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The Anesthetic Management of Interventional Procedures for Acute Ischemic Stroke
Abstract Acute ischemic stroke is a medical emergency. Expedient reperfusion is a key component of treatment and improves the odds for a good outcome. Anesthesiologists play an important role in the peri-procedural management of cerebral revascularization procedures in patients with acute ischemic stroke. We review critical concepts and provide evidence-based recommendations, when available, for the management of patients having angiographic procedures to treat acute ischemic stroke.
Source: Current Anesthesiology Reports - June 29, 2016 Category: Anesthesiology Source Type: research

A Case-Based Discussion on the Management of Cryptogenic Stroke and Patent Foramen Ovale in the Patient With a Hypercoagulable Disorder
UP TO 40% of all ischemic strokes are considered cryptogenic, implying a stroke without a definitive etiology.1,2 With a dearth of evidence-guided treatment strategies, the literature surrounding cryptogenic stroke is highly variable and not well-standardized. Even though existing guidelines do not specify the exact testing required, the cryptogenic stroke evaluation includes a variety of imaging modalities (eg, echocardiography, angiography, magnetic resonance imaging, carotid ultrasound) and laboratory investigations (eg, genetic testing, hypercoagulable disorder panels, erythrocyte sedimentation rate).
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 27, 2019 Category: Anesthesiology Authors: Neal S. Gerstein, Stacey D. Clegg, Daniel B. Levin, Adam C. Fish, Kirsten Tolstrup, Koki Nakanishi, Yuriko Yoshida, Shunichi Homma Tags: Case Conference Source Type: research

Eagle Syndrome: A Rare Cause of Stroke in a Young Patient
We report the case of a 26-year-old man who presented to the emergency department because he noticed that his right hand had become clumsy. He first noticed this symptom five days before his presentation, but he noticed that his symptom had improved significantly since it began. He reported that he had episodes of neck pain and pain around the ear. He visited the family physician clinic several times for this complaint and was diagnosed as having a temporomandibular joint disorder. Neurological examination revealed decreased muscle strength in the right upper limb with a power of 4/5 along with a sensory deficit. The coord...
Source: Pain Physician - February 15, 2022 Category: Anesthesiology Authors: Hussain A Alobaidi Ali A Alfaran Hawa H Algazwi Fatimah I Alkhater Hussain M Alshooalah Abdulrahman K Alanzi Ibrahim A Almindil Abdullah K Alqasim Aisha A Faqeeh Amani A Almutairi Ghaida H Alnaqa Najla H Alnaqa Renad M Alasmari Razan M Almashouf Faisal Al Source Type: research

Evaluation of the risk factors for neurological and neurocognitive impairment after selective cerebral perfusion in thoracic aortic surgery
ConclusionsWe found that prolonged SCP time and coronary artery disease increased the risk of postoperative stroke. Heterogeneous carotid plaque, history of cerebrovascular disease, concomitant CABG and prolonged operation time were further significant predictors of POCD.
Source: Journal of Anesthesia - May 1, 2020 Category: Anesthesiology Source Type: research

Effect of Intra-arterial Nimodipine on Cerebral Oxygen Saturation and Systemic Hemodynamic Indices in Patients With Cerebral Vasospasm: A Prospective Cohort Study
This study assessed the effect of IaN on rScO2 and systemic hemodynamic indices during IaN therapy for cerebral vasospasm after aSAH. Methods: This prospective cohort study was conducted in 20 patients over sixteen month period after ethics committee approval and informed consent. Patients with angiographic evidence of vasospasm received IaN 3mg over 30 minutes in the spastic vessels. Data regarding rScO2 heart rate (HR), mean blood pressure (MBP) cardiac index (CI), stroke volume index (SVI), stroke volume variation (SVV), and total peripheral resistance index (TPRI) were collected during IaN treatment. The primary out...
Source: Journal of Neurosurgical Anesthesiology - March 10, 2020 Category: Anesthesiology Tags: Short Reports Source Type: research

