keyword
https://read.qxmd.com/read/37840126/use-of-levosimendan-in-hemodynamic-management-of-heart-failure-in-two-neonates-with-intracranial-arteriovenous-shunts-a-case-series
#21
JOURNAL ARTICLE
Francesca Landolfo, Paola Giliberti, Domenico Umberto De Rose, Flaminia Pugnaloni, Alessandra Santisi, Claudia Columbo, Ludovica Martini, Maria Paola Ronchetti, Luca Di Chiara, Alessandra Toscano, Carlo Gandolfo, Andrea Dotta, Irma Capolupo
BACKGROUND: The hemodynamic status of newborns with intracranial arteriovenous shunts (AVSs) may be extremely complex. Mini-invasive hemodynamic monitoring through innovative techniques such as Near-Infrared Spectroscopy (NIRS) and Pressure Recording Analytical Method (PRAM) may help in understanding hemodynamics in newborns with AVSs. Levosimendan is a calcium sensitizer and inodilator, and it is known to improve ventricular function, but its use in newborns is limited. In our cases, we evaluated the effect of levosimendan on hemodynamics through NIRS and PRAM...
October 15, 2023: Italian Journal of Pediatrics
https://read.qxmd.com/read/37830801/stenting-for-venous-sinus-stenosis-in-patients-with-idiopathic-intracranial-hypertension-an-updated-systematic-review-and-meta-analysis-of-the-literature
#22
JOURNAL ARTICLE
Jaims Lim, Andre Monteiro, Cathleen C Kuo, Wady T Jacoby, Justin M Cappuzzo, Alexander B Becker, Jason M Davies, Kenneth V Snyder, Elad I Levy, Adnan H Siddiqui
BACKGROUND AND OBJECTIVES: Although venous sinus stenting (VSS) improves cerebrospinal fluid reabsorption and decreases intracranial pressure in patients with idiopathic intracranial hypertension (IIH), the underlying pathophysiology of IIH is not well understood. We present a review and meta-analysis of the literature on VSS for IIH treatment, focusing on the rates of restenosis and symptom recurrence. METHODS: We performed a systematic review of PubMed and Embase databases between January 1, 2011, and December 31, 2021...
October 13, 2023: Neurosurgery
https://read.qxmd.com/read/37795563/therapy-intensity-level-scale-for-traumatic-brain-injury-clinimetric-assessment-on-neuro-monitored-patients-across-52-european-intensive-care-units
#23
JOURNAL ARTICLE
Shubhayu Bhattacharyay, Erta Beqiri, Patrick Zuercher, Lindsay Wilson, Ewout W Steyerberg, David W Nelson, Andrew I R Maas, David K Menon, Ari Ercole
Intracranial pressure (ICP) data from traumatic brain injury (TBI) patients in the intensive care unit (ICU) cannot be interpreted appropriately without accounting for the effect of administered therapy intensity level (TIL) on ICP. A 15-point scale was originally proposed in 1987 to quantify the hourly intensity of ICP-targeted treatment. This scale was subsequently modified-through expert consensus-during the development of TBI Common Data Elements to address statistical limitations and improve usability...
November 2, 2023: Journal of Neurotrauma
https://read.qxmd.com/read/37770798/closure-intracranial-pressure-as-a-determinant-of-surgical-decompression-adequacy-in-spontaneous-supratentorial-intracerebral-haematoma-a-multicentre-observational-study
#24
JOURNAL ARTICLE
Jia Xu Lim, Nivedh Dinesh, Jiani Sherry Liu, Rambert Wee, Sukit Shu Kiat Chan, Julian Xinguang Han, Min Wei Chen
PURPOSE: Despite significant advances, the literature on the optimal surgical treatment for spontaneous supratentorial intracerebral haematoma (ICH) remains lacking. Intraoperative ICP measured on closure (closure ICP) was reported to be a potential marker of adequate decompression in various neurosurgical conditions. We hypothesize that closure ICP also correlates with outcomes in ICH. METHODS: A multicentre retrospective study of 203 decompressive surgeries performed for ICHs was conducted (clot evacuation with either craniectomy or craniotomy)...
