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Predictors of left atrial appendage thrombogenic milieu in patients subjected to transesophageal echocardiography prior to cardioversion of persistent atrial fibrillation.
CONCLUSIONS    CHA2DS2 -VASc scores did not discriminate between the presence/absence of TEE surrogate risk factors for thromboembolism in patients scheduled for CV due to persistent AF. Only one component of CHA2DS2 -VASc scale, radiographic evidence of aortic plaques, as well as TTE parameters, augmentation of the left atrium and left ventricular end-diastolic dimension, were independent predictors of TEE markers for LAA thrombogenic milieu. Complex clinical and echocardiographic assessment of individual risk seems to be a valuable approach in subjects scheduled for CV of persistent AF. PMID: 26811148 [PubMed - as...
Source: Polskie Archiwum Medycyny Wewnetrznej - January 28, 2016 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

Pediatric cavernous sinus thrombosis: A case series and review of the literature
Conclusion: Our case series demonstrates low morbidity and mortality with early, aggressive surgical, antimicrobial, and anticoagulation therapies. Although anticoagulation and surgery were not associated with significantly different outcomes, more study is needed.
Source: Neurology - August 31, 2015 Category: Neurology Authors: Smith, D. M., Vossough, A., Vorona, G. A., Beslow, L. A., Ichord, R. N., Licht, D. J. Tags: Childhood stroke, Secondary headache disorders, Pediatric headache, All Imaging, Cerebral venous thrombosis ARTICLE Source Type: research

Corrective spinal surgery may be protective against stroke in patients with blunt traumatic vertebral artery occlusion.
CONCLUSIONS Traumatic VA occlusion is associated with a risk of ischemic stroke and mortality. Corrective cervical spine surgery potentially decreases the risk of ischemic stroke by stabilizing the spine and thereby reducing motion across the occluded segment of the VA and preventing embolization of thrombus. While a high stoke risk may be inherent to the disease, novel therapies should be investigated. PMID: 26186525 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - July 17, 2015 Category: Neurosurgery Authors: Foreman PM, Griessenauer CJ, Chua M, Hadley MN, Harrigan MR Tags: J Neurosurg Spine Source Type: research

Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture.
Abstract Acute internal carotid artery (ICA) terminus occlusion is associated with extremely poor functional outcomes or mortality, especially when it is caused by plaque rupture of the cervical ICA with engrafted thrombus that elongates and extends into the ICA terminus. The goal of this study was to evaluate the efficacy and safety of surgical embolectomy in conjunction with carotid endarterectomy (CEA) for acute ICA terminus occlusion associated with cervical plaque rupture resulting in tandem occlusion. A retrospective review of medical records was performed. Clinical and radiographic characteristics were eval...
Source: Journal of Neurosurgery - January 9, 2015 Category: Neurosurgery Authors: Hasegawa H, Inoue T, Tamura A, Saito I Tags: J Neurosurg Source Type: research

Iatrogenesis imperfecta: stroke caused by accidental carotid artery catheterization.
CONCLUSION:: Even with ultrasound-guided central venous catheterization, it is essential to remain vigilant for the early detection of vascular complications. Clinical suspicion combined with diagnostic modalities such as chest radiograph, transduction and manometry can increase the detection rates. PMID: 25041919 [PubMed - as supplied by publisher]
Source: The Journal of Vascular Access - November 27, 2014 Category: Surgery Tags: J Vasc Access Source Type: research

Bm-12 * cerebral infarction secondary to pulmonary vein compression and left atrial appendage tumor infiltration as the presenting sign of metastatic squamous cell carcinoma of the base of the tongue
CONCLUSION: Cardiac metastases are rare and non-myxomatous tumor embolization to the brain even rarer especially in the setting of cerebral infarction due to pulmonary vein thrombus. Here we describe a case of multiple acute cerebral infarctions appearing from a proximal source refractory to anticoagulation. Thromboembolism from the pulmonary vein and tumor embolization from cardiac metastases are the likely mechanisms for his clinical presentation and radiographic findings. This case demonstrates the complexity of multiple stroke etiologies in one patient and the importance of cardiac imaging in stroke evaluation, particu...
Source: Neuro-Oncology - November 3, 2014 Category: Cancer & Oncology Authors: Dredla, B., Siegel, J., Jaeckle, K. Tags: BRAIN METASTASES (CLINICAL AND/OR LABORATORY RESEARCH) Source Type: research

Radiographic features of pulmonary embolism: Westermark and Palla signs
We present a case highlighting the importance of recognising these unusual radiological signs in patients presenting with haemodynamically unstable pulmonary emboli (box 1). Box 1CXR appearance of Westermark and Palla signs Westermark sign: regional pulmonary oligaemia Palla sign: enlargement of the descending pulmonary artery Case A 78-year-old lady presented to the emergency department with collapse and pleuritic chest pain. On examination, the patient was in respiratory distress and haemodynamic compromise with a respiratory rate of 36 breaths/min, an oxygen saturation of 86% on room air, a heart rate of 120 b...
Source: Postgraduate Medical Journal - June 18, 2014 Category: Journals (General) Authors: Abbas, A., St Joseph, E. V., Mansour, O. M. A., Peebles, C. R. Tags: Emergency medicine, Journalology, Patients, Drugs: cardiovascular system, Echocardiography, Pain (neurology), Stroke, Hypertension, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests, Radiology (diagnostics), Epidemiology, Et Source Type: research

