Enrico Ferrante, Michele Trimboli, Giuseppe Petrecca, Francesco Allegrini
BACKGROUND: The occurrence of cerebral venous thrombosis (CVT) in patients with spontaneous intracranial hypotension (SIH) raises difficult practical questions regarding the management of the two conditions. The first-line therapy for CVT is anticoagulation (AC); however, its potential benefit in SIH/CVT patients, especially if complicated by subdural haematoma, must be carefully evaluated taking account of the intracranial haemorrhage risk. Venous system recanalization and good prognosis in SIH/CVT patients treated with epidural blood patch (EBP), the main treatment option for SIH, have been already described...
April 19, 2021: Journal of the Neurological Sciences
S A M Kularatne, Udaya Ralapanawa, Chamara Dalugama, Jayanika Jayasinghe, Sawandika Rupasinghe, Prabashini Kumarihamy
BACKGROUND: Dengue has global importance as a dreaded arboviral infection. It has 4 serotypes of epidemiological imporatnce. The classification denotes two clinical spectrums- dengue fever (DF) and dengue haemorragic fever (DHF). Most cases are stereotype and amenable to fluid resuscitation. However, unusual manifestations cause fatalities and often overlooked. This study describes 10 such dengue cases to fill the knowledge gaps. CASE PRESENTATION: All 10 patients presented to the Teaching Hospital, Peradeniya, Sri Lanka during mid-year epidemic of dengue in 2016...
December 18, 2018: BMC Infectious Diseases
Nebojsa M Antonijevic, Ivana D Zivkovic, Ljubica M Jovanovic, Dragan M Matic, Mladen J Kocica, Igor B Mrdovic, Vladimir I Kanjuh, Milica D Culafic
The superiority of dabigatran has been well proven in the standard dosing regimen in prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) and extended venous thromboembolism (VTE) treatment. Dabigatran, an anticoagulant with a good safety profile, reduces intracranial bleeding in patients with atrial fibrillation and decreases major and clinically relevant non-major bleeding in acute VTE treatment. However, several important clinical issues are not fully covered by currently available directions with regard to dabigatran administration...
2017: Current Drug Metabolism
Satya Bhusan Senapati, Sudhansu Sekhar Mishra, Manmath Kumar Dhir, Srikanta Das
Hemophilia A is an inherited, X-linked, recessive disorder caused by deficiency of clotting factor VIII. Intracranial hemorrhage is the leading cause of morbidity and mortality in these patients. Use of factor replacement products and medications had improved outcome in these patients. But in developing countries many such patients are not able to afford factor replacement products. We report a case of traumatic intracerebellar hemorrage in a hemophilia child. This child presented to us as a case of sub-acute intracerebellar hemorrage, he was managed conservatively with six units of fresh frozen plasma transfusion...
April 2016: Asian Journal of Neurosurgery
Athanassios Zissimopoulos, Theodosia Vogiatzaki, Fotini Babatsikou, Marion Velissaratou, Lukia Baloka, Evangelos Karathanos, Anastasia Pistola, Xristos Christofis, Xristos Iatrou
OBJECTIVE: Subarachnoid haemorrhage is responsible to a great extend for the death rate of patients who are hospitalised in intensive care units (ICU) with haemorrhage. The early detection of its severity plays an important role for the resulting health of the patients. Neurohormone Copeptin is the C-end of pro-arginine vasopressin in plasma has been used as a prognostic marker in a number of various illnesses (acute myocardial infarction, heart and renal failure, acute dyspnoea, intracerebral and subarachnoid haemorrhage, ischaemic stroke, liver cirrhosis, acute pancreatitis)...
September 2015: Hellenic Journal of Nuclear Medicine
S Kumar K, M Venugopal, S Rajan
Malignant transformation in middle ear cleft is an extremely rare phenomenon, squamous cell carcinoma being the most likely neoplasm. Classical hallmarks of otologic haemorrage, facial palsy and inner ear damage may not be evident in a few cases though a long history of CSOM provides accolade. We present a young male operated upon for a seemingly benign otologic supprative illness where an extensively destructive malignant disease with intracranial extension was unveiled.
