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O-035 Endovascular treatment of cerebral venous thrombosis involving the deep venous system
ConclusionsAlthough deep venous involvement of CVT is uncommon, these patients are at risk of quickly becoming critically ill with an elevated rate of death or dependency. Although these patients may develop stroke, hemorrhage, or neurologic decline prompting consideration of endovascular therapy, the deep cerebral venous system is not easily accessible with catheters due to small lumens and risk of perforation. It has been proposed that deep cerebral veins may have a higher chance of recanalization if venous thrombus burden is reduced in other parts of the dural venous sinuses. Current literature has not fully explored th...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Morel, B., Hoffman, J., Folzenlogen, Z., Roark, C., Seinfeld, J., Case, D. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

E-108 Ruptured intracranial aneurysm presenting as isolated acute subdural hemorrhage
ConclusionIn rare cases, ruptured intracranial aneurysms can be associated with isolated subdural hemorrhage. Common treatment options include endovascular coiling and microsurgical clipping. However, endovascular repair is often preferred especially when the patient may not be able to tolerate a surgical procedure, as was the case with this patient. In this case, the patient presented with stroke-like symptoms and was found to have a subdural hemorrhage. After emergent craniotomy to evacuate the hematoma, successful endovascular coiling was performed, and the patient was stabilized for further management>Disclosures D....
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Babici, D., Johansen, P., Newman, S., Packer, E., Snelling, B. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-187 Pipeline embolization stent for treatment of giant supraclinoid aneurysms: a case series
ConclusionThe Pipeline embolization device is a novel technique that can be utilized for treatment of giant cerebrovascular aneurysms with emerging evidence of immediate and long-term success. Further patient enrollment and clinical trials will be required to assess its efficacy in comparison to other endovascular and surgical approaches for the treatment of giant aneurysms.Disclosures M. Fana: None. O. Alsrouji: None. M. Rehman: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Fana, M., Alsrouji, O., Rehman, M. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Acute Stroke Diagnosis
Am Fam Physician. 2022 Jun 1;105(6):616-624.ABSTRACTStroke accounts for significant morbidity and mortality and is the fifth leading cause of death in the United States, with direct and indirect costs of more than $100 billion annually. Expedient recognition of acute neurologic deficits with appropriate history, physical examination, and glucose testing will help diagnose stroke and rule out mimicking presentations. The National Institutes of Health Stroke Scale should be used to determine stroke severity and to monitor for evolving changes in clinical presentation. Initial neuroimaging is used to differentiate between isc...
Source: American Family Physician - June 15, 2022 Category: Primary Care Authors: Edwin Y Choi Gilberto A Nieves Darrell Edward Jones Source Type: research

Professor Rathke ’s gift to neurosurgery: the cyst, its diagnosis, surgical management, and outcomes
ConclusionOur results reflect the philosophy of a conservative surgical approach, designed to preserve normal pituitary function, and avoid DI, while achieving the maximal feasible resection. Evacuation of the cyst contents and meticulous sampling of the cyst wall when possible for histopathological diagnosis are crucial. The postoperative relief of symptoms and signs is gratifying, as are the overall rates of recurrence and outcomes.
Source: Pituitary - September 5, 2021 Category: Endocrinology Source Type: research

Stroke-Like Migraine Attacks After Radiation Therapy (SMART) Syndrome: A Comprehensive Review
AbstractPurpose of ReviewSMART syndrome is a delayed complication of cranial irradiation that can be misconstrued as tumor recurrence or some other intracranial neurological disease. Recognition of this clinical syndrome is imperative as it can obviate the need for invasive diagnostic testing and can provide reassurance to both the patient and their loved ones.Recent FindingsSMART syndrome is generally considered a reversible clinical syndrome; however, neurological deficits may become permanent. Pathophysiology of SMART syndrome may involve cerebrovascular autoregulation impairment, neuronal dysfunction leading to trigemi...
Source: Current Pain and Headache Reports - March 24, 2021 Category: Neurology Source Type: research