Functional Outcome After Perinatal Cerebral Sinovenous Thrombosis: A Prospective Cohort Study (S42.006)
CONCLUSIONS: We found a high rate of neurological morbidity and seizure burden after perinatal CSVT which significantly impacted achievement of age-appropriate developmental milestones and function. Measures and predictors of functional outcome following perinatal CSVT need further exploration.Disclosure: Dr. Billinghurst has nothing to disclose. Dr. Uohara has nothing to disclose. Dr. Licht has nothing to disclose. Dr. Ichord has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Billinghurst, L., Uohara, M., Licht, D., Ichord, R. Tags: Child Neurology I Source Type: research

Polymethylmethacrylate cement pulmonary embolism and infarct
Discussion Pulmonary cement emboli can occur in up to 23% of percutaneous vertebroplasty.1 This procedure is widely used making emergency practitioner recognition of complications important. Most complications are related to leakage of the bone cement into the venous system. Pulmonary migration...
Source: Emergency Medicine Journal - February 13, 2014 Category: Emergency Medicine Authors: Stevens, A. C. Tags: Fractures, Drugs: cardiovascular system, Pain (neurology), Stroke, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Trauma Images in emergency medicine Source Type: research

Simultaneous onset of myocardial infarction and ischemic stroke in a patient with atrial fibrillation: Multiple territory injury revealed on angiography and magnetic resonance
An 84-year-old man with a history of hypertension and paroxysmal atrial fibrillation (AF) who received no anticoagulant drugs experienced acute chest pain and transient loss of consciousness. He was transferred to our emergency room. His initial electrocardiogram showed sinus rhythm with ST-segment elevation in the I, aVL, and V1–V6 leads. His blood pressure was 158/92mmHg and his pulse was regular at 70beats per minute. A chest radiograph showed increased heart size and pulmonary vascular congestion. His troponin T level was elevated (more than 0.1ng/mL). He was diagnosed with ST-elevation myocardial infarction (MI) and...
Source: International Journal of Cardiology - February 4, 2014 Category: Cardiology Authors: Osamu Hashimoto, Kozo Sato, Yohei Numasawa, Joji Hosokawa, Masahiro Endo Tags: Online Letters to the Editor Source Type: research

157 E-Books New to JEFFLINE
Scott Library added these 157 e-books to the growing collection in May and June: Accurate Results in the Clinical Laboratory Adult Emergency Medicine Adult-Gerontology and Family Nurse Practitioner Certification Examination (4th ed.) Advanced Assessment: Interpreting Findings and Formulating Differential Diagnoses (2nd ed.) Advancing Your Career: Concepts of Professional Nursing (5th ed.) Arrhythmia Essentials Atlas of Advanced Operative Surgery Atlas of Clinical Neurology (3rd ed.) Atlas of Hematopathology: Morphology, Immunophenotype, Cytogenetics, and Molecular Approaches Atlas of Human Infectious Diseases Atlas of No...
Source: What's New on JEFFLINE - June 25, 2013 Category: Databases & Libraries Authors: Gary Kaplan Tags: All News Clinicians Researchers Students Teaching Faculty Source Type: news

Compliance with Early Use of Prophylactic Anticoagulation after Intracerebral Hemorrhage (P02.047)
CONCLUSIONS: Despite implementation of guideline-based practice, 12% of our ICH patients did not receive early prophylactic anticoagulation despite a clear lack of contraindication. Continued quality improvement towards guideline-driven care may be enhanced by the use of checklists to overcome individual physician biases and preferences.Disclosure: Dr. Hoang has nothing to disclose. Dr. John has nothing to disclose. Dr. Garg has received research support from the AHA. Dr. Busl has nothing to disclose. Dr. Temes has nothing to disclose. Dr. Bleck has nothing to disclose. Dr. Prabhakaran has nothing to disclose.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Hoang, T., John, S., Garg, R., Busl, K., Temes, R., Bleck, T., Prabhakaran, S. Tags: P02 Cerebrovascular Disease II Source Type: research

Right superior vena cava drainage into the left atrium revealed by multiples strokes after pacemaker implantation
An 84-year-old woman had undergone dual-chamber pacemaker implantation in a primary care hospital for sick sinus syndrome. The leads were inserted through the right subclavian vein because the patient was left-handed. One year later, she suffered from an ischemic stroke. During ventricular pacing, ECG showed a right bundle branch block pattern, and chest radiography (A) suggested that pacing lead tips were in the left atrium (LA) and left ventricle. After transthoracic and transesophageal echocardiography, it was initially thought that the leads passed through a patent foramen ovale. A thrombus on the ventricular lead was ...
Source: Heart Rhythm - August 2, 2012 Category: Cardiology Authors: Pierre-Yves Courand, Nicolas Girerd, Samuel Chauveau, Philippe Chevalier Tags: Images Source Type: research

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