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Sample records for intracranial hemorrhages perinatal

  1. Nontraumatic intracranial hemorrhage.

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    Fischbein, Nancy J; Wijman, Christine A C

    2010-11-01

    Nontraumatic (or spontaneous) intracranial hemorrhage most commonly involves the brain parenchyma and subarachnoid space. This entity accounts for at least 10% of strokes and is a leading cause of death and disability in adults. Important causes of spontaneous intracranial hemorrhage include hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformations, and hemorrhagic infarcts (both venous and arterial). Imaging findings in common and less common causes of spontaneous intracranial hemorrhage are reviewed.

  2. Computed tomography and intracranial hemorrhages in the neonate

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    Shibata, Iekado; Kushida, Yoshimasa; Shishido, Masaru; Nagasawa, Sadatsugu; Seiki, Yoshikatsu (Toho Univ., Tokyo (Japan). School of Medicine)

    1983-02-01

    Thirty-two of 290 neonates admitted to the Perinatal Intensive Care Unit, Toho University Medical School, were examined by CT scan because of tentative clinical diagnosis of intracranial hemorrhage. CT scanner employed in this study was TCT-60 A from the Toshiba The Electric Co., Ltd. Fourteen cases (44%) were confirmed by the CT scan to have intracranial hemorrhage. Four cases had hemorrhage in the ventricle, while the remaining ten cases had subarachnoid hemorrhage. Subdural hemorrhage was not revealed in our series. Three of the four cases with intraventricular hemorrhage showed a typical subependymal germinal matrix hemorrhage. The prognosis of intraventricular hemorrhage in neonates seemed to be poor; two of the four cases died within a week. Their body weight at birth was apparently under the standard, and their Apgar score was 3 points. The subarachnoid hemorrhage was the main type of intracranial neonatal hemorrhages. In our series, it was constituted approximately 70% of the intracranial hemorrhages. The CT images of the subarachnoid hemorrhage in neonate were greatly different from those in adults. An irregular, wide high-density area around the falxtentorial junction was characteristic of the CT in many neonatal subarachnoid hemorrhages. In severe subarachnoid hemorrhages, a characteristic Y-shaped, high-density figure was demonstrated. In cases of subarachnoid hemorrhage from the deep venous system, high-density spreading immediately ventral to the falx-tentrium junction was demonstrated. These high-density areas due to blood in the subarachnoid space rapidly disappeared with the lapse of time. On the other hand, high-density areas in cerebral cisterns and/or fissures were rarely demonstrated in neonatal subarachnoid hemorrhages. The prognosis of subarachnoid hemorrhage in neonates was fairly good in the sense of life and cerebral functions.

  3. Intracranial Hemorrhage in Pregnancy

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    Afshan B. Hameed

    2012-11-01

    Full Text Available A pregnant woman with a mechanical prosthetic mitral valve was anticoagulated with low-molecular-weight heparin in the first trimester followed by warfarin until 36 weeks' gestation. She was then switched to intravenous unfractionated heparin infusion to allow for regional anesthesia in anticipation of vaginal delivery. She developed severe headache on hospital day 2 that was refractory to pain medications. Cranial imaging demonstrated a large subdural hematoma with midline shift. She delivered a healthy baby girl by cesarean section. Eventually, symptoms and intracranial abnormalities resolved over time. In conclusion, subdural hematoma is a relatively rare complication that requires multidisciplinary management plan.

  4. Hemostasis in Intracranial Hemorrhage

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    Gulati, Deepak; Dua, Dharti; Torbey, Michel T.

    2017-01-01

    Spontaneous non-traumatic intracerebral hemorrhage (ICH) is associated with high morbidity and mortality throughout the world with no proven effective treatment. Majority of hematoma expansion occur within 4 h after symptom onset and is associated with early deterioration and poor clinical outcome. There is a vital role of ultra-early hemostatic therapy in ICH to limit hematoma expansion. Patients at risk for hematoma expansion are with underlying hemostatic abnormalities. Treatment strategy should include appropriate intervention based on the history of use of antithrombotic use or an underlying coagulopathy in patients with ICH. For antiplatelet-associated ICH, recommendation is to discontinue antiplatelet agent and transfuse platelets to those who will undergo neurosurgical procedure with moderate quality of evidence. For vitamin K antagonist-associated ICH, administration of 3-factor or 4-factor prothrombin complex concentrates (PCCs) rather than fresh frozen plasma to patients with INR >1.4 is strongly recommended. For patients with novel oral anticoagulant-associated ICH, administering activated charcoal to those who present within 2 h of ingestion is recommended. Idarucizumab, a humanized monoclonal antibody fragment against dabigatran (direct thrombin inhibitor) is approved by FDA for emergency situations. Administer activated PCC (50 U/kg) or 4-factor PCC (50 U/kg) to patients with ICH associated with direct thrombin inhibitors (DTI) if idarucizumab is not available or if the hemorrhage is associated with a DTI other than dabigatran. For factor Xa inhibitor-associated ICH, administration of 4-factor PCC or aPCC is preferred over recombinant FVIIa because of the lower risk of adverse thrombotic events. PMID:28360881

  5. Factor XIII Deficiency and Intracranial Hemorrhage

    OpenAIRE

    1990-01-01

    A 38 month old boy with excessive bleeding following circumcision as a newborn and two episodes of intracranial hemorrhage at four months and at 85 months of age is reported from the Scott and White Clinic, Temple, TX.

  6. Aspirin-Induced Neonatal Intracranial Hemorrhage

    OpenAIRE

    1994-01-01

    A term newborn infant with intracranial hemorrhage associated with maternal acetylsalicylic acid ingestion before delivery is reported from the Departments of Pediatrics and Neurology, Eastern Virginia Medical School, Norfolk, VA.

  7. Intracranial hemorrhages and late hemorrhagic disease associated cholestatic liver disease

    OpenAIRE

    2012-01-01

    Deficiency of vitamin K predisposes to early, classic or late hemorrhagic disease of the newborn (HDN); of which late HDN may be associated with serious and life-threatening intracranial hemorrhage. Late HDN is characterized intracranial bleeding in infants aged 1 week to 6 months due to severe vitamin K deficiency. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. Children with cholestatic liver dis...

  8. Intracranial hemorrhage in late hemorrhagic disease of the newborn.

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    Pooni, Puneet A; Singh, Daljit; Singh, Harmesh; Jain, B K

    2003-03-01

    This study was conducted to evaluate the clinical profile and outcome in late hemorrhagic disease of the newborn (HDN) with particular reference to intracranial hemorrhage. Infants (n = 42) presenting with late HDN from January 1998 to December 2001 were studied. Majority (76%) were in the age group of 1-3 months. All were term babies on exclusive breast-feeding and none received vitamin K at birth. 71% patients presented with intracranial hemorrhage, commonest site being intracerebral and multiple ICH. Visible external bleeding was noted in 1/3rd of patients only. Three patients expired. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. Isolated intracranial hemorrhage is a common mode of presentation.

  9. Intracranial Hemorrhage Annotation for CT Brain Images

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    Tong Hau Lee

    2011-01-01

    Full Text Available In this paper, we created a decision-making model to detect intracranial hemorrhage and adopted Expectation Maximization(EM segmentation to segment the Computed Tomography (CT images. In this work, basically intracranial hemorrhage is classified into two main types which are intra-axial hemorrhage and extra-axial hemorrhage. In order to ease classification, contrast enhancement is adopted to finetune the contrast of the hemorrhage. After that, k-means is applied to group the potential and suspicious hemorrhagic regions into one cluster. The decision-making process is to identify whether the suspicious regions are hemorrhagic regions or non-regions of interest. After the hemorrhagic detection, the images are segmented into brain matter and cerebrospinal fluid (CSF by using expectation-maximization (EM segmentation. The acquired experimental results are evaluated in terms of recall and precision. The encouraging results have been attained whereby the proposed system has yielded 0.9333 and 0.8880 precision for extra-axial and intra-axial hemorrhagic detection respectively, whereas recall rate obtained is 0.9245 and 0.8043 for extra-axial and intra-axial hemorrhagic detection respectively.

  10. Intracranial hemorrhages and late hemorrhagic disease associated cholestatic liver disease.

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    Per, Hüseyin; Arslan, Duran; Gümüş, Hakan; Coskun, Abdulhakim; Kumandaş, Sefer

    2013-01-01

    Deficiency of vitamin K predisposes to early, classic or late hemorrhagic disease of the newborn (HDN); of which late HDN may be associated with serious and life-threatening intracranial hemorrhage. Late HDN is characterized intracranial bleeding in infants aged 1 week to 6 months due to severe vitamin K deficiency. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. Children with cholestatic liver disease are at risk for developing secondary vitamin K deficiency because of fat malabsorbtion and inadequate dietary intake. In this study, we described 11 infants with cholestatic liver disease with different etiologies exhibiting intracranial hemorrhage (ICH). Six patients underwent surgical evacuation of ICH, following the administration of vitamin K and/or fresh frozen plasma. The possibility of cholestatic liver disease should be considered in the treatment of ICH due to vitamin K deficiency.

  11. Intracranial hemorrhage due to late hemorrhagic disease in two siblings.

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    Per, Hüseyin; Kumandaş, Sefer; Ozdemir, Mehmet Akif; Gümüş, Hakan; Karakukcu, Musa

    2006-07-01

    Deficiency of vitamin K predisposes to early, classic or late hemorrhagic disease of the newborn (HDN); late HDN may be associated with serious and life-threatening intracranial hemorrhage. Late HDN is characterized by intracranial bleeding in infants aged 1 week to 6 months due to severe vitamin K deficiency, occurring particularly in exclusively breastfed infants. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. In this study, we report on two siblings with intracranial bleeding who were fully breastfed without a routine supplementation of vitamin K. Vitamin K should be given to all newborns as a single, intramuscular dose of 1 mg.

  12. Intracranial Hemorrhage in Full Term Infants; A Follow-Up Study

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    Mehmet Şah İpek

    2012-12-01

    Full Text Available Introduction: The aim of this study was to determine the risk factors related to, clinical presentation and outcome of intracranial hemorrhage among full-term newborn infants.Materials and Methods: Full-term newborn infants who were diagnosed with intracranial hemorrhage in the neonatal intensive care unit of Dr. Sami Ulus Maternity and Children’s Hospital, between 2005 and 2010, were reviewed retrospectively. Cases were diagnosed with ultrasonography, computed tomography, or magnetic resonance imaging. The infants followed an average of 36 months had been underwent neurologic evaluations. Results: Fourteen full-term infants with intracranial hemorrhage were identified. The half of cases presented within the first week of life (7/14, and the most common presenting sign was seizure (8/14. Bleeding were placed frequently intraventricular (9/14 and subarachnoid (7/14, while 8 patients had two or more hemorrhage areas. The majority of cases (11/14 had a causal or contributory risk factor for intracranial hemorrhage. Only one patient required neurosurgical intervention. Two patients died during the neonatal period, and another with severely handicapped at ten months of age. Of the survivors, two patients showed severe neurodevelopmental delay, while one patient showed mild. The remaining 8 patients had a favorable outcome. Conclusions: Intracranial hemorrhage in the term newborn is usually associated with perinatal risk factors. Because of neurodevelopmental outcome may surprisingly be normal, despite severe hemorrhage, the long-term outcome is difficult to predict. (Journal of Current Pediatrics 2012; 10: 85-91

  13. Intracranial drug delivery for subarachnoid hemorrhage.

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    Macdonald, Robert Loch; Leung, Ming; Tice, Tom

    2012-01-01

    Tice and colleagues pioneered site-specific, sustained-release drug delivery to the brain almost 30 years ago. Currently there is one drug approved for use in this manner. Clinical trials in subarachnoid hemorrhage have led to approval of nimodipine for oral and intravenous use, but other drugs, such as clazosentan, hydroxymethylglutaryl CoA reductase inhibitors (statins) and magnesium, have not shown consistent clinical efficacy. We propose that intracranial delivery of drugs such as nimodipine, formulated in sustained-release preparations, are good candidates for improving outcome after subarachnoid hemorrhage because they can be administered to patients that are already undergoing surgery and who have a self-limited condition from which full recovery is possible.

  14. Rapid growth of an infectious intracranial aneurysm with catastrophic intracranial hemorrhage.

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    Koffie, Robert M; Stapleton, Christopher J; Torok, Collin M; Yoo, Albert J; Leslie-Mazwi, Thabele M; Codd, Patrick J

    2015-03-01

    Infectious intracranial aneurysms are rare vascular lesions that classically occur in patients with infective endocarditis. We present a 49-year-old man with altered mental status and headache with rapid growth and rupture of an infectious intracranial aneurysm with catastrophic intracranial hemorrhage, and review issues related to open neurosurgical and endovascular interventions.

  15. Superficial siderosis is a warning sign for future intracranial hemorrhage.

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    Linn, Jennifer; Wollenweber, Frank A; Lummel, Nina; Bochmann, Katja; Pfefferkorn, Thomas; Gschwendtner, Andreas; Bruckmann, Hartmut; Dichgans, Martin; Opherk, Christian

    2013-01-01

    Supratentorial superficial siderosis (SS) is a frequent imaging marker of cerebral amyloid angiopathy (CAA). It is most probably caused by focal subarachnoid hemorrhages (fSAHs). Based on single-case observations, it has been proposed that such fSAHs might be a predisposing factor for future intracranial hemorrhage. Here we tested the hypothesis if a SS as a residue of fSAHs must be regarded as a warning sign for future intracranial hemorrhage. Fifty-one consecutive patients with SS and no apparent cause other than possible or probable CAA were identified through a database search and followed-up for a median interval of 35.3 months (range 6-120 months). Main outcome measures were rate and location of new intracranial hemorrhages. Twenty-four patients (47.1 %) had experienced any new intracranial hemorrhage, 18 patients (35.3 %) had an intracerebral hemorrhage (ICH), and in 13 of them (25.5 %), the hemorrhage was located at the site of pre-existing siderosis. Six patients (11.7 %) had developed a new subarachnoid hemorrhage (SAH), four of them at the site of siderosis. Patients with SS are at substantial risk for subsequent intracranial hemorrhage. SS can be considered a warning sign of future ICH or SAH, which frequently occur adjacent to pre-existing SS. Prospective studies are needed to confirm these findings.

  16. A retrospective study of spontaneous intracranial hemorrhage

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    Eka J. Wahjoepramono

    2016-02-01

    Full Text Available Spontaneous intracerebral hemorrhage (SICH is a serious disease despite progressing medical knowledge. SICH appears suddenly without warning, unlike ischemic strokes that are often preceded by a transient ischemic attack. Outcome is determined by the initial severity of the bleeding; mortality and morbidity of SICH are high. The aim of this study was to describe the characteristics of type, location, and outcome of SICH. A retrospective review was conducted on the records of 2042 cases admitted to a private hospital in Karawaci, Tangerang, between 1 January 1996 to 31 December 2008. Analysis was done on type, location, and the final outcome measures by the Glasgow Outcome Scale (GOS. The results of the study showed that the most prevalent type of SICH was hypertensive stroke, amounting to 1698 cases (83.1%, and the least commonly encountered type was dural fistula totaling  5 cases (0.3%. SICH due to hypertensive stroke frequently occurred in the basal ganglia (50.8% comprising the putamen, caudate nucleus and globus pallidus. On average, the outcome at the time of dismissal was good, where 105 cases (88.2% were GOS 4 and 5. SICH requires prompt and appropriate management. Therefore the signs and symptoms of intracranial hemorrhage should be promptly recognized and followed by appropriate ancillary examinations in order to promptly determine the management required, including possible surgical interventions.

  17. Intracranial hemorrhage in congenital bleeding disorders.

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    Tabibian, Shadi; Motlagh, Hoda; Naderi, Majid; Dorgalaleh, Akbar

    2017-09-09

    : Intracranial hemorrhage (ICH), as a life-threatening bleeding among all kinds of congenital bleeding disorders (CBDs), is a rare manifestation except in factor XIII (FXIII) deficiency, which is accompanied by ICH, early in life, in about one-third of patients. Most inherited platelet function disorders (IPFDs) are mild to moderate bleeding disorders that can never experience a severe bleeding as in ICH; however, Glanzmann's thrombasthenia, a common and severe inherited platelet function disorder, can lead to ICH and occasional death. This bleeding feature can also be observed in grey platelet syndrome, though less frequently than in Glanzmann's thrombasthenia. In hemophilia, intracerebral hemorrhage is affected by various risk factors one of which is the severity of the disease. The precise prevalence of ICH in these patients is not clear but an estimated incidence of 3.5-4% among newborns with hemophilia is largely ascertained. Although ICH is a rare phenomenon in CBDs, it can be experienced by every patient with severe hemophilia A and B, FXIII deficiency (FXIIID), FVIID, FXD, FVD, FIID, and afibrinogenemia. Upon observing the general signs and symptoms of ICH such as vomiting, seizure, unconsciousness, and headache, appropriate replacement therapies and cranial ultrasound scans must be done to decrease ICH-related morbidity and mortality.

  18. [Correction of intracranial pressure in patients with traumatic intracranial hemorrhages].

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    Virozub, I D; Chipko, S S; Chernovskiĭ, V I; Cherniaev, V A

    1986-01-01

    Therapeutical correction of intracranial pressure changes were conducted in 14 patients suffering from traumatic intracranial hematomas by endolumbar administration of physiological solution. The distinguishing feature of this method is the possibility of continuous control of the intracranial pressure level by means of long-term graphic recording of epidural pressure. This makes it possible to perform endolumbar administration of physiological solution in a dose which is determined by the initial level of epidural intracranial pressure. Therapeutic correction of intracranial pressure by endolumbar injection of physiological solution proved successful in the initial stages of dislocation of the brain and in stable intracranial hypotension.

  19. NEUROMONITORING IN PATIENTS WITH INTRACRANIAL NONTRAUMATIC HEMORRHAGE

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    M. A. Alakova

    2015-01-01

    Full Text Available Background: Investigation of patients with intracranial non-traumatic hemorrhage (INH with the use of prolonged electroencephalographic (EEG monitoring allows for more effective identification of acute symptomatic seizures, subclinic epileptiform activity, local and diffuse abnormalities that are markers of brain functional activity.Aim: To increase treatment efficacy of patients with INH.Materials and methods: Thirty three patients were assessed in acute period of INH. Assessments included clinical and neurological examination, NIHSS (National Institute of Health Stroke Severity scale, GCS (Glasgow coma scale, HHS (Hunt-Hess scale; prolonged EEG monitoring with computerized tomography and/or magnetic resonance imaging of the brain. Patients received medical and surgical treatment (minimally invasive endovascular interventions or open operations, such as aneurysm clipping or wrapping/coating.Results: Twenty seven patients had open-type surgeries (among them, 23 patients had aneurysm clipping and 4, aneurysm wrapping. Two patients underwent the procedure of aneurysm embolization. Four patients were treated conservatively. According to results of prolonged pre-, peri- and postoperative EEG monitoring, most of patients had signs of disorganized electrical activity, with no regional differences, fragmented or absent alfa rhythm and diffuse polymorphic theta-activity. Marked EEG abnormalities correlated with severity registered with the assessment scales and with outcomes. During the study, epileptiform activity was registered in 1 patient, EEG comate in 3, diffuse abnormalities in 15 and local abnormalities in 14.Conclusion: The use of prolonged pre-, peri- and postoperative EEG monitoring allows for timely identification of status epilepticus, including the one without seizures. Minimally invasive interventions performed on time are associated with better prognosis in INH patients, whereas marked EEG abnormalities are associated with low scores of

  20. Intracranial hemorrhage revealing pseudohypoparathyroidism as a cause of fahr syndrome.

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    Swami, Abhijit; Kar, Giridhari

    2011-01-01

    Pseudohypoparathyroidism is an infrequently encountered disease. It is one of the causes of Fahr syndrome which also is a rare clinical entity caused by multiple diseases. A 4-year-old man hospitalized for sudden onset left hemiparesis and hypertension was diagnosed to have right thalamic and midbrain hemorrhage on plain CT scan of the head which also revealed co-existent extensive intracranial calcifications involving the basal ganglia and cerebellum bilaterally. General physical examination revealed features of Albright hereditary osteodystrophy, goitre, hypertension, left hemiparesis, and signs of cerebellar dysfunction. Laboratory findings suggested hypocalcemia, hyperphosphatemia along with high TSH, low FT(4), low FT(3), and high anti-TPO antibody. Though bilateral intracranial calcifications are usually encountered as an incidental radiological finding in the CT scan of brain, in this case, the patient admitted for thalamic and midbrain hemorrhage was on investigation for associated intracranial calcification, and goitre was also found to have coexisting pseudohypoparathyroidism and autoimmune hypothyroidism.

  1. Intracranial Hemorrhage Revealing Pseudohypoparathyroidism as a Cause of Fahr Syndrome

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    Abhijit Swami

    2011-01-01

    Full Text Available Pseudohypoparathyroidism is an infrequently encountered disease. It is one of the causes of Fahr syndrome which also is a rare clinical entity caused by multiple diseases. A 4-year-old man hospitalized for sudden onset left hemiparesis and hypertension was diagnosed to have right thalamic and midbrain hemorrhage on plain CT scan of the head which also revealed co-existent extensive intracranial calcifications involving the basal ganglia and cerebellum bilaterally. General physical examination revealed features of Albright hereditary osteodystrophy, goitre, hypertension, left hemiparesis, and signs of cerebellar dysfunction. Laboratory findings suggested hypocalcemia, hyperphosphatemia along with high TSH, low FT4, low FT3, and high anti-TPO antibody. Though bilateral intracranial calcifications are usually encountered as an incidental radiological finding in the CT scan of brain, in this case, the patient admitted for thalamic and midbrain hemorrhage was on investigation for associated intracranial calcification, and goitre was also found to have coexisting pseudohypoparathyroidism and autoimmune hypothyroidism.

  2. Multiple intracranial hemorrhages in pregnancy: A common autoimmune etiology

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    Hans Raj Pahadiya

    2016-01-01

    Full Text Available Systemic lupus erythematosus (SLE is an autoimmune disorder, primarily affect female in fertile age. Pregnancy in SLE female is a high-risk situation which can adversely affect maternal-fetal dyad. SLE can flare during pregnancy or in postpartum period. We describe a case of a young pregnant female who presented because of right hemiparesis due multiple hemorrhages in the brain. The first presentation of the SLE with multiple intracranial hemorrhages in pregnancy, preceding the other characteristic clinical symptoms is rare. Here, we high lighten the major neurological issues and maternal-fetal dyad issues in SLE pregnancy and treatment strategies for management of SLE in pregnancy.

  3. Neurosensory outcome of prematurely born children following intracranial hemorrhage

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    Velisavljev-Filipović Gordana

    2011-01-01

    Full Text Available Introduction. More and more survival of newborns with small or extremely small body mass at birth, as well as increasing percent of prematurely born babies, have emphasized the significance of intracranial haemorrhage problem. Prematurely born infants are under increased risk for strabismus, amblyopia, blinding and hearing loss. Objective. Establishing the frequency of sensory damages (damage of sight and hearing in prematurely born infants with various degrees of intracranial haemorrhage. Methods. The study is prospective, controlled and included 120 prematurely born infants with diagnosed four different grade intracranial haemorrhage on ultrasonic examination of the central nervous system. The study excluded prematurely born children from twin pregnancies with congenital malformations and stoppage of intrauterine growth. Ophthalmological examination was done at 9, 12, and 36 months of postnatal age. Audilogical examination was done after delivery, at 2 months of age. Results. There are statistically significant differences (p<0.01 related to the presence of strabismus among groups of examinees with vairious hemorrhage degrees. Strabismus was present only in one premature infant with 1st and in 10 children (33.3% with the 4th degree. Amblyopia occurred only among examinees with 4th degree hemorrhage. There were statistically significant differences (p<0.01 related to the finding of transitory otoacoustic emission of the left ear and the right ear among the groups. The finding of the right ear was not usual in 7 examinees from the 4th degree hemorrhage. The finding of the left ear was not usual in 1 examinee from the third and in 7 examinees from the fourth group. Conclusion. Prematurely born children with a higher degree intracranial hemorrhage have a greater risk for the loss of hearing and development of visual handicap.

  4. Intracranial chordoma presenting as acute hemorrhage in a child: Case report and literature review

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    Kenneth A Moore

    2015-01-01

    Conclusion: There are few previous reports of petroclival chordomas causing acute intracranial hemorrhage. To the authors′ knowledge, this is the first case of a petroclival chordoma presenting as acute intracranial hemorrhage in a pediatric patient. Although uncommon, it is important to consider chordoma when evaluating a patient of any age presenting with a hemorrhagic lesion of the clivus.

  5. Association between linear skull fractures and intracranial hemorrhage in children with minor head trauma

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    Erlichman, David B.; Blumfield, Einat; Weiss, Amanda [Jacobi Medical Center, Department of Pediatric Radiology, Albert Einstein College of Medicine, Bronx, NY (United States); Rajpathak, Swapnil [Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (United States)

    2010-08-15

    To determine whether skull fractures can be used to associate intracranial hemorrhage with minor head trauma (MHT). We conducted a retrospective study evaluating the association between linear skull fractures and intracranial hemorrhage among children with MHT. Furthermore, we evaluated the significance of small intracranial hemorrhages by assessing the need for neurosurgical interventions. The case group included 114 children with a diagnosis of a linear skull fracture and the control group included 125 children without the diagnosis. We conducted multivariable logistic regression analyses to estimate the odds ratio (OR) between linear skull fractures and intracranial bleeding. Among the cases, 29 of 114 (25%) children were diagnosed with an intracranial hemorrhage on CT, compared to only 14 of 125 (11%) among the controls. The multivariable OR for intracranial hemorrhages comparing cases and controls adjusted for age and gender was 2.17 (95% confidence interval [CI]: 1.01, 4.68). All the intracranial hemorrhages were small (3.8 {+-} 2.3 mm) and none of them required any neurosurgical intervention. The presence of a linear skull fracture is an independent risk factor for intracranial hemorrhage. However, all the intracranial hemorrhages associated with the skull fractures were small and did not require any neurosurgical interventions. (orig.)

  6. [Neurologic complications of subarachnoid hemorrhage due to intracranial aneurysm rupture].

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    Rama-Maceiras, P; Fàbregas Julià, N; Ingelmo Ingelmo, I; Hernández-Palazón, J

    2010-12-01

    The high rates of morbidity and mortality after subarachnoid hemorrhage due to spontaneous rupture of an intracranial aneurysm are mainly the result of neurologic complications. Sixty years after cerebral vasospasm was first described, this problem remains unsolved in spite of its highly adverse effect on prognosis after aneurysmatic rupture. Treatment is somewhat empirical, given that uncertainties remain in our understanding of the pathophysiology of this vascular complication, which involves structural and biochemical changes in the endothelium and smooth muscle of vessels. Vasospasm that is refractory to treatment leads to cerebral infarction. Prophylaxis, early diagnosis, and adequate treatment of neurologic complications are key elements in the management of vasospasm if neurologic damage, lengthy hospital stays, and increased use of health care resources are to be avoided. New approaches to early treatment of cerebral lesions and cortical ischemia in cases of subarachnoid hemorrhage due to aneurysm rupture should lead to more effective, specific management.

  7. Subarachnoid hemorrhage from intracranial aneurysms during pregnancy and the puerperium.

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    Kataoka, Hiroharu; Miyoshi, Takekazu; Neki, Reiko; Yoshimatsu, Jun; Ishibashi-Ueda, Hatsue; Iihara, Koji

    2013-01-01

    Subarachnoid hemorrhage (SAH) due to the rupture of an intracranial aneurysm (IA) is a rare but serious complication of pregnancy and is responsible for important morbidity and mortality during pregnancy. This study reviewed reports of ruptured IA during pregnancy and the puerperium, and our own cases of ruptured IA in pregnant women. Hemorrhage occurred predominantly during the third trimester of pregnancy, when maternal cardiac output and blood volume increase and reach maximum. Physiological and hormonal changes in pregnancy are likely to affect the risk of IA rupture. Ruptured IAs during pregnancy should be managed based on neurosurgical considerations, and the obstetrical management of women with ruptured IAs should be decided according to the severity of SAH and the gestational age. Emergent cesarean section followed by clipping or coiling of aneurysms is indicated if the maternal condition and the gestational age allow such interventions. Although SAH during pregnancy can result in disastrous outcomes, the necessity of intracranial screening for high-risk pregnant women is still controversial.

  8. Effect of intracranial hypertension on cerebral hemorrhage induced autonomic nerve imbalance

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    Xuelong Jin; Wenli Jing; Fengxia Yan; Zhaoqiang Zhang; Fengjun Lü; Shuiqing Jing; Na Sun; Kazushige Mizoguchi

    2007-01-01

    BACKGROUND: Cerebral hemorrhage can cause the imbalance of nerve function, whereas its mechanism and main impact factors are still not quite clear.OBJECTIVE: To explore the rules about the changes of intracranial pressure in brainstem hemorrhage and internal capsule hemorrhage, and analyze the role of intracranial hypertension in the changes of nerve function caused by cerebral hemorrhage.DESIGN: A self-controlled trial.SETTING: Department of Physiology, Tianjin Medical University.MATERIALS: Sixty-five healthy male Japanese white rabbits with long ears (1.5-1.8 kg) were supplied and fed by the Department of Animal Experiment of Tianjin Medical University. The RM6240B biological signal collecting and processing system was used.METHODS: The experiments were conducted in the Department of Physiology, Tianjin Medical University from August 2001 to May 2006. ① The rabbits were anesthetized, then fixed onto the brain stereotaxic apparatus, and afterwards fenestration on skull and intubation to lateral ventricle were performed. The dynamic changes of intracranial pressure were monitored continuously. Rabbits were infused with autologous arterial blood (0.3 mL) into midbrain corpora quadrigemina inferior colliculus to induce model of acute brainstem hemorrhage; models of internal capsule hemorrhage were established by infusing autologous arterial blood into internal capsule. ② The dynamic intracranial pressures under the above conditions were recorded continuously with the RM6240B biological signal collecting and processing system. ③ An animal model of persistent intracranial hypertension was established by infusion of physiologic saline into lateral ventricle. ④ The changes of the intensity of autonomic nerve discharge were analyzed, using the biological signal collecting and processing system before and after hemorrhage and under persistent intracranial hypertension. ⑤ Ten animal models of internal capsule hemorrhage and 10 of brainstem hemorrhage were selected

  9. A rare complication of spinal anesthesia: Intracranial subdural hemorrhage

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    Cengiz Kaplan

    2015-02-01

    Full Text Available Spinal (subarachnoid anesthesia (SA is a widely used general-purpose anesthesia. Postdural Puncture Headaches (PDPHs represent one of the principal complications of spinal anesthesia. A 21-year-old man underwent inguinal herniorrhaphy and orchiectomy using spinal anesthesia. Postoperatively, our patient started to have a headache with nausea. The patient received symptomatic therapy, but the severe headache persisted even in the supine position, with his vital signs and neurological examination being normal. Cranial MRI showed a bilateral subdural hematoma from his frontal to temporal region. A postdural puncture headache is a frequent complication after spinal anesthesia. However, serious complications, such as an intracranial subdural hemorrhage, can rarely occur. [Arch Clin Exp Surg 2015; 4(1.000: 54-56

  10. Intravascular volume administration: a contributing risk factor for intracranial hemorrhage during extracorporeal membrane oxygenation?

    NARCIS (Netherlands)

    Mol, A.C. de; Gerrits, L.C.; Heijst, A.F.J. van; Straatman, H.; Staak, F.H.J.M. van der; Liem, K.D.

    2008-01-01

    OBJECTIVE: The objective of this study was to determine the relationship between the frequency and total volume of intravascular volume administration and the development of intracranial hemorrhage during venoarterial extracorporeal membrane oxygenation. METHODS: In a retrospective, matched,

  11. The role of hypertension in bromocriptine-related puerperal intracranial hemorrhage

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    Kirsch, C. [Dept. of Radiology, University Hospital, Newark, NJ (United States); Iffy, L. [Dept. of Obstetrics, Gynecology and Womens Health, University Hospital, Newark, NJ (United States); Zito, G.E. [Dept. of Neurology, University Hospital, Newark, NJ (United States); McArdle, J.J. [Dept. of Pharmacology, University Hospital, Newark, NJ (United States)

    2001-04-01

    The spate of medicolegal inquiries following the disqualification of Parlodel (bromocriptine mesylate) by the Food and Drug Administration for postpartum ablactation, uncovered previously unreported side effects associated with its postpartum administration. In 1994, bromocriptine mesylate was withdrawn from the market as a milk suppressant. Since this time, over a dozen cases of postpartum intracranial hemorrhages associated with its use have been reported. We describe three additional cases of postpartum intracranial hemorrhage related to bromocriptine usage. One patient, previously normotensive, developed hypertension and a headache; initial CT was normal, but CT 24 h later demonstrated intracranial hemorrhage. This suggests that the blood-pressure elevation was drug-induced and was the cause, rather than the consequence, of bromocriptine-related intracranial hemorrhage. (orig.)

  12. Intracranial hemorrhage of the mature newborn infant. Centering around the CT picture

    Energy Technology Data Exchange (ETDEWEB)

    Takemine, Hisao

    1983-08-01

    The labour course, treatment, and prognoses were discussed concerning four mature newborn infants with intracranial hemorrhage diagnosed by CT. Of intracranial hemorrhage, 70.7% was small hemorrhage along the cerebellar tentorium and the falx cerebri, 12.2% subdural hemorrhage in the posterior cranial fossa, and 9.8% subdural hemorrhage in the fornex. Intraventricular or extradural hemorrhage was rarely found. The prognosis is determined by the severity of neurotic symptoms due to cerebral hypoxia. Subdural hemorrhage of the posterior cranial fossa resulted in cerebral palsy in one fifth of the cases, and in slight enlargement of the ventricle in three fifths. Subdural hematoma left porencephaly in one fourth of the patients, but the remaining recovered to normal.

  13. Risk analysis for aspirin and postoperative intracranial hemorrhage - report of 3 cases

    Institute of Scientific and Technical Information of China (English)

    YU Shu-qing; WANG Ji-sheng; JI Nan; LIU Wei; QIAN Ke

    2009-01-01

    @@ Aspirin has been widely used clinically since 1899.For patients with cerebral ischemia and implanted intravascular stents, aspirin has been used routinely for prevention of intracranial hemorrhage and for anticoagulation treatment. However, many multi-center,large sample, controlled studies have shown that aspirin may actually increase the risk of spontaneous cerebral hemorrhage, and that aspirin was an independent predictor of death shortly after cerebral hemorrhage. Here we report a case series, between July 1 2006 and January 1 2008, of 3 patients who experienced postoperative intracranial hemorrhage after receiving regular aspirin treatment before surgery in the Center of Neurosurgery,Beijing Tiantan Hospital, Capital Medical University.Two of them died. There were 86 patients in all receiving regular aspirin treatment before surgery in the same period. The incidence of intracranial hemorrhage in this group is 3.49%.

  14. Therapeutic anticoagulation can be safely accomplished in selected patients with traumatic intracranial hemorrhage

    Directory of Open Access Journals (Sweden)

    Byrnes Matthew C

    2012-07-01

    Full Text Available Abstract Introduction Therapeutic anticoagulation is an important treatment of thromboembolic complications, such as DVT, PE, and blunt cerebrovascular injury. Traumatic intracranial hemorrhage has traditionally been considered to be a contraindication to anticoagulation. Hypothesis Therapeutic anticoagulation can be safely accomplished in select patients with traumatic intracranial hemorrhage. Methods Patients who developed thromboembolic complications of DVT, PE, or blunt cerebrovascular injury were stratified according to mode of treatment. Patients who underwent therapeutic anticoagulation with a heparin infusion or enoxaparin (1 mg/kg BID were evaluated for neurologic deterioration or hemorrhage extension by CT scan. Results There were 42 patients with a traumatic intracranial hemorrhage that subsequently developed a thrombotic complication. Thirty-five patients developed a DVT or PE. Blunt cerebrovascular injury was diagnosed in four patients. 26 patients received therapeutic anticoagulation, which was initiated an average of 13 days after injury. 96% of patients had no extension of the hemorrhage after anticoagulation was started. The degree of hemorrhagic extension in the remaining patient was minimal and was not felt to affect the clinical course. Conclusion Therapeutic anticoagulation can be accomplished in select patients with intracranial hemorrhage, although close monitoring with serial CT scans is necessary to demonstrate stability of the hemorrhagic focus.

  15. An autopsy case of methanol induced intracranial hemorrhage.

    Science.gov (United States)

    Kim, Hye-Jeong; Na, Joo-Young; Lee, Young-Jik; Park, Jong-Tae; Kim, Hyung-Seok

    2015-01-01

    The major component of car washer fluid is a methanol. Intracranial hemorrhage is a rare but lethal complication in methanol poisoning. We report a case of massive bilateral basal ganglia hematoma in a 32-year-old man with methanol poisoning. He drank car washer solution twice time (about 500 ml), and was admitted to a territorial hospital 10 hours post-ingestion for depressed mental status, lower blood pressure, and high anion gap metabolic acidosis. Computed tomographic (CT) scan showed lesions in both putamen and cerebral deep white matter. Twenty-one days after methanol exposure, he suddenly developed cardiorespiratory arrest. In autopsy, external examination revealed moderate cerebral edema, but no evidence of herniation. Coronal sections of the brain showed softening and about 34 g hematoma in the bilateral putamen and 3rd ventricles. The toxic effect of methanol on the visual system has been noted in the absence of neurologic manifestations; however, there have also been a report of concomitant brain in Korea.

  16. Rapid MRI evaluation of acute intracranial hemorrhage in pediatric head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, Maura E.; Jaju, Alok [Northwestern University Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States); Ciolino, Jody D. [Northwestern University, Biostatistics Collaboration Center, Department of Preventive Medicine Feinberg School of Medicine, Chicago, IL (United States); Alden, Tord [Northwestern University Feinberg School of Medicine, Department of Neurological Surgery, Chicago, IL (United States); Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Neurosurgery, Chicago, IL (United States)

    2016-08-15

    Rapid MRI with ultrafast T2 sequences can be performed without sedation and is often used in place of computed tomography (CT) to evaluate pediatric patients for indications such as hydrocephalus. This study investigated the sensitivity of rapid magnetic resonance imaging (MRI) for detection and follow-up of acute intracranial hemorrhage in comparison to CT, which is commonly the first-line imaging. Patients presenting to a pediatric hospital with acute intracranial hemorrhage on CT and follow-up rapid MRI within 48 h were included. Rapid MRI studies consisted of three plane ultrafast T2 sequences either with or without axial gradient echo (GRE) sequences. Identification of hemorrhage on rapid MRI was assessed by readers both blinded and unblinded to prior CT results. One hundred two acute hemorrhages in 61 patients were identified by CT. Rapid MRI detection of subdural and epidural hemorrhages was modest in the absence of prior CT for comparison (sensitivity 61-74 %), but increased with review of the prior CT (sensitivity 80-86 %). Hemorrhage size was a significant predictor of detection (p < 0.0001). Three plane fast T2 images alone without GRE sequences were poor at detecting subarachnoid hemorrhage (sensitivity 10-25 %); rapid MRI with GRE sequences identified the majority of subarachnoid hemorrhage (sensitivity 71-93 %). GRE modestly increased detection of other extra-axial hemorrhages. Rapid MRI with GRE sequences is sensitive for most acute intracranial hemorrhages only when a prior CT is available for review. Rapid MRI is not adequate to replace CT in initial evaluation of intracranial hemorrhages but may be helpful in follow-up of known hemorrhages. (orig.)

  17. [Two cases of acute myelogenous leukemia with Bacillus cereus bacteremia resulting in fatal intracranial hemorrhage].

    Science.gov (United States)

    Yoshida, H; Moriyama, Y; Tatekawa, T; Tominaga, N; Teshima, H; Hiraoka, A; Masaoka, T; Yoshinaga, T

    1993-12-01

    This manuscript reports Bacillus cereus sepsis in two cases with acute myelogenous leukemia (AML) who suffered complications of fatal intracranial hemorrhage during remission induction therapy. The first case was 43-year-old male with AML (M0) receiving first consolidation chemotherapy who developed sudden diarrhea, abdominal pain and spiking fever. Two days later, he died of intracranial hemorrhage. The second case was 15-year-old male with AML (M5b) who was receiving first induction chemotherapy. He developed headache and vomiting following spiking fever and diarrhea. He died of subarachnoid hemorrhage the next day. In both cases, Bacillus cereus was isolated from blood culture. Fatal intracranial hemorrhage due to severe bleeding tendency caused rapid to death in both cases. These bleeding tendencies might have been induced by B. cereus sepsis. In addition, we should not overlook B. cereus as contamination, but rather consider it as a potential pathogen, when isolated from blood culture.

  18. [Intra-cranial hemorrhage in infants due to vitamin K deficiency - report of 2 cases

    Science.gov (United States)

    Grillo, E; Silva, R J; Filho, J H

    2000-01-01

    OBJECTIVE: Drive attention to the late form of the hemorrhagic disease of the newborn, secondary to vitamin K deficiency, as a cause of intracranial hemorrhage in young infants.METHODS: The authors describe and analyze two cases of late hemorrhagic disease of the newborn, secondary to vitamin K deficiency, producing intracranially hemorrhage during the second month of age. The most important publications on this subject are reviewed.RESULTS: Both infants had not received prophylaxis with vitamin K at birth. They were both being fed exclusively on breast milk. They developed intracranial hemorrhage, and the clotting defect was rapidly corrected with intramuscular vitamin K. At 3 and 4 years of age, one of them has showed normal psychomotor development, and the other has showed moderate developmental delay with microcephaly.CONCLUSION: Late hemorrhagic disease of the newborn must be considered in young infants, between 2 and 12 weeks of age, with intracranial hemorrhage, especially those fed exclusively on breast milk who did not receive vitamin K at birth. It may produce neurodevelopmental delay. The clotting defect is rapidly corrected with intramuscular vitamin K. This condition is preventable. The prophylaxis is recommended with 1 mg of intramuscular vitamin K to all newborns, at birth, even without risk factors.

  19. Post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Su; Kim, Kyu Bo; Chie, Eui Kyu; Kim, Yoon Jun; Yoon, Jung Hwan; Lee, Hyo Suk; Ha, Sung W. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-03-15

    To evaluate the incidence and risk factors of post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma (HCC). Medical records of 81 patients who have been diagnosed of brain metastases from HCC and underwent surgery, radiosurgery and/or whole brain radiotherapy (WBRT) between January 2000 and December 2013 were retrospectively reviewed. Intracranial hemorrhage was present in 64 patients (79%) at the time of diagnosis. Median value of alpha-fetoprotein (AFP) level was 1,700 ng/mL. The Eastern Cooperative Oncology Group (ECOG) performance status for 20 patients was greater than 2. Fifty-seven patients underwent WBRT and the others were treated with surgery and/or radiosurgery without WBRT. During follow-up, 12 events of intracranial hemorrhage after treatment were identified. Three-month post-treatment hemorrhage rate was 16.1%. Multivariate analyses revealed that ECOG performance status, AFP, and WBRT were associated with post-treatment hemorrhage (p = 0.013, 0.013, and 0.003, respectively). Kaplan-Meier analysis showed that 3-month post-treatment hemorrhage rate of new lesion was higher in patients treated without WBRT, although statistical significance was not reached. (18.6% vs. 4.6%; p = 0.104). Ten of 12 patients with post-treatment hemorrhage died with neurologic cause. WBRT should be considered to prevent post-treatment hemorrhage in the treatment of brain metastases from HCC.

  20. Magnetic resonance susceptibility weighted imaging in detecting intracranial calcification and hemorrhage

    Institute of Scientific and Technical Information of China (English)

    ZHU Wen-zhen; QI Jian-pin; ZHAN Chuan-jia; SHU Hong-ge; ZHANG Lin; WANG Cheng-yuan; XIA Li-ming; HU Jun-wu; FENG Ding-yi

    2008-01-01

    Background Computed tomography (CT) is better than routine magnetic resonance imaging (MRI) in detecting intracranial calcification. This study aimed to assess the value of MR susceptibility weighted imaging (SWI) in the detection and differentiation of intracranial calcification and hemorrhage.Methods Enrolled in this study were 35 patients including 13 cases of calcification demonstrated by CT and 22 cases of intracerebral hemorrhage. MR sequences used in all the subjects included axial T1WI, T2WI and SWI. The phase shift (PS) of calcification and hemorrhage on SWI was calculated and their signal features on corrected phase images were compared. The sensitivity of T1WI, T2WI and SWI in detecting intracranial calcification and hemorrhage was analyzed statistically.Results The detection rate of SWI for cranial calcification was 98.2%, significantly higher than that of T1 Wl and T2WI. It was not significantly different from that of CT (P >0.05). There were 49 hemorrhagic lesions at different stages detected n SWI, 30 on T2WI and 18 on T1WI. The average PS of calcification and hemorrhage was +0.734han routine MRI in detecting micro-hemorrhage, SWI may play an important role in differentiating cerebral diseases associated with calcification or hemorrhage.

  1. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de [University Medical Center Utrecht, Department of Neonatology, Wilhelmina Children' s Hospital, PO Box 85090, Utrecht (Netherlands); Nievelstein, Rutger-Jan A. [University Medical Center Utrecht, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Han, Sen K. [University Medical Center Utrecht, Department of Neurosurgery, Wilhelmina Children' s Hospital, Utrecht (Netherlands)

    2010-06-15

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  2. Clinical analysis of intracranial hemorrhage of newborn%新生儿颅内出血临床分析

    Institute of Scientific and Technical Information of China (English)

    贾艳玲

    2014-01-01

    目的 探讨新生儿颅内出血的临床特点及发病因素.方法 选取2013年1月至2014年12月商丘市第一人民医院收治的15例颅内出血新生儿的临床资料进行回顾,新生儿均于出生后1周内行头颅CT检查,全部患儿均给予常规治疗,对患儿颅内出血程度及治疗效果进行评价,并采用SPSS 13.00软件包对数据进行统计学分析,P32~35周组和>35~38周组,差异有统计学意义(P<0.05,P<0.01),说明新生儿颅内出血的发生率与出血程度和胎龄密切相关.全部患儿中显效7例,有效3例,无效3例,有2例放弃治疗.结论 新生儿颅内出血严重威胁患儿的生命安全,提高孕期妇女围产期保健意识,及早发现和治疗是降低新生儿颅内出血发生率,提高抢救成功率的关键.%Objective To investigate the clinical features and risk factors of intracranial hemorrhage of newborn.Methods Choose between January 2013 and December 2013, shangqiu ifrst people's hospital clinical data of 15 cases of neonatal intracranial hemorrhage in our hospital to review.All the newborns check CT examination 1 weeks after birth.All children were given routine therapy. To evaluate the degree and treatment in children with intracranial hemorrhage. Using SPSS 13.0 software to carry on the analysis, P < 0.05 for the difference was statistically signiifcant.Results Gestational age of 32 weeks or less neonatal Ⅲ,Ⅳ hemorrhage was signiifcantly higher than 32 ~35 weeks group and 35 ~ 38 weeks group, the difference was statistically signiifcant (P < 0.05,P < 0.01), the incidence of neonatal intracranial hemorrhage is closely related to the degree of bleeding and gestational age.In children with all 7 cases, ineffective in 3 cases,Invalid 3 cases and there are 2 cases give up treatment.Conclusions A serious threat to children with intracranial hemorrhage of newborn life safety, improve the consciousness of pregnant women in perinatal health care. Early detection and treatment is to

  3. PREVALENCE OF FACTORS INVOLVED IN INTRACRANIAL HEMORRHAGE OF PREMATURE NEONATES LESS THAN 34 WEEKS

    Directory of Open Access Journals (Sweden)

    M. Rahmani

    2008-06-01

    Full Text Available Intracranial hemorrhage is one of the major causes of neonatal mortality and morbidity. It is the most severe cranial problem in that period. Those who survive would be affected by hydrocephalus, encephalomalacia, and finally brain atrophy. With accurate knowledge of risk factors, hemorrhage may be diagnosed earlier and the complications managed earlier. This study was performed in Neonatal Intensive Care Unit of Imam Khomeini Hospital. All the neonates less than 34 weeks of gestation were undergone intracranial sonography from Feb 2005 to Feb 2006. Sonography was performed via anterior fontanel with proper probe according to neonatal age. 113 neonates less than 34 weeks of gestation have been studied. Mean gestational age was 32 weeks. Mean neonatal weight were 1566 ± 734 grams. Intracranial hemorrhage was evident in 21% of them; 16.8% was grade 1, 0.9% grade 2, 2.7% grade 3, 0.9% grade 4. The mean weight of neonates with hemorrhage was 1504.11 grams. Intracranial hemorrhage had correlation with respiratory acidosis and pneumothorax. The latter was also correlated with hemorrhage grade. Supposing the safety and non-invasiveness of intacranial sonography, we suggest performing sonography in all premature neonates with low birth weight, and also in those neonates with pneumothorax and respiratory acidosis.

  4. CT and MRI characteristics of intracranial hemorrhage complicating breech and vacuum delivery

    Energy Technology Data Exchange (ETDEWEB)

    Odita, J.C. [Department of Radiology, Hamad Medical Corp., Doha (Qatar); Hebi, S. [Department of Pediatrics, Hamad Medical Corp., Doha (Qatar)

    1996-11-01

    The CT/MRI brain findings and sequelae of intracranial hemorrhage resulting from traumatic breech and vacuum delivery of 16 term newborn infants are presented. Eleven infants were vacuum extracted, while the remaining five infants were delivered breech. Except for three breech-delivered infants who had intraventricular hemorrhage, the location and nature of hemorrhage were similar in both groups. Nine of the 11 vacuum-extracted babies showed complete resolution of hemorrhage on follow-up examination. None of the breech cases had a normal outcome. All five of the latter group had hydrocephalus, and one case each demonstrated porencephaly and encephalomalacia. (orig.). With 3 figs., 3 tabs.

  5. Refractory High Intracranial Pressure following Intraventricular Hemorrhage due to Moyamoya Disease in a Pregnant Caucasian Woman

    Science.gov (United States)

    Montiel, Virginie; Grandin, Cécile; Goffette, Pierre; Fomekong, Edward; Hantson, Philippe

    2009-01-01

    Intraventricular hemorrhage during pregnancy is usually followed by a poor recovery. When caused by moyamoya disease, ischemic or hemorrhagic episodes may complicate the management of high intracranial pressure. A 26-year-old Caucasian woman presented with generalized seizures and a Glasgow Coma Score (GCS) of 3 during the 36th week of pregnancy. The fetus was delivered by caesarean section. The brain CT in the mother revealed bilateral intraventricular hemorrhage, a callosal hematoma, hydrocephalus and right frontal ischemia. Refractory high intracranial pressure developed and required bilateral ventricular drainage and intensive care treatment with barbiturates and hypothermia. Magnetic resonance imaging and cerebral angiography revealed a moyamoya syndrome with rupture of the abnormal collateral vascular network as the cause of the hemorrhage. Intracranial pressure could only be controlled after the surgical removal of the clots after a large opening of the right ventricle. Despite an initially low GCS, this patient made a good functional recovery at one year follow-up. Management of refractory high intracranial pressure following moyamoya related intraventricular bleeding should require optimal removal of ventricular clots and appropriate control of cerebral hemodynamics to avoid ischemic or hemorrhagic complications. PMID:20508823

  6. Refractory High Intracranial Pressure following Intraventricular Hemorrhage due to Moyamoya Disease in a Pregnant Caucasian Woman

    Directory of Open Access Journals (Sweden)

    Virginie Montiel

    2009-02-01

    Full Text Available Intraventricular hemorrhage during pregnancy is usually followed by a poor recovery. When caused by moyamoya disease, ischemic or hemorrhagic episodes may complicate the management of high intracranial pressure. A 26-year-old Caucasian woman presented with generalized seizures and a Glasgow Coma Score (GCS of 3 during the 36th week of pregnancy. The fetus was delivered by caesarean section. The brain CT in the mother revealed bilateral intraventricular hemorrhage, a callosal hematoma, hydrocephalus and right frontal ischemia. Refractory high intracranial pressure developed and required bilateral ventricular drainage and intensive care treatment with barbiturates and hypothermia. Magnetic resonance imaging and cerebral angiography revealed a moyamoya syndrome with rupture of the abnormal collateral vascular network as the cause of the hemorrhage. Intracranial pressure could only be controlled after the surgical removal of the clots after a large opening of the right ventricle. Despite an initially low GCS, this patient made a good functional recovery at one year follow-up. Management of refractory high intracranial pressure following moyamoya related intraventricular bleeding should require optimal removal of ventricular clots and appropriate control of cerebral hemodynamics to avoid ischemic or hemorrhagic complications.

  7. [Hemorrhagic Adult Unilateral Moyamoya Disease with Multiple Unruptured Intracranial Aneurysms: A Case Report].

    Science.gov (United States)

    Ozaki, Saya; Inoue, Akihiro; Miyazaki, Hajime; Onoue, Shinji; Ichikawa, Haruhisa; Fukumoto, Shinya; Iwata, Shinji; Kohno, Kanehisa

    2016-02-01

    Adult unilateral moyamoya disease with intracranial aneurysm is frequently reported in the literature, but there is much variation in its treatment. In this case report, we describe the time course and treatment regimen of a patient with moyamoya disease and review the literature regarding moyamoya disease with intracranial aneurysm. A 64-year-old man had untreated intracranial aneurysm and unilateral moyamoya disease for 10 years. He presented with sudden-onset right hemiparesis and aphasia due to a subcortical hemorrhage. He was admitted to the local neurosurgical unit, and upon resolution of symptoms, he was admitted to our hospital. A cerebral angiogram revealed the champagne bottleneck sign of the left carotid artery and obliteration of the top of the left intracranial carotid artery with a moyamoya phenomenon. Two unruptured intracranial aneurysms were identified in the anterior communicating artery(Acom A) and the right intracranial carotid artery(C3). We performed superficial temporal artery-middle cerebral artery anastomosis followed by aneurysmal neck clipping of the Acom A aneurysm. Postoperative imaging showed no new ischemic damage and improved cerebral blood flow. Although the patient experienced temporal worsening of aphasia, his function recovered a few months later and he was able to resume his normal daily life activities. The combination of direct bypass surgery and aneurysmal neck clipping might be a therapeutic option for hemorrhagic unilateral moyamoya disease with unruptured intracranial aneurysm.

  8. Temporal comparative analysis of computed tomography with ultrasound for intracranial hemorrhage in premature infants

    Energy Technology Data Exchange (ETDEWEB)

    Quisling, R.G.; Reeder, J.D.; Kaude, J.V.; Setzer, E.S.

    1983-02-01

    This study focuses on comparison of computed tomography and ultrasound in premature infants with intracranial hemorrhage and its complications. It was determined that close correlation (95%) exists between CT and ultrasound for evaluations of ventriculomegaly. Although there is reasonable correlation for the identification and localization of periventricular, intraventricular and choroidal hemorrhages, ultrasound defined such lesions at higher rates. Subarachnoid blood and periventricular edema were diagnosed better or exclusively by CT.

