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Cerebral Haemorrhage

Giuseppe Mulè, Alessandra Sorce, Marta Giambrone, Brigida Fierro, Santina Cottone, Giovanni Cerasola
Intracerebral haemorrhage (ICH) is a devastating cerebrovascular disease, which accounts to 15% of all strokes. Among modifiable risk factors for ICH, hypertension is the most frequent. High blood pressure (BP) is detected in more than 75-80% of patients with ICH. Extremely elevated BP has been associated with early hematoma growth, a relatively frequent occurrence and powerful predictor of poor outcome in patients with spontaneous ICH. On the other hand, excessively low BP might cause cerebral hypoperfusion and ultimately lead to poor outcome...
February 18, 2019: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
Josefine Thomsen, Ulrik Sprogøe
In this case report, we present a 28-year-old woman who was admitted to a neuro-intensive care unit with sub-arachnoid haemorrhage. She was intubated and haemodynamically unstable. Over five days the need for norepinephrine reached the level of 1.2 µg/kg/min to insure a sufficient cerebral perfusion pressure. Epinephrine and vasopressin were without effect in raising the blood pressure. On suspicion of tachyphylaxis the norepinephrine infusion was stopped, and no decline in blood pressure was observed. After two days without use of any vasopressor agents, the efficacy of norepinephrine returned to normal...
February 11, 2019: Ugeskrift for Laeger
Tiago Gregorio, Inês Albuquerque, Vasco Neves, Rui Reinas, Sara Pipa, Luís Azevedo, Paulo Castro Chaves
BACKGROUND: Intracerebral haemorrhage (ICH) is a devastating condition, with more than half of patients dying or becoming dependent after such an event. Natriuretic peptides, frequently used in the management of heart failure, have been shown to correlate with disease severity and prognosis in brain disorders. The aim of this study was to test the hypothesis that NT-pro-BNP correlates with disease severity and is an independent prognostic marker for non-traumatic ICH patients. METHODS: A consecutive sample of 201 non-traumatic ICH patients, who were non-comatose on admission and medically treated in a stroke unit, were evaluated for in-hospital mortality and three-month functional dependency (modified Rankin Scale >2)...
February 8, 2019: Journal of the Neurological Sciences
Anna Tölli, Charlotte Höybye, Bo-Michael Bellander, Jörgen Borg
OBJECTIVE: To explore associations between pituitary dysfunction and clinical outcome at 12 months after traumatic brain injury and aneurysmal subarachnoid haemorrhage. METHODS: Prospective cohort study of 82 patients with traumatic brain injury and 45 with aneurysmal subarachnoid haemorrhage, included at 1 neurointensive care unit. Baseline data comprised age, sex, Glasgow Coma Scale (GCS) score, S100B and pupil light reactions. Hormone data were collected in the neurointensive care unit and 3, 6 and 12 months...
February 14, 2019: Journal of Rehabilitation Medicine
S G Lum, B S Gendeh, S Husain, H S Gendeh, M R Ismail, C J Toh, A Izaham, H J Tan
Iatrogenic internal carotid artery injury is a catastrophic but uncommon complication of endonasal sinus surgery. We present our experience in managing this emergency situation. A 52-year-old man underwent revision endoscopic repair of recurrent cerebrospinal fluid leak that was complicated with profuse haemorrhage during removal of the anterior wall of sphenoid sinus using a Hajek sphenoid punch forceps. Immediate packing of the sphenoid sinus controlled the haemorrhage. Urgent angiography revealed injury at the paraclival segment of the left internal carotid artery...
January 31, 2019: Acta Otorhinolaryngologica Italica
David Lagier, David Tonon, Philippe Garrigue, Benjamin Guillet, Laura Giacomino, Jean-Charles Martin, Marie-Christine Alessi, Nicolas Bruder, Lionel J Velly
BACKGROUND: Several lipid metabolites in cerebrospinal fluid are correlated with poor outcomes in aneurysmal subarachnoid haemorrhage. Most of these metabolites bind to ubiquitous thromboxane-prostaglandin (TP) receptors, causing vasoconstriction and inflammation. Here, we evaluated terutroban (TBN), a specific TP receptor antagonist, for the prevention of post-haemorrhage blood-brain barrier disruption, neuronal apoptosis and delayed cerebral hypoperfusion. METHODS: The rat double subarachnoid haemorrhage model was produced by twice injecting (days 1 and 2) autologous blood into the cisterna magna...