What Are the Main Acyanotic Congenital Heart Diseases?
Discussion Congenital heart diseases (CHD) are malformations of the heart and great vessels. It occurs in about 5-8/1000 live births. Cyanotic congenital heart disease is often noted perinatally because of cyanosis, respiratory distress and/or poor feeding or other distress type problems. A review can be found here. Acyanotic congenital heart disease (ACHD) can present at birth but often is seen in older children or adults unless the lesions are severe, especially obstructive lesions. Severe lesions may also cause cyanosis and distress type problems in patients also. Shunting lesions cause problems by diverting blood flo...
Source: PediatricEducation.org - August 17, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Cholangiocarcinoma manifesting as non-bacterial thrombotic endocarditis in a young patient
A 41-year-old female with steroid-dependent rheumatoid arthritis and a recent (four months prior) cerebellar stroke presented with complaints of constant headache and right eye blindness of one day.  At the time of the cerebellar stroke, she had presented with persistent headaches, dizziness and gait instability. That workup, including hypercoagulability evaluation, was unremarkable apart from the radiographic abnormalities diagnosing her left medial cerebellar hemisphere infarct. She was disc harged with a plan for outpatient loop recorder placement and aspirin for secondary stroke prevention.
Source: The American Journal of Medicine - January 23, 2020 Category: General Medicine Authors: Ninad Nadkarni, Young Ju Lee, Ryan Hoefen, Richard Alweis Tags: Diagnostic Dilemma Source Type: research

Remote poststroke headache in children: Characteristics and association with stroke recurrence
Conclusions Remote poststroke headache is a common morbidity among pediatric stroke survivors, particularly in older children. Headaches may increase health care utilization, including neuroimaging and hospital admissions. We identified a possible association between poststroke headache and stroke recurrence.
Source: Neurology Clinical Practice - June 9, 2019 Category: Neurology Authors: Chelse, A. B., Kurz, J. E., Gorman, K. M., Epstein, L. G., Balmert, L. C., Ciolino, J. D., Wainwright, M. S. Tags: Childhood stroke, Secondary headache disorders, Pediatric headache, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke, Risk factors in epidemiology Research Source Type: research

Cerebral Hyperperfusion Syndrome After Carotid Revascularization and Acute Ischemic Stroke
AbstractPurpose of ReviewCerebral hyperperfusion syndrome (CHS) is a rare but significant complication after carotid revascularization and is increasingly recognized after acute stroke treatments. In this review, we discuss the epidemiology and pathophysiology of CHS, clinical presentation including ipsilateral headache, seizures, and focal neurological deficits, and radiographic presentation. We propose preventive therapies with emphasis on acute stroke post-thrombectomy hyperperfusion.Recent FindingsCHS was first described after carotid revascularization but is now also reported in patients with acute ischemic stroke. Pr...
Source: Current Pain and Headache Reports - March 19, 2018 Category: Neurology Source Type: research

Letter to the Editor: Pneumocephalus: Is the needle size significant?
Discussion. Pneumocephalus is defined by two mechanisms: a ball-valve and an inverted bottle concept.1 The ball-valve type implies positive pressure events, such as coughing or valsalva maneuvers, that prevent air escape. Tension pneumocephalus is included in this mechanism, causing a parenchymal mass effect. The inverted bottle theory includes a negative intracranial pressure gradient following cerebrospinal fluid drainage, relieved by air influx. A small pneumocephalus is usually sealed by blood clots or granulation, allowing spontaneous reabsorption and resolution.[1] Otherwise, the lateral positioning of a patient duri...
Source: Innovations in Clinical Neuroscience - February 1, 2018 Category: Neuroscience Authors: ICN Online Editor Tags: Assessment Tools CNS Infections Current Issue Letters to the Editor Neurologic Systems and Symptoms Neurology Stroke Traumatic Brain Injury epidural needle size Pneumocephalus spinal tap Source Type: research

O-035 Risk factors for delayed deterioration after cerebral venous thrombosis: a model to identify patients for early aggressive endovascular therapy
Conclusion We found that decreased mental status, seizure activity, papilledema, number of involved sinuses, sodium level, and platelet level to be the most important factors in predicting deterioration after CVT. This group may represent a subset of patients in who early thrombectomy may be considered. Further prospective trials are needed to confirm this hypothesis. Abstract O-035 Figure 1Odds ratios of clinical deterioration for the predictors of the multivariable logistic regression model. To get the ratio of deterioration for catergory 1 versus 0, one needs to take the reciprocal Disclosures S. Bushnaq: None. T. ...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Bushnaq, S., Thacker, T., Abbas, M., Qeadan, F., Carlson, A. Tags: Oral Abstracts Source Type: research

Miller fisher syndrome presenting with prodromal thunderclap headache
Conclusions Although not radiographically confirmed, we postulate the headache may have been due to reversible cerebral vasoconstriction syndrome (RCVS), given the characteristics of the headache and dramatic response to nimodipine. Although headache is infrequently observed in Miller Fisher syndrome, the exact aetiology is unclear and there has been no previously reported association with RCVS.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: Waters, M. J., Kiley, M. Tags: Abstracts Source Type: research

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