  9. A Case of Hemophilia A Associated with Spontaneous Hemorrhagic Pleural Effusion and Intracranial Hem

    Directory of Open Access Journals (Sweden)

    Nuri Tutar

    2014-03-01

    Full Text Available Hemophilia A is a sex-linked recessive coagulation disorder almost exclusively occurring in male subjects and caused by a deficiency of factor VIII. It  is a rare disorder characterized by spontaneous hemorrhages. Spontaneous bleeding in the pleural space is very rare in hemophilia both in children and adults. Here in, we present the case of a 56-year-old hemophilia A patient with hemorrhagic pleural effusion and intracranial hematoma.

  10. Term neonate with intracranial hemorrhage and hereditary hemorrhagic telangiectasia: a case report and review of the literature.

    Science.gov (United States)

    Delaney, H M; Rooks, V J; Wolfe, S Q; Sawyer, T L

    2012-08-01

    Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by mucocutaneous telangiectases and arteriovenous malformations (AVMs). The disease rarely presents in the neonatal period, primarily manifesting with epistaxis and gastrointestinal bleeding in adulthood. Occasionally, HHT can also present with symptoms related to AVMs in the cerebral, pulmonary or gastrointestinal vasculature. In prior reports, intracranial hemorrhage (ICH) secondary to cerebral AVM in neonates with HHT has been catastrophic and uniformly fatal. Here we report a case of a newborn with HHT and ICH from a suspected AVM who survived with aggressive medical management and surgical intervention, and provide a comprehensive review of the literature on ICH in neonates with HHT.

  11. Intracranial hypotension in the setting of concurrent perineural cyst rupture and subarachnoid hemorrhage.

    Science.gov (United States)

    Sivakumar, Walavan; Ravindra, Vijay M; Cutler, Aaron; Couldwell, William T

    2014-06-01

    Although most patients with intracranial hypotension typically present with headaches, the rest of the clinical spectrum is characteristically non-specific and often quite variable. In a patient with concurrent pathologies that can produce a similar clinical picture, a high index of suspicion must be maintained to achieve the correct diagnosis. The authors report a patient with intracranial hypotension in the setting of concurrent perineural cyst rupture and subarachnoid hemorrhage. A 63-year-old woman with a family history of ruptured intracranial aneurysms presented after a sudden thunderclap headache and was found to have diffuse subarachnoid hemorrhage. Imaging revealed anterior communicating and superior hypophyseal artery aneurysms. Following the uneventful clipping of both aneurysms, the patient experienced a delayed return to her neurological baseline. After it was noted that the patient had an improved neurological examination when she was placed supine, further investigation confirmed intracranial hypotension from perineural cyst rupture. The patient improved and returned to her neurological baseline after undergoing a high-volume blood patch and remained neurologically intact at postoperative follow-up. Although intracranial hypotension is known to be commonly associated with cerebrospinal fluid leak, its causal and temporal relationship with subarachnoid hemorrhage has yet to be elucidated. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Headache in subarachnoid hemorrhage and headache attributed to intracranial endovascular procedures.

    Science.gov (United States)

    Agostoni, E; Zagaria, M; Longoni, M

    2015-05-01

    Headache is a critical problem in the emergency setting. In this paper we briefly review the epidemiological data regarding headache in Subarachnoid Hemorrhage (SAH), considering the role of headache as a warning symptom and the other clinical manifestation of SAH. We have also introduced a recent clinical entity, represented by headache associated to intracranial endovascular procedures (IEPs).

  13. Intracranial hemorrhagic infarct after local anesthesia on nasal mucosa: A case report

    Directory of Open Access Journals (Sweden)

    Murat Koçyiğit

    2015-01-01

    Conclusion: We want to emphasize that all surgeons especially the ENT surgeons should be careful while using local anesthetic medicines which contains adrenaline for rare complication of intracranial hemorrhagic infarction. Another fact is that the patients must sign an informed consent form including those situations even for all minor surgical procedures to avoid a medicolegal problem.

  14. Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation

    DEFF Research Database (Denmark)

    Korompoki, Eleni; Filippidis, Filippos T; Nielsen, Peter B

    2017-01-01

    OBJECTIVE: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up. METHODS: A comprehensive literature search including MEDLINE, EMBASE, Cochrane...

  15. The effect of furosemide on intracranial pressure and hemorrhage in preterm rabbits.

    Science.gov (United States)

    Lorenzo, A V; Greene, C S; Hornig, G W; Zavala, L M; Welch, K

    1989-05-01

    The hypothesis that intracranial hypotension due to excessive postnatal fluid loss places the premature infant at risk for germinal matrix and intraventricular hemorrhage (GM-IVH) was tested in preterm rabbits delivered at 28 and 29 days of gestation (term 32 days). Furosemide administered to newborn pups induced a diuresis that resulted in a 11% to 22% loss in body weight and a concomitant decline in muscle water (13% to 16%) and sodium (18% to 21%). Paradoxically, no change occurred in the water or electrolyte content of the brain even though cerebrospinal fluid and brain tissue pressure, but not blood pressure, declined. These changes were absent in littermates treated with saline. Microscopic examination of brain sections revealed a greater incidence of intracranial hemorrhage, particularly in the germinal matrix and choroid plexus, in furosemide-treated than in saline-treated preterm rabbit pups. These results are consistent with the hypothesis that intracranial hypotension promotes the incidence of GH-IVH in preterm animals.

  16. Association between Venous Angioarchitectural Features of Sporadic Brain Arteriovenous Malformations and Intracranial Hemorrhage.

    Science.gov (United States)

    Alexander, M D; Cooke, D L; Nelson, J; Guo, D E; Dowd, C F; Higashida, R T; Halbach, V V; Lawton, M T; Kim, H; Hetts, S W

    2015-05-01

    Intracranial hemorrhage is the most serious outcome for brain arteriovenous malformations. This study examines associations between venous characteristics of these lesions and intracranial hemorrhage. Statistical analysis was performed on a prospectively maintained data base of brain AVMs evaluated at an academic medical center. DSA, CT, and MR imaging studies were evaluated to classify lesion side, drainage pattern, venous stenosis, number of draining veins, venous ectasia, and venous reflux. Logistic regression analyses were performed to identify the association of these angiographic features with intracranial hemorrhage of any age at initial presentation. Exclusively deep drainage (OR, 3.42; 95% CI, 1.87-6.26; P < .001) and a single draining vein (OR, 1.98; 95% CI, 1.26-3.08; P = .002) were associated with hemorrhage, whereas venous ectasia (OR, 0.52; 95% CI, 0.34-0.78; P = .002) was inversely associated with hemorrhage. Analysis of venous characteristics of brain AVMs may help determine their prognosis and thereby identify lesions most appropriate for treatment. © 2015 by American Journal of Neuroradiology.

  17. Association Between Venous Angioarchitectural Features of Sporadic Brain Arteriovenous Malformations and Intracranial Hemorrhage

    Science.gov (United States)

    Alexander, Matthew D.; Cooke, Daniel L.; Nelson, Jeffrey; Guo, Diana E.; Dowd, Christopher F.; Higashida, Randall T.; Halbach, Van V.; Lawton, Michael T.; Kim, Helen; Hetts, Steven W.

    2015-01-01

    Background and Purpose Intracranial hemorrhage is the most serious outcome for brain arteriovenous malformations (AVM). This study examines associations between venous characteristics of these lesions and intracranial hemorrhage. Materials and Methods Statistical analysis was performed on a prospectively maintained database of brain AVMs evaluated at an academic medical center. DSA, CT, and MRI studies were evaluated to classify lesion side, drainage pattern, venous stenosis, number of draining veins, venous ectasia, and venous reflux. Logistic regression analyses were performed to identify association of these angiographic features with intracranial hemorrhage of any age at initial presentation. Results Exclusively deep drainage (OR 3.42, 95% CI 1.87–6.26, p<0.001) and a single draining vein (OR 1.98, 95% CI 1.26–3.08, p=0.002) were associated with hemorrhage, whereas venous ectasia (OR 0.52, 95% CI 0.34–0.78, p=0.002) was inversely associated with hemorrhage. Conclusion Analysis of venous characteristics of brain AVMs may help determine their prognosis and thereby identify lesions most appropriate for treatment. PMID:25634722

  18. Toward understanding non-coding RNA roles in intracranial aneurysms and subarachnoid hemorrhage

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    Huang Fengzhen

    2017-05-01

    Full Text Available Subarachnoid hemorrhage (SAH is a common and frequently life-threatening cerebrovascular disease, which is mostly related with a ruptured intracranial aneurysm. Its complications include rebleeding, early brain injury, cerebral vasospasm, delayed cerebral ischemia, chronic hydrocephalus, and also non neurological problems. Non-coding RNAs (ncRNAs, comprising of microRNAs (miRNAs, small interfering RNAs (siRNAs and long non-coding RNAs (lncRNAs, play an important role in intracranial aneurysms and SAH. Here, we review the non-coding RNAs expression profile and their related mechanisms in intracranial aneurysms and SAH. Moreover, we suggest that these non-coding RNAs function as novel molecular biomarkers to predict intracranial aneurysms and SAH, and may yield new therapies after SAH in the future.

  19. Supratentorial primitive neuroectodermal tumor presenting with intracranial hemorrhage in adult

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    Bashar Abuzayed

    2014-01-01

    Full Text Available A 24-year-old female patient presented with complaints of nausea, vomiting and of loss of consciousness lasted for 15 minutes with left sided weakness. Neuroradiological evaluation revealed a hemorrhagic mass lesion in the right frontal lobe. The patient was operated and intraoperative findings showed a cortical-subcortical hematoma including hemorrhagic and disrupted tissue with a pathologic purple tissue on the periphery of the hematoma. Postoperative course was uneventful and postoperative histopathological examination revealed primitive neuroectodermal tumor. The patient was then referred to medical and radiation oncology clinics for further evaluation and treatment.

  20. A fast cranial drilling technique in treating severe intracranial hemorrhage

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    Jun-Jie Wei

    2015-01-01

    Conclusion: Fast-D procedure is much faster (6.7 min vs. 53.6 min of the Dandy′s procedure and can be performed outside operating rooms (computed tomography room or bedside. This technique could serve as a tool to rapidly release intracranial pressure and reduce subsequent morbidity and mortality of severe craniocerebral diseases when resource and condition are limited and more elaborate operating room procedures are not possible.

  1. Abnormalities of the neonatal brain: MR imaging. Part I. Intracranial hemorrhage.

    Science.gov (United States)

    McArdle, C B; Richardson, C J; Hayden, C K; Nicholas, D A; Crofford, M J; Amparo, E G

    1987-05-01

    The authors prospectively evaluated 82 neonates, ranging in gestational age from 29 to 44 weeks postconception, with magnetic resonance (MR) imaging at 0.6 T. Twenty-two cases of hemorrhage in 15 infants were identified. Ultrasound (US) and computed tomography (CT) were superior to MR in the first few days after parenchymal hemorrhage, since at this time lesions were apparent on only T2-weighted images. After the first 3 days, MR was the single best modality because (a) hemorrhage on CT became imperceptible in the 2d week, whereas the high signal of hemorrhage on MR persisted for 2-11 weeks; (b) MR permitted rough dating of hemorrhage according to changes in signal intensity; and (c) MR was superior in identifying subdural or epidural hemorrhage. Because of the nonspecificity and restricted field of view of US and the inability of CT to depict hemorrhage after 7-10 days, the authors conclude that MR significantly improves the detection of intracranial hemorrhage in neonates.

  2. Intrauterine skull depression and intracranial hemorrhage in a premature infant

    Energy Technology Data Exchange (ETDEWEB)

    Batton, G.D.; DiCarmine, F.; Boal, D.K.

    1988-04-01

    The authors describe a case of a premature infant born with a parietal skull depression who suffered an intraventricular hemorrhage and an ipsilateral intracerebral injury. At 21 months of life the infant's gross motor milestones were delayed and he had moderate spastic hemiplegia. Although skull depressions at birth are usually benign, they may be associated with long-term neurologic sequelae.

  3. Utility of mobile devices in the computerized tomography evaluation of intracranial hemorrhage

    Directory of Open Access Journals (Sweden)

    Sridhar G Panughpath

    2013-01-01

    Full Text Available Aim: To evaluate the utility of a mobile device to detect and assess intracranial hemorrhage (ICH on head computed tomographys (CT performed in the emergency setting. Materials and Methods: 100 head CT scans were randomly selected from our emergency radiology database and anonymized for patient demographics and clinical history. The studies were independently interpreted by two experienced radiologists in a blinded manner, initially on a mobile device (iPad, Apple computers and subsequently, at an interval of one week, on a regular desktop workstation. Evaluation was directed towards detection, localization and characterization of hemorrhage. The results were assessed for accuracy, sensitivity, specificity and positive predictive value. Statistical significance was ascertained using Fisher′s exact test. Results: 27 of the examinations were positive for ICH, of which 11 had multiple hemorrhages. Of these there were 17 subdural, 18 intraparenchymal, 8 subarachnoid, 4 intraventricular and 2 extradural hemorrhages. In 96 of the studies there was complete concurrence between the iPad and desktop interpretations for both radiologists. Of 49 hemorrhages, 48 were accurately detected on the iPad by one of the radiologists. In the remaining case, a tiny intraventricular hemorrhage was missed by both radiologists on the iPad as well as on the workstation, indicating that the miss was more likely related to the very small size of the hemorrhage than the viewer used. Conclusion: We conclude that in the emergency setting, a mobile device with appropriate web-based pictue archiving and communication system (PACS is effective in the detection of intracranial hemorrhage present on head CT.

  4. [Effectiveness of cerebrolysin in hypertensive supratentorial intracranial hemorrhages: results of a randomized triple blind placebo-controled study].

    Science.gov (United States)

    Maksimova, M Iu; Briukhov, V V; Timerbaeva, S L; Kistenev, B A; Rebrova, O Iu; Suslina, Z A

    2009-01-01

    Cerebrolysin was administered to 38 patients with small hypertensive supratentorial intracranial hemorrhages. Cerebrolysin was used intravenous in drops in dosage of 30 ml during 14 days. High effectiveness and good tolerability of the treatment was shown. In the end of treatment, groups receiving cerebrolysin or placebo were statistically significant differed by the total NIHSS score, Bartel index and the Rankin's modified scale. Moreover, a trend to the decrease of intracranial hemorrhage volume was observed in patients treated with cerebrolysin.

  5. Analysis of intracranial hemorrhage grade in preterm singleton pregnancies delivered vaginally or by cesarean section

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    Ljuština Saša

    2013-01-01

    Full Text Available Background/Aim. Preterm birth is the leading cause of neonatal mortality. Periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH remains a significant cause of both morbidity and mortality in infants prematurely born. The aim of the study was to evaluate the perinatal outcome regarding IVH of premature babies according to the mode of delivery. Methods. A total of 126 women in preterm singleton pregnancies with vertex presentation and 126 neonates weighted from 750 g to 1,500 g at birth were enrolled. The outcomes of 64 neonates born vaginally were compared to 62 neonates born by cesarean section. Results. There was no significant difference in the incidence of IVH among both groups. Conclusion. Our data is consistent with the hypothesis that the mode of delivery does not influence IVH and consenquently perinatal outcome in preterm neonates.

  6. The Severity of Intracranial Hemorrhages Measured by Free Hemoglobin in the Brain Depends on the Anticoagulant Class: Experimental Data

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    Kyle M. Ware

    2017-01-01

    Full Text Available Background and Purpose. Anticoagulant therapy is broadly used to prevent thromboembolic events. Intracranial hemorrhages are serious complications of anticoagulation, especially with warfarin. Direct oral anticoagulants reduce but do not eliminate the risk of intracranial hemorrhages. The aim of this study is to determine the degree of intracranial hemorrhage after application of anticoagulants without additional triggers. Methods. Rats were treated with different anticoagulant classes (vitamin K antagonists, heparin, direct thrombin inhibitor, and factor Xa inhibitor. Brain hemorrhages were assessed by the free hemoglobin concentration in the brain parenchyma. Results. Vitamin K antagonists (warfarin and brodifacoum significantly increased free hemoglobin in the brain. Among direct oral anticoagulants, thrombin inhibitor dabigatran also significantly increased free hemoglobin in the brain, whereas treatment with factor Xa inhibitor rivaroxaban did not have significant effect on the free hemoglobin concentration. Conclusions. Our data indicates that the severity of brain hemorrhages depends on the anticoagulant class and it is more pronounced with vitamin K antagonists.

  7. Treatments for Reversing Warfarin Anticoagulation in Patients with Acute Intracranial Hemorrhage: A Structured Literature Review

    Science.gov (United States)

    2011-07-08

    CINAHL® Via EBSCOhost ®) for relevant reviews and articles as of December 2009. We identified no relevant reviews in the Cochrane Database . A search...of articles relevant to intracranial hemorrhage and warfarin and treatment in the emergency department was performed. Databases for PubMed, CINAHL...multiple database searches revealed 586 papers for review for possible inclusion. The final consensus of our comprehensive search strategy was a total

  8. Cerebral venous dynamics in newborn mice with intracranial hemorrhage studied using wavelets

    Science.gov (United States)

    Pavlov, A. N.; Semyachkina-Glushkovskaya, O. V.; Sindeeva, O. A.; Pavlova, O. N.; Shuvalova, E. P.; Huang, Q.; Zhu, D.; Li, P.; Tuchin, V. V.; Luo, Q.

    2015-03-01

    We investigate the stress-induced development of the intracranial hemorrhage in newborn mice with the main attention to its latent stage. Our study is based on the laser speckle contrast imaging of the cerebral venous blood flow and the wavelet-based analysis of experimental data. We study responses of the sagittal sinus in different frequency ranges associated with distinct regulatory mechanisms and discuss significant changes of the spectral power in the frequency area associated with the NO-related endothelial function.

  9. Detrended fluctuation analysis of cerebral venous dynamics in newborn mice with intracranial hemorrhage

    Science.gov (United States)

    Pavlov, A. N.; Semyachkina-Glushkovskaya, O. V.; Bibikova, O. A.; Pavlova, O. N.; Mohammad, Y. K.; Huang, Q.; Zhu, D.; Li, P.; Tuchin, V. V.; Luo, Q.

    2015-03-01

    We study pathological changes in cerebral venous dynamics in newborn mice using the laser speckle contrast imaging and the detrended fluctuation analysis with a special attention to the latent stage of the development of the intracranial hemorrhage. We show that this stage is characterized by a high responsiveness of the sagittal sinus to pharmacological stimulations of adrenorelated dilation. We conclude that this effect can be considered as an important mechanism underlying the development of ICH in newborns.

  10. Easy ways to remember the progression of MRI signal intensity changes of intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Maizlin, Z.V. [Dept. of Radiology, McMaster Univ. Medical Centre, Hamilton, Ontario (Canada)], E-mail: zeev25@yahoo.com; Shewchuk, J.R. [Medical Imaging, Royal Columbian Hospital, New Westminster, British Columbia (Canada); Clement, J.J. [Radiology, St Paul' s Hospital, Vancouver, British Columbia (Canada)

    2009-04-15

    This paper discusses the different ways to remember the progression of MRI signal intensity changes of intracranial hemorrhage. Several techniques that have been proposed to remember the progression of MRI signal intensity changes occurring in hematomas with time are discussed. In the opinion of the authors, the graph method is the easiest to remember. This may be because radiology is a highly visual speciality, and visual mnemonics seem easier to remember.

  11. MR imaging of intracranial hemorrhage in neonates and infants at 2.35 Tesla.

    Science.gov (United States)

    Zuerrer, M; Martin, E; Boltshauser, E

    1991-01-01

    The variations of the relative signal intensity and the time dependent changing contrast of intracranial hemorrhages on high-field spin-echo magnetic resonance images (MRI) were studied in 28 pediatric patients. For T1-weighted images, a repetition time (TR) of 500 ms and an echo time (TE) of 30 or 23 ms was used. The corresponding times for T2-weighted images were TR 3000 ms and TE 120 ms. Intracranial hematomas, less than 3 days old, were iso- to mildly hypointense on short TR/TE scans and markedly hypointense on long TR/TE scans (acute stage). In the following four days the signal of the hematomas became hyperintense on short TR/TE scans, beginning in the periphery and proceeding towards the center. On long TR/TE scans the signal remained markedly hypointense (early subacute stage). 7-14 days old hematomas were of high signal intensity on short TR/TE scans. On long TR/TE scans they appeared hypointense in the center and hyperintense in the periphery (late subacute stage). By the end of the second week the hematomas were of high signal intensity on all pulse sequences (chronic stage). Chronic hematomas were surrounded by a parenchymal rim of hypointensity on long TR/TE scans. 28 neonates and infants (with 11 follow-up examinations) of 31.5-70.6 weeks postconceptional age (PCA), with an intracranial hemorrhage were examined. The etiologies of the hemorrhages were: asphyxia (17 cases), brain infarct (2), thrombocytopenia (1), clotting disorder (1) and unknown origin (7). The aim of this study was to describe the appearance of intracranial hemorrhages in neonates and infants with MRI at 2.35 Tesla using spine-cho sequences.

  12. ECG pattern in reverse takotsubo cardiomyopathy demonstrated in 5 cases with intracranial hemorrhage.

    Science.gov (United States)

    Elikowski, Waldemar; Małek-Elikowska, Małgorzata; Kudliński, Bartosz; Skrzywanek, Paweł; Smól, Sławomir; Rzymski, Stanisław

    2016-09-29

    In typical takotsubo cardiomyopathy (TC) apical transient left ventricular dysfunction with concomitant ECG changes mimicking acute anterior myocardial infarction can be observed. Reverse TC (RTC) characterized by contractile disturbances in all basal and often simultaneous mid-ventricular segments is definitely less frequent. ECG pattern of RTC is less known. The authors present ECG findings in 5 cases of RTC in course of intracranial hemorrhage (ICH); 3 patients were diagnosed with subarachnoid hemorrhage (SAH) and the other two with intracerebral hemorrhage or subdural posttraumatic hematoma. In all patients, initial ECG appearance was dominated by ST segment depression in inferior leads (II, III, avF) and/or lateral leads (V4-6). In 4 patients, concurrent ST segment elevation in avR and avL leads was seen, additionally 4 patients had low QRS voltage in high lateral leads (I, avL). Potential normalization of these changes did not influence the patient`s survival. In one woman, immediately before death, early repolarization was recorded. In subjects with an increased risk of TC, for example in intracranial hemorrhage, particularly in SAH, the ECG abnormalities presented may indicate a need for further search of its atypical echocardiographic variants.

  13. Acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery: a case report

    Directory of Open Access Journals (Sweden)

    Hagino Tetsuo

    2012-03-01

    Full Text Available Abstract Introduction Spinal anesthesia is a widely used general purpose anesthesia. However, serious complications, such as intracranial subdural hemorrhage, can rarely occur. Case presentation We report the case of a 73-year-old Japanese woman who had acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery. Conclusion This case highlights the need to pay attention to acute intracranial subdural hemorrhage as a complication after spinal anesthesia. If the headache persists even in a supine position or nausea occurs abruptly, computed tomography or magnetic resonance imaging of the brain should be conducted. An intracranial subdural hematoma may have a serious outcome and is an important differential diagnosis for headache after spinal anesthesia.

  14. The Effects of Vasospasm and Re-Bleeding on the Outcome of Patients with Subarachnoid Hemorrhage from Ruptured Intracranial Aneurysm.

    Science.gov (United States)

    Filipce, Venko; Caparoski, Aleksandar

    2015-01-01

    Vasospasm and re-bleeding after subarachnoid hemorrhage from ruptured intracranial aneurysm are devastating complication that can severely affect the outcome of the patients. We are presenting a series of total number of 224 patients treated and operated at our Department due to subarachnoid hemorrhage, out of which certain number developed vasospasm and re-bleeding. We are evaluating the effect of these complications on the outcome of the patients according to the Glasgow Outcome Scale at the day of discharge. In our experience both vasospasm and ReSAH can significantly influence the outcome of patients with subarachnoid hemorrhage from ruptured intracranial aneurysm.

  15. Risk factors of intracranial hemorrhage in premature neonates.

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    Nasrin Khalessi

    2014-09-01

    Full Text Available Intraventricular hemorrhage (IVH is an important cause of brain injury in premature neonates. Current study tries to define associated risk factors of IVH in preterm neonates in Aliasghar Children Hospital during 2008 to 2011. In this study, the risk factors have been evaluated in premature neonates with IVH, who had at least one brain sonography since their admission in NICU. A total of 63 premature neonates with IVH were assessed. Mean gestational age was 29.81 (24-34 weeks and mean birth weight was 1290.83±382.96 gr. Other risk factors such as sex, mode of delivery, history of using infertility drugs, maternal disease, maternal hypertension and preeclampsia, lumbar puncture, ventilator therapy and pneumothorax were considered. Because no absolute treatment for IVH is available, identifying risk factors is important in prevention and management of IVH.

  16. Reversible coma and Duret hemorrhage after intracranial hypotension from remote lumbar spine surgery: case report.

    Science.gov (United States)

    Bonow, Robert H; Bales, James W; Morton, Ryan P; Levitt, Michael R; Zhang, Fangyi

    2016-03-01

    Intracranial hypotension is a rare condition caused by spontaneous or iatrogenic CSF leaks that alter normal CSF dynamics. Symptoms range from mild headaches to transtentorial herniation, coma, and death. Duret hemorrhages have been reported to occur in some patients with this condition and are traditionally believed to be associated with a poor neurological outcome. A 73-year-old man with a remote history of spinal fusion presented with syncope and was found to have small subdural hematomas on head CT studies. He was managed nonoperatively and discharged with a Glasgow Coma Scale score of 15, only to return 3 days later with obtundation, fixed downward gaze, anisocoria, and absent cranial nerve reflexes. A CT scan showed Duret hemorrhages and subtle enlargement of the subdural hematomas, though the hematomas remained too small to account for his poor clinical condition. Magnetic resonance imaging of the spine revealed a large lumbar pseudomeningocele in the area of prior fusion. His condition dramatically improved when he was placed in the Trendelenburg position and underwent repair of the pseudomeningocele. He was kept flat for 7 days and was ultimately discharged in good condition. On long-term follow-up, his only identifiable deficit was diplopia due to an internuclear ophthalmoplegia. Intracranial hypotension is a rare condition that can cause profound morbidity, including tonsillar herniation and brainstem hemorrhage. With proper identification and treatment of the CSF leak, patients can make functional recoveries.

  17. The Intracranial-B2LEED3S Score and the Risk of Intracranial Hemorrhage in Ischemic Stroke Patients Under Antiplatelet Treatment

    NARCIS (Netherlands)

    Amarenco, Pierre; Sissani, Leila; Labreuche, Julien; Vicaut, Eric; Bousser, Marie Germaine; Chamorro, Angel; Fisher, Marc; Ford, Ian; Fox, Kim M; Hennerici, Michael G; Mattle, Heinrich; Rothwell, Peter M; Steg, Philippe Gabriel; Diener, Hans-Christoph; Sacco, Ralph L; Greving, Jacoba P; Algra, Ale

    2017-01-01

    BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a

  18. Application of T2* measurement on gradient echo T2*-weighted imaging in differential diagnosis of intracranial hemorrhage and calcification

    Institute of Scientific and Technical Information of China (English)

    LIU Lan-xiang; YI Hui-ling; HAN Hong-bin; QI Xi-ming

    2012-01-01

    Background Differential diagnosis of intracranial hemorrhage and calcification is a common problem encountered in clinical imaging diagnosis.The purpose of this study was to investigate the feasibility of T2* measurement on gradient echo (GRE) T2*-weighted imaging (T2*WI) in differential diagnosis of intracranial hemorrhage and calcification.Methods Thirty-eight hemorrhagic foci in 18 patients and 11 calcification foci in seven patients were included in this study.The diagnosis of hemorrhage and calcification was confirmed in all cases with enhanced T2* weighted angiography (ESWAN) magnetic resonance imaging (MRI) and CT respectively.The significance for the difference of T2* value between the central and peripheral areas of hemorrhage and calcification lesions was tested with univariate analysis of variance.Results The detection rate of GRE T2*WI on intracranial hemorrhage was 1.9-fold higher than that of CT,especially for the hemorrhage in the brainstem and cerebellum.However,GRE T2*WI was far less sensitive to calcification than CT.There was a significant difference in the T2* value between the central area of hemorrhage and calcification (P <0.001),though no difference in the T2* value was obtained between the peripheral area of hemorrhage and calcification (P>0.05).Conclusions Quantitative measurement of T2* value on GRE T2*WI with a single MRI examination provides a fast,convenient,and effective means in differential diagnosis between intracranial hemorrhage and calcification,which may thus reduce the medical cost and save precious time for clinical management.

  19. [Intracranial hemorrhage during hemorrhagic disease of the newborn infant at term].

    Science.gov (United States)

    Moyoukolo, J; Retbi, J M; Allemon, M C; Semaan, N; J'Mii, B

    1990-01-01

    The authors report a case of intra-cerebral hematoma in a patient with hemorrhagic disease of the newborn. This hematoma had to be taped, and after that, an hydrocephalus shunted. The state of deficiency of vitamin K in the newborn should be treated systematically. The oral route is as good as the intra-muscular route for the baby.

  20. Remote intracranial hemorrhage following surgery for giant orbitofrontal growing skull fracture: A lesson learnt

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    Sachin Baldawa

    2016-01-01

    Full Text Available Growing skull fracture is an extremely rare complication of pediatric head injury, especially in infants. Repair of the dural tear early in the course of development of growing skull fracture has been suggested for a better outcome. Surgical repair of large, tense growing skull fractures, especially those in the communication of the ventricles can lead to potentially life-threatening complications. The author reports a rare case of remote intracranial hemorrhage following surgery for large, tense growing skull fracture in a 12-year-old girl and discusses the likely pathogenesis and possible ways to avoid this life-threatening complication.

  1. Anosognosia for hemiplegia with preserved awareness of complete cortical blindness following intracranial hemorrhage.

    Science.gov (United States)

    Prigatano, George P; Matthes, Jessica; Hill, Stacy W; Wolf, Thomas R; Heiserman, Joseph E

    2011-01-01

    A 51-year-old woman presented with anosognosia for hemiplegia (AHP), neglect, and a complete loss of vision, for which she was almost immediately aware. Neuroimaging studies revealed intracranial hemorrhages in the medial temporal lobes bilaterally, extending back to the occipital cortex, but sparing the calcarine cortex. A large right frontal-parietal hemorrhage which extended to the posterior body of the corpus callosum was also observed. The patient's vision slowly improved, and by 11 months post onset, formal visual fields revealed improvement primarily in the left upper quadrants only. In contrast, resolution of her AHP occurred between the 26th and 31st day post onset. Awareness of motor impairment was correlated with her ability to initiate finger tapping in her left hemiplegic/paretic hand. During the time she was unaware of her motor deficits but aware of her visual impairments, her dreams did not reflect concerns over visual or motor limitations. The findings support a "modular" theory of anosognosia.

  2. Transfontanelle Sonography of Brain in Neonates: Focused on Anatomy, Doppler and Intracranial Hemorrhage

    Directory of Open Access Journals (Sweden)

    "M. Rahmani

    2005-08-01

    Full Text Available Introduction & Background: Sonography of the brain is now very important in the care of neonates, especially among high risk premature infants. Screening of premature infants with transfontanelle ultrasonography is highly sensitive and specific for intracranial hemorrhage. It is also valuable in follow-up of hydrocephalus and periventricular leukomalacia. Patients & Methods: In this cross-sectional study, 200 high risk premature newborns admitted to neonate ICU of Vali-e-Asr hospital were evaluated by a sonograghy through fontanels. The time of sonograghy for ICH was in the first day of life If it was negative for ICH, evaluation was repeated in the 3rd day and again if negative, the last examination was performed in the 7th day. Result: Overall, 200 neonates were evaluated. The most common pathologic finding in our high risk premature neonates was germinal matrix hemorrhage, mostly grade 1and 2. A few cases of congenital anomalies were also found.

  3. Spontaneous intracranial hemorrhage in children – ruptured lobar arteriovenous malformations: report of two cases

    Directory of Open Access Journals (Sweden)

    Tascu A.

    2015-03-01

    Full Text Available Brain arteriovenous malformations (AVMs are lesions thought to be primarily congenital in origin, consisting of fistulous connections of abnormal arteries and veins, without normal intervening capillary beds and no cerebral parenchyma between vessels. In the pediatric population, AVMs represent the most common cause of spontaneous intracranial hemorrhage (ICH, with a high recurrent bleeding risk. The aim of this paper is to report 2 cases of ruptured lobar AVMs in children, presenting with spontaneous ICH. Due to the patients’ neurological status, the only imaging examination performed preoperatively was a CT scan, showing intraparenchymal hemorrhage. Thus, there was no MRI/angiographic examination to prove the existence of a brain AVM prior to the surgical interventions. Also, the cerebral angiography performed after the surgery showed, in both patients, no signs of residual vascular malformations. Therefore, the diagnosis of AVM was certified by macroscopic and microscopic pathological findings, with no brain imaging suggestive of a vascular malformation.

  4. Alpha1-antitrypsin deficiency with fatal intracranial hemorrhage in a newborn.

    Science.gov (United States)

    Israels, S J; Gilfix, B M

    1999-01-01

    A 4-week-old boy had a fatal intracranial hemorrhage resulting from vitamin K deficiency. The infant had received no vitamin K prophylaxis and was exclusively breastfed. At autopsy, examination of the liver showed cholestasis and fibrosis. DNA was isolated from a blood spot on a Gutherie sample card obtained from the infant for routine metabolic screening. This DNA was used for alpha1-antitrypsin genotyping studies. Genotyping studies identified homozygosity for the point mutation 9989G-->A, confirming a diagnosis of alpha1-antitrypsin deficiency (ZZ phenotype), and resulted in appropriate screening of siblings born after this child's death. Alpha1-antitrypsin deficiency should be considered in the differential diagnosis of infants with late hemorrhagic disease of the newborn. Use of blood from the metabolic screening card as a source of DNA allowed confirmation of this diagnosis after the infant's death.

  5. Spontaneous intracranial hemorrhage as an initial manifestation of primary Sjögren’s syndrome: a case report

    OpenAIRE

    2013-01-01

    Background Sjögren’s syndrome can involve the central nervous system; however, spontaneous intracranial hemorrhage has rarely been reported as the initial manifestation. Case presentation We report a 39-year-old woman with primary Sjögren’s syndrome presenting with intracranial hemorrhage. The diagnosis of primary Sjögren’s syndrome was based on the presence of ocular dryness, salivary gland secretory and excretory dysfunction confirmed with dynamic tracer emission CT, and positive anti-Sjögr...

  6. Two pediatric cases of variant neurogenic stress cardiomyopathy after intracranial hemorrhage.

    Science.gov (United States)

    Wittekind, Samuel G; Yanay, Ofer; Johnson, Erin M; Gibbons, Edward F

    2014-10-01

    Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy, is an acquired form of left ventricular systolic dysfunction seen in the setting of physiologic stress and the absence of coronary artery disease. It is thought to be caused by excessive sympathetic stimulation. It is well described in the adult literature associated with subarachnoid hemorrhage where it is known as neurogenic stress cardiomyopathy (NSC), but few such pediatric cases have been reported. We describe our experience with 2 children (13- and 10-year-old girls) who presented with spontaneous intracranial hemorrhage followed by pulmonary edema and shock. Echocardiography revealed similar patterns of left ventricular wall motion abnormalities consistent with NSC, inverted Takotsubo variant. One child progressed to death, whereas the other made a remarkable recovery, including significant improvement in cardiac function over the course of 1 week. We argue that at least 1 of these cases represents true stress-induced cardiomyopathy. This report will alert pediatricians to this transient cardiomyopathy that is likely underdiagnosed in pediatric intensive care. We also highlight the challenges of managing both shock and elevated intracranial pressure in the setting of NSC.

  7. Incidental intracranial hemorrhage after uncomplicated birth: MRI before and after neonatal heart surgery

    Energy Technology Data Exchange (ETDEWEB)

    Tavani, F.; Zimmerman, R.A. [Neuroradiology Dept., The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Clancy, R.R.; Licht, D.J. [Dept. of Neurology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Mahle, W.T. [Children' s Heart Hospital, Atlanta, GA (United States)

    2003-04-01

    We investigated the prevalence of intracranial hemorrhage (ICH) before and after neonatal heart surgery. We carried out pre- and postoperative MRI looking for brain lesions in 24 full-term new-borns with known congenital heart disease. They underwent heart surgery with cardiopulmonary bypass (CPB), usually with deep hypothermic circulatory arrest (DHCA). The first MRI was 1-22 days after birth. There were 21 children born after uncomplicated vaginal delivery and three delivered by cesarean section (CS). ICH was seen in 13 (62%) of the vaginal delivery group but in none of the CS group. We saw subdural bleeding along the inferior surface of the tentorium in 11 (52%) and supratentorially in six (29%) of the 21 children with ICH. Small hemorrhages were present in the choroid plexus in seven (33%), in the parenchyma in one (5%) and in the occipital horn in one (5%). There were 26 foci of bleeding in these 21 patients (1.2 per patient). None was judged by formal neurologic examination to be symptomatic from the hemorrhage. Follow-up MRI after cardiac surgery was obtained in 23 children, showing 37 foci of ICH (1.6 per patient), but all appeared asymptomatic. Postoperatively, ICH had increased in 10 children (43%), was unchanged in seven (30%) and was less extensive in six (26%). (orig.)

  8. POST-NOAC: Portuguese observational study of intracranial hemorrhage on non-vitamin K antagonist oral anticoagulants.

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    Marques-Matos, Cláudia; Alves, José Nuno; Marto, João Pedro; Ribeiro, Joana Afonso; Monteiro, Ana; Araújo, José; Silva, Fernando; Grenho, Fátima; Viana-Baptista, Miguel; Sargento-Freitas, João; Pinho, João; Azevedo, Elsa

    2017-08-01

    Background There is a lower reported incidence of intracranial hemorrhage with non-vitamin K antagonist oral anticoagulants compared with vitamin K antagonist. However, the functional outcome and mortality of intracranial hemorrhage patients were not assessed. Aims To compare the outcome of vitamin K antagonists- and non-vitamin K antagonist oral anticoagulants-related intracranial hemorrhage. Methods We included consecutive patients with acute non-traumatic intracranial hemorrhage on oral anticoagulation therapy admitted between January 2013 and June 2015 at four university hospitals. Clinical and demographic data were obtained from individual medical records. Intracranial hemorrhage was classified as intracerebral, extra-axial, or multifocal using brain computed tomography. Three-month functional outcome was assessed using the modified Rankin Scale. Results Among 246 patients included, 24 (9.8%) were anticoagulated with a non-vitamin K antagonist oral anticoagulants and 222 (90.2%) with a vitamin K antagonists. Non-vitamin K antagonist oral anticoagulants patients were older (81.5 vs. 76 years, p = 0.048) and had intracerebral hemorrhage more often (83.3% vs. 63.1%, p = 0.048). We detected a non-significant trend for larger intracerebral hemorrhage volumes in vitamin K antagonists patients ( p = 0.368). Survival analysis adjusted for age, CHA2DS2VASc, HAS-BLED, and anticoagulation reversal revealed that non-vitamin K antagonist oral anticoagulants did not influence three-month mortality (hazard ratio (HR) = 0.83, 95% confidence interval (CI) = 0.39-1.80, p = 0.638). Multivariable ordinal regression for three-month functional outcome did not show a significant shift of modified Rankin Scale scores in non-vitamin K antagonist oral anticoagulants patients (odds ratio (OR) 1.26, 95%CI 0.55-2.87, p = 0.585). Conclusions We detected no significant differences in the three-month outcome between non-vitamin K antagonist oral anticoagulants- and

  9. Effect of inter-tissue inductive coupling on multi-frequency imaging of intracranial hemorrhage by magnetic induction tomography

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    Xiao, Zhili; Tan, Chao; Dong, Feng

    2017-08-01

    Magnetic induction tomography (MIT) is a promising technique for continuous monitoring of intracranial hemorrhage due to its contactless nature, low cost and capacity to penetrate the high-resistivity skull. The inter-tissue inductive coupling increases with frequency, which may lead to errors in multi-frequency imaging at high frequency. The effect of inter-tissue inductive coupling was investigated to improve the multi-frequency imaging of hemorrhage. An analytical model of inter-tissue inductive coupling based on the equivalent circuit was established. A set of new multi-frequency decomposition equations separating the phase shift of hemorrhage from other brain tissues was derived by employing the coupling information to improve the multi-frequency imaging of intracranial hemorrhage. The decomposition error and imaging error are both decreased after considering the inter-tissue inductive coupling information. The study reveals that the introduction of inter-tissue inductive coupling can reduce the errors of multi-frequency imaging, promoting the development of intracranial hemorrhage monitoring by multi-frequency MIT.

  10. Spontaneous intracranial hemorrhage in a patient with Middle East respiratory syndrome corona virus

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    Al-Hameed, Fahad M.

    2017-01-01

    The Middle East respiratory syndrome corona virus (MERS-CoV) is a novel positive sense singlestranded ribonucleic acid virus of the genus Beta corona virus. This virus was first isolated from a patient who died from severe respiratory illness in June 2012 in Jeddah, Kingdom of Saudi Arabia. We describe an unusual case of a 42 year old healthcare worker who was admitted to our Intensive Care Unit (ICU) King Abdul-Aziz Medical City, with MERS-CoV and severe acute respiratory distress Syndrome and developed a sudden-onset diabetes insipidus and spontaneous massive intracranial hemorrhage with intra-ventricular extension and tonsillar herniation. Computed angiogram of the brain did not reveal any aneurysm or structural defects. She never had uncontrolled hypertension, or coagulopathy, nor she received antiplatelets. We are reporting a rare case of structural neurological damage associated with MERS-CoV infection. PMID:28133694

  11. Predictors for Symptomatic Intracranial Hemorrhage After Endovascular Treatment of Acute Ischemic Stroke.

    Science.gov (United States)

    Hao, Yonggang; Yang, Dong; Wang, Huaiming; Zi, Wenjie; Zhang, Meng; Geng, Yu; Zhou, Zhiming; Wang, Wei; Xu, Haowen; Tian, Xiguang; Lv, Penghua; Liu, Yuxiu; Xiong, Yunyun; Liu, Xinfeng; Xu, Gelin

    2017-05-01

    Symptomatic intracranial hemorrhage (SICH) pose a major safety concern for endovascular treatment of acute ischemic stroke. This study aimed to evaluate the risk and related factors of SICH after endovascular treatment in a real-world practice. Patients with stroke treated with stent-like retrievers for recanalizing a blocked artery in anterior circulation were enrolled from 21 stroke centers in China. Intracranial hemorrhage was classified as symptomatic and asymptomatic ones according to Heidelberg Bleeding Classification. Logistic regression was used to identify predictors for SICH. Of the 632 enrolled patients, 101 (16.0%) were diagnosed with SICH within 72 hours after endovascular treatment. Ninety-day mortality was higher in patients with SICH than in patients without SICH (65.3% versus 18.8%; P0.83 (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.24-3.46), pretreatment Alberta Stroke Program Early Computed Tomography Score of stroke of cardioembolism type (OR, 1.91; 95% CI, 1.13-3.25), poor collateral circulation (OR, 1.97; 95% CI, 1.16-3.36), delay from symptoms onset to groin puncture >270 minutes (OR, 1.70; 95% CI, 1.03-2.80), >3 passes with retriever (OR, 2.55; 95% CI, 1.40-4.65) were associated with SICH after endovascular treatment. Incidence of SICH after thrombectomy is higher in Asian patients with acute ischemic stroke. Cardioembolic stroke, poor collateral circulation, delayed endovascular treatment, multiple passes with stent retriever device, lower pretreatment Alberta Stroke Program Early Computed Tomography Score, higher baseline neutrophil ratio may increase the risk of SICH. © 2017 American Heart Association, Inc.

  12. CT examination, clinical situation and experimental characteristics of infants with intracranial hemorrhage induced by delayed vitamin K deficiency

    Institute of Scientific and Technical Information of China (English)

    Zhiqing Lin; Feng Fang; Min Chen; Guoxiang Cai

    2006-01-01

    BACKGROUND: Delayed vitamin K deficiency is characterized by acute onset, severe illness and high fatality rate. 33%-50% survivors accompany with other various nervous system sequelas. Therefore, diagnosis and treatment of intracranial hemorrhage in time become a key factor for improving healing rate and reducing fatality rate and incidence of sequela.OBJECTTVE: To investigate the clinical situation, experimental characteristics, CT examination and terminative characteristics of infants with intracranial hemorrhage induced by delayed vitamin K deficiency.DESIGN: Case analysis.SETTING: Department of Pediatrics, Zhongshan Hospital Affiliated to Xiamen University.PARTICIPANTS: A total of 17 infants with intracranial hemorrhage induced by delayed vitamin K deficiency aged 1-3 months including 11 boys and 6 girls were selected from Department of Pediatrics, Zhongshan Hospital Affiliated to Xiamen University from January 1994 to December 2005. All infants had drowsiness,rejective milk, spiting milk, gaze of both eyes, tic, coma, full anterior fontanelle, high muscular tension and cerebral hernia, etc. Experimental examination demonstrated that infants had anemia at various degrees;prothrombin time and partial thromboplastin time were prolonged; platelet count was normal. CT examination indicated that screenages of subarachnoid hemorrhage, subdural hematoma, cerebral parenchyma hemorrhage and intraventricular hemorrage were changed. Hemorrhage was stopped by the application of vitamin K. All patients provided informed consent.METHODS: ① Clinical situation and physical sign of infants were observed after hospitalization and scanned with rapid spiral CT scanning system. The thickness and average space of layers were 8-10 mm and the scanning time was 5 s with window width of 30-80 Hu and window position of 28-35 Hu. ② After hospitalization, four items of blood coagulation was measured with Futura meter and biochemical indexes of blood, such as serum calcium, serum

  13. Rapidly calcified all of multiple intracranial hemorrhages occurred in a patient with Chronic idiopathic thrombocytopenic purpura

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    Seong Rok Han, M.D., Ph.D.

    2016-03-01

    Full Text Available We report a 38-year-old female patient with chronic idiopathic thrombocytopenic purpura (ITP who occurred in rapidly calcified all of multiple intracranial hemorrhage (ICH lesions. The patient was admitted with poor oral intake and confused mentality. Neurologic examination revealed drowsy consciousness but no motor weakness. She had been diagnosed ITP 5 years ago, however, she was not taking any medication at the time of presentation. Brain CT demonstrated that multiple ICHs, which were located in left frontal lobe, left temporal lobe and right cerebellar hemisphere. Platelet count was 10,000 cells/mm3. The patient was treated with conservative management, which included corticosteroids and platelet transfusion. Follow-up CT performed 12 days after the admission revealed that multiple ICHs were grossly resolving state. Interestingly, high attenuated lesions were seen all of multiple ICH sites, which were considered calcification. After 30 months after hemorrhage, follow-up brain CT showed prominent calcification of all of previous multiple ICH lesions. The patient was well- being state.

  14. Usefulness of {sup 99m}Tc-HMPAO SPECT in Patients with Subarachnoid Hemorrhage due to Ruptured Intracranial Aneurysm

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    Choi, C. W.; Lee, K. H.; Kim, J. H.; Kwark, C. E.; Lee, D. S.; Chung, J. K.; Lee, M. C.; Han, D. H.; Koh, C. S. [Seoul National University Hospital, Seoul (Korea, Republic of)

    1993-07-15

    We evaluated the usefulness of {sup 99m}Tc-HMPAO SPECT in 21 Patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm and in 3 patients with unruptured intracranial aneurysm. SPECT study could detect the bilaterally hypoperfused cases in 10 patients(48%), but CT/MRI showed the bilateral abnormalities in only 3 patients(14%). The number of abnormal lesions were 56 in SPECT and 25 in CT/MRI. The lesions found in SPECT were well correlated with the neurological signs of the patients such as aphasia or hemiplegia. SPECT study during Matas test was helpful in evaluating the risk for carotid artery occlusion therapy. We thought that {sup 99m}Tc-HMPAO brain SPECT is helpful in evaluating the functional changes in patients with subarachnoid hemorrhage.

  15. Regularization design for high-quality cone-beam CT of intracranial hemorrhage using statistical reconstruction

    Science.gov (United States)

    Dang, H.; Stayman, J. W.; Xu, J.; Sisniega, A.; Zbijewski, W.; Wang, X.; Foos, D. H.; Aygun, N.; Koliatsos, V. E.; Siewerdsen, J. H.

    2016-03-01

    Intracranial hemorrhage (ICH) is associated with pathologies such as hemorrhagic stroke and traumatic brain injury. Multi-detector CT is the current front-line imaging modality for detecting ICH (fresh blood contrast 40-80 HU, down to 1 mm). Flat-panel detector (FPD) cone-beam CT (CBCT) offers a potential alternative with a smaller scanner footprint, greater portability, and lower cost potentially well suited to deployment at the point of care outside standard diagnostic radiology and emergency room settings. Previous studies have suggested reliable detection of ICH down to 3 mm in CBCT using high-fidelity artifact correction and penalized weighted least-squared (PWLS) image reconstruction with a post-artifact-correction noise model. However, ICH reconstructed by traditional image regularization exhibits nonuniform spatial resolution and noise due to interaction between the statistical weights and regularization, which potentially degrades the detectability of ICH. In this work, we propose three regularization methods designed to overcome these challenges. The first two compute spatially varying certainty for uniform spatial resolution and noise, respectively. The third computes spatially varying regularization strength to achieve uniform "detectability," combining both spatial resolution and noise in a manner analogous to a delta-function detection task. Experiments were conducted on a CBCT test-bench, and image quality was evaluated for simulated ICH in different regions of an anthropomorphic head. The first two methods improved the uniformity in spatial resolution and noise compared to traditional regularization. The third exhibited the highest uniformity in detectability among all methods and best overall image quality. The proposed regularization provides a valuable means to achieve uniform image quality in CBCT of ICH and is being incorporated in a CBCT prototype for ICH imaging.

  16. Surgical evacuation of neonatal intracranial hemorrhage due to vitamin K deficiency bleeding.

    Science.gov (United States)

    Zidan, Ashraf Shaker; Abdel-Hady, Hesham

    2011-03-01

    Although the incidence of vitamin K deficiency bleeding (VKDB) in neonates has dramatically decreased in the developed world since the adoption of routine vitamin K prophylaxis, in developing countries the incidence is still high. Intracranial hemorrhage (ICH) is the most dangerous complication. Early recognition and management are important to decrease the mortality rate and neurological sequelae. The authors conducted a prospective study between January 2008 and June 2010. They included all full-term neonates referred to the Department of Neurosurgery at Mansoura University Children's Hospital with ICH complicating VKDB and necessitating surgical evacuation. The objective was to evaluate the clinical presentation, diagnosis, hospital course, and outcome of ICH in full-term neonates with VKDB after surgical evacuation. Thirty-two neonates with ICH due to VKDB were included. Diagnosis and classification of ICH were based on detailed history, physical examination, and the interpretation of CT or MR imaging studies. The diagnosis of VKDB was based on pretreatment coagulation studies (prothrombin time [PT] and partial thromboplastin time [PTT]), which are grossly abnormal, together with a normal platelet count and correction of coagulation results to normal after vitamin K administration. The mean age (± SD) at onset of symptoms was 20.4 ± 4.9 days. Two neonates (6.25%) had early VKDB, 7 (21.9%) had classic VKDB, and 23 (71.9%) had late VKDB. The most common neurological manifestations included focal seizures, disturbed consciousness level, and tense anterior fontanel. The most common general manifestations included pallor, respiratory distress, and bleeding from other sites. Radiological findings varied from acute subdural hemorrhage (SDH) in 18 cases (56.3%), intracerebral hemorrhage in 10 (31.3%), and acute SDH with underlying intracerebral hemorrhage, intraventricular hemorrhage, and/or subarachnoid hemorrhage in 4 (12.5%). Before administration of vitamin K

  17. Genotype and phenotype correlation in intracranial hemorrhage in neonatal factor VII deficiency among Thai children

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    Traivaree C

    2017-06-01

    Full Text Available Chanchai Traivaree,1 Chalinee Monsereenusorn,1 Arunotai Meekaewkunchorn,2 Premsak Laoyookhong,3 Saranya Suwansingh,4 Boonchai Boonyawat5 1Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and College of Medicine, 2Division of Hematology/Oncology, Department of Pediatrics, 3Division of Neonatology, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok, 4Division of Hematology/Oncology, Department of Pediatrics, Chiangrai Prachanukroh Hospital, Chiang Rai, 5Division of Genetics, Department of Pediatrics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand Abstract: Congenital factor VII (FVII deficiency is a rare inherited coagulopathy. The clinical manifestations and clinical findings vary widely, ranging from asymptomatic to life-threatening bleeding, including intracranial hemorrhage (ICH, with prolonged prothrombin time, normal partial thromboplastin time and normal platelet counts, which are confirmed by the low level of FVII assay. Treatment consists of fresh frozen plasma (FFP, prothrombin complex concentrates (PCCs, and recombinant activated FVII to treat bleeding and prophylactic therapy. Here, we report four patients with FVII levels <5% (severe type who presented ICH during the neonatal period. The IVS6+1G>T was the most common (50% mutation identified in our study, followed by the K376X nonsense mutation (37.5%. In our study, we found that genetic information affected the severity of congenital FVII deficiency with ICH. Keywords: mutation analysis, factor VII deficiency, Thai children

  18. Maternal anti-platelet β3 integrins impair angiogenesis and cause intracranial hemorrhage.

    Science.gov (United States)

    Yougbaré, Issaka; Lang, Sean; Yang, Hong; Chen, Pingguo; Zhao, Xu; Tai, Wei-She; Zdravic, Darko; Vadasz, Brian; Li, Conglei; Piran, Siavash; Marshall, Alexandra; Zhu, Guangheng; Tiller, Heidi; Killie, Mette Kjaer; Boyd, Shelley; Leong-Poi, Howard; Wen, Xiao-Yan; Skogen, Bjorn; Adamson, S Lee; Freedman, John; Ni, Heyu

    2015-04-01

    Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a life-threatening disease in which intracranial hemorrhage (ICH) is the major risk. Although thrombocytopenia, which is caused by maternal antibodies against β3 integrin and occasionally by maternal antibodies against other platelet antigens, such as glycoprotein GPIbα, has long been assumed to be the cause of bleeding, the mechanism of ICH has not been adequately explored. Utilizing murine models of FNAIT and a high-frequency ultrasound imaging system, we found that ICH only occurred in fetuses and neonates with anti-β3 integrin-mediated, but not anti-GPIbα-mediated, FNAIT, despite similar thrombocytopenia in both groups. Only anti-β3 integrin-mediated FNAIT reduced brain and retina vessel density, impaired angiogenic signaling, and increased endothelial cell apoptosis, all of which were abrogated by maternal administration of intravenous immunoglobulin (IVIG). ICH and impairment of retinal angiogenesis were further reproduced in neonates by injection of anti-β3 integrin, but not anti-GPIbα antisera. Utilizing cultured human endothelial cells, we found that cell proliferation, network formation, and AKT phosphorylation were inhibited only by murine anti-β3 integrin antisera and human anti-HPA-1a IgG purified from mothers with FNAIT children. Our data suggest that fetal hemostasis is distinct and that impairment of angiogenesis rather than thrombocytopenia likely causes FNAIT-associated ICH. Additionally, our results indicate that maternal IVIG therapy can effectively prevent this devastating disorder.

