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Total 207 results found since Jan 2013.

Vessel perforation during withdrawal of Trevo ProVue stent retriever during mechanical thrombectomy for acute ischemic stroke.
Abstract The authors report a case of an intracranial extravasation during the withdrawal of a Trevo ProVue stent retriever device in a patient being treated for acute ischemic stroke. An 82-year-old woman developed sudden left hemiparesis and aphasia during an urgent cardiac catheterization procedure for a non-ST elevation myocardial infarction. She had a baseline National Institutes of Health Stroke Scale (NIHSS) score of at least 10 and no improvement with intravenous administration of tissue plasminogen activator (tPA). Cerebral angiography was performed with conscious sedation, confirming an occlusion of the ...
Source: Journal of Neurosurgery - June 13, 2014 Category: Neurosurgery Authors: Leishangthem L, Satti SR Tags: J Neurosurg Source Type: research

Cardiovascular highlights from non-cardiology journals
Warfarin for atrial fibrillation in patients with chronic kidney disease – does the thromboembolic benefit outweigh the bleeding risk? Chronic kidney disease (CKD) predisposes to high risks for both thrombo-embolism and bleeding. As a result, understanding the risk-benefit profile for use of anticoagulation therapies among CKD patients with atrial fibrillation is important to optimize patient outcomes. However, clinical trials evaluating efficacy and safety of anti-coagulants for atrial fibrillation generally exclude CKD patients and observational studies have had conflicting results. Accordingly, this prospective co...
Source: Heart - June 9, 2014 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research

Stroke treatment, outcomes improve at hospitals participating in UCLA-led initiative
Administering a clot-dissolving drug to stroke victims quickly — ideally within the first 60 minutes after they arrive at a hospital emergency room — is crucial to saving their lives, preserving their brain function and reducing disability. Given intravenously, tPA (tissue plasminogen activator) is currently the only Food and Drug Administration–approved therapy shown to improve outcomes for patients suffering acute ischemic stroke, which affects some 800,000 Americans annually. Now, a UCLA-led study demonstrates that hospitals participating in the "Target: Stroke" national quality-improvement program have markedly...
Source: UCLA Newsroom: Health Sciences - April 23, 2014 Category: Universities & Medical Training Source Type: news

Association between periodontal disease and non-fatal ischemic stroke: a case-control study.
Conclusion. This case-control study demonstrates that periodontal disease, especially markers such as BOP and bone loss, is independently associated with ischemic stroke. PMID: 24720864 [PubMed - as supplied by publisher]
Source: Acta Odontologica Scandinavica - April 11, 2014 Category: Dentistry Authors: Lafon A, Tala S, Ahossi V, Perrin D, Giroud M, Béjot Y Tags: Acta Odontol Scand Source Type: research

Central venous oxygen saturation and carbon dioxide gap as resuscitation targets in a hemorrhagic shock
ConclusionsIn this SV‐guided bleeding and fluid resuscitation model, both ScvO2 and dCO2 correlated well with changes in SV, but only the dCO2 returned to its baseline, normal value, while ScvO2 remained significantly lower than at baseline. These results suggest that dCO2 may be a good hemodynamic endpoint of resuscitation, while ScvO2 is not strictly a hemodynamic parameter, but rather an indicator of the balance between oxygen delivery and consumption.
Source: Acta Anaesthesiologica Scandinavica - March 19, 2014 Category: Anesthesiology Authors: M. NÉMETH, K. TÁNCZOS, G. DEMETER, D. ÉRCES, J. KASZAKI, A. MIKOR, Z. MOLNÁR Tags: Original Article Source Type: research

Quick magnesium treatment fails to improve stroke outcomes, but study has silver lining
In the first study of its kind, a consortium led by UCLA physicians found that giving stroke patients intravenous magnesium within an hour of the onset of symptoms does not improve stroke outcomes.   However, the 8-year trial did find that with the help of paramedics in the field, intravenous medications can frequently be administered to stroke victims within that so-called "golden hour," during which they have the best chance to survive and avoid debilitating, long-term neurological damage.   The latter finding is a "game-changer," said Dr. Jeffrey Saver, director of the UCLA Stroke Center and a professor of ...
Source: UCLA Newsroom: Health Sciences - February 13, 2014 Category: Universities & Medical Training Source Type: news