September 28, 2023: Acta Neurochirurgica
https://read.qxmd.com/read/37701249/perplexing-initial-presentations-of-mogad-in-two-children-intracranial-hypertension-and-new-onset-seizure
#25
Daniel J Zhou, Andria M Powers, Caleb A Cave, Emily K Dickas, Mary C Rickard, Geetanjali Rathore, Rhonda R Wright, Rana K Zabad, Sookyong Koh
We report two distinct challenging initial presentations of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Case 1 describes a 12-year-old boy who developed headaches refractory to pain medication followed by cranial neuropathies and intracranial hypertension, confirmed by lumbar puncture with an opening pressure >36 cm H2 O. Case 2 describes a 3-year-old boy who developed new-onset seizures refractory to antiseizure medications, a presentation of FLAIR-hyperintense lesions in MOG-antibody associated encephalitis with seizures (FLAMES)...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37589472/transverse-venous-stenting-for-the-treatment-of-idiopathic-intracranial-hypertension-with-a-pressure-gradient-of-70-mm-hg-a-technical-note-and-systematic-review
#26
JOURNAL ARTICLE
Marc Ghanem, Kareem El Naamani, Abbas Rawad, Stavropoula I Tjoumakaris, M Reid Gooch, Robert H Rosenwasser, Pascal M Jabbour
BACKGROUND AND IMPORTANCE: Venous sinus stenosis is believed to play a role in the pathogenesis of idiopathic intracranial hypertension (IIH). Venous stenting has emerged as a promising treatment option for patients with IIH because of venous sinus stenosis refractory to medical management or unsuitable for shunt placement. In this technical note, we present a case of IIH with the highest recorded pressure gradient to date. CLINICAL PRESENTATION: This technical note presents the successful use of intracranial venous stenting in a patient with IIH because of severe venous sinus stenosis, leading to significant improvement in vision and reduction in intracranial pressure...
August 17, 2023: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/37576534/intracranial-hypertension-following-acute-mesenteric-ischemia-a-case-study-on-the-multiple-compartment-syndrome
#27
JOURNAL ARTICLE
Derek O Pipolo, Sara Guevara, Lana Vasiljevic, Andres E Di Pietrantonio, Walter Brennan, Humberto Asmus, Alexia McCann-Molmenti, Young Min Cho, Koichiro Shinozaki, Kei Hayashida, Yu Okuma, Muhammad Shoaib, Lance B Becker, Mary E Decker, Hermoon A Worku, Petra Majdak, Grace Donzelli, Akash Patel, Sherwin Davoud, Andres Vaca-Zorrilla, Sascha S Beutler, Ernesto P Molmenti, Santiago J Miyara
In this case study, we describe a 25-year-old male who was admitted due to a severe traumatic brain injury, requiring invasive intracranial pressure monitoring. At 48 hours posttrauma, he developed intracranial hypertension refractory to medical treatment without tomographic changes in the brain. Subsequently, intra-abdominal hypertension and tomographic signs of abdominal surgical pathology were observed. An exploratory laparotomy was performed with an intraoperative diagnosis of acute mesenteric ischemia...
September 2023: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://read.qxmd.com/read/37532593/pentobarbital-coma-for-management-of-intracranial-hypertension-following-traumatic-brain-injury-lack-of-early-response-to-treatment-portends-poor-outcomes
#28
JOURNAL ARTICLE
Brittany M Stansbury, Caitlin J Kelley, Robert F Rudy, Sophia S Bonnin, Kristina M Chapple, Laura A Snyder, Jordan A Weinberg, Dih-Dih Huang
INTRODUCTION: Traumatic brain injury (TBI) results in the death of over 50,000 and the permanent disability of 80,000 individuals annually in the United States. Much of the permanent disability is the result of secondary brain injury from intracranial hypertension (ICH). Pentobarbital coma is often instituted following the failure of osmotic interventions and sedation to control intracranial pressure (ICP). The goal of this study was to evaluate the efficacy of pentobarbital coma with respect to ICP management and long-term functional outcome...