  19. Intracranial hemorrhage after blunt head trauma in children with bleeding disorders.

    Science.gov (United States)

    Lee, Lois K; Dayan, Peter S; Gerardi, Michael J; Borgialli, Dominic A; Badawy, Mohamed K; Callahan, James M; Lillis, Kathleen A; Stanley, Rachel M; Gorelick, Marc H; Dong, Li; Zuspan, Sally Jo; Holmes, James F; Kuppermann, Nathan

    2011-06-01

    To determine computerized tomography (CT) use and prevalence of traumatic intracranial hemorrhage (ICH) in children with and without congenital and acquired bleeding disorders. We compared CT use and ICH prevalence in children with and without bleeding disorders in a multicenter cohort study of 43 904 children bleeding disorders; all had Glasgow Coma Scale (GCS) scores of 14 to 15. These children had higher CT rates than children without bleeding disorders and GCS scores of 14 to 15 (risk ratio, 2.29; 95% CI, 2.15 to 2.44). Of the children who underwent imaging with CT, 2 of 186 children with bleeding disorders had ICH (1.1%; 95% CI, 0.1 to 3.8) , compared with 655 of 14 969 children without bleeding disorders (4.4%; 95% CI, 4.1-4.7; rate ratio, 0.25; 95% CI, 0.06 to 0.98). Both children with bleeding disorders and ICHs had symptoms; none of the children required neurosurgery. In children with head trauma, CTs are obtained twice as often in children with bleeding disorders, although ICHs occurred in only 1.1%, and these patients had symptoms. Routine CT imaging after head trauma may not be required in children without symptoms who have congenital and acquired bleeding disorders. Copyright © 2011 Mosby, Inc. All rights reserved.

  20. A complicated case of antepartum eclamptic fit with HELLP syndrome, acute renal failure and multiple intracranial hemorrhages: A mortality report

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    Ahmed Samy El-agwany

    2016-04-01

    Full Text Available HELLP is an acronym for hemolysis, elevated liver enzymes and low platelets count, affecting 0.2–12% of all pregnancies or 4–12% of those with preeclampsia. The maternal mortality reported from the literature is up 4% due to disseminated intravascular coagulation, placental abruption, acute renal failure, eclampsia, and cerebral hemorrhage. A 20 year old, G2P1, at 36 weeks of gestation, was referred to our hospital because of postictal coma state with bilateral mydriasis and epistaxis due to repeated antepartum eclamptic fits. Elevated blood pressure level 170/110 mmHg was accompanied with massive proteinuria. Cesarean section was performed and female newborn were delivered. Laboratory findings were characteristic of preeclampsia, HELLP syndrome and renal failure. The patient developed an intraventricular hematoma and an intracerebral hemorrhage with subarachnoid one, which were not suitable to neurosurgical treatment. The patient died from refractory hemolytic anemia, spontaneous bleeding of multiple organs, renal failure and intracranial hemorrhage. Preeclampsia, HELLP syndrome, and acute fatty liver of pregnancy might overlap and be associated with potentially fatal complications, including intracranial hemorrhage, as in the present case. Early detection and diagnosis are crucial to ensure appropriate management and treatment success.

  1. Life-threatening intracranial bleeding in a newborn with congenital cytomegalovirus infection: late-onset neonatal hemorrhagic disease.

    Science.gov (United States)

    Dallar, Yildiz; Tiras, Ulku; Catakli, Tulin; Gulal, Gonul; Sayar, Yavuz; Selvar, Beray; Alioglu, Bulent

    2011-02-01

    The authors present a case of a 36-day-old infant with intracranial and intramuscular hemorrhage due to vitamin K deficiency bleeding, who received intramuscular vitamin K prophylaxis at birth. In this case, laboratory tests showed anemia, liver dysfunction with cholestasis, and coagulopathy, consistent with vitamin K deficiency abnormality. Serological analyses showed that cytomegalovirus immunoglobulin (Ig)M and IgG avidity were both positive. The infant was treated successfully with intravenous ganciclovir and blood products. This case suggests that it is imperative to meticulously investigate the etiology in neonates with late-onset hemorrhagic disease of the newborn. Cholestatic liver disease caused by congenital cytomegalovirus infection should be in mind in term infants who presented with late-onset hemorrhagic disease.

  2. Left Atrial Appendage Closure for Atrial Fibrillation Is Safe and Effective After Intracranial or Intraocular Hemorrhage.

    Science.gov (United States)

    Fahmy, Peter; Spencer, Ryan; Tsang, Michael; Gooderham, Peter; Saw, Jacqueline

    2016-03-01

    Atrial fibrillation (AF) affects 1%-2% of the general population and 13% of individuals older than 80 years of age. Anticoagulation has been the mainstay therapy to reduce stroke risk. Patients with previous intracranial hemorrhage (ICH) or intraocular hemorrhage (IOH) are at increased risk of recurrence if anticoagulation is continued or initiated. Left atrial appendage (LAA) closure may obviate the need for long-term anticoagulation in these patients. We report our consecutive series of patients with nonvalvular AF with previous ICH or IOH who underwent LAA closure with the AMPLATZER Cardiac Plug (ACP; St Jude Medical, St Paul, MN), AMPLATZER Amulet, or WATCHMAN (Boston Scientific, Natick, MA) device. Demographics, clinical status, procedural outcomes, and complications were collected at baseline, during the procedure, at 3 months, at 1 year, and annually thereafter. Twenty-six patients with previous ICH (n = 24) or IOH (n = 2) underwent LAA closure (9 with the ACP, 3 with the Amulet, and 7 with the WATCHMAN). The mean age was 76 ± 7 years, and 61.5% were men with a mean CHADS2 (Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke/Transient Ischemic Attack) score of 3.2 ± 1.4 and CHA2DS2-VASc (Congestive Heart Failure, Hypertension, Age [≥ 75 years], Diabetes, Stroke/Transient Ischemic Attack, Vascular Disease, Age [65-74 years], Sex [Female] score) of 4.9 ± 1.7. No procedure-related complications occurred. Mean follow-up was 11.9 ± 13.3 months. One patient died at 13 months (this death was not related to the procedure), and 1 patient had a transient ischemic attack at 20.6 months after the procedure. No ischemic stroke, haemorrhagic stroke, or bleeding problems occurred during follow-up. In our consecutive series, LAA closure was found to be safe and effective in patients with AF and a history of ICH or IOH. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  3. Characteristics of Symptomatic Intracranial Hemorrhage in Patients Receiving Non-Vitamin K Antagonist Oral Anticoagulant Therapy.

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    Hisanao Akiyama

    Full Text Available The first non-vitamin K antagonist oral anticoagulant (NOAC introduced to the market in Japan was dabigatran in March 2011, and three more NOACs, rivaroxaban, apixaban, and edoxaban, have since become available. Randomized controlled trials of NOACs have revealed that intracranial hemorrhage (ICH occurs less frequently with NOACs compared with warfarin. However, the absolute incidence of ICH associated with NOACs has increased with greater use of these anticoagulants, and we wanted to explore the incidence, clinical characteristics, and treatment course of patients with NOACs-associated ICH.We retrospectively analyzed the characteristics of symptomatic ICH patients receiving NOACs between March 2011 and September 2014.ICH occurred in 6 patients (5 men, 1 woman; mean ± SD age, 72.8 ± 3.2 years. Mean time to onset was 146.2 ± 111.5 days after starting NOACs. Five patients received rivaroxaban and 1 patient received apixaban. None received dabigatran or edoxaban. Notably, no hematoma expansion was observed within 24 h of onset in the absence of infusion of fresh frozen plasma, activated prothrombin complex concentrate, recombinant activated factor VIIa or hemodialysis. When NOAC therapy was initiated, mean HAS-BLED and PANWARDS scores were 1.5 ± 0.5 and 39.5 ± 7.7, respectively. Mean systolic blood pressure was 137.8 ± 15.9 mmHg within 1 month before spontaneous ICH onset.Six symptomatic ICHs occurred early in NOAC therapy but hematoma volume was small and did not expand in the absence of infusion of reversal agents or hemodialysis. The occurrence of ICH during NOAC therapy is possible even when there is acceptable mean systolic blood pressure control (137.8 ± 15.9 mmHg and HAS-BLED score ≤ 2. Even stricter blood pressure lowering and control within the acceptable range may be advisable to prevent ICH during NOAC therapy.

  4. Analysis of Associated Spinal Fractures in Cases of Traumatic Intracranial Hemorrhage or Skull Fracture

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    Yunoki M

    2016-03-01

    Full Text Available Introduction: Patients with traumatic intracranial hemorrhage (ICH or skull fracture are typically admitted to the Department of Neurosurgery for fear of delayed neurological deterioration. Neurosurgeons, therefore, must be careful not to overlook a spinal fracture in these patients. In this study, we investigated the occurrence and risk factor of spinal fracture in patients with traumatic ICH or skull fracture. Patients and methods: We retrospectively analyzed the hospital records of 134 patients admitted to the Department of Neurosurgery at Kagawa Rosai Hospital for traumatic ICH or skull fracture. The etiology of trauma, level of consciousness, presence or absence of ICH, skull fracture, craniotomy and spinal surgery were investigated. Furthermore, in cases of spinal fracture, its type, neurological symptoms, treatment were investigated. Results: In an analysis of 134 patients, Ground level fall and traffic accident were the most frequent etiologies of trauma (47.0% and 23.9% respectively. Glasgow coma scale on admission was 15-13 for 106 patients (79.1%. Spinal fracture was identified in 10 of 134 patients (7.5%. Two patients had cervical, 8 had thoracolumbar fractures. In the analysis of risk factors, an accidental fall and skull fracture was observed significantly more in the spinal fracture cases. Conclusion: The majority of traumatic ICH or skull fracture cases treated in the Department of Neurosurgery were caused by minor head impacts. When treating these patients, it is necessary to investigate not only the cervical, but also the thoracolumbar spine, especially when the cause of injury is an accidental fall and a skull fracture is identified.

  5. Cerebral infarction following intracranial hemorrhage in pediatric Moyamoya disease - A case report and brief review of literature

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    Soumya Patra

    2012-01-01

    Full Text Available Moyamoya disease is a clinical entity characterized by progressive cerebrovascular occlusion with spontaneous development of a collateral vascular network called Moyamoya vessels. This disease mainly manifests as cerebral ischemia. Intracranial bleeding is another major presentation of patients with Moyamoya disease. We report here a 12-year-old male child who presented with severe headache, vomiting and meningismus. Initial neuroimaging study with noncontrast computed tomography scan revealed fresh intraventricular hemorrhage in right-sided lateral ventricle. Magnetic resonance imaging with angiography of brain was done 5 days later when the child developed right-sided hemiparesis, and the diagnosis of Moyamoya disease was confirmed along with lacunar infarction of right posterior peri and paraventricular area and in the left paraventricular area and centrum semiovale. Simultaneous presence of cerebral infarction along with intraventricular hemorrhage in adult with bleeding-type Moyamoya disease is reported in literature, but it is a rare entity in a child.

  6. 颅脑超声对新生儿颅内出血的诊断价值%Diagnostic value by craniocerebral ultrasound for neonatal intracranial hemorrhage

    Institute of Scientific and Technical Information of China (English)

    闫媛媛; 丁枚; 石伟波; 谷小乐

    2016-01-01

    目的:探讨颅脑超声对诊断新生儿颅内出血的临床价值。方法对196例疑似颅内出血的新生儿(早产儿127例,足月儿69例)进行超声检查,观察检测结果。结果196例疑似颅内出血的新生儿病例中,超声诊断颅内出血111例,患病率(56.6%);早产儿颅内出血患病率高于足月儿,比较差异有统计学意义(χ2=9.247, P0.05)。结论颅脑超声具有早期诊断和动态观察新生儿颅内出血的优势,可作为首选方法。%Objective To investigate clinical value by craniocerebral ultrasound for neonatal intracranial hemorrhage.Methods A total of 196 newborn (127 premature infants and 69 term infants)with suspected intracranial hemorrhage received ultrasonic examination, and their outcomes were observed.Results Among 196 newborn with suspected intracranial hemorrhage, 111 cases with intracranial hemorrhage diagnosed by ultrasound, with morbidity as 56.6%. Premature infants had higher morbidity of intracranial hemorrhage than term infants, and the difference had statistical significance (χ2=9.247,P0.05).Conclusion Craniocerebral ultrasound contains advantages of early diagnosis and dynamic observation for neonatal intracranial hemorrhage, and this method can be taken as the preferred measure.

  7. Risk of intracranial hemorrhage in users of oral antithrombotic drugs: Study protocol for a nationwide study [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sasha Gulati

    2015-12-01

    Full Text Available Background A wide range of antithrombotic medications can be used in the prevention and treatment of thrombosis. Among hemorrhagic complications of antithrombotic drugs, intracranial hemorrhage may have particularly devastating consequences with high morbidity, disability and mortality rates. The incidence and risks of intracranial hemorrhage in patients on antithrombotic treatments from regular clinical practice outside clinical trials remain largely unknown. It is not known if results from clinical trials can be extrapolated to everyday clinical practice. We will conduct a nationwide study to investigate the risks and incidence rates of intracranial hemorrhage in users oral antithrombotic drugs in Norway from 2008 through 2014.  Methods and design The aim of this nationwide study is to investigate the incidence rates of intracranial hemorrhage requiring hospitalization in users of oral antithrombotic drugs. The study will be conducted within the approximately 4.7 million inhabitants of Norway from January 1st, 2008, to December 31st, 2014. Treatment and outcome data are obtained from the Norwegian patient registry and the Norwegian prescription database.  Trial registration number Clinicaltrials.gov (NCT02481011

  8. The Role of ABO Blood Group in Cerebral Vasospasm, Associated Intracranial Hemorrhage, and Delayed Cerebral Ischemia in 470 Patients with Subarachnoid Hemorrhage.

    Science.gov (United States)

    Dubinski, Daniel; Won, Sae-Yeon; Konczalla, Jürgen; Mersmann, Jan; Geisen, Christof; Herrmann, Eva; Seifert, Volker; Senft, Christian

    2017-01-01

    Rupture of an intracranial aneurysm usually presents with an acute onset and requires multidisciplinary intensive care treatment and the overall death and disability rates are high. The ABO blood type is known to play an important role in hemostasis, thrombosis, and vascular NO response. The aspect of ABO blood type in onset, clinical progress, and outcome after subarachnoid hemorrhage (SAH) is largely unexplored. We conducted this study to elucidate the association of ABO blood type with the occurrence and outcome of aneurysmal SAH. In our retrospective study, 470 patients with aneurysmal SAH treated at our institution were included. We performed a χ(2) test for comparison between blood types and World Federation of Neurosurgical Societies admission status, cerebral vasospasm, delayed infarction, associated intracerebral hemorrhage and Fisher grade for analysis for their association with SAH. No significant difference between blood type and the reviewed variables for SAH outcome were identified: World Federation of Neurosurgical Societies admission status (odds ratio, 1.12; 95% confidence interval [CI], 0.7-1.6; P = 0.56); SAH-associated intracerebral hemorrhage (odds ratio, 0.81; 95% CI, 0.5-1.3; P = 0.36); cerebral vasospasm (odds ratio, 1.08; 95% CI, 0.7-1.6; P = 0.71); DCI (odds ratio, 1.23; 95% CI, 0.8-1.8; P = 0.30); Fisher grade (odds ratio, 1.13; 95% CI, 0.7-1.6; P = 0.19). Although a possible relationship between the ABO blood group and the clinical course of patients with SAH was hypothesized, our study showed no significant influence of patient's ABO blood type on cerebral vasospasm onset, SAH-associated intracerebral hemorrhage, or delayed infarction. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Late vitamin K deficiency intracranial hemorrhage CT diagnosis value%晚发性维生素K缺乏症颅内出血的CT诊断价值

    Institute of Scientific and Technical Information of China (English)

    关春

    2013-01-01

    Objective:To explore the CT late vitamin K deficiency intracranial hemorrhage diagnosis value. Materials and methods:Col ection of 16cases with late vitamin K deficiency intracranial hemorrhage in children with CT clinical data analysis. Results:Intracerebral hemorrhage in 14 cases,11 cases with subarachnoid hemorrhage, subdural hematoma in 8 cases,4 cases of epidural hematoma, intraventricular hemorrhage in 2 cases. Conclusion:CT can rapidly and accurately display intracranial hemorrhage, bleeding location, quantity, for clinical diagnosis, treatment and has the important value.%目的:探讨CT对晚发性维生素K缺乏症颅内出血的诊断价值。资料与方法:收集16例晚发性维生素K缺乏症颅内出血患儿的CT临床资料进行分析。结果:脑实质内出血14例,蛛网膜下腔出血11例,硬膜下血肿8例,硬膜外血肿4例,脑室内出血2例。结论:CT检查能快速准确地显示颅内出血的部位、范围、出血量的多少,对临床诊断、治疗等具有重要价值。

  10. Prediction models for intracranial hemorrhage or major bleeding in patients on antiplatelet therapy: a systematic review and external validation study.

    Science.gov (United States)

    Hilkens, N A; Algra, A; Greving, J P

    2016-01-01

    ESSENTIALS: Prediction models may help to identify patients at high risk of bleeding on antiplatelet therapy. We identified existing prediction models for bleeding and validated them in patients with cerebral ischemia. Five prediction models were identified, all of which had some methodological shortcomings. Performance in patients with cerebral ischemia was poor. Background Antiplatelet therapy is widely used in secondary prevention after a transient ischemic attack (TIA) or ischemic stroke. Bleeding is the main adverse effect of antiplatelet therapy and is potentially life threatening. Identification of patients at increased risk of bleeding may help target antiplatelet therapy. This study sought to identify existing prediction models for intracranial hemorrhage or major bleeding in patients on antiplatelet therapy and evaluate their performance in patients with cerebral ischemia. We systematically searched PubMed and Embase for existing prediction models up to December 2014. The methodological quality of the included studies was assessed with the CHARMS checklist. Prediction models were externally validated in the European Stroke Prevention Study 2, comprising 6602 patients with a TIA or ischemic stroke. We assessed discrimination and calibration of included prediction models. Five prediction models were identified, of which two were developed in patients with previous cerebral ischemia. Three studies assessed major bleeding, one studied intracerebral hemorrhage and one gastrointestinal bleeding. None of the studies met all criteria of good quality. External validation showed poor discriminative performance, with c-statistics ranging from 0.53 to 0.64 and poor calibration. A limited number of prediction models is available that predict intracranial hemorrhage or major bleeding in patients on antiplatelet therapy. The methodological quality of the models varied, but was generally low. Predictive performance in patients with cerebral ischemia was poor. In order to

  11. Predicting intracranial hemorrhage after traumatic brain injury in low and middle-income countries: A prognostic model based on a large, multi-center, international cohort

    Directory of Open Access Journals (Sweden)

    Subaiya Saleena

    2012-11-01

    Full Text Available Abstract Background Traumatic brain injury (TBI affects approximately 10 million people annually, of which intracranial hemorrhage is a devastating sequelae, occurring in one-third to half of cases. Patients in low and middle-income countries (LMIC are twice as likely to die following TBI as compared to those in high-income countries. Diagnostic capabilities and treatment options for intracranial hemorrhage are limited in LMIC as there are fewer computed tomography (CT scanners and neurosurgeons per patient as in high-income countries. Methods The Medical Research Council CRASH-1 trial was utilized to build this model. The study cohort included all patients from LMIC who received a CT scan of the brain (n = 5669. Prognostic variables investigated included age, sex, time from injury to randomization, pupil reactivity, cause of injury, seizure and the presence of major extracranial injury. Results There were five predictors that were included in the final model; age, Glasgow Coma Scale, pupil reactivity, the presence of a major extracranial injury and time from injury to presentation. The model demonstrated good discrimination and excellent calibration (c-statistic 0.71. A simplified risk score was created for clinical settings to estimate the percentage risk of intracranial hemorrhage among TBI patients. Conclusion Simple prognostic models can be used in LMIC to estimate the risk of intracranial hemorrhage among TBI patients. Combined with clinical judgment this may facilitate risk stratification, rapid transfer to higher levels of care and treatment in resource-poor settings.

  12. Equal contribution of increased intracranial pressure and subarachnoid blood to cerebral blood flow reduction and receptor upregulation after subarachnoid hemorrhage. Laboratory investigation

    DEFF Research Database (Denmark)

    Ansar, Saema; Edvinsson, Lars

    2009-01-01

    OBJECT: Cerebral ischemia remains the key cause of disability and death in the late phase after subarachnoid hemorrhage (SAH), and its pathogenesis is still poorly understood. The purpose of this study was to examine whether the change in intracranial pressure or the extravasated blood causes the...

  13. Equal contribution of increased intracranial pressure and subarachnoid blood to cerebral blood flow reduction and receptor upregulation after subarachnoid hemorrhage. Laboratory investigation

    DEFF Research Database (Denmark)

    Ansar, Saema; Edvinsson, Lars

    2009-01-01

    OBJECT: Cerebral ischemia remains the key cause of disability and death in the late phase after subarachnoid hemorrhage (SAH), and its pathogenesis is still poorly understood. The purpose of this study was to examine whether the change in intracranial pressure or the extravasated blood causes the...

  14. Multiple intracranial hemorrhages in a normotensive demented patient: A probable cerebral amyloid angiopathy.

    Science.gov (United States)

    Chitsaz, Ahmad; Norouzi, Rasul; Marashi, Seyed Mohammad Javad; Salimianfard, Marzieh; Fard, Salman Abbasi

    2012-01-01

    Cerebral amyloid angiopathy (CAA) is the most common cause of lobar intracerebral hemorrhage. Repeated bleeding may be presented with vascular dementia. We have reported a 68-year-old normotensive demented patient with probable CAA presented with hemiparesia, headache and vomiting. According to the experience of this case, it is recommended to consider CAA for normotensive elderly patients presented with multiple and superficial intracerebral hemorrhage.

  15. Intracranial hemorrhage from undetected aneurysmal rupture complicating transphenoidal pituitary adenoma resection.

    Science.gov (United States)

    Rustagi, Tarun; Uy, Edilfavia Mae; Rai, Mridula; Kannan, Subramanian; Senatus, Patrick

    2011-08-01

    We report a case of a 39-year-old man who presented with a nonfunctioning pituitary macroadenoma which extended into the suprasellar region. He underwent a transcranial resection of the tumor followed eight months later by transsphenoidal surgery for the residual tumor. Postoperatively he developed massive subarachnoid and intraventricular hemorrhage. A cerebral angiogram revealed a leaking anterior communicating artery aneurysm which was not seen on the computed tomography angiography and magnetic resonance angiography before the surgery. Complications of transsphenoidal surgery, particularly vascular hemorrhagic complications, and risk of rupture of undetected aneurysms are discussed.

  16. Severe pathological manifestation of cerebral amyloid angiopathy correlates with poor outcome from cerebral amyloid angiopathy related intracranial hemorrhage

    Institute of Scientific and Technical Information of China (English)

    TANG Ya-juan; WANG Shuo; ZHU Ming-wei; SUN Yi-lin; ZHAO Ji-zong

    2013-01-01

    Background Cerebral amyloid angiopathy (CAA) is one of the main causes of spontaneous intracranial hemorrhage (ICH).No established link is available between pathological scores of CAA and its outcome.This study aimed to identify the correlations between pathological severity and poor postoperative outcome in the Chinese population.Methods Between May 2006 and April 2011,367 consecutive patients who underwent surgery for CAA-related ICH in 71 hospitals throughout the mainland of China were enrolled in this study.Twelve months after surgery,we evaluated these patients' outcomes according to the modified Rankin Scale (mRS) and statistically correlated risk factors (demographics,medical history,pathological results,and surgical details) that are associated with a favorable (mRS <3)and poor (mRS >3) outcome groups.Results Risk factors for poor postoperative outcome in 367 patients with CAA-related ICH included advanced age (OR 1.034,95% Cl 1.001-1.067,P=-0.042),CAA pathology severity (OR 2.074,95% CI 7.140-16.25,P <0.001),lobar hematoma (OR 0.225,95% Cl 0.104-0.486,P <0.001),presence of intraventricular hemorrhage (OR 0.478,95% CI 0.229-1.001,P=-0.050),and/or subarachnoid hemorrhage (OR 2.629,95% CI,1.051-6.577,P=-0.039).Conclusions Poor postoperative outcome of patients with CAA-related ICH was more related to the severe pathological manifestation instead of other factors.Prior ischemia may present an early stage of CAA.

  17. Restarting Anticoagulant Treatment After Intracranial Hemorrhage in Patients With Atrial Fibrillation and the Impact on Recurrent Stroke, Mortality, and Bleeding: A Nationwide Cohort Study.

    Science.gov (United States)

    Nielsen, Peter Brønnum; Larsen, Torben Bjerregaard; Skjøth, Flemming; Gorst-Rasmussen, Anders; Rasmussen, Lars Hvilsted; Lip, Gregory Y H

    2015-08-11

    Intracranial hemorrhage is the most feared complication of oral anticoagulant treatment. The optimal treatment option for patients with atrial fibrillation who survive an intracranial hemorrhage remains unknown. We hypothesized that restarting oral anticoagulant treatment was associated with a lower risk of stroke and mortality in comparison with not restarting. Linkage of 3 Danish nationwide registries in the period between 1997 and 2013 identified patients with atrial fibrillation on oral anticoagulant treatment with incident intracranial hemorrhage. Patients were stratified by treatment regimens (no treatment, oral anticoagulant treatment, or antiplatelet therapy) after the intracranial hemorrhage. Event rates were assessed 6 weeks after hospital discharge and compared with Cox proportional hazard models. In 1752 patients (1 year of follow-up), the rate of ischemic stroke/systemic embolism and all-cause mortality (per 100 person-years) for patients treated with oral anticoagulants was 13.6, in comparison with 27.3 for nontreated patients and 25.7 for patients receiving antiplatelet therapy. The rate of ischemic stroke/systemic embolism and all-cause mortality (per 100 person-years) for recurrent intracranial hemorrhage, the rate of ischemic stroke/systemic embolism, and all-cause mortality (per 100 person-years) patients treated with oral anticoagulants was 8.0, in comparison with 8.6 for nontreated patients and 5.3 for patients receiving antiplatelet therapy. The adjusted hazard ratio of ischemic stroke/systemic embolism and all-cause mortality was 0.55 (95% confidence interval, 0.39-0.78) in patients on oral anticoagulant treatment in comparison with no treatment. For ischemic stroke/systemic embolism and for all-cause mortality, hazard ratios were 0.59 (95% confidence interval, 0.33-1.03) and 0.55 (95% confidence interval, 0.37-0.82), respectively. Oral anticoagulant treatment was associated with a significant reduction in ischemic stroke/all-cause mortality

  18. Fetal Intracranial Hemorrhage (Fetal Stroke: Report of Four Antenatally Diagnosed Casesand Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ying-Fen Huang

    2006-06-01

    Conclusion: This small series demonstrate that an antenatal diagnosis of fetal stroke with intraventricular hemorrhage Grades III and IV or with brain parenchymal involvement appears to be associated with poor neurologic outcome. Due to the significant neonatal neurologic impairment and potential medicolegal implications of antepartum fetal ICH, it follows that obstetricians and sonographers should be familiar with predisposing factors and typical diagnostic imaging findings of rare in utero ICH events.

  19. Permanent Sensorineural Deafness in a Patient with Chronic Myelogenous Leukemia Secondary to Intracranial Hemorrhage

    Directory of Open Access Journals (Sweden)

    Sakshi Kapur

    2013-01-01

    Full Text Available A 52-year-old male presented with tinnitus and fullness in left ear for one day. Workup revealed a white blood cell count of 685×103/μL with marked increase in granulocyte series and myeloid precursors on peripheral smear. The initial impression was chronic myelogenous leukemia with hyperleukocytosis, and patient was started on hydration, hydroxyurea, and allopurinol. Patient tolerated bone marrow biopsy well but continued to bleed excessively from the biopsy site. Results confirmed Philadelphia chromosome positive chronic myelogenous leukemia (chronic phase. On day three of hospitalization, patient developed sudden slurred speech along with shaking movements involving extremities. Magnetic resonance imaging revealed multiple hemorrhages throughout the brain. Hydroxyurea was continued until insurance coverage for nilotinib was getting approved. On day nine of hospitalization, patient developed sudden bilateral sensorineural deafness. Repeat magnetic resonance imaging revealed multiple new hemorrhages throughout the brain. Computer tomography of the temporal bones showed inflammatory changes in right and left mastoid cells. Nilotinib was started on day eleven of hospitalization. Patient’s white blood cell count continued to decrease, but there was no improvement in hearing. Four months later, patient was treated with bilateral transmastoid cochlear implants. This case highlights permanent deafness as a hemorrhagic complication secondary to chronic myelogenous leukemia.

  20. Intracranial hemorrhage requiring surgery in neurosurgical patients given ketorolac: a case-control study within a cohort (2001-2010).

    Science.gov (United States)

    Magni, Giuseppina; La Rosa, Italia; Melillo, Guido; Abeni, Damiano; Hernandez, Helssy; Rosa, Giovanni

    2013-02-01

    Ketorolac tromethamine (ketorolac) is a nonsedating drug with potent analgesic and moderate anti-inflammatory activity, which does not increase the sedation level. The safety of ketorolac with respect to risk of bleeding has been demonstrated in large numbers of patients undergoing general surgery, yet comparable safety data for neurosurgical patients are lacking. We studied the risk of symptomatic bleeding requiring surgery in patients undergoing elective neurosurgical procedures who received ketorolac as analgesic therapy. We established a cohort of patients who had elective intracranial procedures from January 2001 to August 2010 (excluding patients with urgent surgery, coagulopathy, history of anticoagulant or nonsteroidal, anti-inflammatory drug therapy) and verified the occurrence of postcraniotomy intracranial hemorrhage (ICH; detected by computed tomography and requiring surgery) in patients who received or did not receive ketorolac. Then, to control for potential confounders, we conducted a "nested" case-control study within the cohort: cases were defined as patients with ICH; controls were patients without ICH matched in a 2:1 ratio. The cohort included 4086 craniotomy patients (mean age, 52.4±14.3 years, 2124 male, 52%). Of the 1571 patients who received ketorolac (mean dosage, 50±15 mg/d), 8 (0.5%) suffered ICH; of the 2515 patients who did not receive ketorolac, 35 (1.3%) had ICH (relative risk, 0.37; 95% confidence interval, 0.17-0.79; P=0.007). In the nested case-control study, the adjusted odds ratio for ketorolac administration between the 2 groups was 1.09 (95% confidence interval, 0.35-3.44; P=0.88). Although the adjusted estimate for risk of symptomatic bleeding requiring surgery and ketorolac use is very close to the null effect, it may be not reproducible, and the width of the confidence interval is not conclusive evidence of the safety of ketorolac after elective neurosurgical procedures.

  1. Identifying patients with mild traumatic intracranial hemorrhage at low risk of decompensation who are safe for ED observation.

    Science.gov (United States)

    Pruitt, Peter; Penn, Joshua; Peak, David; Borczuk, Pierre

    2017-02-01

    Patients with traumatic intracranial hemorrhage and mild traumatic brain injury (mTIH) receive broadly variable care which often includes transfer to a trauma center, neurosurgery consultation and ICU admission. However, there may be a low risk cohort of patients who can be managed without utilizing such significant resources. Describe mTIH patients who are at low risk of clinical or radiographic decompensation and can be safely managed in an ED observation unit (EDOU). Retrospective evaluation of patients age≥16, GCS≥13 with ICH on CT. Primary outcomes included clinical/neurologic deterioration, CT worsening or need for neurosurgery. 1185 consecutive patients were studied. 814 were admitted and 371 observed patients (OP) were monitored in the EDOU or discharged from the ED after a period of observation. None of the OP deteriorated clinically. 299 OP (81%) had a single lesion on CT; 72 had mixed lesions. 120 patients had isolated subarachnoid hemorrhage (iSAH) and they did uniformly well. Of the 119 OP who had subdural hematoma (SDH), 6 had worsening CT scans and 3 underwent burr hole drainage procedures as inpatients due to persistent SDH without new deficit. Of the 39 OP who had cerebral contusions, 3 had worsening CT scans and one required NSG admission. No patient returned to the ED with a complication. Follow-up was obtained on 81% of OP. 2 patients with SDH required burr hole procedure >2weeks after discharge. Patients with mTIH, particularly those with iSAH, have very low rates of clinical or radiographic deterioration and may be safe for monitoring in an emergency department observation unit. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Intracranial subarachnoid fat and hemorrhage secondary to sacral fracture with spondylopelvic dissociation.

    Science.gov (United States)

    Carreres Polo, J; Álvarez Martínez, M V; Sánchez Mateos, D

    2017-06-10

    We describe a case of fat droplets and blood in the cerebral subarachnoid space secondary in a patient with a complex sacral fracture without associated cranial trauma, a few days after admission. To our knowledge, there is only one published case with similar findings and without any other underlying lesion as cause. We explain the differences in the mechanism of production between this direct fat embolism and brain fat embolism syndrome, which is an intravascular embolism with different radiological appearance. The most important features of sacral fracture with spondylopelvic dissociation are described. Finally, this entity should be taken into account in the differential diagnosis of the few causes of fat in the subarachnoid space. In the context of high-energy trauma fractures of the sacrum or spine must be ruled out as a potential cause of this uncommon intracranial finding. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Multiplanar reconstructed CT images increased depiction of intracranial hemorrhages in pediatric head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Langford, Stacey; Panigrahy, Ashok; Narayanan, Srikala; Hwang, Misun; Fitz, Charles; Flom, Lynda; Lee, Vincent Kyu; Zuccoli, Giulio [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Section of Neuroradiology, Pittsburgh, PA (United States)

    2015-12-15

    The benefits of multiplanar reconstructed images (MPR) of unenhanced axial head computed tomography (CT) data have not been established in trauma patients younger than 3 years old, a population in which a reliable history and physical examination may be most difficult. We retrospectively evaluated unenhanced head CTs in pediatric trauma patients to investigate the various benefits of MPR in this age group. A total of 221 unenhanced head CTs performed for any case of head trauma (HT) on children younger than 3 years old were independently reviewed by two radiologists. Studies were reviewed first in the standard axial plane alone and then with the addition of MPR. Reviewers were asked to determine if the MPR affected the ability to make findings of hemorrhage, incidental findings, and artifacts. MPR improved the detection of hemorrhage in 14 cases (6.5 %, p-value < 0.01) and incidental findings in five cases (2.3 %, p-value < 0.05) as well as helped prove artifacts in five cases (2.3 %, p-value < 0.05). Routine use of MPR in HT patients younger than 3 years old has the potential to increase the detection of acute and incidental imaging findings. (orig.)

  4. Clinical and angiographic characteristics of cavernous sinus dural arteriovenous fistulas manifesting as venous infarction and/or intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Miyamoto, Naoko; Naito, Isao; Takatama, Shin; Shimizu, Tatsuya; Iwai, Tomoyuki [Geriatrics Research Institute and Hospital, Department of Neurosurgery, Maebashi (Japan); Shimaguchi, Hidetoshi [Gunma University Graduate School of Medicine, Department of Neurosurgery, Maebashi (Japan)

    2009-01-15

    Cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) rarely cause venous infarction (VI) and/or intracranial hemorrhage (ICH) despite the presence of cortical venous drainage (CVD). The present study investigated the characteristics of CS DAVFs manifesting as VI/ICH. Fifty-four patients treated for CS DAVFs were retrospectively studied. Six patients presented with VI/ICH. Two of the three patients presenting with ICH had CVD only to the superficial sylvian vein (SSV) or the deep sylvian vein (DSV). Three patients presenting with VI had multiple drainages, and angiography of these patients showed a varix on the SSV, drainage into the DSV with agenesis of the second and third segment of basal vein of Rosenthal, and thrombosis of the distal petrosal vein. CS DAVF with CVD only carries higher risk of VI/ICH than multiple drainages. Many CS DAVFs presenting with VI, especially those with drainage into the petrosal vein, have multiple drainages in the early stage. Thrombosis of the inferior and superior petrosal sinuses and superior orbital vein gradually increases pressure of the CVD, and then, VI may occur. In contrast, CS DAVFs with CVD only from the beginning, common in the patients with drainage into the SSVs and DSVs, are likely to cause ICH. Angiographic risk factors causing VI/ICH are CVD only, varix formation, agenesis of the second and third segment of basal vein of Rosenthal, and thrombosis of the superior orbital vein, lateral half of the superior petrosal sinus, and distal CVD. (orig.)

  5. 外伤迟发性颅内出血死亡案例研究%A Case Study on Delayed Traumatic Intracranial Hemorrhage Death

    Institute of Scientific and Technical Information of China (English)

    张海宁

    2013-01-01

    通过对一例外伤迟发性颅内出血死亡案例分析,探讨了外伤迟发性颅内出血的临床表现、诊断依据、病理组织学特点及相关法医检验的应对要素。研究发现,外伤性迟发性颅内出血是外伤后早期未发生出血、经数日或数周突发出血,引发伤者出现颅内压升高症状及体征,经CT复查而发现的一种延迟性出血。其成因为外伤时外力作用致脑实质多发小软化灶,持续地损伤脑内血管,因诱因导致血压的突然升高或附近组织急剧变化的抵抗而发生出血。所以,对于外伤性迟发性颅内出血,需结合调查,全面分析其伤后医疗病历、CT检查回报以及尸检病理组织学所见等,综合判断。以避免引起伤者、致伤者、医院甚至办案单位等多方纠纷。%Through a case analysis of delayed traumatic intracranial hemorrhage death, this article discusses the clinical manifestations, diagnosis bases, histopathological features of intracranial hemorrhage and key factors of dealing with relevant forensic examinations. Studies show that delayed traumatic intracranial hemorrhage is a type of delayed intracranial bleeding that suddenly occurs in several days or weeks after the initial trauma. It can result in the signs and symptoms of increased intracranial pressure, which is often diagnosed by CT reexamination. Its attributing reason is that exogenic action makes brain parenchyma produce multiple small softened lesions, which continuously damage brain vessels, and ultimately lead to bleeding upon a surge in blood pressure or rapid changes of nearby tissue. Therefore, the delayed traumatic intracranial hemorrhage should be judged by investigations, comprehensive analyses of their post-injury medical records, results of CT examination and pathological histology of corps so as to avoid multi-party disputes among the injured, the people causing injury, hospitals and even the law-enforcement agencies

  6. 109例新生儿颅内出血病因分析%Clinical analysis of newborn with intracranial hemorrhage.

    Institute of Scientific and Technical Information of China (English)

    陆蓓; 王静; 罗小丽

    2011-01-01

    Obijective To analyze the dements of high-risk factors and clinical features of newborn with intracranial hemorrhage, and to offer evidences for clinical early treatment. Methods Review one hundred and nine newborn between January 2009 and April 2009 in The west China Second hospital, and diagnose intracranial hemorrhage by cranial chromatic ultrasound and cranial computed tomography. Results The incidence of intracranial hemorrhage not only associated with prematurity and hypoxia, but also associated with birth weight、mode of parturition、state of health with pregnant woman. Conclusion Strengthens the permatal health care,exammation of cranial chromatic ultrasound and cranial computed tomography is necessary for newborn with high-risk factors of intracranial hemorrhage at their early age. Early detection and corrective measures could avoid damages to the central nervous system of newborn with intracranial hemorrhage.%目的 探讨新生儿颅内出血的高危因素及临床特点,为临床早期干预提供可借鉴的依据.方法 对四川大学华西附二院自2009年1月~2009年4月,经头颅彩超、头颅CT确诊为新生儿颅内出血109例进行回顾性分析.结果 新生儿颅内出血不仅与早产和低氧有关,而且与新生儿出生体重、生产方式、孕妇健康状况也有密切关系.结论 加强围产期保健,对存在颅内出血高危因素的新生儿应尽早行头颅彩超、头颅CT检查.及时发现颅内出血,早期治疗,避免或减少后遗症的发生.

  7. Subarachnoid hemorrhage due to ruptured intracranial aneurysm following posterior reversible encephalopathy syndrome

    Directory of Open Access Journals (Sweden)

    Takamasa Nanba

    2016-01-01

    Full Text Available Although posterior reversible encephalopathy syndrome (PRES is rarely associated with subarachnoid hemorrhage, to our knowledge, rupture of a concomitant cerebral aneurysm following PRES has not been reported. We describe a patient with atypical PRES involving the brainstem, thalamus, and periventricular white matter without cortical or subcortical edema of the parietooccipital lobe on magnetic resonance imaging, with rupture of a concomitant cerebral aneurysm. Preexisting extremely high blood pressure may trigger atypical PRES, and failure to lower blood pressure may lead to a concomitant aneurysm rupture. In the future treatment of hypertensive urgency with a recurrence of symptoms and mean arterial blood pressure >150 mmHg, it is advisable to immediately hospitalize the patient for aggressive blood pressure management, especially if PRES is suspected based on clinical and radiological features.

  8. EARLY TREATMENT OF CHILDREN WHIT INTRACRANIAL HEMORRHAGES IN THE ADVISORY INSTITUTION FOR DEVELOPMENT IN BITOLA

    Directory of Open Access Journals (Sweden)

    Liljana NAUMOVSKA

    1998-09-01

    Full Text Available In the period 1985-1995, 38 children with intracranal hemorrhages were treated in the Advisory Institution for Development in Bitola.Out of them:· or 44.7% were no consequences;· or 18.4% were with mute paresis;· or 36.8% were with cerebral paralysesTreatment in the Advisory Institution commences on the 15 day or within the first month of the child at the most. By using the Gunzberg defektology method the organization of the psycho-motor coordination, speech and knowledge functions are assessed. This diagnosis is necessary in order to begin with an early neuropsyhiatric habilitation treatment.Our Advisory Institution uses the method of conscious development synthesis which requires maximum involvement of the parent in the habilitation, rehabilitation and reeducation treatment.Parents are motivated and educated to participate through frequent visits to Advisory Institution by a defectologist-somatopead.

  9. ASPHYXIA, INTRACRANIAL HEMORRHAGES AND BRAIN EDEMA OF RISK CHILDREN IN THE ADVISORY INSTITUTE IN BITOLA FROM 1989-1994

    Directory of Open Access Journals (Sweden)

    M. ILIEVSKA,

    1997-09-01

    Full Text Available 3986 files have been examined in the Advisory Institute for a five year period in relation to the present risk factors in the pre, peri and postnatal period, the occurrence of asphyxia, I.H. (intracranial hemorrhages and brain edema and their outcome for the children. There were 958 or 32% risk children, out of them 206 or 22% were with asphyxia, 25 or 3% were with brain edema and 14 or 1,5% were with intracranial hemorrhages.The analysis for the risk factors shows that 119 of them were abortive , and from them 15% were born with asphyxia; 124 were SFD and 21% of them with asphyxia; 272 children weighed over 4500 gr., 7% of them with asphyxia and 0.4% with I.H., there were 68 twins, 12% of them with asphyxia. Out of the children with no risk registered, 6 were born with I.H., or 0,2%.Mothers under the age of 18 gave birth to 13% children with asphyxia; treated for sterility and anemia during pregnancy 15%; with increased blood pressure 14%; and 5% with maintained pregnancy.The highest delivery risk is present with children born with vacuum extraction (30% or every third child is with asphyxia and 3% with I.H. and with children delivered by caesarean section (14% with asphyxia.As for the position of the fetus-Citus pedalicus gave 55% children with asphyxia, and Situs pelvicus 12%.The worst damage is suffered by infants with premature amnion disruption (62% are with asphyxia; with the umbilical cord round the neck-56% with asphyxia and 6% with I.H.; and with muddled amniotic fluid and placenta pelvia-50%.The order of risk factors related to asphyxia, I.H. and brain edema is as follows: the first is premature amnion disruption, then follows the umbilical cord round the neck, the muddled amniotic fluid, and placenta previa and Citus pedalicus-which are obstetric problems. The next are the vacuum extraction and S.C. As for the gestatory period the order is as follows: first the abortive, then the twins and hypertrofic infants. The outcome of the

  10. Effect of residue hematoma volume on inflammation factors in hypertensive intracranial hemorrhage

    Directory of Open Access Journals (Sweden)

    You-san ZHANG

    2016-10-01

    Full Text Available Objectives  In this study, the relationships of residue hematoma volume to brain edema and inflammation factors were studied after intracerebral hematoma was evacuated with a frameless stereotactic aspiration. Methods  Eighty-nine patients with hypertensive intracerebral hemorrhage (ICH were treated by frameless stereotactic aspiration. According to residual volume of the hematoma, the patients were divided into gross-total removal of hematoma (GTRH (≤5ml and sub-total removal of hematoma (STRH (≥10ml groups after the operation. The pre-operative and postoperative data of the patients were compared between the two groups. The pre-operative data included age, sex, hematoma volume, time interval from the ictus to the operation, and Glasgow Coma Scale (GCS scores. The post-operative information included edema grade, level of thromboxane B2 (TXB2, 6-keto-prostaglandin F1α(6-K-PGF1α, tumor necrosis factor-α(TNF-α and endothelin (ET in hematoma cavity or cerebral spinal fluid (CSF. Results  There were 46 patients in GTRH group and 43 in STRH group respectively. There was no statistical difference in the pre-operative data between the two groups. The levels of TXB2, 6-K-PGF1α, TNF-αand ET were significantly lower in the GTRH group than in the STRH group at different post-operative time points. There was a significant difference between the two groups. The post-operative CT scan at different time points showed that the brain edema grades were better in the GTRH group than in the STRH group. Conclusions  GTRH is helpful for decreasing ICH-induced injury to brain tissue, which is related to decreased perihematomal edema formation and secondary injury by coagulation end products activated inflammatory cascade. DOI: 10.11855/j.issn.0577-7402.2016.09.12

  11. Investigation of UCH-L1 levels in ischemic stroke, intracranial hemorrhage and metabolic disorder induced impaired consciousness.

    Science.gov (United States)

    Yigit, Ihsan; Atescelik, Metin; Yilmaz, Mustafa; Goktekin, Mehmet Cagri; Gurger, Mehtap; Ilhan, Nevin

    2017-06-21

    We aimed to determine the levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) in patients admitted to the emergency department with impaired consciousness due to metabolic or neurological reasons. The study included 80 patients with ischemic stroke (IS), 40 patients with intracranial hemorrhage (ICH), 80 patients with metabolic disorder induced impaired consciousness (MDIC) and 40 healthy controls. The levels of UCH-L1 [median (IQR)] were as follows: 5.59ng/mL (3.90-9.37) in IS, 5.44ng/ml (4.01-13.98) in ICH, 3.34ng/ml (2.29-5.88) in MDIC and 3.94ng/ml (3.31-7.95) in healthy volunteers. Significantly higher levels were detected in IS and ICH than in MDIC and healthy volunteers. In ROC curve analysis, we detected 63.75% sensitivity and 62.5% specificity (AUC=0.626, plevels were found to increase significantly with increasing time between the onset of symptoms and blood sampling (r=0.345, plevels and age (r=0.014, p=0.833), GCS (r=-0.115, p=0.074), mRS (r=0.063, p=0.475) and NIHSS (r=0.056, p=0.520). In this study, we detected significantly higher levels of UCH-L1 in patients with IS and ICH compared to patients with MDIC and healthy volunteers. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Design and characterization of a dedicated cone-beam CT scanner for detection of acute intracranial hemorrhage

    Science.gov (United States)

    Xu, J.; Sisniega, A.; Zbijewski, W.; Dang, H.; Stayman, J. W.; Wang, X.; Foos, D. H.; Aygun, N.; Koliatsos, V. E.; Siewerdsen, J. H.

    2016-03-01

    Purpose: Prompt and reliable detection of intracranial hemorrhage (ICH) has substantial clinical impact in diagnosis and treatment of stroke and traumatic brain injury. This paper describes the design, development, and preliminary performance characterization of a dedicated cone-beam CT (CBCT) head scanner prototype for imaging of acute ICH. Methods: A task-based image quality model was used to analyze the detectability index as a function of system configuration, and hardware design was guided by the results of this model-based optimization. A robust artifact correction pipeline was developed using GPU-accelerated Monte Carlo (MC) scatter simulation, beam hardening corrections, detector veiling glare, and lag deconvolution. An iterative penalized weighted least-squares (PWLS) reconstruction framework with weights adjusted for artifact-corrected projections was developed. Various bowtie filters were investigated for potential dose and image quality benefits, with a MC-based tool providing estimates of spatial dose distribution. Results: The initial prototype will feature a source-detector distance of 1000 mm and source-axis distance of 550 mm, a 43x43 cm2 flat panel detector, and a 15° rotating anode x-ray source with 15 kW power and 0.6 focal spot size. Artifact correction reduced image nonuniformity by ~250 HU, and PWLS reconstruction with modified weights improved the contrast to noise ratio by 20%. Inclusion of a bowtie filter can potentially reduce dose by 50% and improve CNR by 25%. Conclusions: A dedicated CBCT system capable of imaging millimeter-scale acute ICH was designed. Preliminary findings support feasibility of point-of-care applications in TBI and stroke imaging, with clinical studies beginning on a prototype.

  13. Development and clinical translation of a cone-beam CT scanner for high-quality imaging of intracranial hemorrhage

    Science.gov (United States)

    Sisniega, A.; Xu, J.; Dang, H.; Zbijewski, W.; Stayman, J. W.; Mow, M.; Koliatsos, V. E.; Aygun, N.; Wang, X.; Foos, D. H.; Siewerdsen, J. H.

    2017-03-01

    Purpose: Prompt, reliable detection of intracranial hemorrhage (ICH) is essential for treatment of stroke and traumatic brain injury, and would benefit from availability of imaging directly at the point-of-care. This work reports the performance evaluation of a clinical prototype of a cone-beam CT (CBCT) system for ICH imaging and introduces novel algorithms for model-based reconstruction with compensation for data truncation and patient motion. Methods: The tradeoffs in dose and image quality were investigated as a function of analytical (FBP) and model-based iterative reconstruction (PWLS) algorithm parameters using phantoms with ICH-mimicking inserts. Image quality in clinical applications was evaluated in a human cadaver imaged with simulated ICH. Objects outside of the field of view (FOV), such as the head-holder, were found to introduce challenging truncation artifacts in PWLS that were mitigated with a novel multi-resolution reconstruction strategy. Following phantom and cadaver studies, the scanner was translated to a clinical pilot study. Initial clinical experience indicates the presence of motion in some patient scans, and an image-based motion estimation method that does not require fiducial tracking or prior patient information was implemented and evaluated. Results: The weighted CTDI for a nominal scan technique was 22.8 mGy. The high-resolution FBP reconstruction protocol achieved compensation method was shown in clinical studies to restore visibility of fine bone structures, such as the subtle fracture, cranial sutures, and the cochlea as well as subtle low-contrast structures in the brain parenchyma. Conclusion: The imaging performance of the prototype suggests sufficient quality for ICH imaging and motivates continued clinical studies to assess the diagnosis utility of the CBCT system in realistic clinical scenarios at the point of care.

  14. Systematic Review and Meta-Analysis: Is Pre-Injury Antiplatelet Therapy Associated with Traumatic Intracranial Hemorrhage?

    Science.gov (United States)

    van den Brand, Crispijn L; Tolido, Tanya; Rambach, Anna H; Hunink, Myriam G M; Patka, Peter; Jellema, Korné

    2017-01-01

    The objective of this systematic review and meta-analysis is to evaluate whether the pre-injury use of antiplatelet therapy (APT) is associated with increased risk of traumatic intracranial hemorrhage (tICH) on CT scan. PubMed, Medline, Embase, Cochrane Central, reference lists, and national guidelines on traumatic brain injury were used as data sources. Eligible studies were cohort studies and case-control studies that assessed the relationship between APT and tICH. Studies without control group were not included. The primary outcome of interest was tICH on CT. Two reviewers independently selected studies, assessed methodological quality, and extracted outcome data. This search resulted in 10 eligible studies with 20,247 patients with head injury that were included in the meta-analysis. The use of APT in patients with head injury was associated with significant increased risk of tICH compared with control (odds ratio [OR] 1.87, 95% confidence interval [CI]1.27-2.74). There was significant heterogeneity in the studies (I(2) 84%), although almost all showed an association between APT use and tICH. This association could not be established for patients receiving aspirin monotherapy. When considering only patients with mild traumatic brain injury (mTBI), the OR is 2.72 (95% CI 1.92-3.85). The results were robust to sensitivity analysis on study quality. In summary, APT in patients with head injury is associated with increased risk of tICH; this association is most relevant in patients with mTBI. Whether this association is the result of a causal relationship and whether this relationship also exists for patients receiving aspirin monotherapy cannot be established with the current review and meta-analysis.

  15. Intraoperative imaging for patient safety and QA: detection of intracranial hemorrhage using C-arm cone-beam CT

    Science.gov (United States)

    Schafer, Sebastian; Wang, Adam; Otake, Yoshito; Stayman, J. W.; Zbijewski, Wojciech; Kleinszig, Gerhard; Xia, Xuewei; Gallia, Gary L.; Siewerdsen, Jeffrey H.

    2013-03-01

    Intraoperative imaging could improve patient safety and quality assurance (QA) via the detection of subtle complications that might otherwise only be found hours after surgery. Such capability could therefore reduce morbidity and the need for additional intervention. Among the severe adverse events that could be more quickly detected by high-quality intraoperative imaging is acute intracranial hemorrhage (ICH), conventionally assessed using post-operative CT. A mobile C-arm capable of high-quality cone-beam CT (CBCT) in combination with advanced image reconstruction techniques is reported as a means of detecting ICH in the operating room. The system employs an isocentric C-arm with a flat-panel detector in dual gain mode, correction of x-ray scatter and beam-hardening, and a penalized likelihood (PL) iterative reconstruction method. Performance in ICH detection was investigated using a quantitative phantom focusing on (non-contrast-enhanced) blood-brain contrast, an anthropomorphic head phantom, and a porcine model with injection of fresh blood bolus. The visibility of ICH was characterized in terms of contrast-to-noise ratio (CNR) and qualitative evaluation of images by a neurosurgeon. Across a range of size and contrast of the ICH as well as radiation dose from the CBCT scan, the CNR was found to increase from ~2.2-3.7 for conventional filtered backprojection (FBP) to ~3.9-5.4 for PL at equivalent spatial resolution. The porcine model demonstrated superior ICH detectability for PL. The results support the role of high-quality mobile C-arm CBCT employing advanced reconstruction algorithms for detecting subtle complications in the operating room at lower radiation dose and lower cost than intraoperative CT scanners and/or fixedroom C-arms. Such capability could present a potentially valuable aid to patient safety and QA.

  16. Portable Wideband Microwave Imaging System for Intracranial Hemorrhage Detection Using Improved Back-projection Algorithm with Model of Effective Head Permittivity

    Science.gov (United States)

    Mobashsher, Ahmed Toaha; Mahmoud, A.; Abbosh, A. M.