Ipsilateral arcuate foramen and high-riding vertebral artery: implication on C1–C2 instrumentation
Conclusions: The arcuate foramen and high-riding VA are common anomalies that are often not recognized. Although ipsilateral high-riding VA and arcuate foramen rarely occur in the general population, proper identification of these anomalies on preoperative CT scan facilitates planning the safest technique for C1–C2 instrumentation.
Source: The Spine Journal - February 10, 2014 Category: Orthopaedics Authors: Hossein Elgafy, Frank Pompo, Ryan Vela, Haitham M. Elsamaloty Tags: Technical Reports Source Type: research

Results of the Austrian CT Dose Study 2010: Typical effective Doses of the most frequent CT examinations.
CONCLUSION: Variations between CT operators are generally moderate for most operators, but in some indications the ratio between the minimum and the maximum of average dose to the typical standard patients exceeds a factor of 4 or even 5. Therefore, comparing average doses to Diagnostic Reference Levels (DRLs) and optimizing protocols need to be encouraged. PMID: 24440650 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Medizinische Physik - January 16, 2014 Category: Radiology Authors: Homolka P, Leithner R, Billinger J, Gruber M Tags: Z Med Phys Source Type: research

Rationale and design of the eXplore the efficacy and safety of once-daily oral riVaroxaban for the prEvention of caRdiovascular events in patients with nonvalvular aTrial fibrillation scheduled for cardioversion trial: A comparison of oral rivaroxaban once daily with dose-adjusted vitamin K antagonists in patients with nonvalvular atrial fibrillation undergoing elective cardioversion
The objective of this study is to explore the efficacy and safety of rivaroxaban 20 mg once daily (15 mg if creatinine clearance is 30-49 mL/min) compared with dose-adjusted vitamin K antagonists (VKAs; international normalized ratio 2.0-3.0) in patients scheduled for elective cardioversion.Methods: This is a prospective, randomized, open-label, parallel group comparison of approximately 1,500 patients from 17 countries with hemodynamically stable nonvalvular atrial fibrillation of>48 hours or unknown duration. Patients will be randomized 2:1 (rivaroxaban:VKA) using 2 cardioversion strategies: the first approach is early c...
Source: American Heart Journal - January 16, 2014 Category: Cardiology Authors: Michael D. Ezekowitz, Riccardo Cappato, Allan L. Klein, A. John Camm, Chang-Sheng Ma, Jean-Yves Le Heuzey, Mario Talajic, Maurício I. Scanavacca, Panos E. Vardas, Paulus Kirchhof, Stefan H. Hohnloser, Melanie Hemmrich, Vivian Lanius, Isabelle Ling Meng, Tags: Trial Design Source Type: research

142 * transcatheter aortic valve implantation through carotid artery access under local anaesthesia
Conclusions: TAVI through the CCA approach under LA is feasible and safe in high-risk patients. It allows continuous neurological status monitoring with low risk of stroke, minimal vascular complication risk, excellent bleeding control and immediate patient mobilization. It appears a valuable alternative option compared to transapical, transaxillary or transaortic accesses for patients who cannot undergo transfemoral TAVI.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Azmoun, A., Amabile, N., Ramadan, R., Ghostine, S., Brenot, P., Caussin, C., Deleuze, P., Nottin, R. Tags: Transcatheter aortic valve implantation: Expanding indications and techniques Source Type: research

Systemic treatments for the prevention of venous thrombo-embolic events in paediatric cancer patients with tunnelled central venous catheters.
CONCLUSIONS: We found no significant effects of systemic treatments compared with no intervention in preventing (a)symptomatic VTE in paediatric oncology patients with CVCs. However, this could be a result of the low number of included participants, which resulted in low power. In one CCT, which compared one systemic treatment with another systemic treatment, we identified a significant reduction in symptomatic VTE with the addition of LMWH to AT supplementation.All studies investigated the prevalence of major and/or minor bleeding episodes, and none found a significant difference between study groups. None of the studies ...
Source: Cochrane Database of Systematic Reviews - September 11, 2013 Category: Journals (General) Authors: Schoot RA, Kremer LC, van de Wetering MD, van Ommen CH Tags: Cochrane Database Syst Rev Source Type: research

