Cerebrovascular Diseases - December 14, 2015 Category: Neurology Authors: James W. Garrard, Renata F. Simm, Edson Bor-Seng-Shu, Ricardo C. Nogueira Tags: Case Studies Source Type: research

Headache and Its Approach in Today’s NeuroIntensive Care Unit
Abstract Headache is a very common symptom in the neurointensive care unit (neuroICU). While headache in the neuroICU can be caused by worsening of a pre-existing primary headache disorder, most are secondary to another condition. Additionally, headache can be the presenting symptom of a number of conditions requiring prompt recognition and treatment including subarachnoid hemorrhage, ischemic and hemorrhagic stroke, central nervous system infection, pituitary apoplexy, and cerebral vasoconstriction. The neuroICU also has a unique postoperative population in which postcraniectomy and postcraniotomy headache, posti...
Source: Neurocritical Care - March 20, 2016 Category: Neurology Source Type: research

Analgesia in Neurocritical Care: An International Survey and Practice Audit*
Conclusions: Opiates and acetaminophen are preferred analgesic agents, and gabapentin is a contextual third choice, in neurocritically ill patients. Other agents are rarely prescribed. The discordance in physician self-reports and objective audits suggest that pain management optimization studies are warranted.
Source: Critical Care Medicine - April 16, 2016 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Current Treatment Options in Cardiovascular Medicine: Update on Reversible Cerebral Vasoconstriction Syndrome
ConclusionRCVS can now be accurately diagnosed using clinical and imaging features available upon presentation. Advances in knowledge about the risk factors, prognosis, and potential harmful effects of certain therapeutic strategies, are expected to optimize the management of this increasingly well recognized syndrome.
Source: Current Treatment Options in Cardiovascular Medicine - July 13, 2020 Category: Cardiology Source Type: research

Clinical presentation and assessment of older patients presenting with headache to emergency departments: A multicentre observational study
CONCLUSION: Older patients with headache had different clinical features to the younger cohort and were more likely to have a serious secondary cause of headache than younger adults. There should be a low threshold for investigation in older patients attending ED with non-traumatic headache.PMID:34570422 | DOI:10.1111/ajag.12999
Source: Australasian Journal on Ageing - September 27, 2021 Category: Geriatrics Authors: Sierra Beck Frances B Kinnear Anne Maree Kelly Kevin H Chu Win Sen Kuan Gerben Keijzers Richard Body Mehmet A Karamercan Sharon Klim Tissa Wijeratne Sinan Kamona Colin A Graham Tom Roberts Daniel Horner Said Laribi HEAD Study Group Source Type: research