    2016-02-01

    Intracranial hemorrhage is a medical emergency that requires rapid detection and medication to restrict any brain damage to minimal. Here, an effective wideband microwave head imaging system for on-the-spot detection of intracranial hemorrhage is presented. The operation of the system relies on the dielectric contrast between healthy brain tissues and a hemorrhage that causes a strong microwave scattering. The system uses a compact sensing antenna, which has an ultra-wideband operation with directional radiation, and a portable, compact microwave transceiver for signal transmission and data acquisition. The collected data is processed to create a clear image of the brain using an improved back projection algorithm, which is based on a novel effective head permittivity model. The system is verified in realistic simulation and experimental environments using anatomically and electrically realistic human head phantoms. Quantitative and qualitative comparisons between the images from the proposed and existing algorithms demonstrate significant improvements in detection and localization accuracy. The radiation and thermal safety of the system are examined and verified. Initial human tests are conducted on healthy subjects with different head sizes. The reconstructed images are statistically analyzed and absence of false positive results indicate the efficacy of the proposed system in future preclinical trials.

  17. Remote multiple intracranial hemorrhage in multiple metastatic lung adenocarcinoma following decompression of posterior fossa lesion: Unknown cause

    Directory of Open Access Journals (Sweden)

    Subhas Konar

    2015-01-01

    Full Text Available Cerebral metastasis can present with hemorrhage. However, multiple hemorrhages in metastatic lesions following surgical decompression of a single lesion are never reported. We report a case of cerebral metastasis from lung cancer that developed multiple hemorrhages in supratentorial metastatic lesions following surgical resection of an infratentorial lesion.

  18. [A Case of Aplastic or Twig-Like Middle Cerebral Artery Presenting with an Intracranial Hemorrhage Two Years after a Transient Ischemic Attack].

    Science.gov (United States)

    Uchiyama, Taku; Okamoto, Hiroaki; Koguchi, Motofumi; Tajima, Yutaka; Suzuyama, Kenji

    2016-02-01

    Aplastic or twig-like middle cerebral artery (Ap/T-MCA) is a rare anatomical anomaly, which can be associated with intracranial hemorrhage and cerebral ischemia. A 52-year-old woman who presented with sudden headache was admitted to our hospital. Computed tomography (CT) and magnetic resonance imaging showed no abnormality; however, magnetic resonance angiogram revealed an occlusion or severe stenosis in the left middle cerebral artery. Three-dimensional CT angiography demonstrated severe stenosis in the left middle cerebral artery. The patient was discharged without any neurological deficit; however, she subsequently complained of temporary weakness in the right hand. It was possibly due to a transient ischemic attack; therefore, cilostazol 200 mg/day was administered for prevention of cerebral ischemia. Single photon emission computed tomography(with or without administration of acetazolamide)showed neither significant decrease in the cerebral blood flow nor cerebrovascular reactivity; hence, surgical revascularization was not performed. However, two years after the initial admission, she was urgently admitted to our hospital with sudden headache and nausea followed by aphasia and weakness of the right extremities. CT images showed diffuse subarachnoid hemorrhage and intracerebral hemorrhage in the left temporo-parietal lobe. Cerebral angiography revealed that the left middle cerebral artery was Ap/T-MCA without cerebral aneurysms. The patient was treated conservatively, and she eventually recovered without any neurological deficit except mild aphasia. Since Ap/T-MCA is associated with both hemorrhagic and ischemic stroke, antiplatelet therapy should be administered carefully. Moreover, it is necessary to consider extracranial-intracranial bypass to reduce hemodynamic stress on the abnormal vessels.

  19. Intraventricular hemorrhage of the newborn

    Science.gov (United States)

    ... bleeding. Grade 1 is also referred to as germinal matrix hemorrhage (GMH). Grades 3 and 4 involve ... Saunders; 2015:chap 60. Volpe JJ. Intracranial hemorrhage: germinal matrix-intraventricular hemorrhage. In Volpe JJ, ed. Neurology ...

  20. An assessment of the iPad 2 as a CT teleradiology tool using brain CT with subtle intracranial hemorrhage under conventional illumination.

    Science.gov (United States)

    Park, Joon Bum; Choi, Hyuk Joong; Lee, Jeong Hun; Kang, Bo Seung

    2013-08-01

    We examined the potential of the iPad 2 as a teleradiologic tool for evaluating brain computed tomography (CT) with subtle hemorrhage in the conventional lighting conditions which are common situations in the remote CT reading. The comparison of the clinician's performance was undertaken through detecting hemorrhage by the iPad 2 and the clinical liquid crystal display (LCD) monitor. We selected 100 brain CT exams performed for head trauma or headache. Fifty had subtle radiological signs of intracranial hemorrhage (ICH), while the other 50 showed no significant abnormality. Five emergency medicine physicians reviewed these brain CT scans using the iPad 2 and the LCD monitor, scoring the probability of ICH on each exam on a five-point scale. Result showed high sensitivities and specificities in both devices. We generated receiver operating characteristic curves and calculated the average area under the curve of the iPad 2 and the LCD (0.935 and 0.900). Using the iPad 2 and reliable internet connectivity, clinicians can provide remote evaluation of brain CT with subtle hemorrhage under suboptimal viewing condition. Considering the distinct advantages of the iPad 2, the popular out-of-hospital use of mobile CT teleradiology would be anticipated soon.

  1. “REBOA” – Is it Really Safe? A Case with Massive Intracranial Hemorrhage Possibly due to Endovascular Balloon Occlusion of the Aorta (REBOA)

    Science.gov (United States)

    Uchino, Hayaki; Tamura, Nobuichiro; Echigoya, Ryosuke; Ikegami, Tetsunori; Fukuoka, Toshio

    2016-01-01

    Patient: Female, 86 Final Diagnosis: Polytrauma Symptoms: Shock Medication: — Clinical Procedure: Resuscitative endovascular balloon occlusion of the aorta Specialty: Orthopedics and Traumatology Objective: Unusual or unexpected effect of treatment Background: Non-compressible torso hemorrhage continues to be the leading cause of preventable death in trauma patients. Recent case series report that resuscitative endovascular balloon occlusion of the aorta (REBOA) in the trauma population is a technically feasible method to manage the patients with exsanguinating hemorrhage. On the other hand, it seems that REBOA is being widely promoted prematurely. Complications due to REBOA haven’t been reported much in the literature, and they could have been underestimated. Case Report: An 86-year-old female presented to our emergency department following a pedestrian-vehicle accident. On admission, she was hemodynamically unstable with systolic blood pressure (SBP) of 78 mm Hg. She responded to fluid administration, and computed tomography (CT) scan showed cerebral contusion, subarachnoid hemorrhage, pelvic fracture with contrast extravasation, and thoracic spine fracture. Her condition deteriorated after the CT scan, and she became hemodynamically unstable. REBOA was inserted and inflated. Her blood pressure recovered and even became as high as SBP of 180 mm Hg. Transarterial embolization for pelvic fracture was successfully performed. A subsequent head CT scan showed massive intracranial hemorrhage with penetration to the ventricle, which was fatal. She died on the same day due to cerebral herniation. Conclusions: REBOA is now considered as an alternative to resuscitative thoracotomy or even widely indicated to control hemorrhage. We should be more cautious about using REBOA for polytrauma patients since it could make hemorrhage worse. Further research, assessing its potential complications and safety, will be required to elucidate clear indications for REBOA in trauma

  2. The safety of vasopressor-induced hypertension in subarachnoid hemorrhage patients with coexisting unruptured, unprotected intracranial aneurysms.

    Science.gov (United States)

    Reynolds, Matthew R; Buckley, Robert T; Indrakanti, Santoshi S; Turkmani, Ali H; Oh, Gerald; Crobeddu, Emanuela; Fargen, Kyle M; El Ahmadieh, Tarek Y; Naidech, Andrew M; Amin-Hanjani, Sepideh; Lanzino, Giuseppe; Hoh, Brian L; Bendok, Bernard R; Zipfel, Gregory J

    2015-10-01

    Vasopressor-induced hypertension (VIH) is an established treatment for patients with aneurysmal subarachnoid hemorrhage (SAH) who develop vasospasm and delayed cerebral ischemia (DCI). However, the safety of VIH in patients with coincident, unruptured, unprotected intracranial aneurysms is uncertain. This retrospective multiinstitutional study identified 1) patients with aneurysmal SAH and 1 or more unruptured, unprotected aneurysms who required VIH therapy (VIH group), and 2) patients with aneurysmal SAH and 1 or more unruptured, unprotected aneurysms who did not require VIH therapy (non-VIH group). All patients had previously undergone surgical or endovascular treatment for the presumed ruptured aneurysm. Comparisons between the VIH and non-VIH patients were made in terms of the patient characteristics, clinical and radiographic severity of SAH, total number of aneurysms, number of ruptured/unruptured aneurysms, aneurysm location/size, number of unruptured and unprotected aneurysms during VIH, severity of vasospasm, degree of hypervolemia, and degree and duration of VIH therapy. For the VIH group (n = 176), 484 aneurysms were diagnosed, 231 aneurysms were treated, and 253 unruptured aneurysms were left unprotected during 1293 total days of VIH therapy (5.12 total years of VIH therapy for unruptured, unprotected aneurysms). For the non-VIH group (n = 73), 207 aneurysms were diagnosed, 93 aneurysms were treated, and 114 unruptured aneurysms were left unprotected. For the VIH and non-VIH groups, the mean sizes of the ruptured (7.2 ± 0.3 vs 7.8 ± 0.6 mm, respectively; p = 0.27) and unruptured (3.4 ± 0.2 vs 3.2 ± 0.2 mm, respectively; p = 0.40) aneurysms did not differ. The authors observed 1 new SAH from a previously unruptured, unprotected aneurysm in each group (1 of 176 vs 1 of 73 patients; p = 0.50). Baseline patient characteristics and comorbidities were similar between groups. While the degree of hypervolemia was similar between the VIH and non-VIH patients

  3. Prevalence of serious bleeding events and intracranial hemorrhage in patients receiving activated protein C: a systematic review and meta-analysis.

    Science.gov (United States)

    Khan, Ajmal; Agarwal, Ritesh; Aggarwal, Ashutosh N; Gupta, Dheeraj

    2010-07-01

    Activated protein C reduces 28-day mortality in patients with severe sepsis, but its anticoagulant properties entail a risk of bleeding. The aim of this systematic review was to evaluate the prevalence of serious bleeding events in patients receiving activated protein C. We searched the MEDLINE and EMBASE databases for studies that described the prevalence of serious bleeding events and intracranial hemorrhage in patients receiving activated protein C. We calculated the bleeding rates by calculating proportions and 95% CIs for each study, and then pooled the data to derive a pooled proportion and 95% CI. Our search yielded 17 studies, which included 10,679 patients. The occurrence of serious bleeding events in patients receiving activated protein C ranged from 0.5% to 9.6%, and the pooled prevalence was 3.3% (95% CI 2.4-4.4%) by the random effects model. The occurrence of intracranial hemorrhage ranged from 0% to 1.4%, and the pooled prevalence was 0.44% (95% CI 0.31-0.6%). Sensitivity analysis showed a higher prevalence of bleeding in the observational studies than in the randomized controlled trials. There was substantial clinical and statistical heterogeneity, but no evidence of publication bias. Activated protein C is associated with significant risk of bleeding, so strict inclusion and exclusion criteria should be set prior to administering activated protein C.

  4. Clinical evaluation of flat-panel detector compared with multislice computed tomography in 65 patients with acute intracranial hemorrhage: initial results. Clinical article.

    Science.gov (United States)

    Struffert, Tobias; Eyupoglu, Ilker Y; Huttner, Hagen B; Engelhorn, Tobias; Doelken, Marc; Saake, Marc; Ganslandt, Oliver; Doerfler, Arnd

    2010-10-01

    The goal in this study was to compare flat-panel detector (FD) CT with multislice (MS) CT in the visualization of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), intraventricular hemorrhage, and external ventricular drains (EVDs) to evaluate the diagnostic quality and limitations of the new FD CT imaging modality. Neuroimages obtained in 65 patients, including 24 with EVDs, were reviewed by 2 independent, experienced clinicians. Lesions in all patients were investigated with FD CT and MS CT. The numbers of slices positive for ICH and SAH were counted, and for ICH the diameter and area of the lesion was measured. The positioning of drains was assessed. The presence of ventricular blood was noted. Statistical analysis was performed by calculating the Pearson correlation coefficient (r) to evaluate the level of inter- and intraobserver agreement, and linear regression analysis was done to visualize the results of the numbers of ICH- and SAH-positive slices. The authors found high interobserver agreement regarding the number of slices with evidence of ICH (r = 0.89 for MS CT, r = 0.78 for FD CT) and SAH (r = 0.88 for MS CT, r = 0.9 for FD CT). Thin layers of blood in the ventricles were not detected on FD CT in 36.4% of cases. Six of 7 perimesencephalic SAHs were not seen on FD CT scans. The EVDs could be assessed with both modalities in 83.3% of cases, but the position of the drain could not be determined with FD CT in 16.7% (4 of 24 cases). In some respects, FD CT is of limited use for the visualization of intracranial hemorrhage. However, despite limited contrast resolution, ICH and EVDs can be reliably demonstrated. Perimesencephalic SAH and thin layers of blood in the occipital horns may not be detected using FD CT. Further evaluation and improvement of the image quality is necessary before FD CT will provide identical quality in comparison with MS CT.

  5. 脑室-腹腔分流术后迟发性颅内出血8例临床分析%Clinical analysis of 8 patients with delayed intracranial hemorrhage after ventricular-peritoneal shunt for hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    金浩; 张卫; 朱扬清; 邹煜; 周秋锋; 刘星; 钱伟; 左常阳

    2015-01-01

    目的:探讨脑室-腹腔分流术后出现迟发性颅内出血的类型,以及可能的防治措施。方法对72例脑室-腹腔分流术患者进行回顾性分析,分析术后发生迟发性颅内出血的规律和原因。结果本组患者中发生术后迟发性颅内血肿8例,急性硬膜下血肿2例、慢性硬膜下血肿2例及脑内血肿4例,是脑室-腹腔分流术后主要的三类迟发性颅内出血。结论选择合适的分流管、调整合适阀门压力以及熟练掌握脑室穿刺技巧可以减少及避免出现脑室-腹腔分流术后迟发性颅内出血。%Objective To explore the types of delayed intracranial hemorrhage after ventricular-peritoneal shunt for hydrocephalus , as well as effective prevention and control measures .Methods The clinical data of 72 patients suffered from delayed intracranial hemorrhage by ventricular-peritoneal shunt were analyzed retrospectively .The clinical features and factors were also analyzed .Results There were 8 cases of delayed intracranial hemorrhage after ventricular-peritoneal shunt in this group .The acute subdural hematoma , chronic subdural hematoma and intracerebral hemorrhage were the majory types of delayed intracranial emorrhage after ventricular -peritoneal shunt for hydrocephalus . Conclusion Choose the right shunt system , adjust the appropriate pressure and master the ventricle puncture techniques can reduce and avoid delayed intracranial hemorrhage .

  6. Unruptured intracranial aneurysms

    NARCIS (Netherlands)

    Backes, Daan

    2016-01-01

    Rupture of an intracranial aneurysm results in aneurysmal subarachnoid hemorrhage (SAH), a subtype of stroke with an incidence of 9 per 100,000 person-years and a case-fatality around 35%. In order to prevent SAH, patients with unruptured intracranial aneurysms can be treated by neurosurgical or end

  7. 整体系统护理对新生儿颅内出血的影响%Studying Scientific Nursing’s Influences on Neonatal Intracranial Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    兰静芳

    2012-01-01

      Objective:To discuss scientific nursing’s influences on neonatal intracranial hemorrhage.Method:Chose 45 of those newborn who suffered from intracranial hemorrhage and been treated at our hospital from January 2011 to April 2012,named as study group,gave scientific, comprehensive nursing to those newborn on the basis of routine nursing,such as:heat preservation,intrcrnil pressure,sedation and respiratory system management etc.What’s more,made comparative analysis with 22 of those newborn intracranial hemorrhage patients who received general nursing at our hospital before 2011,and called this new group after control group.Result:Study group’s mortality rate and the ratio of legacy sequela are evidently lower than control group,while the cure rate is obviously higher than control group,the differences have statistics meaning(P<0.05).Conclusion:Scientific nursing can reduce the incidence of mortality and sequelae of neonatal intracranial hemorrhage effectively,and it can improve the cure rate and improve patients’life quality,it is worthy of clinical promotion.%  目的:探讨整体系统护理对新生儿颅内出血的影响.方法:将2010年1月-2011年4月本院收治的45例颅内出血的新生儿,命名为研究组,在常规护理的基础上给予整体的多系统的全面的护理,如保温、降低颅内压、镇静、呼吸系统管理等.并与2010年前在本院进行一般护理的新生儿颅内出血患者22例进行比较分析,将该组命名为对照组.两组患者均随访1年.结果:研究组死亡率及后遗症发生率均明显低于对照组,而痊愈率则明显高于对照组,差异具有统计学意义(P<0.05).结论:科学护理能有效的减少新生儿颅内出血的死亡率和后遗症的发生率,能提高治愈率,提高患儿的生命质量,值得临床推广.

  8. Complicações hemorrágicas intracranianas na osteogênese imperfeita Intracranial hemorrhagic complications in cases of osteogenesis imperfecta

    Directory of Open Access Journals (Sweden)

    Laertel F. Fassoni

    1968-09-01

    Full Text Available São descritas complicações hemorrágicas intracranianas em dois pacientes com osteogênese imperfeita. Sangramento espontâneo ocorreu no espaço subaracnóideo em um dos pacientes e no espaço subdural, no outro. Os achados clínicos e paraclínicos são discutidos à luz de um distrbio mesenquimatoso difuso semelhante ao que caracteriza as demais moléstias hereditárias do mesênquima.The intracranial hemorrhagic complications in two patients with osteogenesis imperfecta are described. Spontaneous bleeding into the subarachnoid space occurred in one patient and into the subdural space in another. The clinical findings and their relationship to a generalized disturbance of mesenchymal tissue are discussed.

  9. Clinical management of intracranial hemorrhage in patients with hemophilia A%A型血友病合并颅内出血的临床救治

    Institute of Scientific and Technical Information of China (English)

    赵东升; 张世明; 蒋永进; 杜朝亮; 王跃胜

    2010-01-01

    @@ 血友病(hemophilia)是一组遗传性凝血活酶生成障碍引起的出血性疾病,约占先天性出血性疾病的88%.在我国血友病中,A型血友病(hemophilia A, HA)约占80%.出血可发生在任何部位,而颅内出血(intracranial hemorrhage, ICH)极少见.自2001年3月至2006年7月我们收治HA合并ICH 11例,结合相关文献分析总结如下.

  10. Hemodynamic changes of brain in newborns with intracranial hemorrhage%颅内出血新生儿的脑血流动力学变化

    Institute of Scientific and Technical Information of China (English)

    程元平; 刘艳平

    2013-01-01

    Objective To explore the hemodynamic changes in the brains of newborns with intracranial hemorrhage.Methods Totally,61 newborns,born in Anyang Maternal and Child Health Hospital of Henan Province,with intracranial hemorrhage diagnosed by ultrasound in early neonatal period,and 50 healthy newborns,also born in the same hospital from December 1,2010 to June30,2012,were selected.Intracranial hemorrhage newborns were graded according to the severity of hemorrhage and divided into mild (n=45) and severe groups (n =7).The peak systolic flow velocity (Vs),end diastolic velocity (Vd),mean flow velocity (Vm) and resistance index (RI) in the middle cerebral artery (MCA) and anterior cerebral artery (ACA) of brain were measured by Doppler ultrasound.Ttest was applied for statistical analysis.Results Among the 61 neonates with intracranialhemorrhage,12(19.7%) were grade Ⅰ,42(68.9%) were grade Ⅱ,6(9.8%) were grade Ⅲ,and one (1.6%) was grade Ⅳ.The Vs,Vm and Vd of MCA and ACA in the mild and severe intracranial hemorrhage group were significantly lower than those in the control group,the differences were statistically significant [MCA:(55.1±9.1) cm/s,(53.0±6.5) cm/s vs (60.1± 10.3) cm/s;(34.2±6.1) cm/s,(32.5±5.2) cm/s vs (38.2±6.9) cm/s; (17.1±4.8) cm/s,(15.3± 4.0) cm/svs (20.2±5.3) cm/s.ACA:(41.3±11.7) cm/s,(39.4±9.2) cm/s vs (45.3±9.8) cm/s;(25.2±5.8) cm/s,(23.3±4.9) cm/s vs (28.1±5.9) cm/s;(15.0±3.9) cm/s,(13.2±3.1) cm/s vs (15.9±3.8) cm/s,all P<0.05].But the RI values were significantly higher in the control group,the differences were statistically significant (MCA:0.70 ± 0.10,0.77 ± 0.07 vs 0.62 ± 0.10 ; ACA:0.67±0.06,0.73±0.08 vs 0.61±0.05;all P<0.05).TheVs,Vm and Vd of MCA and ACA in the severe intracranial hemorrhage group were significantly lower than in the mild hemorrhage group,while the RI values were significantly higher,and the differences were statistically significant (all P<0.05).Conclusions Newborns with intracranial

  11. 婴儿晚发性维生素K缺乏并颅内出血的CT诊断(附23例分析)%Clinical CT analysis of 23 infants with delayed vitamin K deficiency and intracranial hemorrhage

    Institute of Scientific and Technical Information of China (English)

    林新杰; 董学萍; 任玉琴; 纪丽莉

    2001-01-01

    目的:探讨晚发性维生素K(Vit k)缺乏症并颅内出血的发病机制及CT表现,提高CT检查对本病价值的认识。方法:分析了23例临床资料完整,确诊晚发性Vit K缺乏症并颅内出血的临床CT表现。结果:蛛网膜下腔出血16例,硬膜下出血14例,脑内出血11例,脑室内出血4例。结论:CT是Vit K缺乏症并颅内出血的首选检查方法,对临床制定综合治疗计划,估计预后提供可靠依据。%Objecbive:To study the mechanism and CT features of delayed vitamin K deficiency with intracranial hemorrhage,to show the diagnostic value of CT scan to the disease. Methods:Analyzing the clinical CT features of 23 infants with delayed vitamin K deficiency and intracranial hemorrhage. Results: 16 cases with subarachnoid hemorrhage, 14 with subdural hemorrhage,11 with intracerebral hemorrhage, 4 with ventricular hemorrhage. Conclusion:CT scan should be the first reliable choice of accessory examinations for making general plan of treatment to the disease.

  12. The “focus on aneurysm” principle: Classification and surgical principles of management of concurrent arterial aneurysm with arteriovenous malformation causing intracranial hemorrhage

    Science.gov (United States)

    Jha, Vikas; Behari, Sanjay; Jaiswal, Awadhesh K.; Bhaisora, Kamlesh Singh; Shende, Yogesh P.; Phadke, Rajendra V.

    2016-01-01

    Context: Concurrent arterial aneurysms (AAs) occurring in 2.7-16.7% patients harboring an arteriovenous malformation (AVM) aggravate the risk of intracranial hemorrhage. Aim: We evaluate the variations of aneurysms simultaneously coexisting with AVMs. A classification-based management strategy and an abbreviated nomenclature that describes their radiological features is also proposed. Setting: Tertiary care academic institute. Statistics: Test of significance applied to determine the factors causing rebleeding in the groups of patients with concurrent AVM and aneurysm and those with only AVMs. Subjects and Methods: Sixteen patients (5 with subarachnoid hemorrhage and 11 with intracerebral/intraventricular hemorrhage; 10 with low flow [LF] and 6 with high flow [HF] AVMs) underwent radiological assessment of Spetzler Martin (SM) grading and flow status of AA + AVM. Their modified Rankin's score (mRS) at admission was compared with their follow-up (F/U) score. Results: Pre-operative mRS was 0 in 5, 2 in 6, 3 in 1, 4 in 3 and 5 in 1; and, SM grade I in 5, II in 3, III in 3, IV in 4 and V in 1 patients, respectively. AA associated AVMs were classified as: (I) Flow-related proximal (n = 2); (II) flow-related distal (n = 3); (III) intranidal (n = 5); (IV) extra-intranidal (n = 2); (V) remote major ipsilateral (n = 1); (VI) remote major contralateral (n = 1); (VII) deep perforator related (n = 1); (VIII) superficial (n = 1); and (IX) distal (n = 0). Their treatment strategy included: Flow related AA, SM I-III LF AVM: aneurysm clipping with AVM excision; nidal-extranidal AA, SM I-III LF AVM: Excision or embolization of both AA + AVM; nidal-extranidal and perforator-related AA, SM IV-V HF AVM: Only endovascular embolization or radiosurgery. Surgical decision-making for remote AA took into account their ipsilateral/contralateral filling status and vessel dominance; and, for AA associated with SM III HF AVM, it varied in each patient based on diffuseness of AVM nidus, flow

  13. 儿童原发性免疫性血小板减少症颅内出血的多中心临床研究%Multi-center clinical study on intracranial hemorrhage in children with primary immune thrombocytopenia

    Institute of Scientific and Technical Information of China (English)

    胡群; 刘爱国; 金润铭; 徐云云; 李建新; 李晖; 朱斌

    2013-01-01

    To explore the incidence,relevant clinical risk factors and prognosis of intracranial hemorrhage in children with primary immune thrombocytopenia (ITP) . Method:Retrospective analysis was conducted on 17 cases of ITP with intracranial hemorrhage admitted in four children hematologic diseases centers during 2001 to 2011. Result:The incidence of intracranial hemorrhage in children with ITP was 0. 46%. There were some risk factors for intracranial hemorrhage,such as disease course within 1 month for acute patients and longer than 1 year for chronic patients; concurrent-infection; strenuous exercise; trauma and platelet count less than 10 × 109/L. The motality of ITP with intracranial hemorrhage was 11.7% and the prognosis was fine after active treatment. Conclusion: Intracranial hemorrhage in children with ITP was a disease which could be effectively cured through active treatment. The majority of survivors did not have severe neurological sequelae.%目的:探讨我国儿童免疫性血小板减少症(ITP)颅内出血的发生率、相关临床因素及预后.方法:对四大儿童血液病中心2001-2011年收治的儿童ITP并发颅内出血者17例进行回顾性分析.结果:①ITP患儿颅内出血的发生率为0.46%.②颅内出血高危因素为急性患儿起病1个月内,慢性患儿病程1年后;并发感染、剧烈运动和外伤;血小板计数小于10×109/L.③并发颅内出血者病死率为11.7%.④积极治疗后预后良好.结论:ITP患儿的颅内出血是一种可以通过积极治疗而达到有效治愈的疾病,幸存下来的患儿多数无严重的神经系统后遗症.

  14. M RI与超声诊断在新生儿颅内出血中的临床应用%THE DIAGNOSTIC VALUE OF MRI AND ULTRASOUND IN INTRACRANIAL HEMORRHAGE IN THE NEWBORN

    Institute of Scientific and Technical Information of China (English)

    武军; 张秀玲; 倪臣美

    2015-01-01

    目的:对比分析M RI与超声在诊断新生儿颅内出血中的临床应用价值。方法回顾性分析我院于2014年3月~2015年10月收治的221例新生儿患者,均行头颅超声筛查和M RI检查,凡超声诊断有颅内出血者,作为观察组;未见出血者,作为对照组。若其后M RI显示有出血者,仍归为观察组。对比分析两种检查方法对新生儿颅内出血检出率、分布区域及病灶总数之间的差异。结果 M RI诊断颅内出血的分辨率及病灶检出个数明显高于超声,差别有统计学意义( P <0.05)。新生儿颅内出血部位以室管膜下、脑室内出血发生率最高。结论 M RI能更准确的诊断新生儿颅内出血,可以作为一种必要的检查方法。%Objective Comparatively analyze the diagnostic value of MRI and ultrasound in intracranial hemorrhage in the newborn .Methods Two hundred and twenty one cases of neonatal intracranial hemor‐rhage cases during M arch 2013 to October 2015 w ere detected by using M RI sequence and B‐mode ultra‐sonography .The cases of intracranial hemorrhage diagnosed by ultrasound were classified as observation group ,no hemorrhage ,as a control group ,the cases were still owned by the observation group if they were showed hemorrhage by MRI .The detecting rate ,distribution and number of intracranial hemorrhage were compared among those methods .Results The detection rate of MRI sequence was significantly higher than that of B ultrasound for the bleeding lesions .Subependymal intraventricular hemorrhage was the most commonhemorrhage ,there was statistical difference( P < 0 .05) .Conclusion Compared with ultrasound , M RI has obvious advantages in the diagnosis of neonatal intracranial hemorrhage ,it can be used as an es‐sential supplementary examination .

  15. 新生儿颅内高压伴消化道大出血1例的护理体会%Nursing experience of neonatal intracranial hypertension complicated with hemorrhage of digestive tract of 1 case

    Institute of Scientific and Technical Information of China (English)

    郭睿

    2015-01-01

    Based on 1 case of nursing of neonatal intracranial hypertension complicated with hemorrhage of digestive tract,we analyzed the nursing experience of massive hemorrhage of digestive tract caused by intracranial hypertension with stress ulcer,to accumulate experience in order to improve the cure rate of the rescue success rate and disease in children.%通过对1例新生儿颅内高压伴消化道大出血的护理,分析颅内高压引起应激性溃疡导致消化道大出血患儿的护理体会,为提高患儿的救护成功率及疾病的治愈率积累经验。

  16. Related Factors Analysis of 52 Premature Infants of Intracranial Hemorrhage%52例早产儿颅内出血相关因素分析

    Institute of Scientific and Technical Information of China (English)

    刘祖霞

    2013-01-01

    Objective:To investigate the cause of intracranial hemorrhage (ICH) in premature infants associated risk factors. Methods:Research points trial group and control group,the objects in our hospital the neonatal intensie care unit (NICU) of 221 cases were premature from January 2009 to January 2011.52 cases of intracranial bleeding as research group,the rest of the 169 cases of premature infants as control group,retrospective analysis of premature intracranial bleeding risk factors.Results:ICH group and control group for comparison of prenatal abnormal factors,palace distress,amniotic fluid anomaly,pregnancy hypertension sickness,lead the placenta,the umbilical unusual cord,Phenobarbital Sodium,the difference was statistically significant (P<0.05);ICH group and control group premature birth risk factors comparison with Apgar score,birth weight,gestational age,the difference was statistically significant (P<0.05). Conclusion:Premature infants' intracranial hemorrhage may be with palace distress,amniotic fluid anomaly,pregnancy and high blood pressure,lead the placenta,an umbilical cord,Phenobarbital Sodium and Apgar score,birth weight and the gestational age.%  目的:探讨早产儿颅内出血发生的危险因素.方法:本研究分观察组和对照组,选取本院自2009年1月2012年1月新生儿重症监护病房(NICU)收治的221例的早产儿,其中颅内出血52例作为观察组,其余未发生颅内出血的早产儿169例作为对照组,回顾性分析早产儿颅内出血发生的危险因素.结果:对ICH组和对照组的产前异常因素进行比较,宫内窘迫、羊水异常、妊高征、前置胎盘、脐带异常、是否预防应用苯巴比妥钠差异有统计学意义(P<0.05);ICH组和对照组新生儿出生时的异常因素的比较,与Apgar评分、出生体重、胎龄差异有统计学意义(P<0.05).结论:早产儿颅内出血的发生可能与宫内窘迫、羊水异常、妊高征、前置胎盘、脐带

  17. 晚发性维生素K缺乏致颅内出血与低血钙的关系%The relation between the intracranial hemorrhage caused by delayed vitamin k deficiency and hypocalcemia

    Institute of Scientific and Technical Information of China (English)

    刘化英

    2014-01-01

    目的:探讨16例晚发性维生素K缺乏所致颅内出血(其中10例伴有低血钙)的诊治方法。方法:观察其临床表现、血常规、出凝血时间、头部CT或MRI进行综合分析。结果:本组治愈14例,2例自动出院。结论:低血钙惊厥可诱发或加剧维生素K缺乏所致颅内出血、在治疗时应给予补充钙剂。%Objective To explore the diagnosis and treatment of the intracranial hemorrhage and hypocalcemia by researching 16 intracranial hemorrhage children caused by delayed vitamin k deficiency with 10 children found hypocalcemia. Methods The results wound be got by analyzing the clinical manifestation ,blood routine, PT , APTT , brain CT or MRI. Results 14 children clinical cured, 2 children discharged voluntarily during therapy. Conclusion The hypocalcemia can induce or aggravate the intracranial hemorrhage caused by delayed vitamin k deficiency.

  18. The Value of CT in the Diagnosis of Neonatal Intracranial Hemorrhage%CT诊断新生儿颅内出血的临床诊断价值探讨

    Institute of Scientific and Technical Information of China (English)

    吴晓丽; 李丽; 陈瑞鑫

    2016-01-01

    目的:研究新生儿颅内出血使用CT诊断的效果。方法选择我院收治的40例新生儿颅内出血病例来进行研究,为患儿使用B超和CT诊断,对比两种方法的诊断结果。结果 CT诊断的准确率是94%,超声诊断的准确率是70%,P<0.05。结论新生儿颅内出血可以使用CT来进行诊断分析,准确率较高,为临床治疗的开展提供可靠依据。%ObjectiveTo study the effect of CT diagnosis of intracranial hemorrhage in newborn infants.Methods40 cases of neonatal intracranial hemorrhage who were treated in our hospital were studied. The patients received ultrasound and CT diagnosis and the two methods of diagnosis results were compared.ResultsThe clinical accuracy rate of CT diagnosis was 94%,the clinical accuracy of ultrasound diagnosis was 70%,P<0.05.Conclusion Neonatal intracranial hemorrhage can be diagnosed and analyzed by CT. The accuracy rate is high,which provides a reliable basis for clinical treatment.

  19. Thromboembolic risks of recombinant factor VIIa Use in warfarin-associated intracranial hemorrhage: a case–control study

    Directory of Open Access Journals (Sweden)

    H-Y Chou Sherry

    2012-12-01

    Full Text Available Abstract Background Recombinant factor VIIa (rFVIIa may be used for rapid hemostasis in life-threatening hemorrhage. In warfarin-associated intracerebral hemorrhage (wICH, FVIIa use is controversial and may carry significant thromboembolic risks. We compared incidence of baseline thromboembolic risk factors and thromboembolism rates in wICH patients treated with additional rFVIIa to those treated with standard therapy of fresh frozen plasma (FFP and vitamin K alone. Methods We identified 45 consecutive wICH patients treated with additional rFVIIa over 5-year period, and 34 consecutive wICH patients treated with standard therapy alone as comparison group. We compared the incidence of post-hemorrhage cardiac and extra-cardiac thromboembolic complications between two treatment groups, and used logistic regression to adjust for significant confounders such as baseline thromboembolic risk factors. We performed secondary analysis comparing the quantity of FFP transfused between two treatment cohorts. Results Both rFVIIa-treated and standard therapy-treated wICH patients had a high prevalence of pre-existing thromboembolic diseases including atrial fibrillation (73% vs 68%, deep venous thrombosis (DVT or pulmonary embolism (PE (22% vs 18%, coronary artery disease (CAD (38% vs 32%, and abnormal electrocardiogram (EKG (78% vs 85%. Troponin elevation following wICH was prevalent in both groups (47% vs 41%. Clinically significant myocardial infarction (MI, defined as troponin > 1.0 ng/dL, occurred in 13% of rFVIIa-treated and 6% of standard therapy-treated patients (p=0.52. Past history of CAD (p=0.0061 and baseline abnormal EKG (p=0.02 were independently associated with clinically significant MI following wICH while rFVIIa use was not. The incidences of DVT/PE (2% vs 9%; p=0.18 and ischemic stroke (2% vs 0%; p=0.38 were similar between two treatment groups. Recombinant FVIIa-treated patients had lower mean INR at 3 (p=0.0001 and 6 hours (p Conclusions Pre

  20. Successful Renal Replacement Therapy for a Patient with Severe Hemophilia after Surgical Treatment of Intracranial Hemorrhage and Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Noriko Kato

    2011-01-01

    Full Text Available A 21-year-old Japanese male with severe hemophilia A was developed end-stage renal failure. He was placed on combination therapy with peritoneal dialysis (PD and hemodialysis (HD. Eight months later, he developed a hypertensive cerebral hemorrhage. After emergency surgery, he was managed with PD without HD to avoid cerebral edema. One month later, his renal replacement therapy was switched to HD (three times a week from PD, since a ventriculoperitoneal shunt catheter was placed to treat his hydrocephalus. HD could be performed safety without anticoagulant agents on condition that factor VIII is given after every HD.

  1. Effects of Smoking on Ischemic Stroke, Intracranial Hemorrhage, and Coronary Artery Events in Japanese Patients With Non-Valvular Atrial Fibrillation.

    Science.gov (United States)

    Suzuki, Shinya; Otsuka, Takayuki; Sagara, Koichi; Semba, Hiroaki; Kano, Hiroto; Matsuno, Shunsuke; Takai, Hideaki; Kato, Yuko; Uejima, Tokuhisa; Oikawa, Yuji; Nagashima, Kazuyuki; Kirigaya, Hajime; Yajima, Junji; Kunihara, Takashi; Sawada, Hitoshi; Aizawa, Tadanori; Yamashita, Takeshi

    2017-08-03

    The effects of smoking on the prognosis of non-valvular atrial fibrillation (NVAF) patients are unclear.The Shinken Database 2004-11 (n = 17,517) includes all new patients visiting the Cardiovascular Institute between June 2004 and March 2012. Among these cases, 2,102 NVAF patients were identified. The effects of smoking on ischemic stroke (IS), intracranial hemorrhage (ICH), and coronary artery events including percutaneous coronary intervention (PCI) and acute coronary syndrome (ACS) were analyzed. Smokers were younger and had lower risk profiles compared with non-smokers. A similar tendency was observed between current and former smokers. In contrast, patients with high tobacco consumption were older and had higher risk profiles, including uncontrolled hypertension, compared with those with low tobacco consumption. In 8,159 patient-years, IS, ICH, PCI, and ACS occurred at rates of 7.7, 2.7, 12.4, and 3.0 per 1000 patient-years. In multivariate Cox regression analysis, smoking was not significantly associated with any adverse event. However, different effects of smoking were observed when stratified by age. In patients ≥ 65 years old, current smokers were independently associated with PCI. Moreover, current smokers and smokers with a total tobacco amount ≥ 800 were marginally and independently associated with IS. In patients effects of smoking on cardiovascular events in our NVAF patients. In elderly patients who still smoke, smoking was associated with the promotion of atherosclerosis or thromboembolism, whereas in young patients it was associated with bleeding.

  2. Meta-analysis of the risk factors for intracranial hemorrhage in premature infants%早产儿颅内出血危险因素的meta分析

    Institute of Scientific and Technical Information of China (English)

    马江林; 卢红艳; 王秋霞

    2013-01-01

    Objective To evaluate the risk factors for intracranial hemorrhage in premature infants. Methods Cochrane Library, PubMed, ScienceDirect, Chinese Academic Literature Main Database, Chinese Science and Technology Periodi-cal Database, Wanfang Periodicals and Dissertation Database were searched for articles published from January 2000 to December 2012 on the risk factors of intracranial hemorrhage in premature infants, with retrospective retrieval and manual retrieval as supplement. RavMan5.2 provided by Cochrane was used for meta-analysis. Fixed-or random-effects models were selected according to the results of heterogeneity test. Results Nine studies were conifrmed to be eligible. Odds ratio (OR) and 95%conifdence interval (CI) of the risk factors were as follows:gestation age≤32 weeks (OR=3.29, 95%CI=2.76-3.91), birth weight≤1 500g (OR=2.68, 95% CI=2.24-3.20), maternal complications (OR=1.59, 95% CI=1.23-2.06), intrauterine distress or birth asphyxia (OR=2.42, 95% CI=2.06-2.84), mechanical ventilation (OR=3.23, 95% CI=2.55-4.09), metabolic acidosis (OR=2.88, 95%CI=2.04-4.05), use of high concentration of oxygen (OR=2.98, 95%CI=1.63-5.44), prenatal use of dexametha-sone (OR=0.69, 95%CI=0.55-0.86), respiratory distress syndrome (OR=1.57, 95%CI=1.04-2.39). Those differences were all statistically signiifcant. There was no difference in caesarean section (OR=0.99, 95%CI=0.84-1.17), multiparity (OR=1.05, 95%CI=0.79-1.40) and gender (OR=1.25, 95%CI=0.97-1.59). Conclusions The risk factors for intracranial hemorrhage in premature infants are gestation age≤32 weeks, birth weight≤1 500 g, maternal complications, intrauterine distress or birth asphyxia, mechanical ventilation, metabolic acidosis, use of high concentration of oxygen, respiratory distress syndrome, but prenatal use of dexamethasone can reduce the incidence of intracranial hemorrhage in premature infants.%目的综合评价早产儿颅内出血的危险因素。方法检索Cochrane图书馆、PubMed

  3. Incidence of intracranial hemorrhage and outcomes after ground-level falls in geriatric trauma patients taking preinjury anticoagulants and antiplatelet agents.

    Science.gov (United States)

    Reddy, Subhash; Sharma, Rohit; Grotts, Jonathan; Ferrigno, Lisa; Kaminski, Stephen

    2014-10-01

    Antiplatelet and anticoagulant medication increases the risk of intracranial hemorrhage (ICH) after a fall in geriatric patients. We sought to determine whether there were differences in ICH rates and outcomes based on type of anticoagulant or antiplatelet agent after a ground-level fall (GLF). Our institutional trauma registry was used to identify patients 65 years old or older after a GLF while taking warfarin, clopidogrel, or aspirin over a 2-year period. Rates and types of ICH and patient outcomes were evaluated. Of 562 patients who met inclusion and exclusion criteria, 218 (38.8%) were on warfarin, 95 (16.9%) were on clopidogrel, and 249 (44.3%) were on aspirin. Overall ICH frequency was 15 per cent with no difference in ICH rate, type of ICH, need for craniotomy, mortality, or intensive care unit or hospital length of stay between groups. Patients with ICH were more likely to present with abnormal Glasgow Coma Score, history of hypertension, and/or loss of consciousness.

  4. Clinical analysis of ultrasound and CT in diagnosis of intracranial hemorrhage of the newborn%超声与 CT诊断新生儿颅内出血的临床分析

    Institute of Scientific and Technical Information of China (English)

    贾月霞; 温琳峰

    2015-01-01

    Objective:To investigate clinical effects of ultrasound and CT in diagnosis of intracranial hemorrhage of the new-born. Methods:78 newbornsdiagnosed with intracranial hemorrhage were collected and randomly divided into ultrasound group ( n=40, ultrasonic diagnosis) and CT group (n=38, CT diagnosis). Thediagnosis results and clinical diagnosis results of the two groups were analyzed and compared. Results:In the 78 cases, 38 cases in ultrasound group were diagnosed as intracranial hemorrhage with a diagnosis accuracy of 95%, while 34 cases in CT group were diagnosed as intracranial hemorrhage with the diagnosis accuracy of 89. 4%, and the difference was significant (P﹤0. 05). Conclusions:Ultrasound diagnosis has a higher diagnosis accuracyfor newborn intracranial hemorrhage than CT scan diagnosis, and is worthy of clinical promotion.%目的::探讨超声与CT诊断新生儿颅内出血的临床效果。方法:搜集78例确诊颅内出血的新生儿,随机分组,超声组40例新生儿采用超声诊断;CT组38例新生儿采用CT诊断。将两组新生儿的诊断结果与临床确诊结果进行分析和比较。结果:在78例新生儿中,超声组新生儿经超声检查诊断为颅内出血的患儿为38例,诊断准确率为95%;CT组新生儿经CT扫查诊断为颅内出血的患儿为34例,诊断准确率为89.4%。两组新生儿的诊断方法进行比较,差异明显(P﹤0.05)。结论:采用超声检查诊断出新生儿颅内出血的诊断准确率明显高于采用CT扫查诊断,超声诊断新生儿颅内出血值得临床推广。

  5. Hemorragias intracraneales de carácter evitable asociadas a anticoagulantes orales en pacientes con fibrilación auricular Avoidable intracranial hemorrhages associated with oral anticoagulants in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    A. García Luque

    2011-12-01

    Full Text Available Introducción y objetivo: El aumento de la prescripción de anticoagulantes orales ha provocado un aumento de hemorragias intracraneales, la reacción adversa más grave asociada a este grupo farmacológico. El objetivo del estudio es evaluar el carácter evitable de hemorragias intracraneales asociada a anticoagulantes orales que causan ingreso hospitalario en pacientes con fibrilación auricular. Método: Supervisión de las historias clínicas de los pacientes que ingresaron en los Hospitales Universitarios Virgen del Rocío (01/01/03 al 31/03/07 con hemorragia intracraneal y fibrilación auricular; considerando hemorragia intracraneal asociada a anticoagulantes orales aquellas con una relación ≥ posible al aplicar el algoritmo de causalidad del Sistema Español de Farmacovigilancia. Para valorar el carácter evitable de la hemorragia intracraneal se ha estudiado la relación beneficio/riesgo del uso de anticoagulantes orales. Resultados: Al menos 20/57 (35,1% hemorragias intracraneales asociadas a anticoagulantes orales pudieron ser potencialmente evitables, de las cuales en 7/20 (35% el desenlace fue mortal, presentando secuelas 8/13 (61,5% de los supervivientes. El fármaco sospechoso de interaccionar con anticoagulantes orales referenciado con mayor frecuencia fue el omeprazol, 11/57 (19%, a pesar de estar documentada esta interacción como altamente probable en la Bibliografía y en los protocolos del Hospital. Conclusiones: La relación beneficio/riesgo del uso de anticoagulantes orales, el control estricto del Índice Normalizado Internacional, junto con las posibles interacciones medicamentosas deben ser evaluadas de forma individualizada y periódicamente para minimizar el riesgo de hemorragia intracraneal, que en un porcentaje elevado de casos es una reacción adversa potencialmente evitable y mortal.Introduction and objectives: The increase in oral anticoagulants prescription has caused an increase in intracranial hemorrhages

  6. Mechanisms underlying the perifocal neuroprotective effect of the Nrf2–ARE signaling pathway after intracranial hemorrhage

    Directory of Open Access Journals (Sweden)

    Yin XP

    2015-11-01

    Full Text Available Xiao-ping Yin,1,2 Zhi-ying Chen,2 Jun Zhou,1 Dan Wu,1,3 Bing Bao2 1Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China; 2Department of Neurology, Affiliated Hospital of Jiujiang University, Jiujiang, People’s Republic of China; 3Department of Neurology, The Sixth Hospital of Wuhan, Wuhan, People’s Republic of China Background: It has been found that nuclear factor erythroid 2-related factor 2/antioxidant response element (Nrf2–ARE signaling pathway plays a role in antioxidative response, anti-inflammatory response, and neuron-protection in intracerebral hemorrhage (ICH. The aim of this study is to explore mechanisms underlying the perifocal neuroprotective effect of the Nrf2–ARE signaling pathway after ICH.Methods: There were a total of 90 rats with basal ganglia hemorrhage, which were randomly divided into the following four groups: ICH (Sprague–Dawley rats with autologous femoral arterial blood injection into the basal ganglia, sulforaphane (SFN (SFN was intraperitoneally administered into rats, retinoic acid (RA (RA was intraperitoneally administered into rats, and dimethyl sulfoxide (the rats were treated with dimethyl sulfoxide. We observed the neurological score of the rats in the different groups, and collected brain tissues for immunofluorescence, Western blot, and reverse transcription polymerase chain reaction to detect expression of Nrf2, heme oxygenase (HO-1, nuclear factor-κB (NF-κB, and tumor necrosis factor-α (TNF-α.Results: The results indicated that neurological dysfunction of rats was significantly improved in the SFN group, and the expressions of Nrf2 and HO-1 in tissues surrounding the hemorrhage were increased. Also, the level of NF-κB and TNF-α were reduced compared to the ICH group. The RA group exhibited more severe neurological dysfunction and lower levels of Nrf2 and HO-1 than the SFN and ICH groups. Compared to the ICH group, the NF

  7. Attenuation of Acute Phase Injury in Rat Intracranial Hemorrhage by Cerebrolysin that Inhibits Brain Edema and Inflammatory Response.

    Science.gov (United States)

    Yang, Yang; Zhang, Yan; Wang, Zhaotao; Wang, Shanshan; Gao, Mou; Xu, Ruxiang; Liang, Chunyang; Zhang, Hongtian

    2016-04-01

    The outcome of intracerebral hemorrhage (ICH) is mainly determined by the volume of the hemorrhage core and the secondary brain damage to penumbral tissues due to brain swelling, microcirculation disturbance and inflammation. The present study aims to investigate the protective effects of cerebrolysin on brain edema and inhibition of the inflammation response surrounding the hematoma core in the acute stage after ICH. The ICH model was induced by administration of type VII bacterial collagenase into the stratum of adult rats, which were then randomly divided into three groups: ICH + saline; ICH + Cerebrolysin (5 ml/kg) and sham. Cerebrolysin or saline was administered intraperitoneally 1 h post surgery. Neurological scores, extent of brain edema content and Evans blue dye extravasation were recorded. The levels of pro-inflammatory factors (IL-1β, TNF-α and IL-6) were assayed by Real-time PCR and Elisa kits. Aquaporin-4 (AQP4) and tight junction proteins (TJPs; claudin-5, occludin and zonula occluden-1) expression were measured at multiple time points. The morphological and intercellular changes were characterized by Electron microscopy. It is found that cerebrolysin (5 ml/kg) improved the neurological behavior and reduced the ipsilateral brain water content and Evans blue dye extravasation. After cerebrolysin treated, the levels of pro-inflammatory factors and AQP4 in the peri-hematomal areas were markedly reduced and were accompanied with higher expression of TJPs. Electron microscopy showed the astrocytic swelling and concentrated chromatin in the ICH group and confirmed the cell junction changes. Thus, early cerebrolysin treatment ameliorates secondary injury after ICH and promotes behavioral performance during the acute phase by reducing brain edema, inflammatory response, and blood-brain barrier permeability.

  8. 以蛛网膜下腔出血起病的颅内多发动脉瘤的诊治%Diagnosis and treatment for multiple intracranial aneurysms presenting with subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    马琳; 张祥茂

    2014-01-01

    With the wider availability and continuous advances of imaging techniques , the increasing numbers of multiple intracranial aneurysms are detected in patients with aneurysmal subarachnoid hemorrhage. Studies have shown that unruptured aneurysms in patients with previous subara-chnoid hemorrhage have higher rupture risk than those without previous subarachnoid hemorrhage. For patients with multiple intracranial aneurysms presenting with subarachnoid hemorrhage , in addition to the ruptured aneurysms are identified and dealt with first , the unruptured aneurysms should be detected and treated aggressively. Therefore, the diagnosis and treatment of multiple intracranial aneurysms are more difficult than those of single ones.%随着脑血管成像技术的广泛应用及不断提高,动脉瘤性蛛网膜下腔出血患者中多发动脉瘤检出率越来越高。研究表明既往有蛛网膜下腔出血病史患者的未破裂动脉瘤破裂风险要高于无蛛网膜下腔出血病史者,对于发生动脉瘤破裂的多发动脉瘤患者除明确责任动脉瘤并首先处理外,其未破裂动脉瘤也应尽量检出并积极治疗,因此多发动脉瘤的诊断和治疗均要比单发动脉瘤复杂。

  9. Risk of Familial Intracranial Aneurysm

    OpenAIRE

    J Gordon Millichap; Millichap, John J.

    2014-01-01

    Investigators at University Medical Center Utrecht, Netherlands, studied the yield of long-term (up to 20 years) screening for intracranial aneurysms in individuals with a positive family history (2 or more first-degree relatives) of aneurysmal subarachnoid hemorrhage (aSAH) or unruptured intracranial aneurysm (1993-2013).

  10. 彩超在新生儿早期小病灶颅内出血的诊断价值%Diagnostic value of ultrasonography on the early neonatal intracranial hemorrhage of small lesions

    Institute of Scientific and Technical Information of China (English)

    黄智勇; 魏达友; 巫朝君

    2015-01-01

    目的 探讨彩超在新生儿早期小病灶颅内出血诊断中的应用价值.方法 选取茂名市人民医院收治的80例早期小病灶颅内出血新生儿作为研究对象,所有患儿均接受颅脑CT和彩色多普勒超声检查,对比两种检查方式的诊断结果.结果 彩超检查检出率为82.3%,漏诊率为17.7%,CT扫描颅脑出血诊断率为92.5%,漏诊率为7.5%,CT检查的诊断符合率略高于彩超检查,但差异无统计学意义(P>0.05).结论 在新生儿颅内出血的早期诊断中,彩色多普勒超声检查为重要的辅助手段,其能有效满足新生儿颅内出血定位诊断需求,为早期诊断和治疗提供依据.%Objective To investigate the application value of color Doppler ultrasound on the diagnosis of intracranial hemorrhage in early newborns small lesion.Methods Eighty cases of early small foci of neonatal intracranial hemorrhage in our hospital were selected as the objects of the study.All of the children underwent brain CT and color Doppler ultrasound,and the diagnosis results of two kinds of examination method were compared.Results The detection rate by ultrasound was 82.3%,the rate of missed diagnosis was 17.7%.The brain hemorrhage diagnosis rate by CT scan was 92.5%,the rate of missed diagnosis was 7.5%.The diagnostic accordance rate of CT examination was slightly higher than that of color Doppler ultrasound,but the difference was not significant(P > 0.05).Conclusions Color Doppler ultrasound is an important auxiliary means in the early diagnosis of neonatal intracranial hemorrhage,which can effectively meet the needs of localization diagnosis of neonatal intracranial hemorrhage,and provide evidence for early diagnosis and treatment.

  11. STREM-1 and PCT on pulmonary hemorrhage in newborn with intrauterine infection in the perinatal period combined pneumonia%sTREM-1与PCT对围生期宫内感染合并肺炎新生儿肺出血的影响研究

    Institute of Scientific and Technical Information of China (English)

    杨祖钦; 余坚; 何笑笑; 姜娜; 肖秀漫; 林振浪

    2016-01-01

    were provided sTREM‐1 and PCT test , and the levels of sTREM‐1 and PCT ,and its relation to the maternal diseases in the perinatal period were ob‐served .RESULTS In this study ,the levels of sTREM‐1 and PCT in observation group of patients were significantly higher than those in the control group (P<0 .05) .The sTREM‐1 and PCT levels in children with NPH were sig‐nificantly higher than those in children with NPH respiratory distress syndrome ,ischemia anoxic encephalopathy and intracranial hemorrhage (P<0 .05) .The sTREM‐1 and PCT levels in children with pulmonary hemorrhage and intrauterine infection in the perinatal period were significantly higher than those in NPH children with pregnancy hypertension in mother ,premature rupture of the amniotic fluid ,placental abruption ,diabetes and other diseases (P<0 .05) .CONCLUSION The monitoring of sTREM‐1 and PCT in clinic could give a predict for occurrence and development of intrauterine infection in the perinatal period combined pneumonia in children ,which has a high clinical value .