April 2001: Indian Journal of Otolaryngology and Head and Neck Surgery
Wendy D Jones, Makarand Kulkarni, K Ravishankar, Rudi Borgstein, Peter Dupont
INTRODUCTION: Headache is a common presenting complaint and has a wide differential diagnosis. Clinicians need to be alert to clues that may suggest an underlying secondary aetiology. We describe a novel case of headache secondary to intracranial hypotension which was precipitated by the rupture of a spinal arachnoid cyst. CASE REPORT: A 51-year-old Indian female presented with sudden onset severe headache suggestive of a subarachnoid haemorrage. Investigations including a computed tomography brain scan, cerebrospinal fluid examination and a magnetic resonance angiogram were normal...
2010: Journal of Medical Case Reports
J Raymond, M Chagnon, J P Collet, F Guilbert, A Weill, D Roy
The safety and efficacy of endovascular treatment of unruptured intracranial aneurysms remain undetermined. A randomized trial may be the best way to demonstrate the potential benefits of endovascular management. We propose a randomized, prospective, controlled trial comparing the incidence of subarachnoid haemorrage of patients treated by endovascular coiling as compared to conservative management. We would also study a composite outcome combining SAH and the morbidity of treatment. All patients with one or more unruptured aneurysm > 3 mm eligible for endovascular treatment would be proposed to participate...
June 29, 2004: Interventional Neuroradiology
Francesca Moscuzza, Francesca Belcari, Vincenzo Nardini, Ambra Bartoli, Chiara Domenici, Armando Cuttano, Paolo Ghirri, Antonio Boldrini
INTRODUCTION: Placental anatomopathologic lesions are usually associated with pregnancy complications and neonatal impaired outcome. PATIENTS AND METHODS: We included in our study 122 patients with gestational age of 26-35 weeks. From the analysis of three pathological aspects (chorioamnionitis, funisitis and chronic hypoxia), a score was assigned to each lesion depending on the severity of the alteration, to establish a correlation with an impaired neonatal outcome in preterm newborns...
May 2011: Gynecological Endocrinology
I Márquez-Rodas, F Longo, R P Rothlin, G Balfagón
Calcitonin gene related peptide (CGRP), a 37 amino acid neuropeptide, is the most potent vasodilator known. Participation of CGRP in hypertension and related diseases, such as preeclampsia or vasospasm after subarachnoid haemorrage, is one of the most studied topics. In this review we summarize the published roles of CGRP in pathophysiology of hypertension in humans and in experimental models. We also discuss the effects of direct administration of CGRP in the treatment of hypertension and of anti-hypertensive drugs that enhance the release or response of endogenous calcitonin gene-related peptide: angiotensin converting enzyme inhibitors, selective antagonists for the angiotensin II receptor, beta-blockers, magnesium sulphate for preeclampsia and rutaecarpine, as well as the possibilities using CGRP in gene therapy for prevention of vasospasm after subarachnoid haemorrage...
March 2006: Journal of Physiology and Biochemistry
K Warin-Fresse, E Auffray-Calvier, H Desal, B Guillon, A De Kersaint-Gilly
PURPOSE: To report four cases of patient with an acute ischemic event as a presenting symptom of a berry aneurysm. PATIENTS AND METHODS: One male and three female (aged range 38 to 65 years) patients were admitted for acute stroke. The neuroradiologic finding disclosed aneurysm thrombosis, inferior to twenty five millimetres in three cases. Lumbar puncture was done in one case and showed subarachnoid haemorrage. DISCUSSION: We will discuss the hypothesis leading to the mechanism of aneurysm thrombosis...