July 19, 2023: American Journal of Surgery
https://read.qxmd.com/read/37499303/venous-sinus-stenting-for-idiopathic-intracranial-hypertension-patients-with-functioning-ventriculoperitoneal-shunts-a-case-series
#29
JOURNAL ARTICLE
Kareem El Naamani, Rawad Abbas, Stavropoula I Tjoumakaris, Nabeel A Herial, Hekmat Zarzour, Richard F Schmidt, Robert H Rosenwasser, Pascal M Jabbour, James Evans, M Reid Gooch
Idiopathic intracranial hypertension (IIH) is a disease defined by increased intracranial pressure and associated with a variety of symptoms ranging from headaches to tinnitus. Ventricular peritoneal shunting has been the mainstay treatment for patients with IIH. Although VPS's have shown efficacy in treating IIH, some patients complain of refractory symptoms even with functioning VPS's. Venus stenting has emerged as a new technique for treating these refractory symptoms. Despite the scarce literature pertaining its efficacy and safety profile, several small studies have shown promising results...
July 13, 2023: Clinical Neurology and Neurosurgery
https://read.qxmd.com/read/37426433/balanced-volatile-sedation-with-isoflurane-in-critically-ill-patients-with-aneurysmal-subarachnoid-hemorrhage-a-retrospective-observational-study
#30
JOURNAL ARTICLE
Martin B Müller, Nicole A Terpolilli, Susanne M Schwarzmaier, Josef Briegel, Volker Huge
INTRODUCTION: In patients with severe aneurysmal subarachnoid hemorrhage (SAH) deep sedation is often used early in the course of the disease in order to control brain edema formation and thus intracranial hypertension. However, some patients do not reach an adequate sedation depth despite high doses of common intravenous sedatives. Balanced sedation protocols incorporating low-dose volatile isoflurane administration might improve insufficient sedation depth in these patients. METHODS: We retrospectively analyzed ICU patients with severe aneurysmal SAH who received isoflurane in addition to intravenous anesthetics in order to improve insufficient sedation depth...
2023: Frontiers in Neurology
https://read.qxmd.com/read/37423091/limitations-of-prone-positioning-in-patients-with-aneurysmal-subarachnoid-hemorrhage-and-concomitant-respiratory-failure
#31
JOURNAL ARTICLE
Jan Leppert, Claudia Ditz, Noura Souayah, Carianne Behrens, Volker M Tronnier, Jan Küchler
OBJECTIVE: Prone positioning (PP) is an established treatment modality for respiratory failure. After aneurysmal subarachnoid hemorrhage (aSAH), PP is rarely performed considering the risk of intracranial hypertension. The aim of this study was to analyze the effects of PP on intracranial pressure (ICP), cerebral perfusion pressure (CPP) and cerebral oxygenation following aSAH. PATIENTS AND METHODS: Demographic and clinical data of aSAH patients admitted over a 6-year period and treated with PP due to respiratory insufficiency were retrospectively analyzed...
July 5, 2023: Clinical Neurology and Neurosurgery
https://read.qxmd.com/read/37420136/indirect-comparisons-of-efficacy-of-zanubrutinib-versus-orelabrutinib-in-patients-with-relapsed-or-refractory-chronic-lymphocytic-leukemia-small-lymphocytic-lymphoma-or-relapsed-or-refractory-mantle-cell-lymphoma
#32
JOURNAL ARTICLE
Yuqin Song, Keshu Zhou, Shenmiao Yang, Jianda Hu, Dehui Zou, Sujun Gao, Ling Pan, Tingyu Wang, Haiyan Yang, Huilai Zhang, Daobin Zhou, Jie Ji, Wei Xu, Ru Feng, Jie Jin, Fangfang Lv, Haiwen Huang, Xiaosi Fan, Sheng Xu, Jun Zhu
We conducted two indirect comparisons to estimate the efficacy of zanubrutinib versus orelabrutinib in Chinese patients with relapsed or refractory (R/R) chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) or R/R mantle cell lymphoma (MCL). An unanchored matching-adjusted indirect comparison (MAIC) was performed in R/R CLL/SLL patients. Individual patient data from zanubrutinib trial (BGB-3111-205) were adjusted to match the aggregated data from the orelabrutinib trial (ICP-CL-00103). A naïve comparison was performed in R/R MCL for the different response assessment methodology and efficacy analysis set between the zanubrutinib (BGB-3111-206) and orelabrutinib (ICP-CL-00102) trials...