  12. 低剂量CT扫描颅内出血性疾病%Low-dose CT Scanning of Intracranial Hemorrhagic Disease

    Institute of Scientific and Technical Information of China (English)

    魏应敏; 毛存南

    2014-01-01

    Objective To explore the application of low-dose CT scanning in intracranial hemorrhagic disease. To study the feasibility of low-dose scans in the clinical diagnosis. Methods German Siemens 16-slice spiral CT was used. The scanning dose was reduced by reducing the tube current. 60 cases with intracranial bleeding diseases underwent CT scanning. 30 patients underwent conventional CT scanning, and another 30 cases underwent low-dose CT scanning. Low-dose CT images were compared to the first checked images to evaluate the development of hemorrhagic disease, and compared with conventional CT scanning images. Results Compared with the first scanning images, low-dose CT scanning images showed no significant difference, and the quality of images did not affect the display of lesions and diagnosis. There was no significant difference compared to conventional CT images. Conclusion The patient's radiation dose was significantly reduced by low-dose CT scanning. As a result of low-dose scanning, the consumption of CT machine was also reduced, which could greatly increase the life of machine.%目的:探讨低剂量CT扫描在颅内出血性疾病复查时扫描的应用价值。并研究低剂量扫描在临床诊断中的可行性。方法采用德国西门子公司生产的16排螺旋CT,通过降低管电流来降低扫描剂量,对60例颅内出血性疾病患者复查扫描。其中30例采用常规扫描,另外30例采用低剂量扫描。将低剂量扫描的图像与首次检查图像比较,评价出血性疾病的发展情况。再与常规扫描比较影像学差异。结果低剂量CT扫描所获得的图像清晰,与首次扫描的图像相比,对比度、病灶边缘显示无明显差异,不影响病灶的显示和诊断结果。与常规扫描图像无明显影像学差异。结论低剂量CT扫描对病人的辐射剂量大大降低了。由于采用低剂量扫描,CT机器的消耗也降低了,大大增加了机器的使用寿命。

  13. Intracranial hemorrhage in infants as a serious, and preventable consequence of late form of vitamin K deficiency: a selfie picture of Turkey, strategies for tomorrow.

    Science.gov (United States)

    Unal, Ekrem; Ozsoylu, Serkan; Bayram, Ayse; Ozdemir, Mehmet Akif; Yilmaz, Ebru; Canpolat, Mehmet; Tumturk, Abdulfettah; Per, Huseyin

    2014-08-01

    Vitamin K deficiency bleeding is one of the most common causes of acquired hemostatic disorder in early infancy. Although vitamin K is practiced routinely after every birth in Turkey, children with type of vitamin K deficiency bleedings (L-VKDB) can be encountered. We aimed to evaluate the clinical features of the children with L-VKDB reported from Turkey. Between 1995 and 2013, 48 studies reporting 534 children with L-VKDB were evaluated in this study. Of the 534 reported children (178 girls, 356 boys), 486 (91 %) were extremely breastfed. The most common bleeding sites were intracranial hemorrhage, gastrointestinal, and umbilical in 414 (77.4 %), 33 (6.2 %), and 33 (6.2 %) children, respectively, and 35 (6.6 %) children had been diagnosed incidentally without any bleeding. The etiology of 399 (74.7 %) children were classified as idiopathic, whereas 135 (25.3 %) were secondary. Intramuscular vitamin K was administered in 248 (46.4 %), not administered in 228 (42.7 %), and the administration of vitamin K were not determined in 58 (10.9 %) children. The outcomes of Turkish cohort showed that 111 (20.8) children died, 257 (48.1 %) cases developed neurologic deficit (mainly epilepsy and psychomotor retardation), and only 166 (31.1 %) patients recovered without squeal. The compliance of prophylactic measures in Turkey does not seem to be satisfactory. As a further measure of tomorrow, we vigorously emphasize that a national surveillance program may be initiated. An additional intramuscular dose or oral supplementation of vitamin K especially for exclusively breast-fed infants may reduce this catastrophic problem in our country.

  14. Risk factors for intracranial hemorrhage in acute ischemic stroke patients treated with recombinant tissue plasminogen activator: a systematic review and meta-analysis of 55 studies.

    Science.gov (United States)

    Whiteley, William N; Slot, Karsten Bruins; Fernandes, Peter; Sandercock, Peter; Wardlaw, Joanna

    2012-11-01

    Recombinant tissue plasminogen activator (rtPA) is an effective treatment for acute ischemic stroke but is associated with an increased risk of intracranial hemorrhage (ICH). We sought to identify the risk factors for ICH with a systematic review of the published literature. We searched for studies of rtPA-treated stroke patients that reported an association between a variable measured before rtPA infusion and clinically important ICH (parenchymal ICH or ICH associated with clinical deterioration). We calculated associations between baseline variables and ICH with random-effect meta-analyses. We identified 55 studies that measured 43 baseline variables in 65 264 acute ischemic stroke patients. Post-rtPA ICH was associated with higher age (odds ratio, 1.03 per year; 95% confidence interval, 1.01-1.04), higher stroke severity (odds ratio, 1.08 per National Institutes of Health Stroke Scale point; 95% confidence interval, 1.06-1.11), and higher glucose (odds ratio, 1.10 per mmol/L; 95% confidence interval, 1.05-1.14). There was approximately a doubling of the odds of ICH with the presence of atrial fibrillation, congestive heart failure, renal impairment, previous antiplatelet agents, leukoaraiosis, and a visible acute cerebral ischemic lesion on pretreatment brain imaging. Little of the variation in the sizes of the associations among different studies was explained by the source of the cohort, definition of ICH, or degree of adjustment for confounding variables. Individual baseline variables were modestly associated with post-rtPA ICH. Prediction of post-rtPA ICH therefore is likely to be difficult if based on single clinical or imaging factors alone. These observational data do not provide a reliable method for the individualization of treatment according to predicted ICH risk.

  15. Intracranial hemorrhage recurrence on vitamin K antagonist: severity of the first episode and HASBLED score fail to identify high-risk patients from the CHIRONE study.

    Science.gov (United States)

    Poli, Daniela; Antonucci, Emilia; Dentali, Francesco; Testa, Sophie; Palareti, Gualtiero

    2017-01-01

    The most feared complication of vitamin K antagonists (VKAs) treatment is intracranial hemorrhage (ICH). The previously published CHIRONE Study fails to identify risk factors associated with ICH recurrence after VKAs resumption. The aim of this secondary analysis of the study is to evaluate if patients who need surgery or with severe neurological sequelae after the first episode show a higher risk of ICH recurrence. The HASBLED score was used to stratify bleeding risk and to evaluate the distribution of recurrence in relation to each class of risk. The study included 267 patients from 27 Italian centers. The treatment of the index ICH, surgical or medical was recorded; modified Rankin Scale score of 3 or more was used to define patients with severe neurological impairment; HASBLED score of 3 or more was used to identify high bleeding risk patients. During follow-up, 20 patients (7.5%) had ICH recurrence (rate of 2.56 × 100 patient-years). No difference in the type of treatment [hazard ratio = 1.5; 95% confidence interval (CI): 0.49-4.74] and neurological impairment with modified Rankin Scale 3 or more (hazard ratio = 0.9; 95% CI: 0.31-2.83) were found in relation to ICH recurrence. The mean HASBLED score was similar between the two groups (P = 0.54). In conclusion, the results of our study suggest that neither the severity of the index ICH at presentation nor the HASBLED clinical prediction rule should be used to assess the risk of recurrence in patients who need VKAs resumption after a previous ICH.

  16. Previously undiagnosed hemophilia patient with intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Eray Atalay

    2015-09-01

    Full Text Available Intracranial bleeding in hemophilia patients is a rare but a mortal complication. Diagnosis of hemophilia in adulthood is an uncommon occurrence. In this case report an adult patient with intracranial hemorrhage is presented.

  17. Minimally invasive intracranial hematoma in patients with hypertensive cerebral hemorrhage%高血压脑出血微创颅内血肿清除术

    Institute of Scientific and Technical Information of China (English)

    赵勇

    2015-01-01

    Objective To observe the clinical effect of minimally invasive intracranial hematoma in treatment of hypertensive in-tracerebral hemorrhage patients. Methods 100 cases of hypertensive cerebral hemorrhage patients were selected as the research object in our hospital from January, 2010 to January, 2014. All the cases are in line with the Chinese Medical Association related diagnostic standard setting the fourth national academic meeting for cerebrovascular disease, 100 patients were randomly divided into observation group and control group with 50 cases in each group, the control group was given the conservative drug treatment, the observation group was given minimally invasive intracranial hematoma. The clinical curative effect and complications incidence and follow-up of quality of life of 6 months were compared between the two groups. Results The clinical efficacy of two groups were compared, the effect of observation group was significantly better than the control group (P<0.05). The observation group there were three cases of digestive tracThemorrhage, pulmonary infection in six cases, cardiac changes in three cases, two cases of cen-tral high fever, the complication rate was 28%; the control group occurred in 7 cases of digestive tracThemorrhage, pulmonary in-fection in 12 cases, cardiac changes in 5 cases, 4 cases of central high fever, the incidence of complications was 56%, group com-parison between observation group than in the control group, with significant difference (P<0.05). The observation group in physio-logical function(RP), social function(SF), the physiological function of overall health (PF), self rating (GH) four aspects of the scores were significantly higher than control group (P<0.05). Conclusion Compared with conservative treatment clinical department of in-ternal medicine, invasive intracranial hematoma is better, which is conducive to the quality of life in patients with recovery, and it has higher security. Therefore, hypertensive

  18. Perinatal brain damage : The term infant

    NARCIS (Netherlands)

    Hagberg, Henrik; David Edwards, A.; Groenendaal, Floris

    2016-01-01

    Perinatal brain injury at term is common and often manifests with neonatal encephalopathy including seizures. The most common aetiologies are hypoxic–ischaemic encephalopathy, intracranial haemorrhage and neonatal stroke. Besides clinical and biochemical assessment the diagnostic evaluation rely

  19. 头颅B超、MRI在新生儿颅内出血诊断中的应用%Application of cranial B ultrasound and MRI in diagnosis of intracranial hemorrhage of the newborn

    Institute of Scientific and Technical Information of China (English)

    梁斐; 丁健; 周慧恩; 黎惠章

    2015-01-01

    目的:评价头颅B超、磁共振成像(MRI)在诊断新生儿颅内出血中的应用价值。方法应用头颅B超、MRI分别对121例疑似颅内出血患儿进行检查,并对两种检查结果进行对照分析。结果头颅B超共检出颅内出血29例, MRI共检出56例, MRI检查在总检出率、足月儿检出率、早产儿检出率均高于头颅B超(P<0.05)。结论头颅B超有操作灵活简单、价格低廉、无辐射等优点,而MRI在检出率方面优于头颅B超,因此,头颅B超、MRI在新生儿颅内出血的临床诊断中具有不可相互替代的作用。%Objective To evaluate the application value of cranial B ultrasound and magnetic resonance imaging (MRI) in diagnosis of intracranial hemorrhage of the newborn.Methods Cranial B ultrasound and MRI were applied for examination of 121 infants with suspected intracranial hemorrhage. Comparative analysis was made on the two methods.Results There were 29 detected intracranial hemorrhage cases by cranial B ultrasound, and 56 cases by MRI. Total detection rate, term infant detection rate, and premature infant detection rate were all higher in MRI than in cranial B ultrasound (P<0.05).Conclusion Cranial B ultrasound contains advantages of easy operation, low cost and no radiation, while MRI provides better performance in detection rate than cranial B ultrasound. Therefore, cranial B ultrasound and MRI contain unique effects apart from each other in clinical diagnosis of intracranial hemorrhage of the newborn.

  20. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K;

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation. T....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  1. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  2. Analysis on the risk factors and preventive measures for neonatal intracranial hemorrhage%新生儿颅内出血的危险因素及预防措施分析

    Institute of Scientific and Technical Information of China (English)

    余连芝; 盛学梅; 余曼玲

    2012-01-01

    目的 探讨引起新生儿颅内出血的危险因素及预防措施.方法 选择2006年1月至2010年12月在本院出生的138例颅内出血新生儿,对颅内出血的病因进行回顾性分析,并选择同期在本院出生的140例正常新生儿进行对照研究.结果 278例新生儿中,早产儿颅内出血发生率为67.3%,窒息率为69.8%;母亲因素中高龄为66.7%,妊高症为70.0%,贫血为59.6%,急产为66.7%;脐带绕颈为60.8%,羊水异常为64.7%.结论 新生儿颅内出血的危险因素包括早产、窒息、母亲因素、脐带绕颈、羊水异常等,早产、窒息和母亲因素是其主要危险因素.%Objective To investigate the risk factors and preventive measures in neonatal intracranial hemorrhage.Methods 138 cases of newborns with intracranial hemorrhage were chosen in our hospital from January 2006 to December 2010,the cause of intracerebral hemorrhage was retrospectively analyzed,in the same period,140 newborns of normal childbirth without intraeerebral hemorrhage were chosen as control group,which were compared to experiment group.Results 278 newborns were compared factors of incidence of intracerebral haemorrhage,incidence of intracerebral haemorrhage of premature was 67.3%,asphyxia was 69.8%; in mother factors,advanced age was 66.7%,hypertension during pregnancy was 70.0%,anemia was 59.6%,precipitate labor was 66.7%; cord around neck was 60.8%,abnormality in amniotic fluid was 64.7%,there was a statistical significant difference(P<0.05).Conclusion Risk factors of neonatal intracranial hemorrhage are premature,asphyxia,mother factors,cord around neck,abnormality in amniotic fluid and so on,premature,asphyxia and mother factors are main risk factors.

  3. Mouse models of intracranial aneurysm.

    Science.gov (United States)

    Wang, Yutang; Emeto, Theophilus I; Lee, James; Marshman, Laurence; Moran, Corey; Seto, Sai-wang; Golledge, Jonathan

    2015-05-01

    Subarachnoid hemorrhage secondary to rupture of an intracranial aneurysm is a highly lethal medical condition. Current management strategies for unruptured intracranial aneurysms involve radiological surveillance and neurosurgical or endovascular interventions. There is no pharmacological treatment available to decrease the risk of aneurysm rupture and subsequent subarachnoid hemorrhage. There is growing interest in the pathogenesis of intracranial aneurysm focused on the development of drug therapies to decrease the incidence of aneurysm rupture. The study of rodent models of intracranial aneurysms has the potential to improve our understanding of intracranial aneurysm development and progression. This review summarizes current mouse models of intact and ruptured intracranial aneurysms and discusses the relevance of these models to human intracranial aneurysms. The article also reviews the importance of these models in investigating the molecular mechanisms involved in the disease. Finally, potential pharmaceutical targets for intracranial aneurysm suggested by previous studies are discussed. Examples of potential drug targets include matrix metalloproteinases, stromal cell-derived factor-1, tumor necrosis factor-α, the renin-angiotensin system and the β-estrogen receptor. An agreed clear, precise and reproducible definition of what constitutes an aneurysm in the models would assist in their use to better understand the pathology of intracranial aneurysm and applying findings to patients.

  4. 颅脑损伤术中继发颅内出血原因分析%Cause analysis of intracranial hemorrhage during operation on patients with brain injury

    Institute of Scientific and Technical Information of China (English)

    张学军; 梁伟; 陈文军

    2010-01-01

    Objective To study the possible reasons and the processing strategy of brain injury operation complicated with intracranial hemorrhage.Methods The clinical data about 22 patients who were digged skull operation because of brain injury and complicated with intracranial hemorrhage in operation in neurosurgery from 2007 June to 2008 February were retrospectively analyzed,and different types intracranial hemorrhage were classified.Results In 22 patients,12 patients were complicated with epidural hematoma,in which the patients (9/12,75.0%) complicated with opposite hematoma were common;5 patients were complicated with intracerebral hematoma,in which the patients (3/5,60%) complicated with ipsilateral hematoma were common;4 patients were complicated with acute subdural hematoma,and all the patients complicated with opposite hematoma;1 patient was complicated with sub-flap hematoma.Conclusions In the patients who are complicated with intracranial hemorrhage because of digging skull operation to brain injury,epidural hematoma are most,then intracerebral hematoma,subdural hematoma,sub-flap hematoma.The important measures of preventing secondary intracranial hemorrhage are definiting force mechanism and distinguishing fracture line before operation,gradiently decompressing,completely removing crushing brain tissue,protecting reflux veins,rigorously stopping bleeding during operation.%目的 探讨颅脑损伤手术中继发颅内出血的可能原因及其处理策略.方法 回顾性分析22例因颅脑损伤行开颅手术治疗且术中继发颅内出血患者的临床资料,对不同类型颅内出血进行归类.结果 22例患者中继发硬膜外血肿12例,以并发手术对侧血肿多见;脑内血肿者5例,以手术同侧脑内血肿多见;急性硬膜下血肿者4例,均发生于首次手术对侧;皮瓣下血肿1例.结论 颅脑损伤开颅手术中所继发的颅内出血以硬膜外出血最多见,其次为脑内、硬膜下出血及手术皮瓣下出血,术

  5. Perioperative management of patients with traumatic intracranial hemorrhage and pretraumatic oral warfarin%口服华法令合并外伤性颅内出血患者的围手术期处理

    Institute of Scientific and Technical Information of China (English)

    陈开来; 鲁晓杰; 季卫阳

    2011-01-01

    Objective To study the perioperative management in the treatment of traumatic intracranial hemorrhage in patients with pretraumatic anticoagulation therapy of oral warfarin. Method 10 patients of traumatic intracranial hemorrhage with pretraumatic anticoagulation therapy of oral warfarin received vitamin K, FFP and PCC treatment to reverse the anticoagulation condition after admission. 9 patients underwent the operation for evacuation of intracranial hematoma. Low - molecular - weight heparin was administered as prophylactic dose in 3 patients. Results All patients in this group were survival. 5 of them get well recovery. 3 of them remained different degrees of hemiplegia or aphasia and 2 patient got vegetative state after operation. Conclusions Pre - operative normalization of coagulation capacity is of utmost importance in patients with head injury and plays an important role in the prognosis of patients.%目的 探讨长期口服抗凝药物华法令合并外伤性颅内出血患者的围手术期处理措施.方法 10例此类患者入院后给予维生素K、新鲜冰冻血浆和凝血酶原复合物来逆转患者的抗凝状态.9例患者接受开颅手术清除颅内血肿.3例患者术后接受预防剂量的低分子肝素的治疗.结果 术后所有患者均存活,其中5例恢复良好,3例遗留不同程度的偏瘫或失语症状,2例患者术后长期植物状态生存.结论 伤后、术前迅速纠正凝血指标参数至关重要,与患者预后密切相关.

  6. 早产儿颅内出血继发梗阻性脑积水相关因素分析%Related factors analysis of obstructive hydrocephalus secondary to intracranial hemorrhage in premature infants

    Institute of Scientific and Technical Information of China (English)

    李冰; 张茜; 时赞扬; 程欣茹

    2015-01-01

    目的:探讨早产儿颅内出血后继发梗阻性脑积水的相关因素。方法将2013年6月至2014年9月住院,头颅超声示严重颅内出血(Ⅲ级及Ⅳ级)的早产儿304例,按是否继发脑积水分为脑积水组(59例)和非脑积水组(185例),分析颅内出血后继发梗阻性脑积水的相关影响因素,比较两组患儿在生后不同时间点的侧脑室增宽程度。结果单因素分析结果显示,胎龄≤32周、出生体质量<1500g、重度窒息、剖宫产、呼吸窒息综合征(RDS)、新生儿感染、心力衰竭、动脉导管未闭(PDA)、pH值≤7.2、血小板减少、凝血功能异常、Ⅲ或Ⅳ级颅内出血的比例,在脑积水与非脑积水两组之间的差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,pH值≤7.2、血小板减少、凝血功能异常、胎龄≤32周、重度窒息、Ⅲ或Ⅳ级颅内出血为继发梗阻性脑积水的独立危险因素(OR:1.76~20.46,P<0.05)。出生后各时间点,脑积水组侧脑室的后角比值均大于非脑积水组,差异有统计学意义(P均<0.05);脑积水组左侧和右侧脑室的后角比值随时间变化的差异均有统计学意义(P均=0.000),均在第14天时逐渐增大,第28天达到高峰。结论重视颅内出血后继发梗阻性脑积水的高危因素,对严重颅内出血患儿定期行头颅超声动态监测脑室增宽情况。%ObjectiveTo explore the risk factors of obstructive hydrocephalus secondary to intracranial hemorrhage in premature infants.MethodsA total of 304 premature infants were selected who were diagnosed as sever intracranial hemor-rhage (grade III and IV) by cranial bedside ultrasound admitted to our hospital from Jun. 2013 to Sep. 2014. According to wheth-er the obstructive hydrocephalus was followed, all infants were divided into hydrocephalus group (n=59) and non-hydrocephalus group (n=185). The risk factors of obstructive hydrocephalus secondary to

  7. 新生儿颅内出血影像学检查方法选择及合并症诊断%The selecting of imaging method and diagnosis of complication in newborn with intracranial hemorrhage

    Institute of Scientific and Technical Information of China (English)

    周丛乐

    2010-01-01

    @@ 颅内出血(intracranial hemorrhage,ICH)是新生儿期常见病,依不同病因,出血可发生在颅内不同部位.新生儿不同类型的ICH临床表现不完全一致,影像学诊断方法选择各异.ICH还会发生一些合并症,造成脑实质损害,成为后期神经系统异常的原因,因此深入认识这些问题,有益于临床诊疗水平的提高.

  8. Phase contrast MRI in intracranial aneurysms

    NARCIS (Netherlands)

    van Ooij, P.

    2012-01-01

    Intracranial aneurysms are outpouchings of intracranial arteries that cause brain hemorrhage after rupture. Unruptured aneurysms can be treated but the risk of treatment may outweigh the risk of rupture. Local intra-aneurysmal hemodynamics can contribute substantially to the rupture risk estimation

  9. 合并颅内动脉瘤的烟雾病:临床特征、出血危险因素和治疗转归%Moyamoya disease associated w ith intracranial aneurysm:clinical features, risk factors of hemorrhage and treatment outcomes

    Institute of Scientific and Technical Information of China (English)

    杨怀滔; 张正善; 段炼

    2015-01-01

    ObjectiveToinvestigatetheclinicalfeatures,riskfactorsforbleedingandtreatment outcomes in moyamoya disease patients w ith intracranial aneurysms. Methods The clinical symptoms, location and size of aneurysm, treatment and the long-term folow-up results of the moyamoya disease patients w ith intracranial aneurysms w ere analyzed retrospectively. Results A total of 34 moyamoya disease patients w ith intracranial aneurysms (35 aneurysms) w ere enrol ed, including 22 (64.7%) in the intracranial hemorrhage group and 12 ( 35.3%) in the non-intracranial hemorrhage group. Of the 35 intracranial aneurysms, 23 (main artery type 11, peripheral artery type 12) w ere in the intracranial hemorrhage group and 12 (main artery type 11, peripheral artery type 1) w ere in the non-intracranial hemorrhage group. There w ere 29 smal aneurysms and 6 medium aneurysms (al w ere patients w ith hemorrhagic moyamoya disease). The aneurysms w ere mainly peripheral arterial type in the intracranial hemorrhage group, and the aneurysms w ere mainly artery type in the non-intracranial hemorrhage group. There w as significant difference in aneurysm typing betw een the tw o groups ( P= 0.013 ). Tw o patients did not perform encephalo-duro-arterio-synangiosis (EDAS) in the intracranial hemorrhage group, other patients and those of the non-intracranial hemorrhage group performed EDAS. Angiographical reexamination revealed that 3 patients w ith peripheral aneurysm disappeared, and 1 aneurysm recurred after aneurysm embolization, and the remaining aneurysms did not have any change. Long-term fol ow-up show ed that 1 patient died of sudden cerebral hemorrhage at 1 year after procedure in the intracranial hemorrhage group, and the others did not have ischemic or hemorrhagic stroke. The modified Rankin scale scores w ere improved in 21 patients. Conclusions There are differences in moyamoya disease patients w ith intracranial aneurysm typing w ith different clinical manifestations. Moyamoya disease

  10. Nursing experience of infants with delayed-onset of vitamin K deficiency induced intracranial hemorrhage%晚发性维生素K缺乏症引起颅内出血患儿的护理

    Institute of Scientific and Technical Information of China (English)

    侍海棠

    2012-01-01

    Objective:To explore intensive care in improving delayed - onset of vitamin K caused by lack of children of the treatment of the role of intracere-bral hemorrhage effect. Methods :22 cases were analyzed retrospectively late onset vitamin K caused by lack of intracranial hemorrhage the children nursing effect. Results:22 cases cure in 18 cases,2 cases died, automatic discharge in 2 cases. Conclusion:Strengthening basic nursing is the key to improve the curative effect;At the same time,strengthen nutrition guidance, the nurse with a formula milk as the reasonable feeding artificially bred son knowledge education of the key is prevention.%目的:探讨晚发性维生素K缺乏致患儿颅内出血的护理措施.方法:回顾性分析22例晚发性维生素K缺乏所致颅内出血患儿全程护理效果.结果:治愈18例,死亡2例,自动出院2例.结论:加强基础护理是提高治愈率的关键;同时加强乳母的营养指导、以配方奶为主的人工喂养儿的合理喂养知识宣教是预防的关键.

  11. Glycemia in Spontaneous Intracerebral Hemorrhage: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Alvis-Miranda Hernando

    2014-10-01

    Full Text Available Spontaneous cerebral hemorrhage or intracranial hemorrhage accounts for 10-15% of all strokes. Intracranial hemorrhage is much less common than ischemic stroke, but has higher mortality and morbidity, one of the leading causes of severe disability. Various alterations, among these the endocrine were identified when an intracerebral hemorrhage, these stress-mediated mechanisms exacerbate secondary injury. Deep knowledge of the injuries which are directly involved alterations of glucose, offers insight as cytotoxicity, neuronal death and metabolic dysregulations alter the prognosis of patients with spontaneous intracerebral hemorrhage.

  12. 急性外伤性颅内血肿患者术后发生迟发性脑出血的临床分析%Clinical analysis of acute traumatic intracranial hematoma with postoperative delayed cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    蔡亮

    2013-01-01

    目的:探讨急性外伤性颅内血肿患者的临床特征与术后迟发性脑出血发生的相关性,寻找防治措施。方法:回顾分析58例急性外伤性颅内血肿患者开颅血肿清除术后再出血的临床资料,其中23例患者术后发生迟发性脑出血( DTIH组),35例未发生( NDTIH)组。对2组患者的临床特征进行总结归纳,分析寻找再出血原因,对迟发性脑出血患者行再次手术治疗,并随访行GOS评分。结果:与NDTIH组比较DTIH组有如下特征:术前GCS评分<8分(p<0.05);术前头颅CT提示多有多发脑挫伤,对冲伤,合并颅骨骨折等,并予及时再次手术治疗,术后随访行GOS评估≥4分18例。结论:根据急性外伤性颅内血肿开颅术后患者的临床特征,及时发现迟发性脑出血,并清除迟发性颅内血肿,是提高疗效的关键。%Objective:To explore the corelation between the clinical features of patients with incidence of acute traumatic intracranial hematoma and late postoperative hemorrhage occurs and to make prevention and control measures .Methods:The clinical data of 58 cases divided two groups,postoperative delayed cerebral hemorrhage (DTIH,n=23) and did not occur (NDTIH,n=35),of acute traumatic in-tracranial hematoma in patients with invasive hematoma removal were retrospectively analyzed ,which to invastigate the reason of rehaemor-rhagia and did surgical treatment again ,to follow up through GOS score .Results:Compared with the NDTIH group ,the DTIH had the fol-lowing characteristics:preoperative GCS score <8 points ( p <0.05);Preoperative skull CT indicated that multiple cerebral contusion , hedge, skull fractures, etc,which to timely surgery again , there were18 cases those value of GOS evaluation were four points or more . Conclusion:According to the clinical features of patients with acute traumatic intracranial hematoma after craniotomy , timely detected the late-onset cerebral

  13. Intracranial aneurysms.

    Science.gov (United States)

    Puskar, G; Ruggieri, P M

    1995-08-01

    MR angiography provides a rapid, accurate, and extremely flexible noninvasive evaluation of intracranial aneurysms without the cost and risk of conventional angiography. TOF and phase contrast techniques each have specific advantages and disadvantages that can be selectively exploited to optimize aneurysm evaluation. Present indications for MR angiography in aneurysm evaluation include: (1) the presence of incidental findings on a CT or MR examination that suggest the possibility of aneurysm (Figs. 7 and 8), (2) when angiography is contraindicated or when the risk is too high, (3) non-invasive follow-up of patients with known aneurysms, (4) patient refusal of contrast angiography, and (5) evaluation of patients with specific clinical symptoms (i.e., third cranial nerve palsy) or patients with non-specific subacute symptoms in whom an aneurysm might explain the clinical presentation. Although MR angiography certainly can detect aneurysms with a high rate of sensitivity and specificity, detailed decision analyses generally have not supported the overall benefit of this type of screening. Future technical advances as well as advances in the overall understanding of aneurysms may one day prove unequivocally the benefit of MR angiography in screening high-risk patient groups. MR angiography has not yet been clinically evaluated as a tool in the evaluation of acute subarachnoid hemorrhage. Potential obstacles to such an evaluation include the clinical instability of SAH patients, limited spatial resolution of the MR angiography acquisitions, the potential for subarachnoid blood or focal intraparenchymal hematomas to obscure or mimic small aneurysms, and the unreliability of MR angiography in demonstrating vasospasm. Currently these factors continue to provide an integral role for contrast angiography in aneurysm evaluation.

  14. Effect of Microinvasive Aspiration and Drainage of Intracranial Hematoma in the Treatment of Cerebral Hemorrhage%脑出血应用微创颅内血肿抽吸引流术治疗的效果探讨

    Institute of Scientific and Technical Information of China (English)

    陈容

    2016-01-01

    Objective To explore the clinical effect of microinvasive aspiration and drainage of intracranial hematoma in the treatment of cerebral hemorrhage. Methods 80 cases with cerebral hemorrhage admitted in our hospital from January 2014 to June 2015 were selected as the subjects and randomly divided into two groups with 40 cases in each. Patients in the con-trol group were treated by medical conservative treatment, and those in the experimental group were treated by microinva-sive aspiration and drainage of intracranial hematoma. And the treatment effect was evaluated by comparing the values of indexes of the two groups. Results The treatment results showed that the total effective rate of the experimental group was significantly higher than that of the control group (P<0.05). The experimental group had significantly lower incidence of complications than the control group (P<0.05). The conscious disturbance scores and nerve function impairment scores were significantly better than those before treatment in both groups, and the conscious disturbance scores and nerve function im-pairment scores were significantly better in the experimental group than in the control group (P<0.05). Conclusion Microin-vasive aspiration and drainage of intracranial hematoma has good overall clinical effect on cerebral hemorrhage, which can significantly improve the symptoms of neurological deficit and the state of consciousness, so it is suitable for wide clinical application.%目的:对脑出血应用微创颅内血肿抽吸引流术治疗的临床效果进行探讨。方法整群选取该院于2014年1月—2015年6月接收的80例脑出血患者为研究对象,将所有患者随机将其分为两组,各40例。其中对照组患者采取内科保守进行干预,而实验组患者采取微创颅内血肿抽吸引流术治疗,在治疗结束后通过比较两组患者的各项指标,评价治疗效果。结果治疗结果表明,实验组患者的治疗总有效率明显高

  15. 新生儿自发性颅内出血的诊治要点%Exploration on Diagnosis and Treatment with Spontaneous Intracranial Hemorrhage(SIH) in Neonates

    Institute of Scientific and Technical Information of China (English)

    马勤

    2016-01-01

    Objective:To explore the clinical features and treatment options of spontaneous intracranial hemorrhage in neonates and the affect of intelligence and psychological development.Method:32 neonates of spontaneous intracranial hemorrhage and 32 normal neonates from June 2009 to June 2014 in our hospital were retrospectively analyzed,their mental development index (MDI) and psychological development were compared. Result:3 neonates were diagnosed with Vatime K defict,23 cases were cerebral arteriovenous malformation, 1 case was cavernous hemangioma,2 cases were posterior communicating artery aneurysm and 2 cases were moyamoya.After treatment,24 cases were healed,4 cases of mild disability, 2 cases of medium disability,and 2 cases were dead.The MDI and developmental quotient were lower than normal neonate after 12 months follow-up, the differences were statistically significant(P<0.05).Conclusion:Neonatal intracranial hemorrhage can impact intelligence and psychological development.Blood coagulation,DSA, CT and MRI make great contribution for diagnosis,the clinician should take appropriate treatment options according to different cause of disease.%目的:探讨新生儿自发性颅内出血的诊断方法、临床特点与治疗方法,并观察其心理与智能发育的影响。方法:选取2009年6月-2014年6月本院收治的32例自发性颅内出血患儿及32例正常新生儿的临床资料进行回顾性分析,并比较其与正常新生儿的智能发育指数(MDI)与心理发育状况。结果:3例患儿诊断为先天性维生素K缺乏症,23例诊断为脑动静脉畸形,1例诊断为海绵状血管瘤,2例诊断为后交通动脉瘤,2例诊断为烟雾病,另有1例原因不明。经过治疗,24例痊愈,4例轻残,2例中残,2例死亡。随访至12个月,自发性颅内出血新生儿MDI指数与发育商均低于正常新生儿,比较差异均有统计学意义(P<0.05)。结论:新生儿颅内出血可导致其

  16. Effects of Minimally Invasive Puncture and Drainage of Intracranial Hematoma on the Blood-brain Barrier in Patients with Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    HUANG Xiaojiang; GUO Shougang; WANG Wei

    2007-01-01

    The effects of minimally invasive surgery on the blood-brain barrier (BBB) of 30 patients with cerebral hemorrhage were investigated. Difference of the BBB index and serum MBP concentration were assessed in 15 cases of conservative treatment group and 15 cases of minimally invasive surgery group. The BBB index in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and the BBB index in the two treatment groups was significantly higher than in control group (P<0.01). Serum MBP concentration in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and that in the two treatment groups was significantly higher than in control group (P<0.01). It was suggested the permeability of BBB in patients with cerebral hemorrhage was increased, and BBB index and serum MBP concentration in patients with cerebral hemorrhage were increased. Minimally invasive surgery can reduce the lesion of cytotoxicity to BBB and cerebral edema.

  17. 新生儿颅内出血连续腰椎穿刺放脑脊液治疗效果分析%The Analysis of the Treatment Effect on Intracranial Hemorrhage of Newborn by Serial Lumbar Punctures Discharge Brain Liquid

    Institute of Scientific and Technical Information of China (English)

    欧阳小桃

    2015-01-01

    Objective:To study and analyze the treatment effect on intracranial hemorrhage of newborn by serial lumbar punctures.Method:The clinical data of 5 cases with intracranial hemorrhage of newborn by serial lumbar punctures from June 2010 to June 2012 was retrospective analyzed.Result:The effective rate of the 5 cases of newborn was 80%.Conclusion:The treatment effect on intracranial hemorrhage of newborn by serial lumbar punctures is obvious,it worth widely using in clinical.%目的:研究分析连续腰椎穿刺治疗新生儿颅内出血的临床治疗效果。方法:回顾性分析2010年6月-2012年6月笔者所在医院收治的5例使用连续腰椎穿刺治疗颅内出血新生儿的临床资料。结果:本次研究分析的5例患儿临床治疗有效率为80%。结论:连续腰椎穿刺治疗新生儿颅内出血效果显著,可以有效抢救新生儿的生命,值得在临床中推广使用。

  18. 外伤性颅内出血患者的观察及护理%Observation and Nursing of Patients with Traumatic Intracranial Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    卢小红

    2015-01-01

    Objective To sum up and explore the observation and nursing care of patients with traumatic intracranial hemor hage, in order to improve the quality of nursing. Methods 78 cases of traumatic intracranial hemor hage were selected to observe and nursing, and nursing experience was summarized. Results Due to serious care and timely treatment, the group recovered bet er in 66 cases, improved in 5 cases, 5 cases were discharged voluntarily, 2 cases died. Mortality rate 2.56%. Conclusion Nursing care as long as the strengthening of sense of responsibility, familiar with the business knowledge, close observation of patients' condition, comprehensive and detailed, to discover the condition changes, for the patient should win the operation time, to avoid the formation of cerebral hernia and endanger life, so as to improve the cure rate.%目的:总结和探讨外伤性颅内出血患者的观察及护理要点,以提高护理质量。方法选择78例外伤性颅内出血患者进行观察和护理,总结护理经验。结果由于认真的护理与及时治疗,本组恢复较好66例,好转5例,自动出院5例,死亡2例。死亡率2.56%。结论护理工作中只要加强责任心,熟悉业务知识,密切观察患者病情,全面细致的护理,才能及时发现病情变化,为患者应赢得手术时间,避免脑疝形成而危及生命,从而提高治愈率。

  19. 磁敏感加权成像与超声对新生儿颅内出血诊断价值的对比研究%The value of ESWAN and ultrasound in the diagnosis of intracranial hemorrhage in the newborn

    Institute of Scientific and Technical Information of China (English)

    王晓虎; 张雷; 陈涛; 任慧鹏; 李静; 李莉; 任转琴; 苟晓光

    2013-01-01

    Objective Through the observation of magnetic susceptibility weighted imaging (ESWAN)and ultrasound in intracranial hemorrhage in the newborn,and objective to discuss the diagnostic value of ESWAN and B ultrasound in intraeranial hemorrhage in the newborn.Methods One hundred fifty cases of neonatal intracranial hemorrhage cases were detected by using ESWAN sequence,conventional MRI sequence and B-mode ultrasonography.The detecting rate,distribution and number of intracranial hemorrhage were compared among those three methods.Results The detection rates of intracranial hemorrhage ESWAN,conventional MRI sequence and ultrasound were 32.7%,22%,25.3% respectively.Subependymal intraventricular hemorrhage was the most common hemorrhage(SEH/IVH),there was statistical difference(P < 0.05).The detection rate of ESWAN sequence was significantly higher than that of B ultrasound and the detection rate of ESWAN sequence was higher than that of conventional MRI sequence for the bleeding lesions.Conclusion Compared with ultrasound,ESWAN has obvious advantages in the diagnosis of neonatal intracranial hemorrhage,it can be used as an essential supplementary examination in the diagnosis of intracranial hemorrhage of the newborn.%目的 通过观察新生儿颅内出血在磁敏感加权成像(SWI)与超声检查中的表现,探讨SWIESWAN序列与超声在新生儿颅内出血中的诊断价值.方法 采用ESWAN序列、常规MRI序列及超声对150例新生儿进行检查,比较三者对新生儿颅内出血的检出率、分布区域及病灶检出个数之间的差异.结果 ESWAN、常规MRI序列及超声对新生儿颅内出血的检出率分别为32.7%、25.3%和22.0%,且均以室管膜下-脑室内(SEH/IVH)出血发生率最高.三者对新生儿颅内出血的检出率的差异具有统计学意义(P<0.05),ESWAN序列对病灶的检出率明显高于超声;对于出血灶检出个数ESWAN序列明显高于常规MRI序列.结论 ESWAN序列对新生儿颅

  20. Multi-site evaluation of a computer aided detection (CAD) algorithm for small acute intra-cranial hemorrhage and development of a stand-alone CAD system ready for deployment in a clinical environment

    Science.gov (United States)

    Deshpande, Ruchi R.; Fernandez, James; Lee, Joon K.; Chan, Tao; Liu, Brent J.; Huang, H. K.

    2010-03-01

    Timely detection of Acute Intra-cranial Hemorrhage (AIH) in an emergency environment is essential for the triage of patients suffering from Traumatic Brain Injury. Moreover, the small size of lesions and lack of experience on the reader's part could lead to difficulties in the detection of AIH. A CT based CAD algorithm for the detection of AIH has been developed in order to improve upon the current standard of identification and treatment of AIH. A retrospective analysis of the algorithm has already been carried out with 135 AIH CT studies with 135 matched normal head CT studies from the Los Angeles County General Hospital/ University of Southern California Hospital System (LAC/USC). In the next step, AIH studies have been collected from Walter Reed Army Medical Center, and are currently being processed using the AIH CAD system as part of implementing a multi-site assessment and evaluation of the performance of the algorithm. The sensitivity and specificity numbers from the Walter Reed study will be compared with the numbers from the LAC/USC study to determine if there are differences in the presentation and detection due to the difference in the nature of trauma between the two sites. Simultaneously, a stand-alone system with a user friendly GUI has been developed to facilitate implementation in a clinical setting.

  1. 急性颅脑创伤后进展性颅内出血的CT表现%CT scan manifestations of progressive intracranial hemorrhage of patients with acute traumaticbrain injury

    Institute of Scientific and Technical Information of China (English)

    黄卫兵

    2014-01-01

    Objective To investigate the CT scan manifestations and clinical significance of progressive intracranial hemor-rhage (PTH) of patients with acute traumatic brain injury .Methods The clinical data of 626 patients with acute traumatic brain injury in our hospital from February 2009 to September 2013 were retrospectively analyzed to observe the CT scan mani-festations of PIH and non-PIH patients and the risk factors of PIH .Results Single factor regression analysis showed that there were statistical difference in the CT scan manifestations of PIH and non-PIH patients such as skull fracture ,subarachnoid hemorrhage ,cerebral contusion and laceration ,epidural hematoma ,subdural hematoma .Multivariate regression analysis found that skull fracture ,subarachnoid hemorrhage ,cerebral contusion and laceration ,epidural hematoma were independent risk fac-tor of PIH in patients with acute traumatic brain injury .Conclusion Patients with acute traumatic brain injury should be tested by CT scan as early as possible to confirm PIN in favor of treating PIH timely .%目的:探讨急性颅脑创伤后进展性颅内出血(PIH)发生的CT表现与临床价值。方法回顾性分析我院2009-02-2013-09收治的626例急性颅脑创伤患者的临床资料,分析PIH患者与非 PIH患者的CT 表现差异以及PIH发生的危险因素。结果单因素回归分析发现,PIH组与非 PIH组首次CT 表现中颅骨骨折、蛛网膜下腔出血、脑挫裂伤、硬膜外血肿、硬膜下血肿差异有统计学意义(P<0·05)。多因素回归分析发现,颅骨骨折、蛛网膜下腔出血、脑挫裂伤、硬膜外血肿是影响急性颅脑创伤后进展性颅内出血的独立危险因素(P<0·05),蛛网膜下腔出血是最强因素。结论急性颅脑创伤后应尽快进行头颅CT检查,以便尽快确诊PIH及时进行治疗。

  2. [Adrenal hemorrhage in a newborn with factor V Leiden--a clinical case].

    Science.gov (United States)

    Vulkova, A; Kovacheva, K; ionov, M; Rosmanova, R; Atanasova, V; Slavkova, N; Ivanov, P

    2009-01-01

    Neonatal adrenal hemorrhage is frequently associated with birth trauma, perinatal asphyxia, septicemia, coagulation defects and thromboembolism. We report a case of bilateral adrenal hemorrhage in newborn baby with perinatal asphyxia. Ultrasound findings of subacute adrenal hemorrhage draw attention to its presumable antenatal genesis. DNA analysis for thrombophilic mutations identifies factor V Leiden.

  3. 新生儿及婴儿自发性颅内出血的CT表现与临床分析%CT Findings and Clinical Analysis of Neonates and Infants with Spontaneous Intracranial Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    孙多成; 肖忠; 夏雨; 叶伙华

    2012-01-01

      Objective To study CTfeatures and clinical analysis with spontaneous intracranial hemorrhage in newborns and Infants , Aims to Guidance clinical .Method Clinical data of 110 cases with intracranial hemorrhage from January 2006 to June 2012  were analysed and summarize, Born time from 2w to 3m . Results CT showed: 2 cases with a single part, 59 cases with two parts, 29 cases with three parts, 10 cases with four parts. 88 cases with subarachnoid hemorrhag (80%), 74 cases with intracerebral hemorrhage (67%), 63 cases with subdural hemorrhage (57%), 30 cases with ventricular hemorrhag (27%), 5 cases with epidural eematomaout (4.5%) ;Follow performance : 43 cases brain with edema (39%) ; 47 cases with with hernia of brain(43%), 30 cases tin the left, 17 cases in the right .Conclusion CT provides useful information about the location and extent of intracranial hemorrhage. CT scan should be the first reliable choice for intracranial hemorrhage. To Timely diagnosis and treatment intracranial emorrhage with different causes , to have important clinical significance for enhance the curative rate and reduce sequela.%  目的探讨新生儿及婴儿自发性颅内出血的CT表现与病因,指导临床.方法 收集我院对2006年1月至2012年6月收治的2周~3个月婴幼儿急性颅内出血110例作回顾性分析.结果 CT表现:单一部位出血12例,二个部位出血59例,三个部位出血29例,四个部位出血10例.其中蛛网膜下腔出血最多88例(占80%),合并脑内出血74例(67%),硬膜下出血63例(57%),脑室出血30例(27%),硬膜外出血5例(4.5%);伴随征象:脑水肿43例(39%);脑疝形成47例(43%),其中向左偏30

  4. 新生儿颅内出血的床旁超声诊断价值%Clinical value of cranial bedside ultrasound in the diagnosis of neonatal intracranial hemorrhage

    Institute of Scientific and Technical Information of China (English)

    段雅琦; 丁桂春; 黄晓玲; 崔丽丽

    2013-01-01

    Objective To evaluate the clinical value of ultrasonography in the diagnosis of intracranialhemorrhage(ICH) in newborns.Methods 287 newborns in our hospital experienced color ultrasonography fromNovember 2010 to April 2011.All these newborns were suspected to have intracranial hemorrhage .Results (1)There were 65 cases of intracranial hemorrhage in 287 neonates.The incidence of ICH was 22.6%.63 cases withICH in 230 premature infant.2 cases with ICH in term infants.The incident in premature infants was significantlyhigher than term infants ( χ2 =14.87, P <0.01).(2) In those ICH patients,27 cases were diagnosed assubependymal hemorrhage,31 cases were diagnosed as intraventricular hemorrhage and 7 were diagnosed as cerebralhemorrhage.All the patients with ICH were proved by CT.There was no significant difference in type of ICH betweenpremature infants and term infants.(3)In cases with lower Vs[(29.2 ±1.75)cm/s],Vd[(10.8 ±1.00)cm/s]andhigher RI(0.63 ±0.02)of middle cerebral artery,the incidence of ICH was significantly higher than those of higherVs,Vd and lower RI [ Vs: (37.8 ±1.99) cm/s, Vd: (17.5 ±1.58 ) cm/s, RI:0.54 ±0.03, P <0.01].Conclusion Ultrasonography can monitor the change of intracranial hemorrhage , and it is a non-invasive,repeatable,cheap and effective examination.It can increase the diagnostic rate of neonatal intracranial hemorrhage ,and the early diagnosis combined with early treatment can lower the mortality and complications of newborns .%目的探讨床旁超声在新生儿颅内出血诊断中的价值。方法应用床旁超声对2010年11月至2011年4月在北京军区总医院八一儿童医院新生儿科住院的出生0~28 d的287例高危患儿行床旁颅脑超声检查,采用Sonosite公司的Turbo床旁彩色超声诊断仪经前囟分别作冠状切面、矢状切面以及经颞窗横切面连续扫描检查,并动态观察其颅内病变的变化。结果(1)287例患儿中发生颅内出血者65例,患病率22.6

  5. Spontaneous intracranial epidural hematoma during rivaroxaban treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ruschel, Leonardo Gilmone; Rego, Felipe Marques Monteiro do; Milano, Jeronimo Buzetti; Jung, Gustavo Simiano; Silva Junior, Luis Fernando; Ramina, Ricardo, E-mail: leonardoruschel@yahoo.com.br [Instituto de Neurologia de Curitiba (INC), Curitiba, PR (Brazil)

    2016-11-15

    According to our research, this is the first case described in the literature of spontaneous intracranial epidural hematoma secondary to the use of Xarelto®. Spontaneous intracranial epidural hematomas are rarely described in the literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura mater and metastasis to the skull. Long-term post-marketing monitoring and independent reports will probably detect the full spectrum of hemorrhagic complications of the use of rivaroxaban. (author)

  6. [Perinatal listeriosis].

    Science.gov (United States)

    Tollan, A; Sundsfjord, A; Lindal, S

    1992-04-30

    Human listeriosis is a rare disease. It may be foodborne. Listeric infection during pregnancy may give a fatal fetal outcome, caused by transplacental passage of organisms from the maternal gastrointestinal tract. We describe a case of perinatal listeriosis which resulted in preterm stillbirth. Perinatal listeriosis should be considered when flue-like symptoms are presented during pregnancy. Early diagnosis and treatment may improve the outcome.

  7. Achados ultra-sonográficos da hemorragia intracraniana em recém-nascidos prematuros Ultrasonic findings of intracranial hemorrhage in preterm neonates

    Directory of Open Access Journals (Sweden)

    Luciano Farage

    2005-09-01

    Full Text Available A hemorragia intracraniana (HIC é a manifestação mais comum no sistema nervoso central de recém-nascidos (RN prematuros, especialmente os de peso menor que 1500 g, ou com idade gestacional (IG menor que 32 semanas. O local mais acometido é a matriz germinal e é classificado em graus por Papile et al. Foram analisados prospectivamente 50 RN pré-termo (IG IGIntracranial hemorrhage ICH is one of the most common neurological events in pre-term newborn ICH is associated with low birth weight ( 33 weeks and B-34-37 weeks. In group A there were 34 children (25 boys wither mean GA of 31 weeks and birth weights average of 1308 g. In group B there were 16 children (2 boys, mean GA 34 weeks and birth weight average of 1951 g. The grades of ICH were: Group A-I-14, II-14, III-4 and IV-2; Group B-I-12, II-3 and III-1. The complications were more common in group A with 12 than group B with 4 children. The lesions happen in greatest number and most severity in children with low birth weight and younger (low gestational age. Ultrasound has shown to be effective for diagnostic and follow up of those children.

  8. Influence of intracranial hemorrhage and neonatal seizures on the neurological and psychomotor development of premature infants at Hospital de Clínicas de Porto Alegre, Brazil Influência da hemorragia intracraniana e crises neonatais sobre o desenvolvimento neurológico e psicomotor de recém-nascidos prematuros no Hospital de Clínicas de Porto Alegre, Brasil

    Directory of Open Access Journals (Sweden)

    Lygia Ohlweiler

    2003-12-01

    Full Text Available This study compared the results of neurodevelopmental examination at 6 months' corrected age of premature infants with neonatal seizures and/or intracranial hemorrhage and normal premature infants. There was a statistically significant correlation (p=0.000007 between intracranial hemorrhage and seizures in the group of 68 premature infants seen in the neurodevelopmental outpatient service at Hospital de Clínicas de Porto Alegre, Brazil. Intracranial hemorrhage was significantly associated with multiparity (p=0.02. The neurodevelopmental examination at 6 months' corrected age revealed that patients who suffered neonatal intracranial hemorrhage and/or seizures had inappropriate muscle tone, strength and reflexes, as well as delay in head control. Conclusion: we compared the results of neurodevelopmental examinations of two groups of premature infants at 6 months' corrected age. The difference in neurological development at 6 months' corrected age was statistically significant when comparison was corrected for premature infants who had neonatal seizures and periventricular hemorrhage.Este estudo comparou os resultados do exame do desenvolvimento neuropsicomotor aos seis meses de idade corrigida de lactentes prematuros com crises neonatais e/ou hemorragia intracraniana com lactentes prematuros sem estas intercorrências. Houve uma correlação estatisticamente significativa (p=0.000007 entre hemorragia intracraniana e crises neonatais no grupo de 68 lactentes prematuros vistos no ambulatório de neurodesenvolvimento do Hospital de Clínicas de Porto Alegre, Brasil. Hemorragia intracraniana foi significativamente associada com multiparidade (p=0.02. O exame do desenvolvimento neuropsicomotor aos 6 meses de idade corrigida mostrou que pacientes que sofreram hemorragia intracraniana neonatal e/ou crises neonatais tiveram tônus, forças e reflexos inapropriados, bem como atraso no controle do sustento cefálico. Conclusões: Comparamos os resultados

  9. 脑动静脉畸形破裂出血并脑疝的急诊手术治疗%Emergent Surgical Treatment of Acute Hemorrhagic Intracranial Arteriovenous Malformation with Intracerebral Herniation

    Institute of Scientific and Technical Information of China (English)

    魏健; 刘维生; 王永和; 曹培成; 卜振富

    2013-01-01

      目的探讨脑动静脉畸形(AVMs)破裂出血并脑疝的急诊手术问题。方法回顾性分析我院17例AVMs急性破裂出血合并脑疝并行急诊手术治疗的病例资料。结果患者术后半年GOS评定疗效,良好4例,中残6例,重残2例,植物生存2例,死亡3例。术后并发肺部感染4例,皮瓣下积液2例,颅内感染并脑积水1例,迟发血肿1例。结论急诊手术治疗是AVMs破裂出血并脑疝首选治疗方法,能够提高病人生存率,降低致残率。%Objective To study the emergent operative treatment of acute hemorrhagic cerebral arteriove-nous malformations(AVMs) with cerebral herniation.Methods A retrospective analysis of 17 patients with acute hemor-rhagic cerebral AVMs with cerebral herniation was carried out ,who were treated with emergent operative treatment .Re-sults According to GOS scale six month after operation ,4 patients recovered well,moderately disabled in 6 cases,se-verely disabled in 2 cases,vegetably survived in 2 cases,3 patients died after operation,4 cases with pneumonia after op-eration,2 cases with subdural hydroma ,1 case with intracranial infection and hydrocephalus ,1 case with recurrent hema-toma.Conclusion The emergent hematoma debridement and AVMs excision by microneurosurgery is the optimal effec-tive method to treat AVMs with cerebral herniation because it can heighten survival rate and decrease disability rate .

  10. Reversible Cerebral Vasoconstriction Syndrome with Intracranial Hypertension: Should Decompressive Craniectomy Be Considered?

    Science.gov (United States)

    Mrozek, Ségolène; Lonjaret, Laurent; Jaffre, Aude; Januel, Anne-Christine; Raposo, Nicolas; Boetto, Sergio; Albucher, Jean-François; Fourcade, Olivier; Geeraerts, Thomas

    2017-01-01

    Background Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracerebral hemorrhage (ICH) causing intracranial hypertension. Methods Case report. Results We report a case of RCVS-related ICH leading to refractory intracranial hypertension. A decompressive craniectomy was performed to control intracranial pressure. We discuss here the management of RCVS with intracranial hypertension. Decompressive craniectomy was preformed to avoid the risky option of high cerebral perfusion pressure management with the risk of bleeding, hemorrhagic complications, and high doses of norepinephrine. Neurological outcome was good. Conclusion RCVS has a complex pathophysiology and can be very difficult to manage in cases of intracranial hypertension. Decompressive craniectomy should probably be considered.

  11. Tuberculosis perinatal

    Directory of Open Access Journals (Sweden)

    Jessica Sáenz-Gómez

    2015-01-01

    Conclusiones: La infección perinatal debe sospecharse en niños con sepsis o neumonía sin respuesta a antibióticos. En este caso, el antecedente de la madre con tuberculosis orientó al diagnóstico.

  12. Intracranial haemorrhage

    African Journals Online (AJOL)

    His interests include vascular neurosurgery and spinal deformities. ... he returned to specialise in neurosurgery after time spent working abroad. ... at Groote Schuur Hospital, where his major interests are skull base surgery and ... intracranial bleed is hypertension – this is an ... cerebellar signs and symptoms or with raised.

