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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

IJERPH, Vol. 19, Pages 9975: Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial
Conclusions: The subluxation distance showed better results in the elastic dynamic sling, which has both proximal and distal parts, than in the Bobath sling, which holds only the proximal part. Both shoulder orthoses showed improvements in the modified Barthel index, upper-extremity function, and manual muscle testing.
Source: International Journal of Environmental Research and Public Health - August 12, 2022 Category: Environmental Health Authors: Min Gyun Kim Seung Ah Lee Eo Jin Park Min Kyu Choi Ji Min Kim Min Kyun Sohn Sung Ju Jee Yeong Wook Kim Jung Eun Son Seo Jun Lee Keum Sun Hwang Seung Don Yoo Tags: Article Source Type: research

Effects of functional electrical stimulation-cycling on shoulder pain and subluxation in patients with acute–subacute stroke: a pilot study
Functional electrical stimulation (FES)-cycling is a technique used to provide voluntary muscle contraction during a functional task. The aims were primarily to determine the effects of FES-cycling on shoulder pain and subluxation, and secondarily to evaluate the improvement of upper extremity motor function in patients with acute–subacute stroke patient. In this prospective trial, 21 patients with acute–subacute stroke, randomly assigned into the FES-cycling group or the standard rehabilitation program (control group). Analyses of shoulder subluxation were carried out by radiography. The numeric rating scale was used ...
Source: International Journal of Rehabilitation Research - February 13, 2019 Category: Rehabilitation Tags: Original articles 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

Clinical risk predictors for cerebral hyperperfusion syndrome after carotid endarterectomy
Conclusions Independent, prospective monitoring of a large cohort of CEA cases identified a brief time interval between ischaemic symptoms and endarterectomy as the clearest risk factor for CHS.
Source: Journal of Neurology, Neurosurgery and Psychiatry - April 8, 2013 Category: Neurosurgery Authors: Maas, M. B., Kwolek, C. J., Hirsch, J. A., Jaff, M. R., Rordorf, G. A. Tags: Epilepsy and seizures, Headache (including migraine), Pain (neurology), Stroke, Hypertension, Ophthalmology, Ischaemic heart disease, Disability Neurosurgery 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

Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial
Publication date: Available online 12 February 2015 Source:The Lancet Neurology Background Extracranial carotid and vertebral artery dissection is an important cause of stroke, especially in young people. In some observational studies it has been associated with a high risk of recurrent stroke. Both antiplatelet drugs and anticoagulant drugs are used to reduce risk of stroke but whether one treatment strategy is more effective than the other is unknown. We compared their efficacy in the Cervical Artery Dissection in Stroke Study (CADISS), with the additional aim of establishing the true risk of recurrent stroke. Methods W...
Source: The Lancet Neurology - February 13, 2015 Category: Neurology Source Type: research

Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation
Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam. Introduction Neurocritically ill patients often require brain magnetic resonance imaging (MRI) in addition to conventional neurological evaluations. Brain MRI can reveal structural lesions with a high sensitivity due to its excellent spatial resolution and enhanced soft tissue contrast (1–3). To acquire MRI images, patients' cooperation is imperative. However, keeping patients with ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Interventions for preventing bone disease in kidney transplant recipients.
CONCLUSIONS: Bisphosphonate therapy may reduce fracture and bone pain after kidney transplantation, however low certainty in the evidence indicates it is possible that treatment may make little or no difference. It is uncertain whether bisphosphonate therapy or other bone treatments prevent other skeletal complications after kidney transplantation, including spinal deformity or avascular bone necrosis. The effects of bone treatment for children and adolescents after kidney transplantation are very uncertain. PMID: 31637698 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - October 21, 2019 Category: General Medicine Authors: Palmer SC, Chung EY, McGregor DO, Bachmann F, Strippoli GF Tags: Cochrane Database Syst Rev 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

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

Treatment of Post-Influenza Vaccination Induced Acute Disseminated Encephalomyelitis (ADEM) with Plasma Exchange - A Case Report (P4.036)
DISCUSSION:Influenza vaccination has been rarely linked to ADEM. Due to a low-incidence of the disease, there are no established treatment guidelines. Our patient did not respond to steroids but showed marked radiographic improvement with PE. PE should be considered for refractory ADEM after influenza vaccination.Disclosure: Dr. Chahil has nothing to disclose. Dr. Pillainayagam has nothing to disclose. Dr. Schulz has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Chahil, M., Pillainayagam, C., Schulz, P. Tags: General Neurology III Source Type: research

A patient with altered mental status and possible seizure reveals an atypical aortic dissection upon workup
In this report, we present the case of a 57-year-old woman who was transported to the emergency department with an acute episode of altered mental status, presenting as a possible stroke with possible seizures. The patient's only complaint was mild low back pain. Physical examination revealed disorientation to time with no other neurologic deficits or abnormal findings. Results from initial noncontrast head computed tomography, chest radiograph, and laboratory studies were all normal, except for an elevated d-dimer and serum creatinine. Chest computed tomography with contrast demonstrated a type A aortic dissection. The pa...
Source: The American Journal of Emergency Medicine - November 18, 2013 Category: Emergency Medicine Authors: Olufolahan J. Lawal, Harinder S. Dhindsa, Joshua W. Loyd Tags: Case Reports Source Type: research

Republished: Paget's disease of bone: clinical review and update
Paget's disease (PD) is a focal disorder of bone remodelling that occurs commonly in older people. In this article, we review clinical aspects of PD with an emphasis on recent findings. The epidemiology of PD appears to be changing rapidly, with several groups in different parts of the world reporting a marked reduction in the prevalence and incidence of PD, as well as in the severity of disease seen by clinicians. These findings seem most likely to be caused by changes in exposure to unknown environmental factors that have a role in the development of PD. However, genetic factors are also important. Mutations in SQSTM1 oc...
Source: Postgraduate Medical Journal - May 17, 2014 Category: Journals (General) Authors: Bolland, M. J., Cundy, T. Tags: Pain (neurology), Stroke, Breast cancer, Epidemiology, Calcium and bone Republished best practice 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

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