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Cerebral foreign body reaction due to hydrophilic polymer embolization following aneurysm treatment by pipeline flow diversion device.
We present a unique case in which visible chipping of the pusher wire for stent placement was observed, followed by clinical and radiographic evidence suggestive of a delayed foreign body reaction to intracranial hydrophilic polymer emboli. A 55-year-old woman underwent placement of a Pipeline embolization device for a left-sided, broad-based aneurysm at the base of the internal carotid artery and posterior communicating artery. Two months later she developed right-sided focal neurological deficits. Imaging showed ipsilateral focal edema and enhancing lesions with contrast. Although not confirmed with biopsy and histopatho...
Source: Interventional Neuroradiology - March 31, 2019 Category: Radiology Tags: Interv Neuroradiol Source Type: research

Outcome and predictive factors in post-stroke seizures: A retrospective case-control study
ConclusionsThe size of anterior infarction, presence of blood products within the infarct bed, and especially LN predicted PSS.
Source: Seizure - September 15, 2018 Category: Neurology Source Type: research

Intracranial complications of acute bacterial endocarditis.
Conclusion: Here, we reviewed the literature for intracranial pathology accompanying ABE versus SBE. ABE typically results in acute ischemia, septic emboli, stroke/hemorrhagic infarcts, or ICH. SBE more classically produces septic microemboli and mycotic aneurysms that may leak, but rarely producing ICH. We also presented a patient with ABE attributed to S. aureus whose septic emboli/stroke was accompanied by a mycotic aneurysm; the ruptured resulting in a large right occipital ICH. PMID: 29930873 [PubMed]
Source: Surgical Neurology International - June 24, 2018 Category: Neurosurgery Tags: Surg Neurol Int Source Type: research

Cerebral Autoregulation in Stroke
AbstractPurpose of ReviewCerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication.Recent FindingsExisting data suggest that CA is general...
Source: Current Atherosclerosis Reports - May 21, 2018 Category: Cardiology 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

Clinical and Radiographic Predictors of Intracerebral Hemorrhage Outcome
Background: Intracerebral hemorrhage (ICH) represents 10-15% of all stroke cases in the US annually. Fewer than 40% of these patients ever reach long-term functional independence, and mortality rate is roughly 40% at 1 month. Due to the high morbidity and mortality rates after ICH, early detection of high-risk patients would be beneficial in directing the management course and goals of care. This review aims to discuss relevant clinical and radiographic characteristics that can serve as predictors of poor prognosis and examine their efficacy in predicting patient outcomes after ICH.Summary: A literature review was conducte...
Source: Interventional Neurology - January 12, 2018 Category: Neurology Source Type: research

Mechanical thrombectomy in basilar artery occlusion: influence of reperfusion on clinical outcome and impact of the first-line strategy (ADAPT vs stent retriever).
CONCLUSIONS Among BAO patients, successful reperfusion is a strong predictor of a 90-day favorable outcome, and the choice of ADAPT as the first-line strategy achieves a significantly higher rate of complete reperfusion with a shorter procedure duration. PMID: 29327997 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - January 12, 2018 Category: Neurosurgery Authors: Gory B, Mazighi M, Blanc R, Labreuche J, Piotin M, Turjman F, Lapergue B, Endovascular Treatment in Ischemic Stroke (ETIS) Research Investigators Tags: J Neurosurg Source Type: research

The Edinburgh CT and genetic diagnostic criteria for lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy: model development and diagnostic test accuracy study
Publication date: Available online 10 January 2018 Source:The Lancet Neurology Author(s): Mark A Rodrigues, Neshika Samarasekera, Christine Lerpiniere, Catherine Humphreys, Mark O McCarron, Philip M White, James A R Nicoll, Cathie L M Sudlow, Charlotte Cordonnier, Joanna M Wardlaw, Colin Smith, Rustam Al-Shahi Salman Background Identification of lobar spontaneous intracerebral haemorrhage associated with cerebral amyloid angiopathy (CAA) is important because it is associated with a higher risk of recurrent intracerebral haemorrhage than arteriolosclerosis-associated intracerebral haemorrhage. We aimed to develop a predict...
Source: The Lancet Neurology - January 12, 2018 Category: Neurology Source Type: research

Impact of Asynchronous Training on Radiology Learning Curve among Emergency Medicine Residents and Clerkship Students.
CONCLUSION: Incorporating asynchronous WBL modules into EM clerkship and residency curriculum provides early radiographic exposure in their clinical training and can enhance diagnostic head CT scan interpretation. PMID: 29272248 [PubMed - in process]
Source: The Permanente journal - December 24, 2017 Category: General Medicine Tags: Perm J Source Type: research

Predictors of hematoma expansion predictors after intracerebral hemorrhage.
Authors: Chen S, Zhao B, Wang W, Shi L, Reis C, Zhang J Abstract Despite years of effort, intracerebral hemorrhage (ICH) remains the most devastating form of stroke with more than 40% 30-day mortality worldwide. Hematoma expansion (HE), which occurs in one third of ICH patients, is strongly predictive of worse prognosis and potentially preventable if high-risk patients were identified in the early phase of ICH. In this review, we summarize data from recent studies on HE prediction and classify those potential indicators into four categories: clinical (severity of consciousness disturbance; blood pressure; blood glu...
Source: Oncotarget - November 29, 2017 Category: Cancer & Oncology Tags: Oncotarget Source Type: research

A direct aspiration first pass technique for acute stroke therapy: a systematic review and meta ‐analysis
ConclusionsADAPT therapy is associated with similar reperfusion rates, clinical outcomes and complication rates compared with thrombectomy with stent retrievers. However, the major limitations of current evidence (i.e. retrospective studies and selection bias) indicate a need for adequately powered, multicenter randomized controlled trials to determine the best strategy.
Source: European Journal of Neurology - November 24, 2017 Category: Neurology Authors: B. Gory, X. Armoiry, R. Sivan ‐Hoffmann, M. Piotin, M. Mazighi, B. Lapergue, R. Blanc, F. Turjman Tags: Original Article Source Type: research

Early Operation in Patients With Mitral Valve Infective Endocarditis and Acute Stroke Is Safe.
CONCLUSIONS: MV surgery for IE and acute stroke can be performed early with a low risk of postoperative neurologic complications. When indicated, surgical intervention for MV IE complicated by acute stroke should not be delayed. PMID: 29132700 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - November 11, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Ghoreishi M, Foster N, Pasrija C, Shah A, Watkins AC, Evans CF, Maghami S, Quinn R, Wehman B, Taylor BS, Dawood MY, Griffith BP, Gammie JS Tags: Ann Thorac Surg Source Type: research

Early Operation in Patients With Mitral Valve Infective Endocarditis and Acute Stroke Is Safe
Conclusions MV surgery for IE and acute stroke can be performed early with a low risk of postoperative neurologic complications. When indicated, surgical intervention for MV IE complicated by acute stroke should not be delayed.
Source: The Annals of Thoracic Surgery - November 11, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

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