  13. Clinical practice guideline for the management of intracranial aneurysms.

    Science.gov (United States)

    Jeong, Hae Woong; Seo, Jung Hwa; Kim, Sung Tae; Jung, Cheol Kyu; Suh, Sang-Il

    2014-09-01

    An intracranial aneurysm, with or without subarachnoid hemorrhage (SAH), is a relevant health problem. The rupture of an intracranial aneurysm is a critical concern for individual health; even an unruptured intracranial aneurysm is an anxious condition for the individual. The aim of this guideline is to present current and comprehensive recommendations for the management of intracranial aneurysms, with or without rupture. We performed an extensive literature search, using Medline. We met in person to discuss recommendations. This document is reviewed by the Task Force Team of the Korean Society of Interventional Neuroradiology (KSIN). We divided the current guideline for ruptured intracranial aneurysms (RIAs) and unruptured intracranial aneurysms (UIAs). The guideline for RIAs focuses on diagnosis and treatment. And the guideline for UIAs focuses on the definition of a high-risk patient, screening, principle for treatment and selection of treatment method. This guideline provides practical, evidence-based advice for the management of patients with an intracranial aneurysm, with or without rupture.

  14. Genetics of intracranial aneurysms and related diseases

    NARCIS (Netherlands)

    van 't Hof, F.N.G.

    2017-01-01

    Intracranial aneurysms (IA) are dilatations of the vessel walls of cerebral arteries. Some can rupture and result in a subarachnoid hemorrhage (SAH), a severe subtype of stroke. This thesis is set out to elucidate the pathophysiology of IA from a genetic perspective. The main conclusions are: 1.

  15. Terson syndrome in conjunction with ruptured intracranial aneurysm and penetrating intracranial injury: a review of two cases.

    Science.gov (United States)

    Rheinboldt, Matt; Francis, Kirenza; Parrish, David; Harper, Derrick; Blase, John

    2014-04-01

    Terson syndrome, the presence of intraocular hemorrhage in the setting of acutely elevated intracranial pressure, was historically described in conjunction with acute subarachnoid hemorrhage; however, more recently, it has been associated with a gamut of intracranial pathophysiology ranging from blunt or penetrating injury to neurosurgical procedures. We describe two cases of profound intracranial injury, secondary to ballistic injury, and a ruptured intracranial aneurysm, in which posterior chamber ocular hemorrhage was noted on CT imaging. Though the outcome in such cases, as with ours, is often poor, the findings are germane to clinical care as the presence of Terson syndrome has been noted to be a negative prognostic factor in multiple clinical reviews. Additionally, clinical recovery can be impacted adversely by lasting visual deficits or retinal degradation in the absence of timely ophthalmologic intervention.

  16. 高血压脑出血无创颅内压及脑灌注压监测临床研究%Monitoring noninvasive intracranial pressure and cerebral perfusion pressure in treatment of patients with hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    张文德; 张湘; 邹志浩; 吴勤奋; 殷捷; 王建江; 郑玺; 莫拉丁

    2012-01-01

    Objective To evaluate clinical significance of monitoring noninvasive intracranial pressure (NICP) and cerebral perfusion pressure (CPP) in treatment of patients with hypertensive intracerebral hemorrhage. Methods This clinical randomized controlled trial enrolled 120 patients with hypertensive intracerebral hemorrhage who had sought medical treatment in our department from June 2008 through May 2010. They were randomized equally into a monitoring group where NICP and CPP were continuously monitored before and after operation and a non-monitoring group where no monitoring of NICP and CPP was performed. Results In the monitoring group,increased NICP and decreased CPP were shown in 50 patients and only 10 patients were shown with normal NICP (<26.6mmHg) and CPP (> 124.3 mm Hg). The abnormal NICP and CPP continuously monitored were treated with specific interventions like further operation or medication. In the non-monitoring group,patients received only conventional treatments.According to the Glasgow Outcome Scale (GOS), 31 patients (51.7%) had good recovery,20 (33.3%) were moderately disabled,5 (8.3%) severely disabled and 4 (6.7%) dead in the monitoring group while 23 (38.3%) patients had good recovery,18 (30.0%)were moderately disabled,10 (16.7%) severely disabled and 9 (15.0%) dead in the non-monitoring group.The outcomes of the monitoring group were significantly better than those of the non-monitoring group (P<0.05). Conclusion Continuous monitoring of NICP and CPP before and after operation should be performed in the treatment of patients with hypertensive intracerebral hemorrhage because it is helpful for clinical medication and reducing complications and mortality as well.%目的 探讨高血压脑出血手术前后监测无创颅内压(NICP)、脑灌注压(CPP)变化的临床意义. 方法 收集解放军第474医院神经外科自2008年6月至2010年5月收治的120例高血压脑出血手术患者,按照随机数字表法分为

  17. Hemorrhagic Colloid Cyst Presenting with Acute Hydrocephaly

    Science.gov (United States)

    Akhavan, Reza; Zandi, Behrouz; Pezeshki-Rad, Masoud; Farrokh, Donya

    2017-01-01

    Colloid cysts are benign slow-growing cystic lesions located on the roof of the third ventricle that usually present with symptoms related to gradual rise of intracranial pressure. They mostly remain asymptomatic and sometimes grow progressively and cause diverse symptoms associated with increased intracranial pressure such as headache, diplopia, and sixth cranial nerve palsy. Here we report a 47-year-old female who presented to the emergency department with acute severe headache and nausea/vomiting. On MRI examination acute hydrocephaly due to hemorrhagic colloid cyst was detected. Acute hemorrhage in colloid cysts is extremely rare and may present with symptoms of acute increase in the intracranial pressure. Intracystic hemorrhage is very rarely reported as a complication of colloid cyst presenting with paroxysmal symptoms of acute hydrocephaly. PMID:28210514

  18. Intracranial endoscopy.

    Science.gov (United States)

    Schroeder, H W; Gaab, M R

    1999-04-15

    The authors' intention is to reduce the invasiveness of intracranial procedures while avoiding traumatization of brain tissue, to decrease the risk of neurological and mental deficits. Intracranial endoscopy is a minimally invasive technique that provides rapid access to the target via small burr holes without the need for brain retraction. Craniotomy as well as microsurgical brain splitting and dissection can often be avoided. Furthermore, because obstructed cerebrospinal fluid pathways can be physiologically restored, the need for shunt placement is eliminated. The ventricular system and subarachnoid spaces provide ideal conditions for the use of an endoscope. Therefore, a variety of disorders, such as hydrocephalus, small intraventricular lesions, and arachnoid and parenchymal cysts can be effectively treated using endoscopic techniques. With the aid of special instruments, laser fibers, and bipolar diathermy, even highly vascularized lesions such as cavernomas may be treated. Moreover, during standard microsurgical procedures, the endoscopic view may provide valuable additional information ("looking around a corner") about the individual anatomy that is not visible with the microscope. In transsphenoidal pituitary surgery, transseptal dissection can be avoided if an endonasal approach is taken. In the depth of the intrasellar space, the extent of tumor removal can be more accurately controlled, especially in larger tumors with para- and suprasellar growth. The combined use of endoscopes and computerized neuronavigation systems increases the accuracy of the approach and provides real-time control of the endoscope tip position and approach trajectory. In the future, the indications for neuroendoscopy will certainly expand with improved technical equipment.

  19. 胎儿颅内出血超声联合磁共振成像诊断与妊娠结局%The prenatal ultrasound and magnatic resonance imaging characteristics of fetal intracranial hemorrhage

    Institute of Scientific and Technical Information of China (English)

    韩瑾; 戴常平; 廖灿; 曾斯慧; 甄理; 杨昕; 潘敏; 刘鸿圣; 李东至; 白洁; 虞翌旻

    2015-01-01

    Objective To investigate the diagnostic value of prenatal ultrasonography and magnatic resonance imaging in the fetal intracranial hemorrhage. Methods The 20 antenatal diagnosed ICH cases was collected from 31 200 prenatal diagnosis units in Guangzhou Women and Children′s Medical Center from July 2012 to June 2014. Maternal characteristics, ultrasound, and magnetic resonance imaging findings, clinical course, and postnatal outcome were reviewed. Results Twenty consecutive cases of fetal ICH were evaluated. All cases were diagnosed at mid or third trimester. Transabdominal ultrasound showed 9 cases of hyper echoic lesions in the lateral ventricle, 2 cases of hypoechonic lesions, 2 cases of irregular mixed echo in the parenchyma, 1 case of hyperechoic cerebellar hemisphere with infarction, and 1 case of abnormal choroid plexus. Seventeen cases were associated with ventriculomegaly, brain compression or brain midline displacement. MRI showed the nodular, patchy or linear low signal on T2WI and high signal on T1WI. Some cases were combined with cortex lesions or abnormal parenchyma. ICH was complicated with other structural abnormalities:1 case of cleft palate, 2 cases of spinal deformity and 3 cases of other cerebral cortical malformations. Prenatal diagnosis results were:2 cases diagnosed as positive cytomegalovirus infection and no chromosome abnormalities found in all cases. The follow up results were:1 case was lost, 16 cases were terminated after prenatal diagnosis. Among the 3 survival cases, 1 case has the neurological complication and the other two were normal till now. Conclusions Fetal intracranial hemorrhage has some image features on ultrasound and magnetic resonance. Ultrasound showed hyper echoic lesions with ventriculomegaly. MRI showed the nodular, patchy or linear low signal on T2WI and high signal on T1WI. MRI may contribute to the accuracy of diagnosis, particularly in bleeding site. The regular ultrasonic monitoring is helpful to improve the

  20. Perinatal risk factors and neonatal complications in discordant twins admitted to the neonatal intensive care unit

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-rui; LIU Jie; ZENG Chao-mei

    2013-01-01

    Background Many studies have shown a relationship between birth weight discordance and adverse perinatal outcomes.This study aimed to investigate the perinatal risk factors and neonatal complications of discordant twins who are admitted to the neonatal intensive care unit.Methods A total of 87 sets of twins were enrolled in this retrospective study,of which 22 sets were discordant twins and 65 sets were concordant twins.Binary Logistic regression analysis was used to identify the risk factors associated with the occurrence of discordant twins.The common neonatal complications of discordant twins were also investigated.Results Multivariate analysis showed that the use of assisted reproductive techniques,pregnancy-induced hypertension,and unequal placental sharing were risk factors for the occurrence of discordant twins.The incidence of small for gestational age infants and very low birth weight infants of discordant twins was significantly higher,while the birth weight of discordant twins was significantly lower than those of concordant twins.The duration of hospitalization of discordant twins was longer than that of concordant twins.The incidence of several neonatal complications,such as neonatal respiratory distress syndrome and intracranial hemorrhage,was higher in discordant twins than that in concordant twins.The percentage of those requiring pulmonary surfactant and mechanical ventilation was significantly higher in discordant twins than that in concordant twins.Conclusions Use of assisted reproductive techniques,pregnancy-induced hypertension,and unequal placental sharing are perinatal risk factors of discordant twins who are admitted to the neonatal intensive care unit.These infants are also much more likely to suffer from various neonatal complications,especially respiratory and central nervous system diseases.It is important to prevent the occurrence of discordant twins by decreasing these risk factors and timely treatment should be given to discordant

  1. Hemorrhagic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Hemorrhagic stroke is the less common type. It happens when ... an artery wall that breaks open. Symptoms of stroke are Sudden numbness or weakness of the face, ...

  2. Intracranial Non-traumatic Aneurysms in Children and Adolescents

    OpenAIRE

    Sorteberg, Angelika; Dahlberg, Daniel

    2013-01-01

    An intracranial aneurysm in a child or adolescent is a rare, but potentially devastating condition. As little as approximately 1200 cases are reported between 1939 and 2011, with many of the reports presenting diverting results. There is consensus, though, in that pediatric aneurysms represent a pathophysiological entity different from their adult counterparts. In children, there is a male predominance. About two-thirds of pediatric intracranial aneurysms become symptomatic with hemorrhage an...

  3. Prevalence of hypopituitarism after intracranial operations not directly associated with the pituitary gland

    National Research Council Canada - National Science Library

    Fleck, Steffen Kristian; Wallaschofski, Henri; Rosenstengel, Christian; Matthes, Marc; Kohlmann, Thomas; Nauck, Matthias; Schroeder, Henry Werner Siegfried; Spielhagen, Christin

    2013-01-01

    ...) and subarachnoid hemorrhage (SAH) has steadily increased. Moreover, recent studies have found that a clinically relevant number of patients develop pituitary insufficiency after intracranial operations and radiation treatment for non-pituitary tumors...

  4. Familial aggregation of intracranial aneurysms in an Inuit patient population in Kalaallit Nunaat (Greenland)

    DEFF Research Database (Denmark)

    Lindgaard, Lars; Eskesen, Vagn; Gjerris, Flemming

    2003-01-01

    The incidence of subarachnoid hemorrhage (SAH) and intracranial aneurysm (IA) has been reported to be higher in Greenlandic Inuits than in Caucasian Danes, but the rate of familial aggregation in Inuits is unknown....

  5. Nonthyroidal illness syndrome in patients with subarachnoid hemorrhage due to intracranial aneurysm Sindrome da doença não tiroideana em pacientes com hemorragia subaracnoidea devida a aneurisma cerebral

    Directory of Open Access Journals (Sweden)

    Luiz Augusto Casulari

    2004-03-01

    Full Text Available We have previously reported that subarachnoid hemorrhage due to ruptured intracranial aneurysm (SH is associated with changes in the hormonal profile in the first 24 hours after the event. We proposed that the hormonal changes observed are due to the intense stress to which the patients are exposed. However, the thyroidal hormonal profile is indicative of the presence of a nonthyroidal illness syndrome (NTIS. In this paper, we examined whether the change in the thyroid hormone profile is compatible with a NTIS. Two groups of patients were included in the study: A 30 patients with SH (21 females and 9 males; 41.7±11.4 years and B a control group including 25 patients with benign diseases of the spine (BDS (lumbar disc hernia or stable spinal trauma (8 females and 17 males; 41.3±14.2 years. In a subgroup of eight patients of each group serum triiodothyronine (T3 and reverse T3 levels were measured. The blood samples were obtained between 8:00 and 9:00 AM. The following results were obtained: The SH group had smaller serum T3 and free T4 levels than the BDS group (pNós apresentamos previamente que a hemorragia subaracnoidea devido à ruptura de aneurisma intracraniano (SH está associada com alterações no perfil hormonal nas primeiras 24 horas após o evento. Nós propusemos que as alterações hormonais observadas são devidas ao intenso estresse ao qual os pacientes estão expostos. Contudo, o perfil hormonal tireoidiano é indicativo da presença da síndrome da doença não tireoidiana (NTIS. Neste trabalho, examinamos se as alterações no perfil dos hormônios tireoidianos são compatíveis com a NTIS. Dois grupos de pacientes foram incluídos no estudo: A 30 pacientes com SH (21 mulheres e 9 homens; 41,7±11,4 anos e B um grupo controle incluindo 25 pacientes com doenças benignas da coluna (BDS (hérnia de disco lombar ou estável trauma da coluna (8 mulheres e 17 homens; 41,3±14,2 anos. Em um subgrupo de oito pacientes de cada grupo

  6. Glioblastoma and intracranial aneurysms: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Rushna Ali

    2015-01-01

    Conclusion: Several theories stand to explain the coincidental occurrence of intracranial aneurysms and GBM. The treating physician should be aware of this association when patients with intraaxial tumors present with unusual manifestation such as an intratumoral hemorrhage or angiogram negative subarachnoid hemorrhage. No guidelines exist to assist in the management of such patients; therefore, authors have attempted to address this issue using a classification and treatment algorithm.

  7. Multiple prograssive intracranial arterial occlusions or Moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Prevo, R.L.; Straalen, A.M. van (Medisch Spectrum Twente, Enschede (Netherlands). Department of Radiology); Geelen, J.A.G. (Medisch Spectrum Twente, Enschede (Netherlands). Department of Neurology)

    A case history is presented of a 21-year-old white female with a clinical diagnosis of an intracranial hemorrhage. CT scanning revealed a hemorrhage in the parenchyma just above the lateral ventricle. Despite her excellent neurological status angiographic findings were severe and compatible with Moyamoya desease. On angiography, leptomeningeal anastomoses and rete mirabile anastomoses were present. The vertebrobasilary system was involved as well. (Author). 23 refs.; 5 figs.

  8. [Infratentorial hemorrhage following supratentorial surgery].

    Science.gov (United States)

    Tomii, M; Nakajima, M; Ikeuchi, S; Ogawa, T; Abe, T

    1999-10-01

    Hemorrhage in regions remote from the site of initial intracranial operations is rare, but does occur. We report three cases of cerebellar hemorrhage that developed after supratentorial surgery, all of which had similar clinical findings and CT images. The first case was a 37-year-old man with a craniopharyngioma in the suprasellar lesion. Partial removal of the tumor was performed through frontal craniotomy and the translaminaterminals approach. A large quantity of cerebospinal fluid (CSF) was suctioned from the third ventricle during the operation, resulting in marked brain shrinkage. The second and third cases were 34- and 51-year-old women with unruptured right middle cerebral aneurysms. Clipping of the aneurysms through the pterional approach was performed in both cases. In the second case, CSF was suctioned in large quantity from the carotid and prechiasmal cistern at the operation, resulting in marked brain shrinkage. In the third case, however, only a small volume of CSF was suctioned from the carotid and prechiasmal cistern during the operation, and no marked brain shrinkage was observed. CT scan showed that the hematomas were located mainly in the subdural or the subarachnoid spaces over the cerebellar hemisphere and partially extending into the cerebellar cortex. The mechanism of cerebellar hemorrhage in these series of patients was thought to be multifactorial. The possible etiology for cerebellar hemorrhage in the three cases presented was examined, including the role of CSF suction during surgery and disturbance of venous circulation in the posterior fossa. Suction of the CSF may cause intracranial hypotension. Further reduction of intracranial pressure leads to an increased transluminal venous pressure. There was no episode of hypertension or disturbed blood coagulation during or after the operation. The preoperative angiogram also revealed no abnormality at the region of the posterior fossa. Neuroimaging of infratentorial hemorrhage after

  9. Preretinal hemorrhage

    Directory of Open Access Journals (Sweden)

    Eduardo Felippe

    2004-12-01

    Full Text Available A case of Valsalva hemorrhagic retinopathy treated with Nd:YAGlaser indescribed. The patient presented decreased visual acuityafter coughing, and a preretinal hemorrhage was diagnosed in theposterior pole; puncturing the posterior hyaloid face was performedwith Nd:Yag laser. Rapid hemorrhage absorption was observedafter the therapy proposed and visual acuity was recovered. Nd:Yaglaser proved to be safe and efficient in the management of preretinalhemorrhage.

  10. Susceptibility loci for intracranial aneurysm in European and Japanese populations

    NARCIS (Netherlands)

    Bilguvar, Kaya; Yasuno, Katsuhito; Niemela, Mika; Ruigrok, Ynte M.; Fraunberg, Mikael von und zu; van Duijn, Cornelia M.; van den Berg, Leonard H.; Mane, Shrikant; Mason, Christopher E.; Choi, Murim; Gaal, Emilia; Bayri, Yasar; Kolb, Luis; Arlier, Zulfikar; Ravuri, Sudhakar; Ronkainen, Antti; Tajima, Atsushi; Laakso, Aki; Hata, Akira; Kasuya, Hidetoshi; Koivisto, Timo; Rinne, Jaakko; Ohman, Juha; Breteler, Monique M. B.; Wijmenga, Cisca; State, Matthew W.; Rinkel, Gabriel J. E.; Hernesniemi, Juha; Jaaskelainen, Juha E.; Palotie, Aarno; Inoue, Ituro; Lifton, Richard P.; Guenel, Murat

    2008-01-01

    Stroke is the world's third leading cause of death. One cause of stroke, intracranial aneurysm, affects similar to 2% of the population and accounts for 500,000 hemorrhagic strokes annually in mid-life (median age 50), most often resulting in death or severe neurological impairment(1). The

  11. Ruptured Intracranial Mycotic Aneurysm in Infective Endocarditis: A Natural History

    Directory of Open Access Journals (Sweden)

    Isabel Kuo

    2010-01-01

    discovered on CT Angiography. His lesion quickly progressed into an intraparenchymal hemorrhage, requiring emergent craniotomy and aneurysm clipping. Current recommendations on the management of intracranial Mycotic Aneurysms are based on few retrospective case studies. The natural history of the patient's ruptured aneurysm is presented, as well as a literature review on the management and available treatment modalities.

  12. Clinical Features and Prognosis of Intracranial Artery Dissection

    NARCIS (Netherlands)

    Sikkema, Tineke; Uyttenboogaart, Maarten; Dijk, van J.M.C.; Groen, Rob J. M.; Metzemaekers, Jan D. M.; Eshghi, Omid; Mazuri, Aryan; Bakker, Nicolaas A.; Luijckx, Gert-Jan

    2015-01-01

    BACKGROUND: Intracranial artery dissections (IADs) are an important cause of stroke or subarachnoid hemorrhage (SAH). Outcome of IAD in the anterior circulation or presentation without SAH is rarely investigated and might be different. OBJECTIVE: To evaluate the clinical features and prognosis of pa

  13. Perinatal rights.

    Science.gov (United States)

    Munir, A E

    1984-01-01

    The history of perinatal rights is traced to determine how far the law has settled with reasonable certainty and principles can be drawn from decided cases, where the law remains uncertain. It is unlikely that there will be legislation in the near future to bring the law up to date in these matters. The right to prevent conception is accepted these day by practically all shades of opinion. Opinions on methods may differ, but the dividing line between what is contraception and what amounts to abortion is sometimes difficult to determine. The object of the offense of abortion is to protect human life. Briefly, Section 58 of the British Offences Against the Person Act 1861 makes it an offense for a pregnant woman to try unlawfully to procure her own miscarriage and for any person to try to procure unlawfully the miscarriage of a woman, whether she is pregnant or not. The precise time from which the developing ovum is protected has not been legislatively or judicially determined. In 1962 a report commissioned by the British Council of Churches suggested that for legal purposes conception should be taken to commence with implantation, i.e., about 2 weeks after fertilization. It is possible to argue that human life begins at fertilization but that is not a very convincing arugument these days. A better view seens to be that so long as the postcoital pill is taken before the fertilized egg is implanted in the womb it is contraception rather than abortion. The matter will not be totally free from question until Parliament of the courts determine the issue. The Attorney General's view that this form of postcoital treatment does not constitute a criminal offenses within either Section 58 or 59 of the Offences Against the Person Act 1860 goes a long way towards clarifying the position. Opinions begin to divide again when considering the next step after conception. Regarding abortion, the doctor should ensure that be keeps within the Abortion Act 1967 by acting with a

  14. Observation on the Effect of Early Puncture Drainage in the Treatment of Patients with Intracranial Hemorrhage Caused by Delayed Vitamin K1 Deficiency%早期穿刺引流在迟发维生素K1缺乏致颅内出血中的疗效观察

    Institute of Scientific and Technical Information of China (English)

    栾劲; 杨皎莹

    2014-01-01

    目的:观察早期穿刺引流在迟发维生素K1缺乏致颅内出血中的疗效。方法:选取2010年1月-2013年4月于本院进行常规治疗的27例迟发维生素K1缺乏致颅内出血患儿为对照组,27例进行早期穿刺引流治疗的患儿为观察组,然后将两组患儿的治疗总有效率、出血停止时间、住院时间、并发症发生率及不同时间的NABA评分进行比较。结果:观察组患儿的治疗总有效率高于对照组,出血停止时间及住院时间均短于对照组,并发症发生率低于对照组,不同时间的NABA评分均优于对照组,差异均有统计学意义( P<0.05)。结论:早期穿刺引流在迟发维生素K1缺乏致颅内出血中的疗效较好,可有效改善患儿的预后。%Objective:To observe the effect of early puncture drainage in the treatment of patients with intracranial hemorrhage caused by delayed vitamin K1 deficiency.Method:27 newborns with intracranial hemorrhage caused by delayed vitamin K1 deficiency who were treated with routine treatment in our hospital from January 2010 to April 2013 were the control group,27 cases who were treated with early puncture drainage were the observation group,then the total effective rate,stopping time of bleeding,hospitalization time,rate of complications and NABA score at different time of two groups were compared.Result:The total effective rate of observation group was higher than that of control group,stopping time of bleeding and hospitalization time were shorter than those of control group,rate of complications was lower than that of control group,ABA score at different time were better than those of control group,there were all significant differences(P<0.05).Conclusion:The effect of early puncture drainage in the treatment of patients with intracranial hemorrhage caused by delayed vitamin K1 deficiency is better,and it can effectively improve the prognosis of newborns.

  15. Monitoring of Intracranial Pressure During Intracranial Endoscopy

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-08-01

    Full Text Available Background: Intracranial endoscopy is a minimum invasive procedure, which reduces trauma to the brain, is cost-effective, and carries a shortened hospital stay with an improved postoperative outcome. Objective: To monitor intracranial pressure changes during intracranial endoscopy among children and adults under general anesthesia/sedation, and to compare the intracranial pressure changes between children and adults receiving general anesthesia and among adults receiving general anesthesia and sedation. Methods: The present cross-sectional study was conducted in one of the tertiary care hospitals of Lucknow. This was carried out in the department of neurosurgery from January 2008 to December 2008. Patients who were not fit for general anesthesia received local anesthesia under sedation. Patients participating in the study were divided into three groups. Intracranial pressure was recorded at specific intervals. Parametric data were subjected to statistical analysis using a student\\s t test. Result: A total of 70 patients were undergoing intracranial endoscopy under general anesthesia during the study period. In both groups A and B, intracranial pressure increases the maximum during inflation of the balloon. In group C, all the variations in ICP were found to be statistically significant. In the comparison of intracranial pressure changes between groups A and B, no significant difference was found. All correlations in the comparison of groups B and C were found to be statistically significant (p< 0.001. Conclusion: There is a need for continuous intraoperative monitoring of ICP intracranial endoscopy, because ICP increases in various stages of the procedure, which can be detrimental to the perfusion of the brain. [Arch Clin Exp Surg 2013; 2(4.000: 240-245

  16. 创伤性颅脑损伤发展为进展性出血性脑损伤的研究进展%The research progress of traumatic craniocerebral injury development for progressive hemorrhage intracranial

    Institute of Scientific and Technical Information of China (English)

    张彦娜; 孙志刚

    2015-01-01

    Traumatic craniocerebral injury prones to coagulant function abnormality,and then the progress of hemor-rhagic brain injury is closely related to the prognosis of patients with brain injury,the progress of the pathogenesis of hemorrhagic brain injury is relatively complex,mainly including tissue factor release,fibrinolytic system goes,platelet function,C-reactive protein,blood dilution effect,inflammation,metabolic acidosis,hypothermia,this paper has reviewed the development mechanism of hemorrhagic brain injury occured after traumatic brain injury.%创伤性颅脑损伤易发生凝血功能异常,而后发生的进展性出血性脑损伤与脑损伤患者的预后有密切联系,进展性出血性脑损伤的发病机制较为复杂,主要包括组织因子释放、纤溶系统亢进、血小板作用、C反应蛋白通路、血液稀释作用、炎性反应、代谢性酸中毒、低体温等几个方面,本研究就创伤性颅脑损伤后发生进展性出血性脑损伤的发展机制作一综述。

  17. CT diagnosis of hyperdense intracranial neoplasms. Review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Ishikura, Reiichi; Ando, Kumiko; Tominaga, Satoru; Nakao, Norio [Hyogo College of Medicine, Nishinomiya (Japan); Ikeda, Jouta; Takemura, Yuriko; Morikawa, Tsutomu

    1999-03-01

    In contrast to typical astrocytic tumors that show hypodense areas on computed tomographic images, some intracranial tumors show hyperdense areas on CT images. The major reasons for hyperdensity on CT images are hypercellular lesions, intratumoral calcification, and intratumoral hemorrhage. Malignant lymphomas, germinomas, and medulloblastomas show homogenous hyperdensity on CT images because of their hypercellularity. Tumorous lesions such as subependymal giant cell astrocytomas, oligodendrogliomas, ependymomas, central neurocytomas, craniopharyngiomas, and meningiomas often present with hyperdense calcified lesions on CT images. Intratumoral hemorrhage also causes hyperdensity on CT images, and is often associated with metastatic brain tumors, glioblastomas, pituitary adenomas, and rarely with any of the other intracranial tumors. Although magnetic resonance imaging is now the major diagnostic tool for diseases of the central nervous system, the first imaging studies for patients with neurologic symptoms are still CT scans. Hyperdense areas on CT images are a clue to making an accurate diagnosis of intracranial neoplasms. (author)

  18. Risk factors responsible for the volume of hemorrhage in aneurysmal subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Jianfeng Liu

    2016-01-01

    Conclusion: Preadmission DBP, multiple aneurysms, and aneurysms of the ACOA are associated with markedly increased volume of hemorrhage as evaluated by the revised Fisher grades. Thus, patients harboring an intracranial aneurysm having the above mentioned features should seek an early intervention in order to prevent the occurrence of aSAH.

  19. The Intracranial Volume Pressure Response in Increased Intracranial Pressure Patients: Clinical Significance of the Volume Pressure Indicator

    Science.gov (United States)

    2016-01-01

    Background For patients suffering from primary brain injury, monitoring intracranial pressure alone is not enough to reflect the dynamic intracranial condition. In our previous study, a segment of the pressure-volume curve can be expressed by the parabolic regression model with single indicator “a”. The aim of this study is to evaluate if the indicator “a” can reflect intracranial conditions. Methods Patients with traumatic brain injury, spontaneous intracranial hemorrhage, and/or hydrocephalus who had external ventricular drainage from January 2009 to February 2010 were included. The successive volume pressure response values were obtained by successive drainage of cerebral spinal fluid from intracranial pressure 20–25 mm Hg to 10 mm Hg. The relationship between withdrawn cerebral spinal fluid volume and intracranial pressure was analyzed by the parabolic regression model with single parameter “a”. Results The overall mean for indicator “a” was 0.422 ± 0.046. The mean of “a” in hydrocephalus was 0.173 ± 0.024 and in severe intracranial mass with slender ventricle, it was 0.663 ± 0.062. The two extreme intracranial conditions had a statistical significant difference (phydrocephalus. Brain computed tomography should be performed early if a rapid elevation of indicator “a” is detected, as it can reveal some ongoing intracranial pathology prior to clinical deterioration. Increased intracranial pressure was frequently observed in patients with intracranial pathology. The progression can be differentiated using the pattern of the volume pressure indicator. PMID:27723794

  20. Epidemiology and genetics of intracranial aneurysms.

    Science.gov (United States)

    Caranci, F; Briganti, F; Cirillo, L; Leonardi, M; Muto, M

    2013-10-01

    Intracranial aneurysms are acquired lesions (5-10% of the population), a fraction of which rupture leading to subarachnoid hemorrhage with devastating consequences. Until now, the exact etiology of intracranial aneurysms formation remains unclear. The low incidence of subarachnoid hemorrhage in comparison with the prevalence of unruptured IAs suggests that the vast majority of intracranial aneurysms do not rupture and that identifying those at highest risk is important in defining the optimal management. The most important factors predicting rupture are aneurysm size and site. In addition to ambiental factors (smoking, excessive alcohol consumption and hypertension), epidemiological studies have demonstrated a familiar influence contributing to the pathogenesis of intracranial aneurysms, with increased frequency in first- and second-degree relatives of people with subarachnoid hemorrhage. In comparison to sporadic aneurysms, familial aneurysms tend to be larger, more often located at the middle cerebral artery, and more likely to be multiple. Other than familiar occurrence, there are several heritable conditions associated with intracranial aneurysm formation, including autosomal dominant polycystic kidney disease, neurofibromatosis type I, Marfan syndrome, multiple endocrine neoplasia type I, pseudoxanthoma elasticum, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos syndrome type II and IV. The familial occurrence and the association with heritable conditions indicate that genetic factors may play a role in the development of intracranial aneurysms. Genome-wide linkage studies in families and sib pairs with intracranial aneurysms have identified several loci on chromosomes showing suggestive evidence of linkage, particularly on chromosomes 1p34.3-p36.13, 7q11, 19q13.3, and Xp22. For the loci on 1p34.3-p36.13 and 7q11, a moderate positive association with positional candidate genes has been demonstrated (perlecan gene, elastin gene, collagen type 1 A2 gene

  1. Epidemiology and genetics of intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Caranci, F., E-mail: ferdinandocaranci@libero.it [Unit of Neuroradiology, Department of Diagnostic Radiology and Radiotherapy, Federico II University, Naples (Italy); Briganti, F., E-mail: frabriga@unina.it [Unit of Neuroradiology, Department of Diagnostic Radiology and Radiotherapy, Federico II University, Naples (Italy); Cirillo, L.; Leonardi, M. [Neuroradiology service, Bellaria Hospital, Bologna (Italy); Muto, M., E-mail: mutomar@tiscali.it [Neuroradiology Service Cardarelli Hospital Naples (Italy)

    2013-10-01

    Intracranial aneurysms are acquired lesions (5–10% of the population), a fraction of which rupture leading to subarachnoid hemorrhage with devastating consequences. Until now, the exact etiology of intracranial aneurysms formation remains unclear. The low incidence of subarachnoid hemorrhage in comparison with the prevalence of unruptured IAs suggests that the vast majority of intracranial aneurysms do not rupture and that identifying those at highest risk is important in defining the optimal management. The most important factors predicting rupture are aneurysm size and site. In addition to ambiental factors (smoking, excessive alcohol consumption and hypertension), epidemiological studies have demonstrated a familiar influence contributing to the pathogenesis of intracranial aneurysms, with increased frequency in first- and second-degree relatives of people with subarachnoid hemorrhage. In comparison to sporadic aneurysms, familial aneurysms tend to be larger, more often located at the middle cerebral artery, and more likely to be multiple. Other than familiar occurrence, there are several heritable conditions associated with intracranial aneurysm formation, including autosomal dominant polycystic kidney disease, neurofibromatosis type I, Marfan syndrome, multiple endocrine neoplasia type I, pseudoxanthoma elasticum, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos syndrome type II and IV. The familial occurrence and the association with heritable conditions indicate that genetic factors may play a role in the development of intracranial aneurysms. Genome-wide linkage studies in families and sib pairs with intracranial aneurysms have identified several loci on chromosomes showing suggestive evidence of linkage, particularly on chromosomes 1p34.3–p36.13, 7q11, 19q13.3, and Xp22. For the loci on 1p34.3–p36.13 and 7q11, a moderate positive association with positional candidate genes has been demonstrated (perlecan gene, elastin gene, collagen type 1 A2

  2. Observation of Autoregulation Indices During Ventricular CSF Drainage After Aneurysmal Subarachnoid Hemorrhage : A Pilot Study

    NARCIS (Netherlands)

    Aries, Marcel J. H.; de Jong, Sytse F.; van Dijk, J. Marc C.; Regtien, Joost; Depreitere, Bart; Czosnyka, Marek; Smielewski, Peter; Elting, Jan Willem J.

    2015-01-01

    Cerebral autoregulation is increasingly recognized as a factor that requires evaluation when managing poor grade aneurysmal subarachno hemorrhage (aSAH) patients. In this single center pilot study, we investigated whether intraventricular intracranial pressure (ICP) derived when

  3. Late hemorrhagic disease of newborn.

    Science.gov (United States)

    D'Souza, I E; Rao, S D Subba

    2003-03-01

    The clinical features of 14 infants diagnosed with late hemorrhagic disease of newborn (LHDN), of which 10 did not receive vitamin K prophylaxis, are presented. All infants were exclusively breast-fed and 12 did not have any underlying illness to explain the abnormal coagulation profile. The common presenting symptoms were seizures (71%), vomiting (57%), poor feeding (50%) and altered sensorium (36%). Physical examination shared pallor in all infants and a bulging anterior fontanel in 64%. Intracranial bleed was the predominant manifestation (93%), with CT scan showing intracranial bleed in 78%. Eight infants (57%) succumbed to their illness, while 36%had neurological sequelae. Since LHDN leads to significant morbidity and mortality, it should be prevented by providing vitamin K prophylaxis to all newborns.

  4. Supernova hemorrhage: obliterative hemorrhage of brain arteriovenous malformations following γ knife radiosurgery.

    Science.gov (United States)

    Alexander, Matthew D; Hetts, Steven W; Young, William L; Halbach, Van V; Dowd, Christopher F; Higashida, Randall T; English, Joey D

    2012-09-01

    Hemorrhage represents the most feared complication of cerebral arteriovenous malformations (AVMs) in both untreated patients and those treated with gamma knife radiosurgery. Radiosurgery does not immediately lead to obliteration of the malformation, which often does not occur until years following treatment. Post-obliteration hemorrhage is rare, occurring months to years after radiosurgery, and has been associated with residual or recurrent AVM despite prior apparent nidus elimination. Three cases are reported of delayed intracranial hemorrhage in patients with cerebral AVMs treated with radiosurgery in which no residual AVM was found on catheter angiography at the time of delayed post-treatment hemorrhage. That the pathophysiology of these hemorrhages involves progressive venous outflow occlusion is speculated and the possible mechanistic link to subsequent vascular rupture is discussed.

  5. Chondromyxoid fibroma invasion of the transverse-sigmoid sinus junction causing posterior fossa hemorrhage.

    Science.gov (United States)

    Hersh, David S; Firempong, Alexander O; Chesler, David; Castellani, Rudolph J; Woodworth, Graeme F

    2016-02-01

    We report a 50-year-old woman with a chondromyxoid fibroma of the occipital bone, who presented with a cerebellar hemorrhage due to invasion of the adjacent sinus. Chondromyxoid fibromas are benign cartilaginous tumors. However, this case represents the first example, to our knowledge, of a chondromyxoid fibroma invading the transverse-sigmoid junction, resulting in intracranial hemorrhage. Our report highlights that the location of an intracranial chondromyxoid fibroma is an important factor in guiding surgical management.

  6. [Alveolar hemorrhage].

    Science.gov (United States)

    Parrot, A; Fartoukh, M; Cadranel, J

    2015-04-01

    Alveolar hemorrhage occurs relatively rarely and is a therapeutic emergency because it can quickly lead to acute respiratory failure, which can be fatal. Hemoptysis associated with anemia and pulmonary infiltrates suggest the diagnosis of alveolar hemorrhage, but may be absent in one third of cases including patients in respiratory distress. The diagnosis of alveolar hemorrhage is based on the findings of a bronchoalveolar lavage. The causes are numerous. It is important to identify alveolar hemorrhage due to sepsis, then separate an autoimmune cause (vasculitis associated with antineutrophil cytoplasmic antibody, connective tissue disease and Goodpasture's syndrome) with the search for autoantibodies and biopsies from readily accessible organs, from a non-immune cause, performing echocardiography. Lung biopsy should be necessary only in exceptional cases. If the hemorrhage has an immune cause, treatment with steroids and cyclophosphamide may be started. The indications for treatment with rituximab are beginning to be established (forms that are not severe and refractory forms). The benefit of plasma exchange is unquestionable in Goodpasture's syndrome. In patients with an immune disease that can lead to an alveolar hemorrhage, removing any source of infection is the first priority. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  7. [Congenital anomalies of cerebral artery and intracranial aneurysm].

    Science.gov (United States)

    Nakajima, K; Ito, Z; Hen, R; Uemura, K; Matsuoka, S

    1976-02-01

    It is well known that congenital anomalies such as polycystic kidney, aortic coarctation, Marfan syndrome, Ehler-Danlos syndrome are apt to be complicated by intracranial aneurysms. In this report we attempt to reveal the relation and incidence between cerebrovascular anomalies and intracranial aneurysms. The etiology of aneurysms has been discussed, too. 12 cases of persistent trigeminl artery, 2 cases of persistent hypoglossal artery and 11 cases of fenestration were obtained from 3841 patients who were angiographically examined in our clinic for 5 years. The incidence is 0.31%, 0.05% and 0.29%, respectively. Persistent trigeminal arteries were complicated by 2 cases of intracranial aneurysms and one case of arterivenous malformations (AVM), persistent hypoglossal arteries were complicated by one case of aneurysm, and fenestrations were complicated by 2 cases of aneurysms and one case of AVM. One case of congenital agenesis of right internal carotid artery was obtained which was complicated by aneurysm of anterior communicating artery. Totally, 8 cases of aneurysms and AVM were obtained from 26 cases of cerebrovascular anomalies (incidence 30.8%). On the other hand, thalamic or caudate hemorrhage revealed the highest incidence of complication of intracranial aneurysms among intracerebral hematomas (10.7%). Compared with the incidence of aneurysms between cerebro vascular anomalies (30.8%) and thalamic or caudate hemorrhage (10.7%), the difference is statistically signigicant (P less than 0.05). The cause of intracranial aneurysm has not yet been clarified. But it is well accepted that the defect of tunica media vasorum is most responsible factor as to the occurrence of intracranial aneurysms. We concluded that the genetic error of cerebral vessels including defect of media caused intracranial aneurysms, and this result was supported from the evidence that cerebrovascular anomalies showed statistically high incidence of complication of intracranial aneurysms.

  8. Molecular basis and genetic predisposition to intracranial aneurysm.

    Science.gov (United States)

    Tromp, Gerard; Weinsheimer, Shantel; Ronkainen, Antti; Kuivaniemi, Helena

    2014-12-01

    Intracranial aneurysms, also called cerebral aneurysms, are dilatations in the arteries that supply blood to the brain. Rupture of an intracranial aneurysm leads to a subarachnoid hemorrhage, which is fatal in about 50% of the cases. Intracranial aneurysms can be repaired surgically or endovascularly, or by combining these two treatment modalities. They are relatively common with an estimated prevalence of unruptured aneurysms of 2%-6% in the adult population, and are considered a complex disease with both genetic and environmental risk factors. Known risk factors include smoking, hypertension, increasing age, and positive family history for intracranial aneurysms. Identifying the molecular mechanisms underlying the pathogenesis of intracranial aneurysms is complex. Genome-wide approaches such as DNA linkage and genetic association studies, as well as microarray-based mRNA expression studies, provide unbiased approaches to identify genetic risk factors and dissecting the molecular pathobiology of intracranial aneurysms. The ultimate goal of these studies is to use the information in clinical practice to predict an individual's risk for developing an aneurysm or monitor its growth or rupture risk. Another important goal is to design new therapies based on the information on mechanisms of disease processes to prevent the development or halt the progression of intracranial aneurysms.

  9. Incidence of Intraventricular Hemorrhage and Post Hemorrhagic Hydrocephalus in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Negar Sajjadian

    2010-07-01

    Full Text Available "nGerminal matrix-intraventricular hemorrhage (IVH is the most common variety of neonatal intracranial hemorrhage and is characteristics of the premature infant. The importance of the lesion relates not only to its high incidence but to their attendant complications (IC: hydrocephalus. Brain sonography is the procedure of choice in diagnosis of germinal matrix- intraventricular hemorrhage and hydrocephalus. In this study we have used brain sonography for detection of intraventricular hemorrhage and post hemorrhagic hydrocephalus and their incidences. The studied population was consisted of premature neonate (birth weight equal or less than 1500g and gestational age equal or less than 37 weeks who admitted in Mofid Hospital NICU (Tehran, Iran during a one year period. For all neonate (including criteria brain sonography in first week of life was done and in presence of IVH, serial Brain sonography was done weekly for detection of hydrocephalus. A total of 57 neonate entered the study. Intraventicular-germinal matrix hemorrhage was seen in 64.4% (35 patients. Forty percent of patients with intraventricular-germinal matrix hemorrhage had grade I, 11% grade II, 25.7% grade III, 2.8% grade VI. Hydrocephalus was detected in 20 percent of patients who had intraventricular-germinal matrix hemorrhage. That incidence of IVH in our study in comparison with other area and situation is higher. Hydrocephaly had direct relation with severity of IVH. This shows that with control of risk factor of IVH, we can control Post hemorrhagic hydrocephalus.

  10. Intracranial Non-traumatic Aneurysms in Children and Adolescents

    Science.gov (United States)

    Sorteberg, Angelika; Dahlberg, Daniel

    2013-01-01

    An intracranial aneurysm in a child or adolescent is a rare, but potentially devastating condition. As little as approximately 1200 cases are reported between 1939 and 2011, with many of the reports presenting diverting results. There is consensus, though, in that pediatric aneurysms represent a pathophysiological entity different from their adult counterparts. In children, there is a male predominance. About two-thirds of pediatric intracranial aneurysms become symptomatic with hemorrhage and the rate of re-hemorrhage is higher than in adults. The rate of hemorrhage from an intracranial aneurysm peaks in girls around menarche. The most common aneurysm site in children is the internal carotid artery, in particular at its terminal ending. Aneurysms in the posterior circulation are more common in children than adults. Children more often develop giant aneurysms, and may become symptomatic from the mass effect of the aneurysm (tumorlike symptoms). The more complex nature of pediatric aneurysms poses a larger challenge to treatment alongside with higher demands to the durability of treatment. Outcome and mortality are similar in children and adults, but long-term outcome in the pediatric population is influenced by the high rate of aneurysm recurrences and de novo formation of intracranial aneurysms. This urges the need for life-long follow-up and screening protocols. PMID:24696670

  11. Spontaneous intracranial hypotension.

    LENUS (Irish Health Repository)

    Fullam, L

    2012-01-31

    INTRODUCTION: Spontaneous\\/primary intracranial hypotension is characterised by orthostatic headache and is associated with characteristic magnetic resonance imaging findings. CASE REPORT: We present a case report of a patient with typical symptoms and classical radiological images. DISCUSSION: Spontaneous intracranial hypotension is an under-recognised cause of headache and can be diagnosed by history of typical orthostatic headache and findings on MRI brain.

  12. NOISY INTRACRANIAL TUMORS

    NARCIS (Netherlands)

    VANDOOREN, BTH; VANBRUGGEN, AC; MOOIJ, JJA; HEW, JM; JOURNEE, HL

    1994-01-01

    Transorbital sound recordings were obtained from 21 patients with intracranial tumours, 28 patients with intracranial aneurysms and 20 control patients. The group of patients with tumours consisted of 12 patients with gliomas, of whom 6 had low-grade gliomas and 6 had high-grade gliomas, and 9 patie

  13. Paediatric intracranial aneurysms

    Directory of Open Access Journals (Sweden)

    A A Wani

    2006-01-01

    Full Text Available Intracranial aneurysms in childhood account for 1-2% of intracranial aneurysms.[1],[2] These aneurysms have unique characteristics that make them different from those in adults. These differences are evident in their epidemiology, location, clinical spectrum, association with trauma and infection, complications and outcome.

  14. Characteristics of Hemorrhagic Stroke following Spine and Joint Surgeries

    Science.gov (United States)

    2017-01-01

    Hemorrhagic stroke can occur after spine and joint surgeries such as laminectomy, lumbar spinal fusion, tumor resection, and total joint arthroplasty. Although this kind of stroke rarely happens, it may cause severe consequences and high mortality rates. Typical clinical symptoms of hemorrhagic stroke after spine and joint surgeries include headache, vomiting, consciousness disturbance, and mental disorders. It can happen several hours after surgeries. Most bleeding sites are located in cerebellar hemisphere and temporal lobe. A cerebrospinal fluid (CSF) leakage caused by surgeries may be the key to intracranial hemorrhages happening. Early diagnosis and treatments are very important for patients to prevent the further progression of intracranial hemorrhages. Several patients need a hematoma evacuation and their prognosis is not optimistic. PMID:28164124

  15. Characteristics of Hemorrhagic Stroke following Spine and Joint Surgeries

    Directory of Open Access Journals (Sweden)

    Fei Yang

    2017-01-01

    Full Text Available Hemorrhagic stroke can occur after spine and joint surgeries such as laminectomy, lumbar spinal fusion, tumor resection, and total joint arthroplasty. Although this kind of stroke rarely happens, it may cause severe consequences and high mortality rates. Typical clinical symptoms of hemorrhagic stroke after spine and joint surgeries include headache, vomiting, consciousness disturbance, and mental disorders. It can happen several hours after surgeries. Most bleeding sites are located in cerebellar hemisphere and temporal lobe. A cerebrospinal fluid (CSF leakage caused by surgeries may be the key to intracranial hemorrhages happening. Early diagnosis and treatments are very important for patients to prevent the further progression of intracranial hemorrhages. Several patients need a hematoma evacuation and their prognosis is not optimistic.

  16. Intracranial blister aneurysms: clip reconstruction techniques.

    Science.gov (United States)

    Barrow, Daniel L; Pradilla, Gustavo; McCracken, D Jay

    2015-07-01

    Intracranial blister aneurysms are difficult to treat cerebrovascular lesions that typically affect the anterior circulation. These rare aneurysms can lead to acute rupture which usually cannot be treated via endovascular methods, but still require urgent surgical intervention. Surgical options are limited given their unique pathology and often require a combination of wrapping and clip reconstruction. In this video we present two patients with acute subarachnoid hemorrhage secondary to ruptured blister aneurysms. We demonstrate several surgical techniques for repairing the vascular defect with and without intraoperative rupture. The video can be found here: http://youtu.be/nz-JM45uKQU.

  17. Intracranial lipomas. Case presentations and CT features

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Takashi; Shojima, Kazuhito; Moritaka, Kazuhiko; Utsunomiya, Hidetsuna; Konishi, Jun (St. Mary' s Hospital, Kurume, Fukuoka (Japan))

    1984-03-01

    Intracranial lipomas are very rare and reports of infantile lipomas are scarce. Nine cases of intracranial lipomas, five in infants and four in adults are described and characteristic findings of the CT are presented. Two of the six cases involved lipomas at the corpus callosum that were associated with frontal dysraphism and cranium bifidum at the midline of frontal region. Five of the nine cases involved lipomas at the quadrigeminal cistern. In one case with an advanced enlargement in circumference of the head in the perinatal period, a V-P shunt was conducted for obstructive hydrocephalus. Another case had widely ranging agenesis of the corpus callosum associated with an interhemispheric cyst showing the right sided parietal and occipital lobes through the callosal agenesis. One of the nine cases had a lipoma in the left sylvian fissure and in the adult was in the interpeduncular cistern. Four of the nine cases were associated with agenesis of the corpus callosum. Based on these cases and published reports, the CT features of intracranial lipoma are discussed.

  18. Analysis of Perinatal Risk Factors for Preterm Children and Complications in 183 Cases%183例早产儿围产期高危因素及并发症分析

    Institute of Scientific and Technical Information of China (English)

    宋鹤; 姜亚峰; 赵凤; 吕明婕; 丁肖英

    2011-01-01

    Objective: To investigate the perinatal risk factors for preterm children and complications. Methods: Review the clinical information of preterm children in our hospital between Januery 2006 and December 2009.Analysis of perinatal risk factors for preterm children and complications in 183 cases. Results: Premature rupture of membranes, multiple pregnancy, pregnancy-induced hypertension is the main reason for preterm birth; preterm children with major complications such as pneumonia and intracranial hemorrhage. Conclusion: Enhance perinatal care, early intervention a variety of perinatal risk factors, active prevention of complications in preterm children, is the key to improve the survival rate of premature children and reduce disability.%探讨早产儿发生的围产期高危因素及并发症.方法:收集我院2006.1-2009.12出生的早产儿183例的临床资料,总结其早产的相关围产期高危因素及并发症.结果:胎膜早破、多胎妊娠、妊娠高血压综合征是早产发生的主要原因;早产儿的主要并发症为肺炎和颅内出血等.结论:加强围生期保健,早期干预各种围产期高危因素,积极防治早产儿各种并发症,是提高早产儿存活率降低致残率的关键.

  19. 单次对比增强双源双能量CT血管成像评估颅内出血及其原因%Evaluation of intracranial hemorrhage and its causes by single-contrast-enhanced dual-source dual-energy CT angiography

    Institute of Scientific and Technical Information of China (English)

    柴学; 张龙江; 盛会雪; 金征宇; 张兆琪; 卢光明

    2012-01-01

    目的 随着双源CT在临床的推广应用,双源CT双能量成像已成为研究热点.文中探讨单次对比增强的双源双能量CT血管血管成像 (CT angiography,CTA)对评估颅内出血及其原因的应用价值.方法对43例蛛网膜下腔出血患者进行双源CT头颅常规平扫(conventional nonenhanced CT,CNCT)及对比增强双能量CT扫描(80kV/400mA和140kV/95mA).利用Liver VNC软件进行对比增强双能量CT数据处理得到虚拟平扫(virtual nonenhanced CT,VNCT)数据,与CNCT检出的蛛网膜下腔出血比较,分析CNCT和VNCT的图像质量、辐射剂量、平均CT值、信噪比、对比噪声比及病灶检出率的差异.利用双能量CTA判断颅内血管异常,并与数字减影血管造影(digital subtraction angiography,DSA)所检出的病变比较诊断符合率.结果 双能量VNCT的图像质量低于常规平扫(Z值=-6.576,P<0.01),但可满足临床诊断要求.VNCT的正常脑组织及出血区CT值、信号噪声比(signal-to-noise ratio,SNR)及对比噪声比(contrast-to-noise ratio,CNR)低于CNCT(P<0.01).VNCT和CNCT对病灶的检出结果 相似.在43例临床疑有脑血管病变的患者中,双能量CTA检出25例患者为动脉瘤,4例为动静脉畸形,3例为烟雾病,11例为阴性,与DSA或手术证实结果 完全一致.双能量CTA患者接受的辐射剂量明显低于常规DSA(P<0.01).结论 从双源双能量CT中获得VNCT平扫图像可用于诊断颅内出血,图像质量可满足临床诊断需要.双能量CTA与DSA的诊断符合率很高.应用该技术可减少每次平扫所接受的辐射剂量,具有潜在的临床应用价值.%Objective Dual-source dual-energy CT imaging is becoming a focus of research with its wide clinical application . This study aimed to investigate intracranial hemorrhage and its causes by single contrast-enhanced dual-source dual-energy CT angiography (CTA). Methods Forty-three patients suspected of subarachnoid hemorrhage underwent head conventional

  20. Intracerebral hemorrhage: a rare late manifestation of vitamin-K deficiency in a breastfed infant. A case report.

    Science.gov (United States)

    Soylu, H; Aslan, Y; Sari, A; Erduran, E

    1997-01-01

    Late hemorrhagic disease of the newborn (HDN) is a rare complication of vitamin-K deficiency and is especially associated with intracranial hemorrhage. It may also occur in infants who received vitamin-K prophylaxis at birth. Here, we reported a case of late HDN with frontal lobe hemorrhage due to vitamin-K deficiency. This form of intracranial hemorrhage of late HDN has been reported in the literature very rarely. We conclude that the efficiency of single-dose vitamin-K prophylaxis should be revaluated.

