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Total 32 results found since Jan 2013.

Neurocognitive, Quality of Life, and Behavioral Outcomes for Patients With Covert Stroke After Cardiac Surgery: Exploratory Analysis of Data From a Prospectively Randomized Trial
CONCLUSIONS: More than one-half of patients undergoing cardiac surgery demonstrated covert stroke. In this exploratory analysis, covert stroke was not found to be significantly associated with neurocognitive dysfunction 1 month after surgery; evidence of impaired quality of life, anxiety, or depression, albeit a type II error, cannot be excluded.PMID:34319914 | DOI:10.1213/ANE.0000000000005690
Source: Anesthesia and Analgesia - July 28, 2021 Category: Anesthesiology Authors: Choy Lewis Annabelle Levine Lauren C Balmert Liqi Chen Saadia S Sherwani Alexander J Nemeth Jordan Grafman Rebecca Gottesman Charles H Brown Charles W Hogue Source Type: research

Management of Acute Ischemic Stroke-Specific Focus on Anesthetic Management for Mechanical Thrombectomy.
Abstract Acute ischemic stroke is a neurological emergency with a high likelihood of morbidity, mortality, and long-term disability. Modern stroke care involves multidisciplinary management by neurologists, radiologists, neurosurgeons, and anesthesiologists. Current American Heart Association/American Stroke Association (AHA/ASA) guidelines recommend thrombolytic therapy with intravenous (IV) alteplase within the first 3-4.5 hours of initial stroke symptoms and endovascular mechanical thrombectomy within the first 16-24 hours depending on specific inclusion criteria. The anesthesia and critical care provider may b...
Source: Anesthesia and Analgesia - September 16, 2020 Category: Anesthesiology Authors: Businger J, Fort AC, Vlisides PE, Cobas M, Akca O Tags: Anesth Analg 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

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

Cerebellar infarct following orchidopexy under spinal anesthesia.
Authors: Goel S, Garg G, Kumar M, Aeron R Abstract The report describes a case of peri-operative stroke that presented as diplopia and gait difficulty on 2nd post-operative day after routine orchidopexy under spinal anesthesia in an otherwise healthy young boy. Magnetic resonance imaging of the brain revealed acute infarct in bilateral cerebellar hemispheres, left half of medulla and left thalamus. A diagnosis of acute stroke (infarct) was made and patient was started on oral aspirin 75mg.day-1, following which his vision started improving after 2 weeks. Possible mechanisms of development of stroke in the peri-oper...
Source: Revista Brasileira de Anestesiologia - November 19, 2018 Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research

Cerebellar infarct following orchidopexy under spinal anesthesia
Publication date: Available online 6 August 2018Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Sunny Goel, Gaurav Garg, Manoj Kumar, Ruchir AeronAbstractThe report describes a case of peri-operative stroke that presented as diplopia and gait difficulty on 2nd post-operative day after routine orchidopexy under spinal anesthesia in an otherwise healthy young boy. Magnetic resonance imaging of the brain revealed acute infarct in bilateral cerebellar hemispheres, left half of medulla and left thalamus. A diagnosis of acute stroke (infarct) was made and patient was started on oral aspirin 75 mg.day...
Source: Brazilian Journal of Anesthesiology - August 7, 2018 Category: Anesthesiology Source Type: research

Little Black Boxes: Noncardiac Implantable Electronic Medical Devices and Their Anesthetic and Surgical Implications.
Abstract Implanted electronic medical devices. or stimulators such as pacemakers and nerve stimulators have grown enormously in diversity and complexity over recent decades. The function and potential interaction of these devices with the perioperative environment is of increasing concern for anesthesiologists and surgeons. Because of the innate electromagnetic environment of the hospital (operating room, gastrointestinal procedure suite, and imaging suite), implanted device malfunction, reprogramming, or destruction may occur and cause physical harm (including nerve injury, blindness, deafness, burn, stroke, para...
Source: Anesthesia and Analgesia - May 4, 2017 Category: Anesthesiology Authors: Srejic U, Larson P, Bickler PE Tags: Anesth Analg Source Type: research

The influence of mean arterial pressure during cardiopulmonary bypass on cerebral complications
Stroke and postoperative cognitive dysfunction are common complications after cardiac surgery. Furthermore, silent strokes detected by diffusion-weighted magnetic resonance imaging (DWI) have been reported in up to 50% of cardiac surgery patients. The majority of these lesions seems to be caused by emboli, but other mechanisms may induce hypoperfusion and consequently lead to tissue ischaemia. A few randomised controlled trials have previously investigated the influence of mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) on cardiac and neurological endpoints with diverging results.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2017 Category: Anesthesiology Authors: Anne Gr ønborg Vedel, F Holmgaard, L Rasmussen, A Langkilde, OB Paulson, PS Olsen, T Lange, HB Ravn, JC Nilsson Source Type: research

Relationship between bioreactance and magnetic resonance imaging stroke volumes
Source: British Journal of Anaesthesia - June 16, 2016 Category: Anesthesiology Authors: Perkins, R. E., Hollingsworth, K. G., Eggett, C., MacGowan, G. A., Bates, M. G. D., Trenell, M. I., Jakovljevic, D. G. Tags: Correspondence Source Type: research

Perfusion pressure cerebral infarction (PPCI trial - a protocol for a randomised clinical trial
Debilitating brain injury occurs in 1.6-5 % of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Diffusion-weighed magnetic resonance imaging (DWI) studies have reported stroke-like lesions in up to 51 % of patients after cardiac surgery. The majority of the lesions seem to be caused by emboli, but inadequate blood flow caused by other mechanisms may increase ischaemia in the penumbra or cause watershed infarcts. During CPB, blood pressure can be below the lower limit of cerebral autoregulation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 30, 2016 Category: Anesthesiology Authors: Anne G Vedel, F Holmgaard, HB Ravn, JC Nilsson Source Type: research

Misconnections in the Critically Ill: Injection of High-Dose Gadolinium into an External Ventricular Drain
We report an unfortunate case of accidental administration of intrathecal gadolinium through an external ventricular drain in a postcraniotomy patient during magnetic resonance imaging of the brain. The incident occurred after the venous contrast line was connected mistakenly to the ventricular drainage catheter. The patient subsequently developed confusion, aphasia, and right facial droop with new computed tomography evidence of diffuse cerebral edema and stroke. Review of the magnetic resonance image revealed the inappropriate presence of subarachnoid gadolinium. Despite all interventions, the patient developed irreversi...
Source: A&A Case Reports - March 1, 2016 Category: Anesthesiology Tags: Case Reports: Clinical Care Source Type: research

A retrospective study of clinical profile and outcomes of critically ill patients with heat-related illness
Conclusion: HRI carries a high mortality and significant neurological morbidity.
Source: Indian Journal of Anaesthesia - November 20, 2015 Category: Anesthesiology Authors: MS KalaiselvanMK RenukaAS Arunkumar Source Type: research

How to monitor the brain in septic patients?
The objective of this review is to summarize recent clinical data about the role of brain monitoring - including TCD, NIRS, EEG, EP, CT, and MRI - in patients with sepsis and to illustrate its potential utility for the diagnosis, management and prognostication. PMID: 25812488 [PubMed - as supplied by publisher]
Source: Minerva Anestesiologica - April 1, 2015 Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research