August 2023: Investigational New Drugs
https://read.qxmd.com/read/37410913/idiopathic-intracranial-venous-hypertension-toward-a-better-understanding-of-venous-stenosis-and-the-role-of-stenting-in-idiopathic-intracranial-hypertension
#33
JOURNAL ARTICLE
Marc J Dinkin, Athos Patsalides
BACKGROUND: Venous sinus stenosis, typically at the junction of the transverse and sigmoid sinus, is increasingly recognized as a contributor to the pathophysiology of idiopathic intracranial hypertension (IIH), whether it be the intrinsic type that does not reverse with normalization of intracranial pressure or the extrinsic type, which does. Efforts to treat the stenosis and reduce the associated transstenotic gradient through placement of a stent at the site of stenosis have been studied over the past 2 decades, primarily through retrospective studies, with variable emphasis on formal visual testing and direct assessment of poststent opening pressure...
July 5, 2023: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://read.qxmd.com/read/37402573/correlations-between-intravascular-pressure-gradients-and-cerebral-blood-flow-in-patients-with-symptomatic-medically-refractory-anterior-circulation-artery-stenosis-an-exploratory-study
#34
JOURNAL ARTICLE
Long Li, Bin Yang, Adam A Dmytriw, Yanling Li, Haozhi Gong, Xuesong Bai, Chao Zhang, Jian Chen, Jia Dong, Yabing Wang, Peng Gao, Tao Wang, Jichang Luo, Xin Xu, Yao Feng, Xiao Zhang, Renjie Yang, Yan Ma, Liqun Jiao
BACKGROUND: Fractional flow reserve is widely used in coronary disease management, with a threshold of 0.80. However, similar thresholds are unclear in functional assessment of intracranial atherosclerotic stenosis (ICAS). OBJECTIVE: To investigate the potential threshold values in functional assessment of ICAS by studying the relation between pressure-derived indexes and perfusion parameters derived from arterial spin labeling (ASL). METHODS: Patients were consecutively screened between June 2019 and December 2020...
July 4, 2023: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/37397060/refractory-delayed-pneumocephalus-after-transsphenoidal-cyst-drainage-for-rathke-s-cleft-cyst-in-a-patient-with-a-cerebrospinal-fluid-shunt
#35
Tetsuo Hashiba, Masahiro Nonaka, Haruka Iwamura, Takamasa Kamei, Junichi Takeda, Akio Asai
A 75-year-old man presented with bilateral lower limb weakness to our hospital from another clinic. Radiological examinations implied the possibilities of idiopathic normal pressure hydrocephalus (iNPH) and a suprasellar cyst, but both were observed conservatively at that time. Due to the progressive gait disturbance, a lumboperitoneal shunt was implanted 1 year later. The clinical symptoms improved, but the cyst had grown after another year, causing visual impairment. Transsphenoidal drainage of the cyst was performed, but delayed pneumocephalus occurred...
June 2023: Asian Journal of Neurosurgery
https://read.qxmd.com/read/37397047/step-ladder-expansive-cranioplasty-a-novel-perspective-in-cranial-volume-augmentation-surgery
#36
JOURNAL ARTICLE
Sudip Kumar Sengupta, Shashivadhanan Sundervadhanan, Tony J Rappai, S M Sudumbrekar, Sankar Prasad Gorthi, Saurabh K Verma
Background  In face of a refractory raised intracranial pressure (ICP), surgeons most commonly resort to decompressive craniectomy (DC). Procedure leaves an unprotected brain underlying the craniectomy defect and Monro-Kellie doctrine: disrupted. Different variants of hinge craniotomies (HC) have been used with clinical outcomes comparable to DC as single stage alternatives. However, both DC and every variant of HC have a limit to the achievable volume augmentation and all invariably cause a compression of the cerebral cortex and its vasculature at the craniotomy site...