February 11, 2019: Critical Care: the Official Journal of the Critical Care Forum
Roland Roelz, Christian Scheiwe, Volker A Coenen, Peter C Reinacher
Delayed Cerebral Infarction (DCI) due to Cerebral Vasospasm (CVS) is an important contributor to poor outcome after aneurysmal subarachnoid haemorrhage (aSAH). Despite established risk factors CVS and DCI are unpredictable at the individual patient level. Efficient treatments are lacking. We report a novel rescue therapy for DCI: Access to the basal cisterns by stereotactic catheter ventriculocisternostomy (STX-VCS) and direct cisternal application of the spasmolytic agent Nimodipine. On the basis of individual treatment decisions three aSAH patients who developed CVS underwent STX-VCS...
February 5, 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Ayman G Elnahry, Gehad A Elnahry
A 61-year-old male presents with diplopia of acute onset and progressive course. He has a history of previous intracranial haemorrhage that was surgically evacuated 7 years ago and was also associated with diplopia. Examination revealed left complete oculomotor nerve paralysis with a fixed and dilated left pupil. Computed tomography (CT) revealed encephalomalacia, evidence of previous craniotomy, and an incidental left parietal convexity meningioma. CT angiography of the brain revealed a left tortuous duplicate middle cerebral artery with fenestration of its proximal part, an anterior communicating artery aneurysm, and a characteristic capillary blush of the meningioma...
February 2019: Neuro-ophthalmology
Animesh Das, Sucharita Anand
No abstract text is available yet for this article.
February 5, 2019: Postgraduate Medical Journal
Simone Maria Kagerbauer, Vojtech Kadera, Lucia Maria Gordan, Manfred Blobner, Elisabeth Török, Sebastian Schmid, Armin Horst Podtschaske, Bettina Jungwirth
The aim of this study was to detect differences in functional outcome after experimental subarachnoid haemorrhage (SAH) in rodents with different hormonal status. For this purpose, the endovascular perforation model was applied to four groups of Sprague-Dawley-Rats: male intact, male neutered, female intact and female neutered animals. Initial impact was measured by ICP, CPP and cerebral blood flow in the first hour after SAH. From day 4-14, the modified hole board test was applied to assess functional and neuro-cognitive outcome...
January 28, 2019: Behavioural Brain Research
B I Geltser, I G Kurpatov, V N Kotelnikov, Yu V Zayats
Literature data of chronic obstructive pulmonary disease (COPD) and cerebrovascular diseases (CVD) comorbidity are represented in this review. Key aspects of this interaction and its importance for clinical medicine have been considered. CVD and COPD are the main mortality factors in adults, which contribute to great economic wastes. The incidence of chronic cerebral ischemia for COPD patients is almost three times as high as for general population. The incidence of ischemic stroke for COPD patients is 1,2 times higher than in general population...
April 19, 2018: Terapevticheskiĭ Arkhiv
Christodoulos Dolapsakis, Eleftheria Kranidioti, Sofia Katsila, Michael Samarkos
We report a case of septic thrombosis of the right cavernous sinus in a diabetic woman in her late 70's due to ipsilateral sphenoid sinusitis. The diagnosis was delayed and made only after the abrupt and dramatic appearance of the manifestations of sinus thrombosis. The patient developed, among the other symptoms, right peripheral facial palsy, which is a very rare manifestation in cavernous sinus thrombosis (CST). She was treated with broad-spectrum antibiotics and enoxaparin. The day of the scheduled drainage of sphenoid sinus-24 hours after the initiation of anticoagulation-she developed fatal subarachnoid haemorrhage...
January 29, 2019: BMJ Case Reports
Oscar M P Jolobe
No abstract text is available yet for this article.
January 17, 2019: QJM: Monthly Journal of the Association of Physicians
Pouya Entezami, Alan Boulos, Junichi Yamamoto, Matthew Adamo
Developmental venous anomalies (DVAs) are the most commonly encountered cerebral malformations. While generally asymptomatic and discovered as incidental findings, there is a small number that can cause intracranial haemorrhage, usually attributed to associated cavernomas; however, venous thrombosis of the draining vein is a rare cause. A 10-year-old woman presented with seizure episodes. Angiographic evaluation revealed a collection of vessels draining into the superior sagittal sinus via the vein of Trolard, concerning for a DVA...