  1. Occult intracranial injury in infants.

    Science.gov (United States)

    Greenes, D S; Schutzman, S A

    1998-12-01

    The objectives of this study were as follows: (1) to determine whether clinical symptoms and signs of brain injury are sensitive indicators of intracranial injury (ICI) in infants admitted with head trauma, (2) to describe the clinical characteristics of infants who have ICI in the absence of symptoms and signs of brain injury, and (3) to determine the clinical significance of those ICIs diagnosed in asymptomatic infants. We conducted a retrospective analysis of all infants younger than 2 years of age admitted to a tertiary care pediatric hospital with acute ICI during a 6(1/2)-year period. Infants were considered symptomatic if they had loss of consciousness, history of behavior change, seizures, vomiting, bulging fontanel, retinal hemorrhages, abnormal neurologic examination, depressed mental status, or irritability. All others were considered to have occult ICI. Of 101 infants studied, 19 (19%; 95% confidence interval [CI] 12%, 28%) had occult ICI. Fourteen of 52 (27%) infants younger than 6 months of age had occult ICI, compared with 5 of 34 (15%) infants 6 months to 1 year, and none of 15 (0%) infants older than 1 year. Eighteen (95%) infants with occult ICI had scalp contusion or hematoma, and 18 (95%) had skull fracture. Nine (47%) infants with occult ICI received therapy for the ICI. No infants with occult ICI (0%) (95% CI 0, 14%) required surgery or medical management for increased intracranial pressure. Only 1 subject (5%) with occult ICI had any late symptoms or complications: a brief, self-limited convulsion. We found that 19 of 101 ICIs in infants admitted with head trauma were clinically occult. All 19 occult ICIs occurred in infants younger than 12 months of age, and 18 of 19 had skull fractures. None experienced serious neurologic deterioration or required surgical intervention. Physicians cannot depend on the absence of clinical signs of brain injury to exclude ICI in infants younger than 1 year of age.

  2. Intracranial venous sinus thrombosis complicating AIDS-associated nephropathy.

    Science.gov (United States)

    Afsari, Khosrow; Frank, Jeffrey; Vaksman, Yulia; Nguyen, Thanhan V

    2003-03-01

    An alert and oriented 27-year-old African American woman with AIDS presented with a 10-day history of fever, cough productive of yellow sputum, nausea, and vomiting and a 1-day history of excruciating headache and photophobia. Her condition rapidly deteriorated into a coma with decorticate and then decerebrate posture, and she died 3 weeks later. There was evidence of extensive intracranial venous sinus thrombosis (ICVST), renal vein thrombosis (RVT), and multiple cerebral hemorrhagic infarcts due to a hypercoagulable state complicating AIDS-associated nephrotic syndrome. This is the first reported case of fatal ICVST and RVT with extensive cerebral hemorrhagic infarcts complicating nephrotic syndrome in a patient with AIDS.

  3. Perinatal and Childhood Stroke

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-03-01

    Full Text Available The epidemiology, risk factors, outcome and prognosis of perinatal and childhood stroke were reviewed at a workshop sponsored by the National Institute of Neurological Disorders and Stroke in Bethesda, MD, on Sept 18 and 19, 2000.

  4. Feasibility and methodology of optical coherence tomography imaging of human intracranial aneurysms: ex vivo pilot study

    Science.gov (United States)

    Vuong, Barry; Sun, Cuiru; Khiel, Tim-Rasmus; Gardecki, Joseph A.; Standish, Beau A.; da Costa, Leodante; de Morais, Josaphat; Tearney, Guillermo J.; Yang, Victor X. D.

    2012-02-01

    Rupture of intracranial aneurysm is a common cause of subarachnoid hemorrhage. An aneurysm may undergo microscopic morphological changes or remodeling of the vessel wall prior to rupture, which could potentially be imaged. In this study we present methods of tissue sample preparation of intracranial aneurysms and correlation between optical coherence tomography imaging and routine histology. OCT has a potential future in the assessment of microscopic features of aneurysms, which may correlate to the risk of rupture.

  5. Intracranial pressure monitoring

    Science.gov (United States)

    ICP monitoring; CSF pressure monitoring ... There are 3 ways to monitor pressure in the skull (intracranial pressure). INTRAVENTRICULAR CATHETER The intraventricular catheter is the most accurate monitoring method. To insert an intraventricular catheter, a ...

  6. Increased intracranial pressure

    Science.gov (United States)

    ... patient's bedside in an emergency room or hospital. Primary care doctors may sometimes spot early symptoms of increased intracranial pressure such as headache, seizures, or other nervous system problems. An MRI ...

  7. Eliminating Perinatal HIV Transmission

    Centers for Disease Control (CDC) Podcasts

    2012-11-26

    In this podcast, CDC’s Dr. Steve Nesheim discusses perinatal HIV transmission, including the importance of preventing HIV among women, preconception care, and timely HIV testing of the mother. Dr. Nesheim also introduces the revised curriculum Eliminating Perinatal HIV Transmission intended for faculty of OB/GYN and pediatric residents and nurse midwifery students.  Created: 11/26/2012 by Division of HIV/AIDS Prevention.   Date Released: 11/26/2012.

  8. Idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne M; Jensen, Rigmor H

    2015-01-01

    AIMS: The aims of this article are to characterize the headache in idiopathic intracranial hypertension (IIH) and to field-test the ICHD diagnostic criteria for headache attributed to IIH. MATERIALS AND METHODS: We included 44 patients with new-onset IIH. Thirty-four patients with suspected...... tinnitus may suggest intracranial hypertension. Based on data from a well-defined IIH cohort, we propose a revision of the ICDH-3 beta diagnostic criteria with improved clinical applicability and increased sensitivity and specificity....

  9. CT perfusion in subarachnoid hemorrhage: pieces of a complicated puzzle

    NARCIS (Netherlands)

    Cremers, C.H.P.

    2016-01-01

    Subarachnoid hemorrhage (SAH) accounts for 5% of all strokes and is caused by a ruptured intracranial aneurysm in 85% of the cases. After aneurysmal SAH (aSAH) many complications can occur. A common neurological complication is delayed cerebral ischemia (DCI), which can present as focal neurological

  10. Endovascular treatment for pediatric intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Lv, Xianli; Jiang, Chuhan; Li, Youxiang; Yang, Xinjian; Wu, Zhongxue [Capital Medical University, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Beijing, Hebei (China)

    2009-11-15

    The purpose of this study is to report the characteristics and outcomes of pediatric patients with intracranial aneurysms. From 1998 to 2005, 25 pediatric patients (aged {<=}17 years) with intracranial aneurysm were treated at our institute. Eleven of 25 patients had subarachnoid hemorrhage. In ten patients, the aneurysm was an incidental finding. One patient presented with cranial nerves dysfunction and three with neurological deficits. The locations of the aneurysms were as follows: vertebral artery (VA; n = 9), middle cerebral artery (MCA; n = 5), posterior cerebral artery (PCA; n = 4), basilar artery (BA; n = 2), anterior communicating artery (n = 2), anterior cerebral artery (n = 2), and internal carotid artery (n = 1). Five patients were treated with selective embolization with coils. Sixteen patients were treated with parent vessel occlusion (PVO). Eight PVOs were performed with balloons and eight were performed with coils. One patient with a VA aneurysm was spontaneously thrombosed 4 days after the initial diagnostic angiogram. In three patients treated with stent alone or stent-assisted coiling, one with BA trunk aneurysm died. One aneurismal recurrence occurred and was retreated. At a mean follow-up duration of 23.5 months, 96% of patients had a Glasgow Outcome Scale score of 4 or 5. Pediatric intracranial aneurysms occur more commonly in male patients and have a predilection for the VA, PCA, and MCA. PVO is an effective and safe treatment for fusiform aneurysms. Basilar trunk fusiform aneurysms were difficult to treat and were associated with a high mortality rate. (orig.)

  11. Maternal and perinatal outcomes in critically ill obstetric patients

    Directory of Open Access Journals (Sweden)

    Arati Appinabhavi

    2014-02-01

    Conclusions: Pregnancy-induced hypertensive disorders and hemorrhage were the major risk factors apart from pneumonia and hepatitis that continue to take toll in obstetric patients. Adequate antenatal care, increased vigilance of women during pregnancy for subtle signs and symptoms, early transfer to tertiary centre and aggressive management to prevent complications can bring about the desired reduction in maternal-perinatal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 189-194

  12. Hemorrhagic disorder

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930167 Relationship among changes of bloodpicture and hemorrhage to skin,fundus occuliand brain in 220 cases of hematologic disease.WU Bingquan(吴秉权),et al.Blood Dis Hosp,CMAS.Tianjin Med J 1992;20(9):515-517.Changes of blood picture related to bleedingof the skin,fundus occuli and brain were ana-lyzed in 220 cases of blood diseases.Resultsshowed,in iron deficient anemia with pro-

  13. Audit of perinatal mortality at SSMCHRC-(Rural teaching hospital a retrospective study

    Directory of Open Access Journals (Sweden)

    M.S. Kokila

    2013-04-01

    Full Text Available Objective: To estimate magnitude, determinants of perinatal mortality and suggest remedial measures for its reduction. Background: Perinatal mortality is mirror reflection of maternal and child health and socioeconomic environment of community. It is influenced by various medicosocial preventable causes. It can be reduced by improving maternal and child health services and by health education. Methods: A retrospective hospital based study of perinatal deaths among 2333 deliveries was conducted from June 2008 to June 2010 in our hospital. Fetomaternal factors like maternal age, religion, residence, parity, mode of delivery, booking status, antenatal complications, baby’s sex, birth weight, congenital anomalies, neonatal complications influencing perinatal mortality rate were tabulated and analyzed. Cause of perinatal death was assessed. Results: perinatal mortality rate was 127.4/1000 total births. Maternal factors like age more than 35 years, muslim religion, inadequate antenatal care, primiparity, grand multiparity, induced deliveries and neonatal factors like low birth weight, prematurity were associated with increased perinatal mortality. The leading cause of stillbirth was antepartum hemorrhage and prematurity for neonatal mortality. Conclusion: Apart from clinical causes high perinatal mortality was due to poverty, illiteracy, lack of health awareness, inadequate antenatal care and delayed referral. Health education, identification of high risk mothers, timely referral, advanced life support of preterm neonates should significantly help to reduce perinatal deaths.

  14. 高龄孕妇早发型重度先兆子痫对新生儿及围生结局影响分析%THE EFFECT OF EARLY ONSET SEVERE PRE- ECLAMPSIA OF ADVANCED AGE PREGNANT WOMEN ON NEONATAL AND PERINATAL OUTCOMES

    Institute of Scientific and Technical Information of China (English)

    胡水珍; 叶春波

    2011-01-01

    目的 分析高龄孕妇早发型重度先兆子痫对新生儿及围生结局的影响.方法 回顾性分析1997年1月-2010年1月早发型重度先兆子痫孕妇86例,其中年龄>35岁40例,设为研究组,年龄0.05).终止妊娠时间及孕妇严重并发症,差异有统计学意义(P<0.01).研究组围生儿病死率及颅内出血,新生儿窒息明显高于对照组(P<0.01).研究组新生儿出生体质量及新生儿Apgar评分明显小于对照组(P<0.01).结论 年龄>35岁孕妇发生早发性重度子痫,更易导致孕妇及围生儿预后不良.%Objective To analyze the effect of early onset severe pre - eclampsia( EOSP ) of advanced age pregnant women on neonatal and perinatal outcomes. Methods Eighty - six pregnant women with EOSP from Jan 1997 to Jan 2010 were chosen and analysed. According to the maternal age, 86 pregnant women with EOSP were classified into two groups, research group( the maternal age was up to 35 years and 40 patients were involved ) and control group( the maternal age was under 35 years and 46 patients were involved ). The parity, gestational age on admission, systolic pressure( SP ) and diastolic pressure( DP ) were recorded. And the pregnant outcomes of gravidas ( such as placental abruption, pneumonedema, heart failure ) and complications of perineal infants( such as perinatal mortality ratio, low birth weight, intracranial hemorrhage, neonatal asphyxia, Apgar score ) were recorded and compared between two groups. Results The parity, gestational age on admission, SP and DP had no different between two groups( P > 0.05 ). The duration of pregnancy termination and severe complication were different between two groups (P < 0. 01 ). Compared to control group, the perinatal mortality ratio, intracranial hemorrhage and neonatal asphyxia in research group were higher ( P < 0.01 ), and the birth weight, Apgar score in research group were lower ( P < 0.01 ). Conclusion The EOSP of advanced age pregnant women could

  15. Neuroprotective effects of Wnt/β-catenin signaling pathway on intracra-nial hemorrhage in rats%Wnt/β-catenin通路对大鼠脑出血的保护作用

    Institute of Scientific and Technical Information of China (English)

    李治华; 陈曦; 臧卫东; 郭付有

    2015-01-01

    Aim:To investigate the neuroprotective effect of Wnt/β-catenin signaling pathway on intracranial hemor-rhage(ICH) in rats.Methods:A total of 96 adult SD rats were allocated into sham-operation group,ICH group,ICH+ve-hicle-treated group,and ICH+siDkk-1 group.The mRNA expressions of Wnt-1 and GSK-3βwere assessed by Real-time PCR at 24 and 72 h after ICH respectively .The expression of β-catenin was evaluated by Western blot analysis .Behavioral test was performed by the vibrissae-elicited forelimb-placing test in different groups .Results:There were remarkably down-regulated expression of Wnt-1 mRNA following ICH at 24 and 72 h, and the mRNA level of Wnt-1 was elevated after siDkk-1 administration(F=9.040 and 26.400, P<0.05).Increased GSK-3βmRNA expression was observed at 24 and 72 h af-ter ICH, and the mRNA level of GSK-3βwere reversed after siDkk-1 administration ( F =41.100 and 17.800, P <0.001).Western blot analysis showed that β-catenin protein was increased at 24 h and 72 h after ICH respectively, and the level of β-catenin was further up-regulated after being treated by siDkk-1 compared with ICH +vehicle-treated group (F=15.100 and 14.000, P<0.05).Meanwhile, decreased behavior scores regarding forelimb use asymmetry was found in the ICH group .However , the behavior scores regarding forelimb use asymmetry was improved after siDkk-1 administra-tion than those in the ICH+vehicle-treated group at 24 and 72 h after ICH(F=2 450.000 and 2 230.000, P<0.001). Conclusion:Wnt/β-catenin signaling pathway has neuroprotective effects against secondary brain injury following ICH , which may be associated with activation of Wnt-1, inhibition of GSK-3βresulting in β-catenin aggregation in the cyto-plasm,subsequent nuclear translocation and the downstream neuroprotective gene transcription .%目的:探讨Wnt/β-连环蛋白(β-catenin )通路对大鼠脑出血的保护作用机制。方法:96只成年SD雄性大鼠随机分为假手术组、脑出血组、

  16. Need for Continued Use of Anticoagulants After Intracerebral Hemorrhage.

    Science.gov (United States)

    Estol, Conrado J.; Kase, Carlos S.

    2003-07-01

    One of the unsolved dilemmas in cerebrovascular disease is the ideal timing to restart anticoagulant therapy (ACT) safely in patients who have suffered an intracranial hemorrhage and have an indication to continue ACT. No randomized studies with evidence-based data are available to settle this issue. Only a few reports have been published; their shortcomings include small numbers of patients evaluated retrospectively, a broad spectrum of indications for ACT, different types of hemorrhage, and variable methods of reversing and restarting ACT. Despite this variability, most reports agree that 1) ACT has to be immediately reversed to decrease the risk of hemorrhage progression; 2) a period between 1 and 2 weeks appears sufficient to allow for management and monitoring of the hemorrhage off ACT; and 3) ACT can be safely restarted after the period off of treatment. A physician confronting a patient with intracranial hemorrhage and the need for ACT faces a situation of individually focused clinical decision making. The problem rests in balancing the risks of a worsening or recurring hemorrhage on one side, and the risk of thromboembolism on the other. From available information and personal experience, an unvalidated risk stratification can be proposed to categorize patients in low- and high-risk groups for hemorrhagic complications and embolic phenomena, assigning them to 5 or 15 days off ACT, respectively. Intermediate-risk patients can have ACT restarted in 5 to 15 days from the onset of the intracranial hemorrhage. Anticoagulation should be immediately reversed. Fresh frozen plasma is the standard treatment in most institutions. Prothrombin complex concentrate is an alternative, but issues of availability make its use impractical. The use of recombinant factor VIIa is an attractive new option.

  17. Intracranial tuberculoma: MR imaging

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    Salgado, P.; Zenteno, M.A.; Rodriguez-Carbajal, J.; Brutto, O.H. del; Talamas, O.

    1989-09-01

    MR studies of 6 patients with intracranial tuberculoma are reviewed. All patients also underwent CT scans which showed hypo- or isodense lesions with abnormal enhancement following contrast administration. MR showed lesions with prolongation of the T1 relaxation time in every case. On the T2-weighted sequences, the signal properties of the tuberculoma varied according to the stage of evolution of the lesion. Incipient tuberculomas appeared as scattered areas of hypointensity surrounded by edema. Mature tuberculomas were composed of a dark necrotic center surrounded by an isointense capsule which was, in turn, surrounded by edema. In one patient, the center of the lesion was hyperintense probably because of liquefaction and pus formation (tuberculous abscess). While both, CT and MR, were equally sensitive in visualizing the intracranial tuberculoma in every patient, MR was slightly superior in demonstrating the extent of the lesion, especially for brainstem tuberculomas. Nevertheless, the potential role for MR diagnosis of intracranial tuberculoma is limited by the fact that other infectious or neoplasic diseases may present similar findings. The diagnosis of intracranial tuberculoma should rest on a proper integration of data from clinical manifestations, cerebrospinal fluid analysis, and neuroimaging studies. (orig.).

  18. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    2014-01-01

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  19. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  20. Cerebral Hemodynamic Changes Induced by a Lumbar Puncture in Good-Grade Subarachnoid Hemorrhage

    OpenAIRE

    Schmidt, Eric A.; Stein Silva; Jean François Albucher; Aymeric Luzi; Isabelle Loubinoux; Anne Christine Januel; Christophe Cognard; Pierre Payoux; François Chollet

    2012-01-01

    Background Patients with good-grade subarachnoid hemorrhage (SAH) are those without initial neurological deficit. However, they can die or present severe deficit due to secondary insult leading to brain ischemia. After SAH, in a known context of energy crisis, vasospasm, hydrocephalus and intracranial hypertension contribute to unfavorable outcome. Lumbar puncture (LP) is sometimes performed in an attempt to reduce intracranial pressure (ICP) and release headaches. We hypothesize that in good...

  1. Management of infectious intracranial aneurysms in the pediatric population.

    Science.gov (United States)

    Flores, Bruno C; Patel, Ankur R; Braga, Bruno P; Weprin, Bradley E; Batjer, H Hunt

    2016-07-01

    Infectious intracranial aneurysms (IIAs) account for approximately 15 % of all pediatric intracranial aneurysms. Histologically, they are pseudoaneurysms that develop in response to an inflammatory reaction within the adventitia and muscularis layers, ultimately resulting in disruption of both the internal elastic membrane and the intima. The majority of pediatric IIAs are located within the anterior circulation, and they can be multiple in 15-25 % of cases. The most common presentation for an IIA is intracerebral and/or subarachnoid hemorrhage. In children with a known diagnosis of infective endocarditis who develop new neurological manifestations, it is imperative to exclude the existence of an IIA. The natural history of untreated infectious aneurysms is ominous; they demonstrate a high incidence of spontaneous rupture. High clinical suspicion, prompt diagnosis, and adequate treatment are of paramount importance to prevent devastating neurological consequences. The prompt initiation of intravenous broad-spectrum antibiotics represents the mainstay of treatment. Three questions should guide the management of pediatric patients with IIAs: (a) aneurysm rupture status, (b) the presence of intraparenchymal hemorrhage or elevated intracranial pressure, and (c) relationship of the parent vessel to eloquent brain tissue. Those three questions should orient the treating physician into either antibiotic therapy alone or in combination with microsurgical or endovascular interventions. This review discusses important aspects of the epidemiology, the diagnosis, and the management of IIAs in the pediatric population.

  2. 伴脑出血史的缺血性卒中患者使用抗血小板药物二级预防的调查%Antiplatelet use: secondary prevention for ischemic stroke with a history of intracranial hemorrhage

    Institute of Scientific and Technical Information of China (English)

    贾伟华; 周立春

    2010-01-01

    Objective To investigate the usage of antiplatelet drugs(APD)therapy in ischemic stroke with a history of intracranial hemorrhage(ICH)and impact of APD therapy in recurrences of the ICH and the ischemic stroke. Methods In a retrospective study, all survivors of ischemic stroke with ICH who visited our hospital previous to this study were followed by clinic visit or by telephone interview and recurrent ICH, ischemic stroke, and APD use were recorded. Kaplan-Meier plot and Logistic regression were used to assess the effect of APD on recurrent ICH and isclemic stroke. Results Recurrent ICH was more common in patients with lobar hemorrhage compared than patients with deep hemorrhage. APD use was more common for prevention of myocardial infarction and atrial fibrillation. APD use did not increase ICH recurrence (OR = 1. 149, 95% CI 0. 376-3.513, P=0.808)and did not shorten duration of ICH recurrence(X2=1.257, P=0.262); however, it did reduce ischemic stroke recurrence(OR=0.410, 95% CI0. 203-0.826, P=0.013)and prolonged duration(X2 =14.315, P=0.001). Conclusion APD use was not associated with ICH recurrence and was beneficial to recurrence ischemic stroke in this observation study.%目的 通过结局调查分析既往有脑出血史的缺血性卒中患者使用抗血小板药物(antiplatelet drugs,APD)的状况以及使用APD对再发脑出血和再发脑梗死的影响.方法 随访我院既往有过脑出血的脑梗死患者的单中心、回顾性队列研究.统计学方法采用生存曲线及Logistic回归分析APD对既往有过脑出血患者缺血性卒中二级预防结局的影响.结果 既往有过脑出血的缺血性卒中合并心房颤动和心肌梗死的患者在心内科就诊时更易接受服用APD.既往有过脑出血患者缺血性卒中二级预防中APD没有增加再发脑出血(OR=1.149,95%CI0.376~3.513,P=0.808);未良好控制的高血压和脑叶出血是再发脑出血的危险因素;APD的使用能明显降

  3. Hemorrhagic disease of the newborn despite vitamin K prophylaxis at birth.

    Science.gov (United States)

    Flood, Veronica H; Galderisi, Faith C; Lowas, Stefanie R; Kendrick, Angela; Boshkov, Lynn K

    2008-05-01

    Late hemorrhagic disease of the newborn (HDN) presents 0.5-6 months after birth with mucocutaneous and intracranial bleeding. We describe here two cases of late HDN in infants who received vitamin K. The first case is a previously healthy breastfed male who received one dose of oral vitamin K at birth and developed an intracranial hemorrhage 5 weeks later. He was treated with intravenous vitamin K and recombinant factor VIIa prior to emergent craniectomy. An unrelated infant presented at 5 months of age with diarrhea and easy bruising despite IM vitamin K at birth. These cases illustrate the morbidity associated with late HDN.

  4. Intracranial Atherosclerotic Disease

    Directory of Open Access Journals (Sweden)

    Maria Khan

    2011-01-01

    Full Text Available Intracranial atherosclerotic disease (ICAD is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques including transcranial ultrasound and MRA are now emerging as reliable modalities to exclude moderate to severe (50%–99% stenosis. Little is known about measures for primary prevention of the disease. In terms of secondary prevention of stroke due to intracranial atherosclerotic stenosis, aspirin continues to be the preferred antiplatelet agent although clopidogrel along with aspirin has shown promise in the acute phase. Among Asians, cilostazol has shown a favorable effect on symptomatic stenosis and is of benefit in terms of fewer bleeds. Moreover, aggressive risk factor management alone and in combination with dual antiplatelets been shown to be most effective in this group of patients. Interventional trials on intracranial atherosclerotic stenosis have so far only been carried out among Caucasians and have not yielded consistent results. Since the Asian population is known to be preferentially effected, focused trials need to be performed to establish treatment modalities that are most effective in this population.

  5. Risk factors for intracranial aneurysm in a Chinese ethnic population

    Institute of Scientific and Technical Information of China (English)

    GU Yu-xiang; CHEN Xian-cheng; SONG Dong-lei; LENG Bing; ZHAO Fan

    2006-01-01

    Background Intracranial aneurysm (IAN) is a protruding bubble or a sac on a brain artery that balloons out over time, which may lead to spontaneous subarachnoid hemorrhage (SAH), ultimately disability and mortality.Current research indicates that the disease is due to multiple causes, including environmental factors and various congenital abnormalities of blood vessels. Apart from congenital predisposition, various high-risk factors such as sex, age, hypertension, and atherosclerosis are involved in the formation of intracranial aneurysms. The aim of this study was to investigate the risk factors associated with the formation of sporadic intracranial aneurysms in Chinese Han ethnic patients.Methods A total of 251 patients with intracranial aneurysm and 338 patients with other cerebral diseases (control group) were enrolled in this study. Single factor and logistic regression model were used to analyze the association of intracranial aneurysms with age; sex; cigarette smoking; alcohol or cocaine consumption; history of hypertension, coronary artery disease, diabetes mellitus and inherited connective tissue disease; and the levels of fasting blood glucose and blood fat. The data expressed as mean ± standard deviation were processed with the statistical software SPSS13. Quantitative and qualitative data were analyzed by the independent-sample t test,and the chi-square test respectively. Logistic regression method was used to analyze the multiple factors.Results In the 251 patients, 163 (64.94%) were at age of 40 to 60 years. Sex (OR, 1.41; 95% CI, 1.01-1.96), cigarette smoking (OR, 1.81; 95% CI, 1.06-3.10), hypertension (OR, 2.32; 95% CI, 1.30-4.16) and fasting blood glucose were significantly associated with intracranial aneurysm (P<0.05). Intracranial aneurysm was correlated with alcohol consumption, coronary artery disease, and the level of blood lipids (P>0.05). Using logistic regression analysis, we identified female sex and advanced age as significant risk

  6. Progressive versus Nonprogressive Intracranial Dural Arteriovenous Fistulas: Characteristics and Outcomes.

    Science.gov (United States)

    Hetts, S W; Tsai, T; Cooke, D L; Amans, M R; Settecase, F; Moftakhar, P; Dowd, C F; Higashida, R T; Lawton, M T; Halbach, V V

    2015-10-01

    A minority of intracranial dural arteriovenous fistulas progress with time. We sought to determine features that predict progression and define outcomes of patients with progressive dural arteriovenous fistulas. We performed a retrospective imaging and clinical record review of patients with intracranial dural arteriovenous fistula evaluated at our hospital. Of 579 patients with intracranial dural arteriovenous fistulas, 545 had 1 fistula (mean age, 45 ± 23 years) and 34 (5.9%) had enlarging, de novo, multiple, or recurrent fistulas (mean age, 53 ± 20 years; P = .11). Among these 34 patients, 19 had progressive dural arteriovenous fistulas with de novo fistulas or fistula enlargement with time (mean age, 36 ± 25 years; progressive group) and 15 had multiple or recurrent but nonprogressive fistulas (mean age, 57 ± 13 years; P = .0059, nonprogressive group). Whereas all 6 children had fistula progression, only 13/28 adults (P = .020) progressed. Angioarchitectural correlates to chronically elevated intracranial venous pressures, including venous sinus dilation (41% versus 7%, P = .045) and pseudophlebitic cortical venous pattern (P = .048), were more common in patients with progressive disease than in those without progression. Patients with progressive disease received more treatments than those without progression (median, 5 versus 3; P = .0068), but as a group, they did not demonstrate worse clinical outcomes (median mRS, 1 and 1; P = .39). However, 3 young patients died from intracranial venous hypertension and intracranial hemorrhage related to progression of their fistulas despite extensive endovascular, surgical, and radiosurgical treatments. Few patients with dural arteriovenous fistulas follow an aggressive, progressive clinical course despite treatment. Younger age at initial presentation and angioarchitectural correlates to venous hypertension may help identify these patients prospectively. © 2015 by American Journal of Neuroradiology.

  7. Fatal hemorrhage from AVM after DBS surgery: case report.

    Science.gov (United States)

    Fukaya, Chikashi; Shimoda, Kentaro; Watanabe, Mitsuru; Morishita, Takashi; Sumi, Koichiro; Otaka, Toshiharu; Obuchi, Toshiki; Toshikazu, Kano; Kobayashi, Kazutaka; Oshima, Hideki; Yamamoto, Takamitsu; Katayama, Yoichi

    2013-01-01

    Intracranial hemorrhage is a crucial complication of deep brain stimulation (DBS) surgery. The bleeding caused by mechanical tissue injury due to microelectrode and/or DBS electrode lead insertion has been well studied. However, hemorrhage caused by a congenital underlying disease such as vascular malformation has not been examined carefully. We encountered a case of intracerebral hemorrhage from arteriovenous malformation (AVM) after DBS surgery. Preoperative magnetic resonance (MR) imaging did not show any abnormality in the patient. Computed tomography (CT) images taken immediately after the surgery did not show any intracranial hematoma and other abnormal findings. However, the patient did not recover from the general anesthesia, and hemorrhage in the left occipital lobe was detected by CT performed a day after the surgery. The location of the hematoma was markedly distant from the trajectory of DBS leads. Evacuation of the hematoma under general anesthesia was immediately performed. As an intraoperative finding, we noted the presence of abnormal vessels inside the hematoma in the occipital lobe. Tissue specimens including the abnormal vessels were obtained for histopathological analysis, results of which led to the diagnosis was AVM. Despite its low incidence, we would like to advise that such a type of hemorrhage could occur and measures should be taken to prevent its occurrence as much as possible. Preoperative detection of abnormal vessels by MR angiography and/or CT angiography might be helpful. Moreover, paying close attention to the possible leakage of cerebrospinal fluid during surgery might be important. © 2012 International Neuromodulation Society.

  8. [Intracranial blood flow velocities evaluated by color Doppler (duplex) in preterm infants].

    Science.gov (United States)

    de Assis, Marcelo Cardoso; Machado, Helio Rubens

    2004-03-01

    In order to ascertain the blood flow velocities in the intracranial arteries we evaluated 73 preterm neonates during a period ranging from June 1994 to March 1999. These preterm infants were divided in two separate groups, 18 healthy and 55 with intracranial hemorrhage. They were subjected to sequential measurements of blood flow velocities in the intracranial arteries. The gestational age of the whole group varied from 28 to 36 weeks and birth weights between 720 and 2530 g. The diagnosis of the intracerebral hemorrhages in these preterm neonates were done using high resolution gray and color scale transfontanellar ultrasonography brain scans. The ultrasound evaluations were performed in the initial 3rd, 7th and 14th day of life. The 73 preterm infants were evaluated with sequential measurements of blood flow velocity in the intracranial arteries using the Doppler technique through the anterior fontanelle. Doppler evaluation of the cerebral vessels were performed on days 3, 7, 30 and 90 of life. These evaluations were performed in the six intracranial arteries, meaning: right and left anterior and middle cerebral arteries and right and left internal carotid arteries. Doppler recordings were made using Duplex Color-Doppler system, pulse echo probe of 3,5; 5,0 and 7,5 MHz. Measuring the blood flow velocity in the cerebral arteries we obtained a maximum systolic velocity and end diastolic velocity with a rate in meters per second (m/s) for each cardiac cycle. After obtaining these numerical values for these velocities we obtained the resistance index (RI) or Pourcelot index. In a progressive way as the resistance index (RI) values were being obtained in each stage of this study they were also being checked in the cerebral arteries of healthy preterm infants and infants with intracranial hemorrhages. We also analyzed in a comparative method the values of the resistive index between the two groups of preterm infants observing their behaviour. The results obtained when

  9. Presentation of moyamoya disease with occipital hemorrhage: a case report

    Directory of Open Access Journals (Sweden)

    Serkan Demir

    2012-12-01

    Full Text Available Moyamoya disease is a cerebrovascular disease which is characterized with stenosis and occlusions at the distal part of internal carotid artery and at the proximal part of anterior and middle cerebral arteries. It rarely causes temporary or recurrent hemiparesis due to intracranial hemorrhage while symptoms like headache, convulsion, nystagmus, aphasia and ataxia may also occur. In this paper, we present a case of Moyamoya disease which was diagnosed with a 23 year old female patient who was admitted to our emergency department with headache, nausea and vomiting complaints and whose radiological findings showed occipital lobe hemorrhage.

  10. The clinical features and treatment of pediatric intracranial aneurysm.

    Science.gov (United States)

    Liang, Jiantao; Bao, Yuhai; Zhang, Hongqi; Wrede, Karsten Henning; Zhi, Xinglong; Li, Meng; Ling, Feng

    2009-03-01

    Intracranial aneurysms are relatively rare in the pediatric population. The objective of this study was to highlight the clinical and radiological features and the therapeutic outcome and clarify the choice of therapeutic strategies for pediatric intracranial aneurysms. Twenty-four consecutive children (age aneurysms in our institute in the last 23 years were included in this study. There were nine (36%) patients with posterior circulation aneurysms and eight (32%) with giant aneurysms. Eleven (46%) patients presented with subarachnoid hemorrhage. Fifteen patients underwent endovascular treatment, and four received microsurgical therapy. Five patients were treated conservatively. Ninety-two percent (n=22) of the patients showed favorable outcomes. Pediatric intracranial aneurysms differ in many ways from those in adults: male predominance; high incidence of giant, dissecting, and fusiform aneurysms; high incidence of aneurysms in the posterior circulation; high incidence of spontaneous thrombosis; better Hunt-Hess grades at presentation; and better therapeutic outcome. For children with intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. For many complex aneurysms, endovascular therapy was the best choice.

  11. Subarachnoid hemorrhage associated with von Willebrand's disease--case report.

    Science.gov (United States)

    Nakau, Reiko; Nomura, Motohiro; Kida, Shinya; Yamashita, Junkoh; Kinoshita, Akira; Nitta, Hisashi; Muramatsu, Naoki

    2005-12-01

    A 59-year-old woman with type IIA von Willebrand's disease (VWD) presented with subarachnoid hemorrhage (SAH). Computed tomography showed SAH in the right sylvian fissure and intracranial hemorrhage in the right temporal lobe. Angiography demonstrated an aneurysm at the bifurcation of the right middle cerebral artery. Neck clipping was performed on the 3rd day after the onset with intra- and postoperative administration of factor VIII/von Willebrand factor concentrate. No excessive bleeding occurred. Patients with prolonged bleeding time should be screened for VWD before surgery. This is a rare case of VWD presenting with SAH secondary to ruptured intracranial aneurysm. The clinical characteristics and the management of SAH in a patient with VWD are discussed.

  12. Incidence of intracranial haemorrhage in low-birth weight infants and its outcome: a hospital based prospective study

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    Rajesh Debbarma

    2016-10-01

    Conclusions: Low gestational age, specially <34 weeks, very low birth weight, male gender, difficult vaginal delivery, birth asphyxia, and hypothermia are risk factors for intracranial hemorrhage, specially intra-ventricular hemorrhage. For better evaluation of risk factors for ICH and its outcome, multicentric study should be performed with large number of simple and longer time period of follow up with the help of newer modalities of investigation. [Int J Res Med Sci 2016; 4(10.000: 4279-4285

  13. Brain herniation in a patient with apparently normal intracranial pressure: a case report

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    Dahlqvist Mats B

    2010-08-01

    Full Text Available Abstract Introduction Intracranial pressure monitoring is commonly implemented in patients with neurologic injury and at high risk of developing intracranial hypertension, to detect changes in intracranial pressure in a timely manner. This enables early and potentially life-saving treatment of intracranial hypertension. Case presentation An intraparenchymal pressure probe was placed in the hemisphere contralateral to a large basal ganglia hemorrhage in a 75-year-old Caucasian man who was mechanically ventilated and sedated because of depressed consciousness. Intracranial pressures were continuously recorded and never exceeded 17 mmHg. After sedation had been stopped, our patient showed clinical signs of transtentorial brain herniation, despite apparently normal intracranial pressures (less than 10 mmHg. Computed tomography revealed that the size of the intracerebral hematoma had increased together with significant unilateral brain edema and transtentorial herniation. The contralateral hemisphere where the intraparenchymal pressure probe was placed appeared normal. Our patient underwent emergency decompressive craniotomy and was tracheotomized early, but did not completely recover. Conclusions Intraparenchymal pressure probes placed in the hemisphere contralateral to an intracerebral hematoma may dramatically underestimate intracranial pressure despite apparently normal values, even in the case of transtentorial brain herniation.

  14. Viral Hemorrhagic Fevers

    Science.gov (United States)

    ... 4 viruses that cause two other hemorrhagic fevers, dengue hemorrhagic fever and yellow fever. Virus Families Information ... 2014 Content source: Centers for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases ( ...

  15. Lateral Ventricular Meningioma Presenting with Intraventricular Hemorrhage: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Zhenyu Fu, Kan Xu, Bing Xu, Limei Qu, Jinlu Yu

    2011-01-01

    Full Text Available Lateral ventricular meningiomas presenting with primary intraventricular hemorrhage are extremely uncommon. We report here a case of primary intraventricular hemorrhage attributable to a lateral ventricular meningioma. This case concerns a 46-year-old female patient who presented with sudden onset of headache. Computed tomography (CT, computed tomography angiography (CTA and magnetic resonance imaging (MRI examinations showed hemorrhage from a ruptured tumor mass, which was pathologically confirmed as a transitional meningioma. The patient underwent surgical treatment and had a good prognosis. A retrospective review of eight previous cases of hemorrhage from ruptured lateral ventricular meningiomas revealed that hemorrhage of lateral ventricular meningiomas and hemorrhage of meningiomas at other intracranial sites have similar causes. The clinical and pathological features of ruptured lateral ventricular meningiomas are consistent with those of unruptured lateral ventricular meningiomas. As this clinical entity is extremely rare, attention is called for while performing differential diagnosis.

  16. Intracranial Hypertension in Children without Papilledema

    OpenAIRE

    Chelse, Ana B.; Epstein, Leon G.

    2015-01-01

    Researchers at Nationwide Children's Memorial Hospital studied the frequency of intracranial hypertension without papilledema in children followed in a multispecialty pediatric intracranial hypertension clinic.

  17. INTRACRANIAL PRESSURE MONITORING

    Directory of Open Access Journals (Sweden)

    Retno Widiyanthi

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Intracranial pressure is total of pressure that is produced by brain, blood, and cerebrospinal fluid/CSF in the tight cranial space. As a respon to intracranial pressure increasing, compensation begin by movement of CSF from ventricle to cerebral subarachnoidal space, and increase the absorption of CSF. Increasing of ICP usually caused by increasing of brain volume (cerebral oedem, blood (intracranial bleeding, space occupying lesion, or CSF (hidrocephalus. Indication in ICP monitoring can be seen from : neurological criteria, abnormal CT-scan result when admission, normal CT-scan result, but had more two risk factors. According to the procedure that must be done, there are two methods in ICP monitoring: invasive ICP monitoring methodes and non-invasive measuring method. Increasing of ICP will decrease the compliance of brain, pulsation of artery more clearly, and the component of vein is lost. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  18. Perinatal risk factors for strabismus

    DEFF Research Database (Denmark)

    Torp-Pedersen, Tobias; Boyd, Heather A; Poulsen, Gry;

    2010-01-01

    Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype.......Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype....

  19. Pediatric intracranial aneurysms.

    Science.gov (United States)

    Tripathy, L N; Singh, S N

    2009-01-01

    The incidence of subarachnoid haemorrhage from intracranial aneurysms in the paediatric age group is extremely rare. Interestingly, occurrence of vasospasm has been reported to be less in comparison to the adults. Both coiling and clipping have been advocated in selected cases. Because of the thinness of the wall of the arteries, utmost care should be taken while handling these arteries during surgery. The overall results of surgery in children have been reported to be better than their adult counterparts. We present four such cases from our own experience. All these children were operated upon, where the solitary aneurysm in each case was clipped and all of them made a good recovery.

  20. Intracranial abscess in Ectopia Cordis.

    Science.gov (United States)

    Merola, Joseph; Tipper, Geoffrey Adrian; Hussain, Zakier; Balakrishnan, Venkataraman; Gan, Peter

    2014-08-25

    We present a case of intracranial abscess in a young female with Ectopia Cordis, an exceptionally rare cardiac condition. The neurosurgical implication is the predisposition to intracranial abscess formation. A heightened awareness of this association will aid diagnosis in similar clinical scenarios.

  1. Infantile intracranial aneurysm of the superior cerebellar artery.

    Science.gov (United States)

    Del Santo, Molly Ann; Cordina, Steve Mario

    2016-02-29

    Intracranial aneurysms in the pediatric population are rare. We report a case of a 3-month-old infant who presented with inconsolable crying, vomiting, and sunset eye sign. CT revealed a subarachnoid hemorrhage, with CT angiogram revealing a superior cerebellar artery aneurysm. An external ventricular drain was placed for acute management of hydrocephalus, with definitive treatment by endovascular technique with a total of six microcoils to embolize the aneurysm. Serial transcranial Dopplers revealed no subsequent vasospasm. Although aneurysms in the pediatric population are rare, once the diagnosis is established, early treatment results in better outcomes. 2016 BMJ Publishing Group Ltd.

  2. Prenatal and perinatal striatal injury: a hypothetical cause of attention-deficit-hyperactivity disorder?

    DEFF Research Database (Denmark)

    Toft, P.B.

    1999-01-01

    , in children who have suffered perinatal adverse events. Evidence is presented to demonstrate that the composition of metabolites in the striatum is altered, primarily in the form of an elevated level of lactate, in human neonates who have suffered various perinatal disorders, such as germinal matrix...... hemorrhage, intrauterine growth retardation, and asphyxia. An elevated level of lactate suggests tissue hypoxia, which may interfere with the formation of frontostriatal circuits and may play a role in the pathogenesis of the behavioral disturbances observed in a proportion of children with a history...

  3. Maternal mortality from hemorrhage.

    Science.gov (United States)

    Haeri, Sina; Dildy, Gary A

    2012-02-01

    Hemorrhage remains as one of the top 3 obstetrics related causes of maternal mortality, with most deaths occurring within 24-48 hours of delivery. Although hemorrhage related maternal mortality has declined globally, it continues to be a vexing problem. More specifically, the developing world continue to shoulder a disproportionate share of hemorrhage related deaths (99%) compared with industrialized nations (1%). Given the often preventable nature of death from hemorrhage, the cornerstone of effective mortality reduction involves risk factor identification, quick diagnosis, and timely management. In this monograph we will review the epidemiology, etiology, and preventative measures related to maternal mortality from hemorrhage.

  4. Perinatal programming by inflammation.

    Science.gov (United States)

    Spencer, Sarah J; Meyer, Urs

    2017-07-01

    Since Levine and then Barker's seminal work mid to late last century demonstrating the importance of early life environment, intensive research has revealed the plasticity, vulnerability and resilience of the developing brain to environmental challenges. In particular, early exposure to infectious pathogens and inflammatory stimuli has a lasting impact on brain and behavior. These data establish clear effects on vulnerability to later disease and neuroinflammatory injury, cognitive function and emotionality, and even responses to pain and susceptibility to metabolic disorders. They also highlight the issues with defining rodent models of complex diseases like autism spectrum disorders and schizophrenia, as well as the complexity of experimental design, for instance when deciding the appropriate allocation of subjects to experimental groups when dealing with whole-litter manipulations in rodents. The studies presented in this special issue of Brain Behavior and Immunity are a collection of the very latest advances in the science of perinatal inflammation and its implications for perinatal programming of brain and behavior. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Postdatism -- a perinatal problem?

    Science.gov (United States)

    Chhabra, S; Sood, S

    1990-01-01

    It has been traditionally accepted that maternal and fetal complications are at their lowest levels 37-42 weeks into gestation. 20% of pregnancies completed after 42 weeks gestation are thought to be affected by the postmaturity syndrome of uteroplacental insufficiency resulting in oligohydramnios, meconium passage, loss of fetal subcutaneous tissue, fetal asphyxia, and fetal death. Some workers, however, have also found that pregnancies completed between 40 and 42 weeks carry significant risk. The authors explored this question in a case-control study of 464 women seen at the Mahatma Gandhi Institute of Medical Sciences in Maharashtra, India. The cases of postdatism occurred in the absence of any other medical or obstetric problem. The operative delivery rate increased significantly among these patients compared to deliveries between 39 and 40 weeks. There was neither significant asphyxia nor perinatal loss in term completed normal patients. Asphyxia and perinatal mortality did, however, occur with postdatism. The authors note the likely role of oligohydramnios combined with placental dysfunction.

  6. Multiple intracranial lipoma

    Directory of Open Access Journals (Sweden)

    B P Venkatesh

    2014-01-01

    Full Text Available Intracranial lipomas are rare congenital, non-neoplastic lesions discovered incidentally on computerised tomography (CT or magnetic resonance imaging (MRI with an incidence rate of less than 0.1% of all intracranial tumours. Most lipomas are asymptomatic pericallosal lesions sometimes presenting with seizures or headache. Corpus callosum agenesis and defects of midline structures differentiation may be present. Callosal lipomas are of two types: Anterior bulky tubulonodular variety associated with forebrain and rostral callosal anomalies, and posterior ribbon-like curvilinear lipoma generally seen with a normal or near normal corpus callosum. Corpus callosal hypogenesis/agenesis is seen in up to 90% of anterior and 30% of posterior pericallosal lipomas. The association of corpus callosal lipoma with choroid plexus lipoma is variable with its reported incidence rate being 20-50%. A 50-year-old patient was referred to our department for CT scan of brain with history of recent onset of headache and one episode of seizure. We present the imaging findings in this rare case of callosal tubulonodular lipoma having prominent intralesional vessels and extensive calcification with a concomitant intraventricular lipoma in a patient with dysgenetic corpus callosum.

  7. Cognitive abilities and language comprehension in preschool children with perinatal brain lesion.

    Science.gov (United States)

    Pavlisa, Jasmina Ivsac; Simlesa, Sanja; Ljubesić, Marta

    2011-01-01

    Perinatal brain lesion is a risk factor for development, making parents of such children particularly worried about consequences it may have on the child's cognitive and language development. Although literature findings on the outcome of perinatal brain lesion are inconsistent, most of the studies have found a positive general outcome, but also subtle deficits that affect the child's academic success. Since language comprehension and cognitive abilities influence learning abilities at school, we wanted to know how six-year olds who were selected based on pathological ultrasonographical findings (ischemic or hemorrhagic brain lesion) would perform on subtests of Wechsler battery (WISC) and language comprehension measures (Reynell Developmental Language Scale and Peabody Picture Vocabulary Test), compared with controls. The second issue we investigated was whether in children who suffered a perinatal brain lesion cognitive abilities predicted the level of language comprehension in the same way as in children without perinatal brain lesion. The relation between cognitive and linguistic abilities is still a controversial one, and a different relation would mean that these two groups of children have different structure of abilities probably due to perinatal brain lesion. Forty children who suffered a perinatal brain lesion and forty age-matched children without perinatal risk factors were examined. Our results showed that the groups differed more in linguistic than in cognitive variables. Also, the two groups showed different relation patterns between cognitive abilities and language comprehension. Cognitive abilities were statistically significantly associated with language comprehension in children who suffered a perinatal brain lesion, while this association was not statistically significant within the control group. Since a number of participants with perinatal brain lesion had language difficulties, it is presumed that they rely on cognitive abilities in order to

  8. Comparison of intracranial computed tomographic (CT) findings in pediatric abusive and accidental head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Hymel, K.P. [University of Colorado Health Sciences Center, 1056 East 19th Avenue, Denver, CO 80218 (United States); Rumack, C.M. [University of Colorado Health Sciences Center, 1056 East 19th Avenue, Denver, CO 80218 (United States); Hay, T.C. [University of Colorado Health Sciences Center, 1056 East 19th Avenue, Denver, CO 80218 (United States); Strain, J.D. [University of Colorado Health Sciences Center, 1056 East 19th Avenue, Denver, CO 80218 (United States); Jenny, C. [University of Colorado Health Sciences Center, 1056 East 19th Avenue, Denver, CO 80218 (United States)

    1997-09-01

    Background. Child abuse specialists rely heavily on diagnostic neuroimaging. Objectives. Study objectives were: (1) to compare the frequencies of six specific intracranial CT abnormalities in accidental and non-accidental pediatric head trauma, and (2) to assess interobserver agreement regarding these CT findings. Materials and methods. Three pediatric radiologists blindly and independently reviewed cranial CT scans of pediatric patients who sustained closed head trauma between 1991 and 1994. All patients were less than 4 years of age. Study cases included thirty-nine (50 %) with non-accidental head trauma and thirty-nine (50 %) with accidental head trauma. Each scan was evaluated for the presence or absence of the following six intracranial findings: (1) interhemispheric falx hemorrhage, (2) subdural hemorrhage, (3) large (non-acute) extra-axial fluid, (4) basal ganglia edema, (5) posterior fossa hemorrhage, and (6) frontal-parietal shearing tear(s). Interobserver agreement was calculated as the percentage of total cases in which all reviewers agreed a specific CT finding was present or absent. Diagnosis required independent agreement by all three pediatric radiologists. The frequencies of these six intracranial CT abnormalities were compared between the two study groups by Chi-square analysis and Fisher`s exact test. Results. Interobserver agreement between radiologists was greater than 80 % for all lesions evaluated, with the exception of frontal-parietal shearing tear(s). Interhemispheric falx hemorrhage, subdural hemorrhage, large (non-acute) extra-axial fluid, and basal ganglia edema were discovered significantly more frequently in non-accidental trauma (P {<=}.05). Conclusion. Although not specific for child abuse, discovery of these intracranial CT abnormalities in young patients should prompt careful evaluation of family and injury circumstances for indicators of non-accidental trauma. (orig.). With 6 figs., 2 tabs.

  9. Assessment of diagnostic methods in adrenal gland hemorrhage in neonates on the basis of own material from the years 2007–2011

    OpenAIRE

    Postek, Grzegorz; Streich, Hanna; Narębski, Krzysztof

    2011-01-01

    Summary We analyzed a group of nine neonates diagnosed with adrenal gland hemorrhage in the years 2007–2011, to evaluate diagnostic methods. We assessed risk factors and factors predisposing to hemorrhage. Severe and moderate perinatal hypoxia was found in 5 cases, while sepsis in 4 cases. Three patients had bilateral adrenal hemorrhage. All patients underwent ultrasound examination and color Doppler US. Their levels of vanillyl-mandelic acid in 24-h urine collection were normal. A complete r...

  10. Intracranial Vessel Wall MRI: An Emerging Technique With a Multitude of Uses.

    Science.gov (United States)

    Schaafsma, Joanna D; Mikulis, David J; Mandell, Daniel M

    2016-04-01

    Intracranial vessel wall magnetic resonance imaging (VW-MRI) can be a useful diagnostic technique in patients with ischemic stroke and subarachnoid hemorrhage. Unlike conventional vascular imaging that depicts only the vessel lumen, VW-MRI allows visualization of pathology in the arterial wall itself. The ability to image the arterial wall is useful, as many pathological processes reside within the wall and only secondarily affect the lumen. In this review, we will present 6 clinical uses for intracranial wall imaging to highlight the versatility of this technique.

  11. [A case of successful treatment of concomitant ruptured intracranial aneurysm and visceral aneurysm].

    Science.gov (United States)

    Diogo, Cláudia; Baltazar, José; Fernandes, Mário

    2012-01-01

    The association between intracranial and visceral aneurysms is very rare, with a bad prognosis. The rupture usually appears in the Emergency Room, and it implies an immediate treatment. We describe the case of a woman with rupture of an anterior communicant artery aneurysm and rupture of a pancreatic duodenal artery aneurysm. The actuation of all specialties allowed the direct surgical treatment of the visceral aneurysm, without the aggravation of the cerebral hemorrhage that the eventual Aorta Artery clamping could provoke. The maintenance of the hemodynamic stability was essential for the posterior treatment of the intracranial aneurysm.

  12. Is acute reperfusion therapy safe in acute ischemic stroke patients who harbor unruptured intracranial aneurysm?

    Science.gov (United States)

    Mowla, Ashkan; Singh, Karanbir; Mehla, Sandhya; Ahmed, Mohammad K; Shirani, Peyman; Kamal, Haris; Krishna, Chandan; Sawyer, Robert N; Ching, Marilou; Siddiqui, Adnan H; Levy, Elad I; Snyder, Kenneth V; Crumlish, Annemarie; Hopkins, L N

    2015-10-01

    Intracranial aneurysms are currently considered as contraindication for intravenous thrombolysis in acute ischemic stroke, very likely due to a possible increase in the risk of bleeding from aneurysm rupture; however, there is limited data available on whether intravenous thrombolysis is safe for acute ischemic stroke patients with pre-existing intracranial aneurysms. To find out the safety of intravenous thrombolysis in acute ischemic stroke patients who harbor unruptured intracranial aneurysms. We retrospectively reviewed the medical records and cerebrovascular images of all the patients treated with intravenous thrombolysis for acute ischemic stroke in our center from the beginning of 2006 till the end of April 2014. Those with unruptured intracranial aneurysm present on cerebrovascular images prior to acute reperfusion therapy were identified. Post-thrombolysis brain imaging was reviewed to evaluate for any intraparenchymal or subarachnoid hemorrhage related or unrelated to the aneurysm. A total of 637 patients received intravenous thrombolysis for acute ischemic stroke in our center during an 8·3-year period. Thirty-three (5·2%) were found to have at least one intracranial aneurysms. Twenty-three (70%) of those received only intravenous thrombolysis, and 10 patients received combination of intravenous and intra-arterial thrombolysis. The size of the largest aneurysm was 10 mm in maximum diameter (range: 2-10 mm). The mean size of aneurysms was 4·8 mm. No symptomatic intracranial hemorrhage occurred among the 23 patients receiving only intravenous thrombolysis. Out of those who received a combination of intravenous and intra-arterial thrombolysis, one developed symptomatic intracranial hemorrhage in the location of acute infarct, distant to the aneurysm location. Our findings suggest that neither intravenous thrombolysis nor combination of intravenous and intra-arterial thrombolysis increases the risk of aneurysmal hemorrhage in acute ischemic stroke

  13. A CASE REPORT-ANTENATAL DIAGNOSIS OF FETAL INTRACRANIAL HAEMORHAGE

    Directory of Open Access Journals (Sweden)

    Kalyani

    2015-10-01

    Full Text Available 26 years old para 1 with 26 weeks of pregnancy presented with intermittent fever. Her obstetric history included one spontaneous first trimester miscarriage and one previous Caesarean Section for meconium stained amniotic fluid. Her antenatal course was uneventful so far. On investigation she tested IgM dengue positive. Her WBC count, platelet count and coagulation profiles were within normal limits. Obstetric sonography was done which was suggestive of a single live intrauterine gestation corresponding with growth appropriate for gestational age with moderate polyhydramnios (AFI 25cms with hyperechoic cerebral cisterns suggestive of intracranial haemorrhage. Fetal MRI was done which revealed generalized atrophy of the brain parenchyma with subdural haematoma over posterior cerebral convexities extending along tentorial leaflets. Patient went into preterm labour at 27 weeks and delivered male baby of 980gms which was an intrapartum fetal demise. Fetal intracranial hemorrhage occurs in 5 in 10,000 pregnancies. Hemorrhage may occur either within the cerebral ventricles (Intraventricular haemorrhage, IVH, subdural space or infratentorial fossa. IVH are common variety and are characteristic of immature brain. IVH are subdivided according to their severity into four grades: the first three grades are limited to the ventricles, while the fourth grade includes parenchymal involvement occurring in the most severe cases. Fetal stroke is caused by antenatal hemorrhagic, ischemic or thrombotic injury. Although there is no identifiable risk factor in 50% of cases of fetal stroke, the most common maternal conditions associated with it are alloimmune thrombocytopenia and trauma. Outcome is usually poor, for those fetuses affected with high grade IVH or subdural hemorrhages. USG helps in accurate diagnosis of fetal ICH and prenatal MRI also contributes to the accuracy of diagnosis.