June 2023: Asian Journal of Neurosurgery
https://read.qxmd.com/read/37383443/hinge-craniotomy-as-an-alternative-technique-for-patients-with-refractory-intracranial-hypertension
#37
JOURNAL ARTICLE
Ibrahim Omerhodzic, Almir Dzurlic, Bekir Rovcanin, Kresimir Rotim, Amel Hadzimehmedagic, Adi Ahmetspahic, Zlatan Zvizdic, Nermir Granov, Enra Suljic
INTRODUCTION: Decompressive craniectomy (DC) can save brain tissue, but unfortunately it has many limitations and complications. Hinge craniotomy (HC), as less aggressive method seems to be adequate alternative not only to DC but also to conservative treatment. RESEARCH QUESTION: Presentation of the results of modified surgical techniques of cranial decompression and comparing with more and less aggressive medical options. MATERIAL AND METHODS: A prospective clinical study was conducted during 86 months...
2023: Brain Spine
https://read.qxmd.com/read/37365094/decompressive-craniectomy-as-a-second-third-tier-intervention-in-traumatic-brain-injury-a-multicenter-observational-study
#38
JOURNAL ARTICLE
Brecht Decraene, Samuel P Klein, Ian Piper, Barbara Gregson, Per Enblad, Arminas Ragauskas, Giuseppe Citerio, Iain Chambers, Jan-Oliver Neumann, Juan Sahuquillo, Karl Kiening, Laura Moss, Pelle Nilsson, Rob Donald, Tim Howells, Milly Lo, Bart Depreitere
OBJECTIVES: RESCUEicp studied decompressive craniectomy (DC) applied as third-tier option in severe traumatic brain injury (TBI) patients in a randomized controlled setting and demonstrated a decrease in mortality with similar rates of favorable outcome in the DC group compared to the medical management group. In many centers, DC is being used in combination with other second/third-tier therapies. The aim of the present study is to investigate outcomes from DC in a prospective non-RCT context...
June 22, 2023: Injury
https://read.qxmd.com/read/37273378/chronic-refractory-insomnia-in-a-patient-with-undiagnosed-bipolar-disorder-and-long-standing-traumatic-brain-injury
#39
Fairouz Ali, James L Megna, Palak A Fichadia, Freya H Shah
Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object or when an object pierces the skull and enters brain tissue. TBI can be classified into primary and secondary brain injury. Primary injury refers to the structural damage caused upon impact. Secondary injury refers to the damage from subsequent cellular processes following a prior injury, such as excitotoxicity, free radical generation, calcium-mediated damage, hypoxia, and increased intracranial pressure...
May 2023: Curēus
https://read.qxmd.com/read/37217244/negative-intracellular-regulators-of-t-cell-receptor-tcr-signaling-as-potential-antitumor-immunotherapy-targets
#40
REVIEW
Vladimir Laletin, Pierre-Louis Bernard, Cathy Costa da Silva, Geoffrey Guittard, Jacques A Nunes
Immunotherapy strategies aim to mobilize immune defenses against tumor cells by targeting mainly T cells. Co-inhibitory receptors or immune checkpoints (ICPs) (such as PD-1 and CTLA4) can limit T cell receptor (TCR) signal propagation in T cells. Antibody-based blocking of immune checkpoints (immune checkpoint inhibitors, ICIs) enable escape from ICP inhibition of TCR signaling. ICI therapies have significantly impacted the prognosis and survival of patients with cancer. However, many patients remain refractory to these treatments...
May 2023: Journal for Immunotherapy of Cancer
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