January 17, 2019: BMJ Case Reports
Amna Bibi, Chathuri Liyanapthirana, Sajjad Khan
This is a case of a female patient presented with a mild headache associated with recurrent episodes of nausea and vomiting, confusion and right-sided hemiparesis, diagnosed of haemorrhagic venous infarction from the thrombosis of left transverse and sigmoid sinus and probably the left vein of Labbe. She had severe microcytic hypochromic anaemia due to iron deficiency, without any other risk factors for cerebral venous thrombosis such as trauma history, infections, coagulation disorders or autoimmune diseases...
January 17, 2019: BMJ Case Reports
Thorsten Fischer, Manfred Mörtl, Philipp Reif, Herbert Kiss, Uwe Lang
In 2017, the Austrian Society for Paediatric and Adolescent Medicine (ÖGKJ) published a guideline on the primary care of premature infants at the limit of viability. In this guideline, it is recommended that a Caesarean section be preferred as mode of delivery with regard to an early preterm birth (22 + 0 - 24 + 6 weeks of pregnancy) due to an allegedly lower perinatal risk of cerebral haemorrhage. In contrast to this, the Austrian Society for Gynaecology and Obstetrics (OEGGG) considers there to be no clinical and scientific basis for this recommendation and the mode of delivery in the case of early preterm birth must be adapted to the individual maternal and foetal clinical situation...
December 2018: Geburtshilfe und Frauenheilkunde
Robert Spaull, Bryony McPherson, Andriana Gialeli, Aled Clayton, James Uney, Axel Heep, Óscar Cordero-Llana
BACKGROUND: Preterm infants are at risk of germinal matrix haemorrhage-intraventricular haemorrhage (GMH-IVH) which leads to post-haemorrhagic hydrocephalus (PHH) in 30% of infants; this is associated with moderate-severe neurodevelopmental impairment and confers significant risk of cerebral palsy. There are however no predictive indicators of the severity or long-term outcome after GMH-IVH. In recent years, endosome-derived extracellular vesicles (EVs) or exosomes have been isolated from biofluids and shown to mediate intercellular communication via selective enrichment in proteins and micro-RNAs...
January 9, 2019: International Journal of Developmental Neuroscience
M Hollingworth, A A B Jamjoom, D Bulters, H C Patel
BACKGROUND: Delayed cerebral ischemia (DCI) is an independent predictor of an unfavorable outcome after aneurysmal subarachnoid hemorrhage (aSAH). Many centers, but not all, use transcranial Doppler (TCD) to screen for vasospasm to help predict DCI. We used the United Kingdom and Ireland Subarachnoid Haemorrhage (UKISAH) Registry to see if outcomes were better in centers that used TCD to identify vasospasm compared to those that did not. METHODS: TCD screening practices were ascertained by national survey in 13 participating centers of the UKISAH...
January 12, 2019: Acta Neurochirurgica
Ji Liu, Guanen Zhou, Bradley J Kolls, Yanli Tan, Chuan Fang, Haichen Wang, Daniel T Laskowitz
Objective: Subarachnoid haemorrhage (SAH) accounts for 3% of all strokes, and is associated with significant morbidity and mortality. There is growing evidence implicating apolipoprotein E (apoE) in mediating adaptive anti-inflammatory and neuroprotective responses following ischaemic and traumatic brain injury. In the current study, we test the efficacy of a small apoE mimetic peptide, CN-105 in a murine model of SAH. Methods: Mice subjected to SAH received repeated intravenous injections of CN-105 every 12 hours for 3 days, with the first dose given 2 hours after injury...
December 2018: Stroke and Vascular Neurology
Rajalakshmi Poyuran, Anita Mahadevan, Arivazhagan Arimappamagan, B N Nandeesh, Madhu Nagappa, Jitender Saini, K V L Narasinga Rao, Yasha T Chickabasaviah
Cerebral amyloid angiopathy (CAA) is the second most common cause of non-traumatic intracerebral haemorrhage (ICH) accounting for 12-15% of lobar haemorrhages in the elderly. Definitive diagnosis of CAA requires histological evaluation. We aimed to evaluate the spectrum of cerebrovascular changes in CAA-related ICH. Between 2011 and 2015, biopsy-confirmed cases of CAA were retrieved and clinical, radiological and pathological features were reviewed. The spectrum of vascular alterations was evaluated and amyloid deposition was graded in accordance with the Greenberg and Vonsattel scale...
January 7, 2019: Virchows Archiv: An International Journal of Pathology
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