Bilateral carotid artery dissection in a severe preeclamptic setting: An unusual cause of postpartum headache.
Abstract A 30-year-old woman with severe preeclampsia presented at 27weeks of amenorrhea with left headache, neck pain, blurred vision and numbness of left hemiface that resolved spontaneously within 2hours. A week later, hypertension remained poorly controlled despite combination of nicardipine and labetalol intravenous therapy; an urgent caesarean section was eventually performed due to onset of HELLP syndrome. At day 5 postpartum, the patient had a Horner syndrome with right ipsilateral disabling tinnitus. A CT-angiography of supra-aortic trunks was performed urgently; it showed a bilateral carotid arterial dis...
Source: Annales Francaises d'Anesthesie et de Reanimation - April 1, 2013 Category: Anesthesiology Authors: Hoffmann C, Augé M, Falzone E, Martel-Jacob S, Mercier FJ Tags: Ann Fr Anesth Reanim Source Type: research

Do cardiac arrest centres save more lives?
Publication date: Available online 13 May 2016 Source:Trends in Anaesthesia and Critical Care Author(s): Eldar Søreide, Michael Busch During the last 15 years post resuscitation care after out-of-hospital cardiac arrest (OHCA) has evolved into something quite complicated and multifaceted. Still, in most countries post resuscitation care is not centralised to specialised hospitals. In other acute and life-threatening diseases like neuro-trauma, acute myocardial infarction and stroke specialised hospital care has now become standard practise. In this review, we present the historic changes in post resuscitation care wit...
Source: Trends in Anaesthesia and Critical Care - June 15, 2016 Category: Anesthesiology Source Type: research

Comparing Methods for Cardiac Output: Intraoperatively Doppler-Derived Cardiac Output Measured With 3-Dimensional Echocardiography Is Not Interchangeable With Cardiac Output by Pulmonary Catheter Thermodilution.
CONCLUSIONS: Despite low bias, the wide limits of agreement of Doppler-derived CO by 3D TEE compared to CO by thermodilution will limit clinical application and can therefore not be considered interchangeable with CO obtained by thermodilution. The lack of agreement is not explained by lack of agreement of the 3D technique. PMID: 29324489 [PubMed - as supplied by publisher]
Source: Anesthesia and Analgesia - January 9, 2018 Category: Anesthesiology Authors: Graeser K, Zemtsovski M, Kofoed KF, Winther-Jensen M, Nilsson JC, Kjaergaard J, Møller-Sørensen H Tags: Anesth Analg Source Type: research

Perioperative management of intramyocardial hydatid cyst with off-pump technique.
We present a case report of an asymptomatic case of off-pump removal of intramyocardial hydatid cyst. A 21-year-old male presented asymptomatically and was diagnosed with a hydatid cyst incidentally during a regular checkup. Echocardiography and cardiac computed tomography angiography images demonstrated an intramyocardial hydatid cyst on the lateral aspect of the left ventricle with slight extension over the anterior and posterior regions. Important aspects of diagnosis and management specific to cardiac hydatid cyst along with the review of literature have been discussed. PMID: 30648688 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - January 1, 2019 Category: Anesthesiology Authors: Gupta Y, Priyadarshi M Tags: Ann Card Anaesth Source Type: research

Head CT for the intensivist: 10 tips and pearls
Minerva Anestesiol. 2022 Feb 24. doi: 10.23736/S0375-9393.22.16200-0. Online ahead of print.ABSTRACTHead imaging is an essential diagnostic tool for the management of patients with most acute neurological emergencies involving the brain. While numerous modalities including magnetic resonance imaging and catheter angiography play a role, computed tomography (CT) of the brain is far and away the most widely utilized technique because of its widespread availability and the fact that it is usually easier to implement in critically ill and potentially unstable patients. CT is particularly useful in identifying acute intracrania...
Source: Minerva Anestesiologica - February 24, 2022 Category: Anesthesiology Authors: Sajeev A Mahendran Oliver Flower J Claude Hemphill Source Type: research

Hemoglobin Concentration May Influence the Incidence of Postoperative Transient Neurological Events in Patients With Moyamoya After Extracranial-intracranial Arterial Bypass: A Retrospective Single Center Experience
Background: Moyamoya is a rare condition characterized by cerebral angiographic findings of intracranial carotid artery stenosis with abnormal net-like vessels in the brain, and often presents as transient ischemic attacks or intracranial hemorrhage. Revascularization in the form of extracranial-intracranial (EC-IC) artery bypass has demonstrated efficacy in preventing ischemic attacks and intracranial hemorrhage, although it is associated with a relatively high rate of perioperative ischemic and hemorrhagic stroke. This retrospective analysis aims to evaluate the possible association between postoperative hemoglobin (...
Source: Journal of Neurosurgical Anesthesiology - March 15, 2022 Category: Anesthesiology Tags: Short Reports Source Type: research

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