June 2006: Journal of Neuroradiology. Journal de Neuroradiologie
H Gunawardena, R Beetham, N Scolding, S D Lhatoo
Missed cerebral aneurysms in CT-negative patients can have serious implications. We set out to determine the usefulness of cerebrospinal fluid (CSF) spectrophotometry and the individual significance of CSF oxyhaemoglobin, bilirubin and methaemoglobin in 463 CT scan-negative patients with suspected subarachnoid haemorrhage (SAH) and normal neurological examination. CSF spectrophotometry resulted in the diagnosis of an intracranial aneurysm in 2% (9/463) of patients with CT-negative suspected SAH. No aneurysms were found in patients in whom spectrophotometry was negative for haem pigments...
2004: European Neurology
C H Castaño-Duque, M de Juan-Delago, J Muñoz-Casadevall, J Martí-Fábregas, E Franquet, J Ruscalleda-Nadal, E Guardia-Mas
INTRODUCTION: The acute vertebrobasilar occlussion is usually a life-treatening disease leading to death or major disability. The treatment with heparin and the selective fibrinolysis no show good results, for this reason the local intra-arterial fibrinolysis appear as the choice treatment in patients with stroke and a agiography with basilar artery occlussion or intracranial vertebral artery occlusion. This tecnique has been proved to be effective treatment for selected patients with acute thromboembolic occlusion of the middle cerebral artery, ophthalmic artery and vertebrobasilar system, reducing the mortality in the vertebrobasilar system from 90% to 40%...
May 16, 2001: Revista de Neurologia
J A Egido, J Carod, M L Cuadrado, J L González
INTRODUCTION: Dolichoectasia of the intracranial arteries may give rise to ischaemic or haemorragic pathology and to compression phenomena. Joint dolichoectasia of the whole circle of Willis, in both the anterior and basilar portions extending to the main basal arteries is an unusual finding. CLINICAL CASE: We describe a 76 year old man who presented with vertigo with vertically downward nystagmus. On neuroimaging studies there was aneurysmal dilation of the left vertebral, basilar and both carotid arteries (in their supra-clinoid portion) and of both medial cerebral arteries...
June 1997: Revista de Neurologia
P Warren, W Garrett, A Lam, A Berry, G Kossoff
The recent development of high-resolution real-time ultrasound scanners has coincided with the awareness of the high incidence of intracranial haemorrage in low birthweight babies, resulting in a considerable expansion in the use of echoencephalography in newborns in recent years. The uses are now further expanded and an overview of the subject is presented.
January 1984: Ultrasound in Medicine & Biology
R Labauge, A Pages, M Pages, J Ribstein, J L Richard
A case of pituitary adenoma in a 55 years old man was revealed by sudden pituitary apoplexy due to haemorragic necrosis of the tumor. Neurological signs were intracranial hypertension, epistaxis and evolutive bilateral ophtalmoplegia. Case history revealed a multiple endocrine neoplasia including a pancreatic insuloma and a parathyroïd adenoma. Biological data were hypercalcemia, hypophosphoremia and elevated serum levels of prolactine and parathormone. The characteristic features of pituitary haemorragic necrosis and multiple endocrine neoplasia are reviewed...
1982: Revue Neurologique
G Galidie, R Le Gall, Y S Cordoliani, C Pharaboz, E Le Marec, G Cosnard
11 cases of cerebral venous thrombosis in adults are reported. Main clinical signs are: intracranial hypertension (headache, nausea, papilledema in 7 cases, loss of consciousness in 6 cases, neurological deficit in 6 cases, seizure in 4 cases. 1 patient is dead, who did not receive heparin treatment. Delay before diagnosis is between 2 and 20 days, and is shortened when arteriography or MRI are available and prescribed. At least one (or several) CT examination was performed in 10 patients. Direct signs of thrombosis are uneasily detected without contrast injection, seen here in 4 cases...
March 1992: Journal de Radiologie
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