Successful outcome after traumatic rupture and secondary thrombosis of the superior sagittal sinus
A 15-year-old adolescent was admitted to the emergency department after a car accident because of severe traumatic brain injury. Upon arrival, he was sedated and intubated because of a Glasgow Coma Scale score below 8. He had isocoria with reactive pupils. An occipital puncture wound (diameter 2 cm) was profusely bleeding. His blood pressure was 85/45 mm Hg. Laboratory values identified a haemoglobin level of 4.6 mmol/l. A CT scan of the brain demonstrated a comminuted-depressed fracture of the parietal bone in the midline with a rupture of the superior sagittal sinus (SSS) and secondary thrombosis (fig...
Source: Journal of Neurology, Neurosurgery and Psychiatry - September 2, 2013 Category: Neurosurgery Authors: Oudeman, E. A., De Witt Hamer, P. C. Tags: Coma and raised intracranial pressure, Neuroimaging, Neurological injury, Stroke, Trauma CNS / PNS, Hypertension, Radiology, Drugs: musculoskeletal and joint diseases, Radiology (diagnostics), Trauma, Injury Neurological pictures Source Type: research

Vitamin K Antagonist–associated Intracerebral Hemorrhage: Lessons from a Devastating Disease in the Dawn of the New Oral Anticoagulants
Conclusions: VKA-associated ICH presents in a particularly vulnerable population and has a poor prognosis that may be reliably predicted by several clinicoradiologic features.
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2013 Category: Neurology Authors: Marta Suárez-Pinilla, Ángeles Fernández-Rodríguez, Lorena Benavente-Fernández, Sergio Calleja-Puerta Tags: Original Articles Source Type: research

A multicenter, randomized, double‐blinded, placebo‐controlled phase III study of Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR III)
BackgroundIn adults, intraventricular thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) facilitates resolution of intraventricular haemorrhage (IVH), reduces intracranial pressure, decreases duration of cerebrospinal fluid diversion, and may ameliorate direct neural injury. We hypothesize that patients with small parenchymal haematoma volumes (<30 cc) and relatively large IVH causing acute obstructive hydrocephalus would have improved clinical outcomes when given injections of low‐dose rtPA to accelerate lysis and evacuation of IVH compared with placebo. MethodsThe Clot Lysis Evaluation of Ac...
Source: International Journal of Stroke - August 1, 2013 Category: Neurology Authors: Wendy C. Ziai, Stanley Tuhrim, Karen Lane, Nichol McBee, Kennedy Lees, Jesse Dawson, Kenneth Butcher, Paul Vespa, David W. Wright, Penelope M. Keyl, A. David Mendelow, Carlos Kase, Christine Wijman, Marc Lapointe, Sayona John, Richard Thompson, Carol Thom Tags: Research Source Type: research

Compartmentalization of Immune Responses during Staphylococcus aureus Cranial Bone Flap Infection.
Abstract Decompressive craniectomy is often required after head trauma, stroke, or cranial bleeding to control subsequent brain swelling and prevent death. The infection rate after cranial bone flap replacement ranges from 0.8% to 15%, with an alarming frequency caused by methicillin-resistant Staphylococcus aureus, which is problematic because of its recalcitrance to antibiotic therapy. Herein we report the establishment of a novel mouse model of S. aureus cranial bone flap infection that mimics several aspects of human disease. Bacteria colonized bone flaps for up to 4 months after infection, as revealed by scan...
Source: The American Journal of Pathology - June 6, 2013 Category: Pathology Authors: Cheatle J, Aldrich A, Thorell WE, Boska MD, Kielian T Tags: Am J Pathol Source Type: research