  14. Pediatric intracranial aneurysms--our experience and review of literature.

    Science.gov (United States)

    Garg, Kanwaljeet; Singh, Pankaj Kumar; Sharma, Bhawani Shankar; Chandra, Poodipedi Sarat; Suri, Ashish; Singh, Manmohanjit; Kumar, Rajinder; Kale, Shashank Sarad; Mishra, Nalin Kumar; Gaikwad, Shailesh K; Mahapatra, Ashok Kumar

    2014-05-01

    Intracranial aneurysms in children are not as common as in adults and there are many differences in the etiology, demographic variables, aneurysm location, aneurysm morphological characteristics, clinical presentation, and outcome in pediatric and adult intracranial aneurysms. All children (≤18 years) suffering from intracranial aneurysm managed at our center from July 2001 through June 2013 were included in the study, and the details of these patients were retrieved from the computerized database of our hospital. A total of 62 pediatric patients were treated for 74 aneurysms during the study period and constituted 2.3% of all intracranial aneurysms treated during the same period. The mean age at presentation was 13.5 years. Headache (82%) was the commonest presenting feature; other symptoms included seizures (21%), ictal loss of consciousness (27%), and motor/cranial nerve deficits (22.6%). Computed tomogram revealed subarachnoid hemorrhage in 58% of patients. Eighty-two percent of aneurysms were in anterior circulation. Sixty-seven percent of aneurysms were complex aneurysms. Fifty-eight percent of patients underwent surgical intervention while 30% underwent endovascular procedures. Twenty-one percent of the patients developed vasospasm. There was no postoperative mortality. Favorable outcome was seen in 72% of the patients. Pediatric intracranial aneurysms are uncommon as compared to in adult patients. Seizures and cranial nerve involvement are seen more often as the presenting features in children. Posterior circulation aneurysms are more common in children, as are the internal carotid artery bifurcation aneurysms. There is high incidence of giant, posttraumatic, and mycotic aneurysms in children.

  15. Incidence and risk factors of intracranial aneurysm: A national cohort study in Korea.

    Science.gov (United States)

    Kim, Tackeun; Lee, Heeyoung; Ahn, Soyeon; Kwon, O-Ki; Bang, Jae Seung; Hwang, Gyojun; Kim, Jeong Eun; Kang, Hyun-Seung; Son, Young-Je; Cho, Won-Sang; Oh, Chang Wan

    2016-10-01

    Background Estimations of the intracranial aneurysm incidence require long-term follow-up of a relatively large at-risk population; as a result, the incidence remains largely unknown. Aims To investigate the national incidence of intracranial aneurysm in a Korean population. Methods After excluding 18,604 potential subjects with a previous history of stroke (I6x.x), 998,216 subjects were included in this observational cohort. The primary endpoint was the earliest date of diagnosis of either unruptured intracranial aneurysm (UIA; I67.1) or subarachnoid hemorrhage (SAH; I60.x). We collected anthropometric data, blood pressure measurements, laboratory data, and smoking, drinking, and physical exercise habits of 132,355 subjects for whom healthcare screening data were available. Factors influencing intracranial aneurysm were evaluated via multivariate Cox regression. Results The overall observation size was 8,792,214 person-years. During follow-up, 4346 subjects were diagnosed with intracranial aneurysm (SAH, 1960; UIA, 2386). The crude incidence of intracranial aneurysm was 49.4/100,000 person-years. The hazard ratio for women was 1.56 ( p intracranial aneurysm. A history of heart disease and family history of stroke were associated with respective hazard ratios of 2.08 and 1.77. Conclusions In this Korean population study, the standardized incidence of intracranial aneurysm was 52.2/100,000 person-years. Older age, female sex, hypertension, history of heart disease, and family history of stroke were independent risk factors for intracranial aneurysm.

  16. Intracranial Large Artery Occlusive Disease

    Institute of Scientific and Technical Information of China (English)

    Wong KS; Li H; Kay R

    2000-01-01

    @@Intracranial large artery stenosis is the most commonly found vascular lesion in stroke patient of Chinese, Hispanic and African ancestry. There .have been few studies on the epidemiology, pathophysiology, treatment and prognosis of this important disease. Recent advances in technology provide safe and reliable investigation for studying large number of patients. Transcranial Doppler is an easily accessible, cheap and reliable method to diagnose intracranial stenosis. It is suitable for screening for and monitoring the progress of intracranial stenosis. Magnetic resonance angiography and CT angiography provide the morphology of lumenal stenosis but are less accessible.

  17. Endoscope-assisted microsurgery for intracranial aneurysms.

    Science.gov (United States)

    Kalavakonda, Chandrasekar; Sekhar, Laligam N; Ramachandran, Pranatartiharan; Hechl, Peter

    2002-11-01

    We discuss the role of the endoscope in the microsurgical treatment of intracranial aneurysms, analyzing its benefits, risks, and disadvantages. This was a prospective study of 55 patients with 79 aneurysms, treated between July 1998 and June 2001, for whom the endoscope was used as an adjunct in the microsurgical treatment of their lesions. Seventy-one aneurysms were located in the anterior circulation, and eight were located in the posterior circulation. Thirty-seven patients presented with subarachnoid hemorrhage. Eighteen patients had unruptured aneurysms, of whom 5 presented with mass effect, 2 presented with transient ischemic attacks, and 11 were without symptoms. In all cases, the endoscope was used in addition to microsurgical dissection and clipping (sometimes before clipping, sometimes during clipping, and always after clipping), for observation of the neck anatomic features and perforators and verification of the optimal clip position. Intraoperative angiography was performed for all patients after aneurysm clipping. In the majority of cases, the endoscope was very useful for the assessment of regional anatomic features. It allowed better observation of anatomic features, compared with the microscope, for 26 aneurysms; in 15 cases, pertinent anatomic information could be obtained only with the endoscope. The duration of temporary clipping of the parent artery was significantly reduced for two patients. The clip was repositioned because of a residual neck or inclusion of the parent vessel during aneurysm clipping in six cases, and the clip position was readjusted because of compression of the optic nerve in one case. One patient experienced a small aneurysm rupture that was directly related to use of the endoscope, but this was easily controlled, with no sequelae. For many patients, the combination of the neuro-endoscope and the micro-Doppler probe made intraoperative angiography redundant. "Endoscope-assisted microsurgery" is a major advance in the

  18. Intracranial Pressure Monitoring

    DEFF Research Database (Denmark)

    Raboel, P H; Bartek, J; Andresen, M;

    2012-01-01

    Monitoring of intracranial pressure (ICP) has been used for decades in the fields of neurosurgery and neurology. There are multiple techniques: invasive as well as noninvasive. This paper aims to provide an overview of the advantages and disadvantages of the most common and well-known methods as ......-invasive techniques are without the invasive methods' risk of complication, but fail to measure ICP accurately enough to be used as routine alternatives to invasive measurement. We conclude that invasive measurement is currently the only option for accurate measurement of ICP....... as well as assess whether noninvasive techniques (transcranial Doppler, tympanic membrane displacement, optic nerve sheath diameter, CT scan/MRI and fundoscopy) can be used as reliable alternatives to the invasive techniques (ventriculostomy and microtransducers). Ventriculostomy is considered the gold...

  19. Effect of HSH on oxygen free radicals and histopathological change of brain tissue in dog with acute intracranial hypertension and hemorrhagic shock%高渗氯化钠羟乙基淀粉注射液输注对急性颅内高压伴失血性休克犬脑组织病理学及氧自由基的影响

    Institute of Scientific and Technical Information of China (English)

    徐翔; 古妙宁; 肖金仿; 肖华平; 赵振龙; 刘高望

    2008-01-01

    Objective To observe the effects of hypertonic sodium chloride hydroxyethyl starch 40 injection(HSH) on recovering of circulating blood volume, lessening edema of brain tissue and decreasing oxygen free radicals in dog with acute intracranial hypertension and hemorrhagic shock. Methods 20 healthy dogs were randomly divided into 4 groups: Group hydroxyethyl starch (HES), Group Ringer- lactate solution (RL), Group hypertonic saline solution (HS) and Group HSH. Acute intracranial hypertension and hemorrhagic shock were made by injecting water into epidural balloon and bleeding artery. Corresponding injections were infused respectively 1h after shock. Mean arterial blood pressure (MAP), central venous pressure (CVP), heart rate (HR) and intracranial pressure (ICP) were monitored, and the level of superoxide dismutase (SOD) and malondialdehyde (MDA) in brain tissue were examined. Specimens of brain tissue were prepared for pathological examination. Results After resuscitation, injections of 4 groups can effectively increase MAP( P < 0.05 )while ICP of Group HES and Group RL significantly increased (P < 0.05 ). Two hours after resuscitation, MAP of Group HS began to decrease (P < 0.05 ). Four hours after resuscitation, only Group HSH can maintain an higher MAP and lower ICP. MDA and SOD levels in Group HSH were evidently lower than other groups at four hours after resuscitation (P < 0. 05). Pathological examination revealed less injury in Group HSH than other groups. Conclusion HSH could effectively resuscitate hemorrhagic shock, decrease ICP, reduce oxygen free radicals levels in brain tissue and relieve tissue ischemia/reperfusion injury.%目的 观察高渗氯化钠羟乙基淀粉40注射液(HSH)在犬急性颅内高压伴失血性休克模型中恢复循环血容量、减轻脑组织水肿和降低脑组织氧自由基含量的作用.方法 健康杂种犬20只,采用硬膜外球囊注水和动脉放血的方法复制急性颅内高压伴失血性休克模型.动物

  20. Studies on the incidence of intracranial haemorrhages and their relation to the delivery by using the cranial computer-tomography (CT) in full-term newborns

    Energy Technology Data Exchange (ETDEWEB)

    Brockerhoff, P.; Brand, M.; Ludwig, B.

    1981-09-01

    The cranial computer-tomography is a new non-invasive method for the diagnosis of perinatal intracranial haemorrhage. Among 80 neonates, who were examined by CT after delivery at term between the 3. and 5. day of life, there were 43 newborns without any neurological symptom. These were examined voluntarily with the permission of their parents. A significant correlation between the CT-finding of an intracranial haemorrhage and the neurological observations was found, whereas there was no relation to the mode of delivery. Parity, birth weight, Apgar-score, cord blood-pH did not correspond to the CT-findings. An extremely short duration of the second stage of labor in spontaneous delivery seems to increase the risk of perinatal intracranial haemorrhage.

  1. Perinatal psychiatric disorders: an overview.

    Science.gov (United States)

    Paschetta, Elena; Berrisford, Giles; Coccia, Floriana; Whitmore, Jennifer; Wood, Amanda G; Pretlove, Sam; Ismail, Khaled M K

    2014-06-01

    Perinatal mental illness has a significant implication on maternal health, birth outcomes, and the offspring's development. Prevalence estimates of perinatal psychiatric illnesses range widely, with substantial heterogeneity in different population studies, with a lower prevalence rate in high- rather than low- or middle-income countries. Because of the potential negative impact on maternal and child outcomes and the potential lability of these disorders, the perinatal period is a critical time to identify psychiatric illnesses. Thus, obstetricians and midwives play a crucial role in assessing women's mental health needs and to refer identified women promptly for multidisciplinary specialist assessment. However, there is still limited evidence on best practice assessment and management policies during pregnancy and postpartum. This review focuses on the prevalence of common perinatal mental disorders and antenatal screening policies to identify women at risk. The effect of these conditions and their management on pregnancy, fetal outcomes, and child development are discussed. Copyright © 2014 Mosby, Inc. All rights reserved.

  2. Computed tomography in hypertensive cerebellar hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Nose, T.; Maki, Y.; Ono, Y.; Yoshizawa, T.; Tsuboi, K. (Tsukuba Univ., Sakura, Ibaraki (Japan))

    1981-11-01

    Fourteen cases of cerebellar hemorrhage were analysed from the point of CT-scan, and the following results were obtained. 1. The number of cases of cerebellar hemorrhage forms 4.4% of that of total intracranial hemorrhage. 2. Most of the cerebellar hematomas extend upward. Downward extension is rare. 3. In acute dead cases hematomas are 5 cm or more in diameter and lie over bilateral hemispheres with the extension to third or fourth ventricles in CT-scans. 4. Slowly progressive cases are detriorated by the secondary hydrocephalus. 5. In mild cases hematomas are 3cm or less in diameter on CT-scans and the hematoma evacuation is not indicated for these cases. 6. The shunt operation alone is sufficient for the life saving of the slowly progressive cases, but the hematoma evacuation is indicated in these cases if the functional prognosis is taken into consideration. 7. Immediate hematoma evacuation together with the ventricular drainage is considered to be effective for the life saving of the acute fulminant cases.

  3. The Familial Intracranial Aneurysm (FIA study protocol

    Directory of Open Access Journals (Sweden)

    Meissner Irene

    2005-04-01

    Full Text Available Abstract Background Subarachnoid hemorrhage (SAH due to ruptured intracranial aneurysms (IAs occurs in about 20,000 people per year in the U.S. annually and nearly half of the affected persons are dead within the first 30 days. Survivors of ruptured IAs are often left with substantial disability. Thus, primary prevention of aneurysm formation and rupture is of paramount importance. Prior studies indicate that genetic factors are important in the formation and rupture of IAs. The long-term goal of the Familial Intracranial Aneurysm (FIA Study is to identify genes that underlie the development and rupture of intracranial aneurysms (IA. Methods/Design The FIA Study includes 26 clinical centers which have extensive experience in the clinical management and imaging of intracerebral aneurysms. 475 families with affected sib pairs or with multiple affected relatives will be enrolled through retrospective and prospective screening of potential subjects with an IA. After giving informed consent, the proband or their spokesperson invites other family members to participate. Each participant is interviewed using a standardized questionnaire which covers medical history, social history and demographic information. In addition blood is drawn from each participant for DNA isolation and immortalization of lymphocytes. High- risk family members without a previously diagnosed IA undergo magnetic resonance angiography (MRA to identify asymptomatic unruptured aneurysms. A 10 cM genome screen will be performed to identify FIA susceptibility loci. Due to the significant mortality of affected individuals, novel approaches are employed to reconstruct the genotype of critical deceased individuals. These include the intensive recruitment of the spouse and children of deceased, affected individuals. Discussion A successful, adequately-powered genetic linkage study of IA is challenging given the very high, early mortality of ruptured IA. Design features in the FIA Study

  4. Intracranial Hypotension with Multiple Complications: An Unusual Case Report

    Directory of Open Access Journals (Sweden)

    Swetha Ade

    2013-01-01

    Full Text Available Background. Undiagnosed intracranial hypotension can result in several complications including subdural hematoma (SDH, subarachnoid hemorrhage (SAH, dural venous sinuses thrombosis (CVT, cranial nerve palsies, and stupor resulting from sagging of the brain. It is rare to see all the complications in one patient. Furthermore, imaging of the brain vasculature may reveal incidental asymptomatic small aneurysms. Given the combination of these imaging findings and a severe headache, the patients are often confused to have a primary subarachnoid hemorrhage. Case Report. We present a patient with spontaneous intracranial hypotension (SIH who had an incidental ophthalmic artery aneurysm on MR imaging, and this presentation led to coiling of the aneurysm. The key aspect in the history “postural headaches” was missed, and this led to life threatening complications and unnecessary interventions. Revisiting the history and significant improvement in symptoms following an epidural blood patch resulted in the diagnosis of SIH. Conclusion. We strongly emphasize that appropriate history taking is the key in the diagnosis of SIH and providing timely treatment with an epidural blood patch could prevent potentially life threatening complications.

  5. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

    Science.gov (United States)

    ... children and tends to be “secondary” which affects males and females equally. The second group, post pubescent teenagers, tends to fit the adult stereotype. How is pediatric idiopathic intracranial hypertension diagnosed? If ...

  6. Spinal and Intracranial Epidural Abscess

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-03-01

    Full Text Available Presentation, epidemiology, diagnosis and treatment of spinal epidural abscess (SEA and intracranial epidural abscess (ICEA are reviewed by researchers at The John's Hopkins University School of Medicine, Baltimore, MD, and Universidad de Santander, Columbia.

  7. Post-thyroidectomy hemorrhage

    DEFF Research Database (Denmark)

    Godballe, Christian; Madsen, Anders Rørbaek; Pedersen, Henrik Baymler;

    2009-01-01

    risk factors for hemorrhage. Increased hospital stay and infection rates were found in patients treated with drainage. The median time for onset of postoperative hemorrhage was 3 h (range 0-105). Compared with international literature our incidence of post-thyroidectomy hemorrhage is relatively high....... Improvement might be reached by the exchange of experience between departments with focus on adequate surgical technique and careful hemostasis....

  8. Treatment of Intracranial Aneurysms: Clipping Versus Coiling.

    Science.gov (United States)

    Liu, Ann; Huang, Judy

    2015-09-01

    Intracranial aneurysms (IAs) have an estimated incidence of up to 10 % and can lead to serious morbidity and mortality. Because of this, the natural history of IAs has been studied extensively, with rupture rates ranging from 0.5 to 7 %, depending on aneurysm characteristics. The spectrum of presentation of IAs ranges from incidental detection to devastating subarachnoid hemorrhage. Although the gold standard imaging technique is intra-arterial digital subtraction angiography, other modalities such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are being increasingly used for screening and treatment planning. Management of these patients depends upon a number of factors including aneurysmal, patient, institutional, and operator factors. The ultimate goal of treating patients with IAs is complete and permanent occlusion of the aneurysm sac in order to eliminate future hemorrhagic risk, while preserving or restoring the patient's neurological function. The most common treatment approaches include microsurgical clipping and endovascular coiling, and multiple studies have compared these two techniques. To date, three large prospective, randomized studies have been done: a study from Finland, International Subarachnoid Aneurysm Trial (ISAT), and the Barrow Ruptured Aneurysm Trial (BRAT). Despite differences in methodology, the results were similar: in patients undergoing coiling, although rates of rebleeding and retreatment are higher, the overall rate of poor outcomes at 12 months was significantly lower. As minimally invasive procedures and devices continue to be refined, endovascular strategies are likely to increase in popularity. However, as long-term outcome studies become available, it is increasingly apparent that they are complementary treatment strategies, with patient selection of critical importance.

  9. Countrywide analysis of perinatal outcome.

    Science.gov (United States)

    Stembera, Z; Kravka, A; Mandys, F

    1988-01-01

    The computer laboratory of the Research Institute for the Care of Mother and Child in Prague performs annually a countrywide analysis of perinatal outcome in order to obtain a background for the preparation of the optimal strategy for improving perinatal care in CSR in the future. The total as well as weight specific perinatal mortality rate further sub-divided into early neonatal death rate and late fetal death rate and differentiated according to the birthweight, was correlated with the incidence of different factors influencing the perinatal mortality rate both countrywide and for each of the eight provinces of CSR. This way a correlation was found between some of the mentioned perinatal outcomes and e.g. instrumental equipment of obstetrical departments and neonatal intensive care units, frequency of caesarean sections, or transport of LBW newborns in incubators or "in utero" etc. The results of this analysis have proved that there still remain in some provinces opportunity for further decrease in perinatal mortality due to the incomplete observance of the two intervention strategies "Risk approach" and "New technology" which were introduced in the whole country during the last 10 years.

  10. Imaging findings in primary intracranial atypical teratoid/rhabdoid tumors

    Energy Technology Data Exchange (ETDEWEB)

    Parmar, Hemant; Shroff, Manohar [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); Hawkins, Cynthia [Hospital for Sick Children, Department of Neuropathology, Toronto, ON (Canada); Bouffet, Eric [Hospital for Sick Children, Department of Neuro-Oncology, Toronto, ON (Canada); Rutka, James [Hospital for Sick Children, Department of Neurosurgery, Toronto, ON (Canada)

    2006-02-01

    Intracranial atypical teratoid/rhabdoid tumors (AT/RT) are rare and extremely aggressive neoplasms seen primarily in childhood. Imaging features are often considered non-specific. However, correct diagnosis of AT/RT is important because these tumors have a markedly different clinical prognosis and require more aggressive therapy. To determine the imaging features of AT/RT. We retrospectively analyzed imaging findings in 11 patients with primary intracranial AT/RT presenting over a period of 5 years. CT (n=11), MR (n=7), clinical (n=11) and pathological (n=11) features were evaluated. FISH analysis showing monosomy of chromosome 22 (absence of bcr 22q11 locus) was available for three patients. Immunohistochemical staining for INI-1 (BAF47) was performed on all tumors. There were 11 patients, 6 boys and 5 girls. The age of presentation varied from 1 month to 15 years (average age 3 years 8 months). Six tumors were located in the posterior fossa and five in the supratentorial compartment. The tumors showed a hyperdense solid component (64%) that showed moderate to marked enhancement with contrast medium. On MR imaging, the predominant signal pattern was isointensity on T1-weighted images (57%) and T2 shortening with heterogeneity on T2-weighted images (86%). All tumors were large in size (average 4.2 x 3.7 cm), and there was a tendency for calcification (36%), hemorrhage (46%), necrosis (46%) and perifocal edema (100%). There was also a high tendency for subarachnoid dissemination, with five patients (46%) demonstrating brain and/or spinal metastasis. At follow-up (n=7), six patients showed local recurrence. At the time of recurrence, all these patients showed extensive leptomeningeal spread of the disease in both intracranial and intraspinal compartments. There are no specific imaging features for intracranial AT/RT. But a high tendency toward large size, a hyperdense solid component on CT scan with calcification, hemorrhage, necrosis and subarachnoid spread suggest

  11. Hypertonic/Hyperoncotic Resuscitation from Shock: Reduced Volume Requirement and Lower Intracranial Pressure

    Science.gov (United States)

    1989-10-01

    Volume 15, No. 4 ABSTRACTS OF PAPERS 433 INTRACRANIAL PRESSURE FOLLOWING RESUSCITATION FROM HEMORRHAGIC SHOCK John H. Whitley, Donald S. Prough, Michael ...SHOCK: COMPARISON OF FLUIDS John M. Whitley, PhD, Michael A. Olympio, MD, Donald S. Prough, MD Department of Anesthesia, Bowman Gray School of Medicine...fluid infused within the range of sodium and colloid concentrations examined in this study. In contrast, Gunnar et al.7’ 2 and Ducey et al.,8

  12. INTRACRANIAL PRESSURE MONITORING TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Ida Bagus Adi Kayana

    2013-03-01

    Full Text Available Head injury is the most significant cause of increased morbidity and mortality. An estimated 1.4 million head injuries occur each year, with and more than 1.1 million come to the Emergency Unit. On each patient head injury, an increase in intracranial pressure (ICP related to poor outcomes and aggressive therapy to increased ICP can improve the outcomes. ICP monitoring is the most widely used because of the prevention and control of ICP as well as maintain the pressure increase perfusion of cerebral (Cerebral Perfusion Pressure/CPP is the basic purpose of handling head injury. There are two methods of monitoring ICP that is an invasive methods (directly and non-invasive techniques (indirectly. The method commonly used, namely intraventricular and intraparenkimal (microtransducer sensor because it is more accurate but keep attention to the existence of the risk of bleeding and infection resulting from installation. Monitoring of ICT can determine the actions that avoid further brain injury, which can be lethal and irreversibel.

  13. Perinatal programming prevention measures.

    Science.gov (United States)

    Larguía, A Miguel; González, María Aurelia; Dinerstein, Néstor Alejandro; Soto Conti, Constanza

    2015-01-01

    Over the past 10 years, there has been outstanding scientific progress related to perinatal programming and its epigenetic effects in health, and we can anticipate this trend will continue in the near future. We need to make use and apply these achievements to human neurodevelopment via prevention interventions. Based on the concept of the interaction between genome and ambiome, this chapter proposes low-cost easy-implementation preventive strategies for maternal and infant health institutions.Breastfeeding and human milk administration are the first preventive measures, as has been reviewed in the policy statement of the American Academy of Pediatrics. Another strategy is the Safe and Family-Centered Maternity Hospitals initiative that promotes and empowers the inclusion of the families and the respect for their rights, especially during pregnancy and birth. (This change of paradigm was approved and is recommended by both United Nations Children's Fund, UNICEF, and Pan American Health Organization, PAHO.) Then, there is also an important emphasis given to the sacred hour-which highlights the impact of bonding, attachment, and breastfeeding during the first hour of life-the pain prevention and treatment in newborns, the control of the "new morbidity" represented by late preterm infants, and finally, the importance of avoiding intrauterine and extrauterine growth restriction. (However, there are not yet clear recommendations about nutritional interventions in order to diminish the potential metabolic syndrome consequence in the adult.).

  14. Hemorrhagic prepatellar bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Donahue, F. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Turkel, D. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Mnaymneh, W. [Dept. of Orthopedics, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Ghandur-Mnaymneh, L. [Dept. of Pathology, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States)

    1996-04-01

    Simple prepatellar bursitis is easily diagnosed both clinically and by MRI. MRI shows the typical T1 and T2 lengthening of fluid within the bursa. However, because of complex MRI appearance of hemorrhage, chronic hemorrhagic bursitis and the size of the prepatellar mass the clinical and MRI appearance can be very different. (orig.)

  15. The Dutch Perinatal Audit Project : a feasibility study for nationwide perinatal audit in the Netherlands

    NARCIS (Netherlands)

    De Reu, Paul; Van Diem, Mariet; Eskes, Martine; Oosterbaan, Herman; Smits, Luc; Merkus, Hans; Nijhuis, Jan

    2009-01-01

    Objective. To investigate the feasibility of nationwide perinatal mortality audits in the Netherlands. Study design. Over a one-year period, data for all cases of perinatal mortality were collected. Six perinatal audit panels of professionals within perinatal care investigated and classified causes

  16. Improving perinatal outcome: towards individualized care

    NARCIS (Netherlands)

    Kazemier, B.M.

    2015-01-01

    Unfortunately not all pregnancies and deliveries take place without complications. Complications during pregnancy or delivery can lead to maternal morbidity and poor perinatal outcomes such as perinatal mortality or (severe) neonatal morbidity. First assessment in antenatal care is to distinguish

  17. Ruptured intracranial aneurysm in patients with osteogenesis imperfecta: 2 familial cases and a systematic review of the literature.

    Science.gov (United States)

    Gaberel, T; Rochey, A; di Palma, C; Lucas, F; Touze, E; Emery, E

    2016-12-01

    Osteogenesis imperfecta is an inherited connective tissue disorder that causes bone fragility. Vascular complications have been described, but only few cases of ruptured intracranial aneurysm have been reported. We first described 2 familial cases of ruptured intracranial aneurysm and then conducted a systematic review of the literature. A mother and her daughter with a typical history of osteogenesis imperfecta presented with subarachnoid hemorrhage, which was related to a posterior communicating artery aneurysm in both cases. The mother had early rebleeding and died. The aneurysm was excluded by coiling in the daughter. Despite occurrence of hydrocephalus and delayed cerebral ischemia, she had an excellent functional outcome. A systematic review of the literature identified seven additional cases. None of the cases were in fact familial. All patients had a previous medical history of multiple fractures. Seven aneurysms were resolved, three by surgical clipping and four by endovascular procedure. No periprocedural complication was reported. One patient died prematurely and 6 experienced good functional outcome. We report the first familial cases of aneurysmal subarachnoid hemorrhage in osteogenesis imperfecta patients. Intracranial aneurysms are probably linked to a collagen pathology, which is at the origin of osteogenesis imperfecta. In cases of aneurysmal subarachnoid hemorrhage in an osteogenesis imperfecta family, intracranial aneurysm screenings in the relatives showing osteogenesis imperfecta should be considered. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. ValueofUltrasoundintheDiagnosisofIntracranialHemorrhageinNewborn%超声诊断新生儿颅内出血的临床价值

    Institute of Scientific and Technical Information of China (English)

    王晓燕

    2013-01-01

      目的探析超声诊断新生儿颅内出血的临床价值。方法选取我院在2011年9月至2012年11月来,所接诊的100例颅内出血的新生儿,对他们采取高频及相控阵的探头对这些新生儿的颅内出血中的超声检查的结果实施有效地分析。结果本组100例新生儿颅内出血的有有92例,诊断符合率为92%。结论应用超声诊断新生儿颅内出血有着非常高的临床价值,开始成为常规性的检测新生儿早期有无颅内病变的最好选择,值得临床推广应用。%Objective The clinical value of ultrasonography in the diagnosis of intracranial hemorrhage of newborn. Methods In our hospital in 2011 September to 2012 November, were 100 cases of intracranial hemorrhage of the newborn, the ultrasound probe high-frequency and phased array of these neonatal intracranial hemorrhage in the results of their implementation effectively analysis. Results In this group, 100 cases of neonatal intracranial hemorrhage were 92 cases, diagnosis rate 92%. Conclusion The application of ultrasound in the diagnosis of intracranial hemorrhage of the newborn has clinical value is very high, began to become the best choice for early detection of neonatal routine without intracranial lesions, is worthy of clinical application.

  19. Obstetrical and perinatal outcomes in patients with or without obstetric analgesia during labor

    Directory of Open Access Journals (Sweden)

    Piedrahíta-Gutiérrez, Dany Leandro

    2016-07-01

    Full Text Available Objective: To describe and compare the obstetric and perinatal outcomes in patients with or without obstetric analgesia during labor, and to determine whether such analgesia is associated with adverse maternal or perinatal outcomes. Methodology: Comparative, retrospective, descriptive study, between January and November 2014, that included 502 healthy patients with normal pregnancies, out of which 250 received obstetric analgesia. The groups were compared as to maternal and perinatal outcomes. Results: Young, single and nulliparous mothers predominated; delivery was vaginal in 86 % of the cases, and by caesarean section in 14 %. Obstetric analgesia was associated with longer duration of the second stage of labor, instrumental delivery and cesarean section due to arrest of dilatation or fetal bradycardia; however, it was not related with higher incidence of postpartum hemorrhage or adverse perinatal outcomes such as meconium-stained amniotic fluid, Apgar under 5 at one minute or under 7 at 5 minutes, the need for neonatal resuscitation or for admission to NICU. Conclusion: Obstetric analgesia increases the duration of the second stage of labor and can increase the rate of caesarean sections and instrumental delivery, but it is not associated with adverse maternal or perinatal outcomes. Therefore, its use in labor is justified.

  20. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...... or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant...... antibiotic treatment, signs and symptoms of elevated intracranial pressure resolved completely. Syphilis is a rare, but very important, differential diagnosis that in this case was clinically indistinguishable from IIH....

  1. Effects of Combination of Pneumonia Infection in Neonatal Pulmonary Hemorrhage%血清可溶性髓细胞触发受体-1和降钙素原对围生期宫内感染合并肺炎新生儿肺出血的影响

    Institute of Scientific and Technical Information of China (English)

    郭笑芳; 卢燕玲; 丁月琴

    2015-01-01

    目的 探讨血清可溶性髓细胞触发受体-1(sTREM-1)和降钙素原(PCT)对围生期宫内感染合并肺炎新生儿肺出血(NPH)的影响.方法 收集48例NPH患儿(观察组)和50例非肺出血患儿(对照组),采用酶联免疫吸附试验(ELISA)检测血清sTREM-1含量,放射免疫分析法检测血清PCT含量.统计学分析血清sTREM-1和PCT含量与NPH患儿原发病类型及母体围产期疾病的关系.结果 NPH患儿血清sTREM-1和PCT含量均高于非肺出血患儿;原发病为肺炎NPH患儿血清 sTREM-1 含量明显高于原发病为缺血缺氧性脑病、颅内出血、呼吸窘迫综合征和寒冷损伤综合征等患儿;母体围产期发生宫内感染NPH患儿血清sTREM-1和PCT含量均高于母体围生期发生妊娠高血压综合征、羊水早破、胎盘早剥及糖尿病NPH患儿(均P<0.05);NPH患儿血清sTREM-1含量和PCT含量明显呈正相关(P<0.01).结论 sTREM-1和PCT检测可能对原发病为肺炎伴母体围生期发生宫内感染的NPH患儿具有预警价值.%Objective To investigate the serum levels of soluble triggering receptor expressed on myeloid cels-1(sTREM-1)and procalcitonin(PCT)on perinatal intrauterine infection complicated with pneumonia in neonatal pulmonary hemorrhage(NPH) effect.Methods Colected from 48 NPH patients(observation group)and 50 cases with pulmonary hemorrhage(control group),Use the content of sTREM-1 in serum ELISA detection and analysis of serum PCT contents were detected by radioimmunoassay.Statistical analysis the relationship between the primary disease types and maternal perinatal diseases,serum sTREM-1 and PCT levels in children with NPH.Results Serum sTREM-1 and PCT levels on NPH patients were higher than those of non-pulmonary hemorrhage.In NPH patients, serum sTREM-1 levels on primary disease onset from pneumonia were significantly higher than those onsets from Hypoxic- ischemic encephalopathy,intracranial hemorrhage,respiratory distress syndrome and cold injury

  2. Intracranial calcification in central diabetes insipidus.

    Science.gov (United States)

    Al-Kandari, Salwa Ramadan; Pandey, Tarun; Badawi, Mona H

    2008-01-01

    Intracranial calcification is a known but extremely rare complication of diabetes insipidus. To date, only 16 patients have been reported and all had the peripheral (nephrogenic) type of diabetes insipidus. We report a child with intracranial calcification complicating central diabetes insipidus. We also report a child with nephrogenic diabetes insipidus, and compare the patterns of intracranial calcification.

  3. Intracranial calcification in central diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Al-Kandari, Salwa R. [Al Razi Hospital, Department of Clinical Radiology, Kuwait (Kuwait); Pandey, Tarun [Al Razi Hospital, Department of Clinical Radiology, Kuwait (Kuwait); University of Arkansas for Medical Sciences, Radiology Department, Little Rock, AR (United States); Badawi, Mona H. [Al-Adan Hospital, Department of Paediatrics, Kuwait (Kuwait)

    2008-01-15

    Intracranial calcification is a known but extremely rare complication of diabetes insipidus. To date, only 16 patients have been reported and all had the peripheral (nephrogenic) type of diabetes insipidus. We report a child with intracranial calcification complicating central diabetes insipidus. We also report a child with nephrogenic diabetes insipidus, and compare the patterns of intracranial calcification. (orig.)

  4. Pseudoarachnoiditis in Spontaneous Intracranial Hypotension

    Directory of Open Access Journals (Sweden)

    Özlem Alkan

    2011-03-01

    Full Text Available Spontaneous intracranial hypotension is an important cause of new daily persistent headaches in young and middle-aged individuals. The diagnosis is made based on low cerebrospinal fluid pressure with characteristic findings upon brain and spinal magnetic resonance imaging (MRI. We present the case of a 15-year-old boy with spontaneous intracranial hypotension. Although his brain MRI was normal, his lumbar spinal MRI showed clustering of the nerve roots characteristic of arachnoiditis. Radionuclide cisternography revealed an epidural leak, which was treated with an epidural blood patch. The patient reached a near-full recovery within 24 h, and the lumbar spinal MRI findings mimicking arachnoiditis disappeared.

  5. Intracranial, intradural aneurysmal bone cyst.

    Science.gov (United States)

    Afnan, Jalil; Snuderl, Matija; Small, Juan

    2015-01-01

    Aneurysmal bone cysts (ABCs) are benign, expansile, blood-filled, osteolytic lesions with internal septations that may be intraosseous or extraosseous. The cysts may cause local mass effect, and changes in the regional vascular supply necessitating intervention. A case of an intracranial, intradural ABC in a young male patient with progressively severe headaches is presented. This is only the third recorded intradural case, the majority of these rare lesions being extracranial and only a minute fraction intracranial. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant......Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...

  7. A systematic review of pipeline embolization device for giant intracranial aneurysms.

    Science.gov (United States)

    Lv, Xianli; Ge, Huijian; He, Hongwei; Jiang, Chuhan; Li, Youxiang

    2017-01-01

    The experience with respect to the treatment of giant intracranial aneurysms with flow-diversion devices is limited. The aim of the present systematic review was to evaluate the effect of the pipeline embolization device (PED) on giant intracranial aneurysms. Eligible related articles were identified by searching the PubMed, Web of Science, Springer, ScienceDirect, and OVID databases using "giant aneurysm" and "pipeline" as the search items. The date of the last search was November 20, 2015. This systematic review adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In a total of 9 eligible studies with 200 patients and 215 aneurysms, 40 (18.6%) giant (aneurysm diameter >25mm) intracranial aneurysms treated with PED were analyzed. During a 6 to 34 month follow-up, complete occlusion was achieved in 23 (57.5%) cases. Seven patients (17.5%) developed intracranial hemorrhage, 5 developed ischemic attack (12.5%), and 13 (32.5%) developed a mass effect after PED treatment. The complication rate was 77.8% in PED for giant vertebrobasilar artery aneurysms. The cumulative mortality rate for giant paraclinoid carotid artery and middle cerebral artery aneurysms was 13.3% and increased up to 50% for giant vertebrobasilar artery aneurysms. The complete obliteration rate of PED for giant intracranial aneurysms was approximately 60%. Mass effect is the most mechanism of complications. Complication and mortality rates associated with PED for giant vertebrobasilar artery aneurysms are still extremely high.

  8. Causes and clinical characteristics of spontaneous intracerebral hemorrhage in children

    Directory of Open Access Journals (Sweden)

    Yan-ju MENG

    2014-01-01

    Full Text Available In this study, clinical data of 31 patients in childhood with spontaneous intracerebral hemorrhage (SICH were retrospectively analyzed. According to various imaging examinations (CT, MRI, CTA, MRA and DSA, 22 cases (70.97% had definite causes, including 9 cases (29.03% with intracranial arteriovenous malformation, 6 cases (19.35% with cavernous hemangioma, 3 cases (9.68% with hematopathy, 2 cases (6.45% with tumor apoplexy, one case (3.23% with intracranial aneurysm and one case (3.23% with moyamoya disease; 9 cases (29.03% had unclear causes. All cases were timely diagnosed and treated. Among all the patients, 23 cases (74.19% were cured with good prognosis, 6 cases (19.35% improved, and the other 2 cases (6.45% died. Therefore, primary diseases should be timely treated as hematoma was removed.

  9. Pulmonary Hemorrhage in Cryoglobulinemia

    Directory of Open Access Journals (Sweden)

    G Kirkpatrick

    2015-01-01

    Full Text Available Pulmonary manifestations of cryoglobulinemia are uncommon and their clinical behaviour is unpredictable, ranging from mild dyspnea to life-threatening presentations. A patient with cryoglobulinemia who presented with hypoxic respiratory failure attributed to pulmonary hemorrhage is reported.

  10. Title:- retrobulbar hemorrhage

    African Journals Online (AJOL)

    Dr.Gagan

    Department of Oral and Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Mangalore. 1. Department of .... technique of orbital decompression that involves fracturing the orbital ... hemorrhage after retrobulbar anesthesia.

  11. MRI of perinatal brain injury

    Energy Technology Data Exchange (ETDEWEB)

    Rutherford, Mary; Allsop, Joanna [Imperial College, Robert Steiner MR Unit, Perinatal Imaging, MRC Clinical Sciences Centre, Hammersmith Hospital, London (United Kingdom); Martinez Biarge, Miriam [La Paz University Hospital, Dept of Neonatology, Madrid (Spain); Counsell, Serena [Imperial College, Robert Steiner MR Unit, Neonatal Medicine, MRC Clinical Sciences Centre, Hammersmith Hospital, London (United Kingdom); Cowan, Frances [Imperial College, Dept of Paediatrics, Hammersmith Hospital, London (United Kingdom)

    2010-06-15

    MRI is invaluable in assessing the neonatal brain following suspected perinatal injury. Good quality imaging requires adaptations to both the hardware and the sequences used for adults or older children. The perinatal and postnatal details often predict the pattern of lesions sustained and should be available to aid interpretation of the imaging findings. Perinatal lesions, the pattern of which can predict neurodevelopmental outcome, are at their most obvious on conventional imaging between 1 and 2 weeks from birth. Very early imaging during the first week may be useful to make management decisions in ventilated neonates but brain abnormalities may still be subtle using conventional sequences. Diffusion-weighted imaging (DWI) is very useful for the early identification of ischaemic tissue in the neonatal brain but may underestimate the final extent of injury, particularly basal ganglia and thalamic lesions. MR imaging is an excellent predictor of outcome following perinatal brain injury and can therefore be used as a biomarker in interventional trials designed to reduce injury and improve neurodevelopmental outcome. (orig.)

  12. Pharmacological neuroprotection after perinatal asphyxia

    NARCIS (Netherlands)

    Fan, Xiyong; van Bel, Frank

    2010-01-01

    Recent progress has provided us with several promising neuroprotective compounds to reduce perinatal hypoxic-ischemic (HI) brain injury. In the early post HI phase, therapies can be concentrated on ion channel blockage (Xenon), anti-oxidation (allopurinol, 2-iminobiotin, and indomethacin), anti-infl

  13. BENIGN INTRACRANIAL HYPOTENSION WITH INCIDENTAL PARASAGITTAL MENINGIOMA

    Directory of Open Access Journals (Sweden)

    Sukumar

    2015-12-01

    Full Text Available Benign intracranial hypotension, otherwise called as idiopathic intracranial hypotension is caused by CSF leaks due to disruption in spinal meninges. It is most commonly caused by disruption and leak at cervical and thoracic spine. Imaging is sometimes the most important key to the diagnosis of idiopathic intracranial hypotension, which helps in appropriate treatment of the patient. Here, we are presenting a case of benign intracranial hypotension associated with incidental parasagittal meningioma. The presence of benign intracranial hypotension was confirmed by taking MR myelogram.

  14. Recurrent intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Shen jinsong; Lu jianhong

    2000-01-01

    Objective: In order to study the clinical manifestation and risk factor of recurrent intracerebral hemorrhage(ICH).Methods:The 256 patients were analysed who admitted to our hospital for intracerebral hemorrhage between 1995 and 1997.The 15(5 .86%)patients had a recurrent ICH.There were 9 men and 6 women and the mean age of the patients was 63.5 ± 6.4years at the first bleeding episode and 67.8± 8. 5 years at the second. The mean interval between the two bleeding episodes was 44.6 ± 12.5 months. The 73.3%patients were hypertensive .′The site of the first hemorrhage was ganglionic in 8 patients , ]ohar in six paients and brainstem in one .The recurrent hemorrhage occurred at a different location from the previous ICH.The most common pattern of recurrence was “ganglionic -ganglionic” (7 patients), lobar - ganglionic (3 patients), lobar-lobar(three patients), which was always observed in hypertensive patients. The outcome after the recurrent hemorrhage was usually poor. By comparison with 24 patients followed up to average 47.5± 18.7 months with isolated ICH without recurrence .Only lobar hematoma and a younger age were risk factors for recurrences whereas sex and previous hypertension were not. The mechanism of recurrence of ICH were multiple(hypertension, cerebral amyloid angiopathy).Contral of blood pressure and good living habit after the first hemorrhage may prevent ICH recurrences.

  15. FACTORS CONTRIBUTING TO PERINATAL MORTALITY : OPTIMIZING OUTCOME

    Directory of Open Access Journals (Sweden)

    Lakshmi

    2015-03-01

    Full Text Available OBJECTIVE: To evaluate the various causes of perinatal deaths and adopt strategies to improve perinatal outcome at a referral teaching hospital in North Kerala. METHODS: A prospective observational study conducted at Institute of Maternal and Child Health, Government Medical College, Kozhikode. All perinatal deaths during the period January 2013 to December 2014 were analysed and from this factors responsible for perinatal deaths were identified. RESULTS: Out of total 30,042 deliveries , there were 966 perinatal deaths during the study period. 566 were still births and 400 early neonatal deaths. The perinatal mortality rate was 31.1 per 1000 live births. Perinatal asphyxia was the major cause of perinatal mortality. The important factors contributing to perinatal asphyxia were prematurity (39%, abruptio placenta (19% and MSAF ( 12%. Among the antenatal factors, hypertensive disorders of pregnancy leading to iatrogenic elective preterm delivery were the most important. CONCLUSION: Perinatal asphyxia due to prematurity and low birth weight emerged as the most important cause of perinatal mortality in this study and hypertensive disorders of pregnancy were the most important antenatal complication leading to prematurity

  16. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Silber, Toni; Ziemann, Ulf [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany); Ernemann, Ulrike [Department of Diagnostic and Interventional Neuroradiology, University of Tübingen (Germany); Bischof, Felix, E-mail: felix.bischof@uni-tuebingen.de [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany)

    2014-12-15

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology.

  17. Imaging intracranial tuberculosis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Jamieson, D.H. [Dept. of Radiology, Red Cross War Memorial Children`s Hospital, Rondebosch (South Africa)

    1995-05-01

    A morphologically based imaging review of intracranial tuberculosis in childhood is presented. The computed tomography and magnetic resonance features of parenchymal tuberculoma, tuberculous meningitis and meningeal/meniningocerebral tuberculoma are illustrated. Recent insight into the nature of tuberculoma necrosis and its magnetic resonance correlation is reviewed. Pathogenesis, relevant clinical background and the role of modern imaging is discussed. (orig.)

  18. Subarachnoid hemorrhage due to retained lumbar drain.

    Science.gov (United States)

    Guppy, Kern H; Silverthorn, James W; Akins, Paul T

    2011-12-01

    Intrathecal spinal catheters (lumbar drains) are indicated for several medical and surgical conditions. In neurosurgical procedures, they are used to reduce intracranial and intrathecal pressures by diverting CSF. They have also been placed for therapeutic access to administer drugs, and more recently, vascular surgeons have used them to improve spinal cord perfusion during the treatment of thoracic aortic aneurysms. Insertion of these lumbar drains is not without attendant complications. One complication is the shearing of the distal end of the catheter with a resultant retained fragment. The authors report the case of a 65-year-old man who presented with a subarachnoid hemorrhage due to the migration of a retained lumbar drain that sheared off during its removal. To the best of the authors' knowledge, this is the first case of rostral migration of a retained intrathecal catheter causing subarachnoid hemorrhage. The authors review the literature on retained intrathecal spinal catheters, and their findings support either early removal of easily accessible catheters or close monitoring with serial imaging.

  19. Intracerebral hemorrhage in children

    African Journals Online (AJOL)

    Ihab Zidan

    2012-04-01

    Apr 1, 2012 ... Results: Thirty patients with ICH were included in this study. ... Peer review under responsibility of Alexandria University Faculty of ... specific and include: motor deficit, sensory deficit, speech prob- ... breathing and circulation), control of the intracranial pressure, ..... prospective consecutive cohort study.

  20. Clinical implication of hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator.

    Science.gov (United States)

    Ho, Bo-Lin; Chen, Chien-Fu; Lin, Ruey-Tay; Liu, Ching-Kuan; Chao, A-Ching

    2016-11-01

    To determine the clinical implications of hemorrhagic transformation (HT) after thrombolysis, 241 eligible patients receiving alteplase for acute ischemic stroke were studied. HT was classified, according to the European Cooperative Acute Stroke Study criteria, as hemorrhagic infarction (HI) or parenchymal hemorrhage (PH). Symptomatic intracranial hemorrhage (SICH) was defined according to the National Institute of Neurological Disorders and Stroke study. A novel classification, clinically significant intracranial hemorrhage (CSICH) was defined as HTs associated with an unfavorable clinical outcome (modified Rankin Scale 5-6) at 3 months. For all subtypes of HT, we found that patients receiving alteplase were more often in the standard-dose group (0.90 ± 0.02 mg/kg) than in the lower dose group (0.72 ± 0.07 mg/kg). PH and SICH were related to an unfavorable clinical outcome, while HI was not. There was a positive trend between age and CSICH in patients receiving the standard dose (P = 0.0101), and between alteplase dose and CSICH in patients ≥70 years old (P = 0.0228). All PHs (including asymptomatic PHs) and symptomatic HIs have been found to be associated with unfavorable outcome, and for this reason defined as CSICH. Independent predictors of CSICH were age ≥70 years and the standard dose of alteplase. Further studies of thrombolysis for ischemic stroke with different doses of alteplase are warranted.

  1. Surgical outcomes of Majewski osteodysplastic primordial dwarfism Type II with intracranial vascular anomalies.

    Science.gov (United States)

    Teo, Mario; Johnson, Jeremiah N; Bell-Stephens, Teresa E; Marks, Michael P; Do, Huy M; Dodd, Robert L; Bober, Michael B; Steinberg, Gary K

    2016-12-01

    OBJECTIVE Majewski osteodysplastic primordial dwarfism Type II (MOPD II) is a rare genetic disorder. Features of it include extremely small stature, severe microcephaly, and normal or near-normal intelligence. Previous studies have found that more than 50% of patients with MOPD II have intracranial vascular anomalies, but few successful surgical revascularization or aneurysm-clipping cases have been reported because of the diminutive arteries and narrow surgical corridors in these patients. Here, the authors report on a large series of patients with MOPD II who underwent surgery for an intracranial vascular anomaly. METHODS In conjunction with an approved prospective registry of patients with MOPD II, a prospectively collected institutional surgical database of children with MOPD II and intracranial vascular anomalies who underwent surgery was analyzed retrospectively to establish long-term outcomes. RESULTS Ten patients with MOPD II underwent surgery between 2005 and 2012; 5 patients had moyamoya disease (MMD), 2 had intracranial aneurysms, and 3 had both MMD and aneurysms. Patients presented with transient ischemic attack (TIA) (n = 2), ischemic stroke (n = 2), intraparenchymal hemorrhage from MMD (n = 1), and aneurysmal subarachnoid hemorrhage (n = 1), and 4 were diagnosed on screening. The mean age of the 8 patients with MMD, all of whom underwent extracranial-intracranial revascularization (14 indirect, 1 direct) was 9 years (range 1-17 years). The mean age of the 5 patients with aneurysms was 15.5 years (range 9-18 years). Two patients experienced postoperative complications (1 transient weakness after clipping, 1 femoral thrombosis that required surgical repair). During a mean follow-up of 5.9 years (range 3-10 years), 3 patients died (1 of subarachnoid hemorrhage, 1 of myocardial infarct, and 1 of respiratory failure), and 1 patient had continued TIAs. All of the surviving patients recovered to their neurological baseline. CONCLUSIONS Patients with MMD

  2. Interleukin-6 as a Prognostic Biomarker in Ruptured Intracranial Aneurysms.

    Directory of Open Access Journals (Sweden)

    Hung-Wen Kao

    Full Text Available Interleukin-6 (IL-6, a proinflammatory cytokine, was found to surge in the cerebral spinal fluid after aneurysmal subarachnoid hemorrhage (SAH. We hypothesized that the plasma level of IL-6 could be an independent biomarker in predicting clinical outcome of patients with ruptured intracranial aneurysm.We prospectively included 53 consecutive patients treated with platinum coil embolization of the ruptured intracranial aneurysm. Plasma IL-6 levels were measured in the blood samples at the orifices of the aneurysms and from peripheral veins. The outcome measure was the modified Rankin Scale one month after SAH. Multiple logistic regression analyses were used to evaluate the associations between the plasma IL-6 levels and the neurological outcome.Significant risk factors for the poor outcome were old age, low Glasgow Coma Scale (GCS on day 0, high Fisher grades, and high aneurysmal and venous IL-6 levels in univariate analyses. Aneurysmal IL-6 levels showed modest to moderate correlations with GCS on day 0, vasospasm grade and Fisher grade. A strong correlation was found between the aneurysmal and the corresponding venous IL-6 levels (ρ = 0.721; P<0.001. In the multiple logistic regression models, the poor 30-day mRS was significantly associated with high aneurysmal IL-6 level (OR, 17.97; 95% CI, 1.51-214.33; P = 0.022 and marginally associated with high venous IL-6 level (OR, 12.71; 95% CI, 0.90-180.35; P = 0.022 after adjusting for dichotomized age, GCS on day 0, and vasospasm and Fisher grades.The plasma level of IL-6 is an independent prognostic biomarker that could be used to aid in the identification of patients at high-risk of poor neurological outcome after rupture of the intracranial aneurysm.

  3. Analysis of the mechanisms of rabbit’s brainstem hemorrhage complicated with irritable changes in the alvine mucous membrane

    Science.gov (United States)

    Jin, Xue-Long; Zheng, Yang; Shen, Hai-Ming; Jing, Wen-Li; Zhang, Zhao-Qiang; Huang, Jian-Zhong; Tan, Qing-Lin

    2005-01-01

    AIM: To explore the dynamic changes in the pressure of the lateral ventricle during acute brainstem hemorrhage and the changes of neural discharge of vagus nerve under the load of intracranial hypertension, so as to analyze their effects on the congestive degree of intestinal mucous membrane and the morphologic changes of intestinal mucous membrane. METHODS: An operation was made to open the skull to obtain an acute brainstem hemorrhage animal model. Microcirculatory microscope photography device and video recording system were used to determine the changes continuously in the caliber of jejunal mesenteric artery during brainstem hemorrhage and the changes with time in the congestion of jejunal mucosal villi. We used HE stain morphology to analyze the changes of duodenal mucosal villi. A recording electrode was used to calculate and measure the electric discharge activities of cervical vagus nerve. RESULTS: (1) We observed that the pressure of lateral cerebral ventricle increased transiently during acute brainstem hemorrhage; (2) The caliber of the jejunal mesenteric artery increased during brainstem hemorrhage. Analysis of red color coordinate values indicated transient increase in the congestion of jejunal mucous membrane during acute brainstem hemorrhage; (3) Through the analysis of the pathologic slice, we found enlarged blood vessels, stagnant blood, and transudatory red blood cells in the duodenal submucous layer; (4) Electric discharge of vagus nerve increased and sporadic hemorrhage spots occurred in duodenal mucous and submucous layer, when the lateral ventricle was under pressure. CONCLUSION: Brainstem hemorrhage could cause intracranial hypertension, which would increase the neural discharge of vagus nerve and cause the transient congestion of jejunal mucous membrane. It could cause hyperemia and diffused hemorrhage in the duodenal submucous layer 48 h after brainstem hemorrhage. PMID:15786536

  4. Estimating risks of perinatal death.

    Science.gov (United States)

    Smith, Gordon C S

    2005-01-01

    The relative and absolute risks of perinatal death that are estimated from observational studies are used frequently in counseling about obstetric intervention. The statistical basis for these estimates therefore is crucial, but many studies are seriously flawed. In this review, a number of aspects of the approach to the estimation of the risk of perinatal death are addressed. Key factors in the analysis include (1) the definition of the cause of the death, (2) differentiation between antepartum and intrapartum events, (3) the use of the appropriate denominator for the given cause of death, (4) the assessment of the cumulative risk where appropriate, (5) the use of appropriate statistical tests, (6) the stratification of analysis of delivery-related deaths by gestational age, and (7) the specific features of multiple pregnancy, which include the correct determination of the timing of antepartum stillbirth and the use of paired statistical tests when outcomes are compared in relation to the birth order of twin pairs.

  5. Duelo perinatal: el duelo olvidado

    OpenAIRE

    Vicente Sáez, Natalia

    2014-01-01

    [ES] El presente trabajo supone una revisión bibliográfica del duelo perinatal. Durante dácadas este dolor no ha sido reconocido y la actitud principal ante el mismo era la de negar la pérdida, tratando de eliminar, en la mayor brevedad posible toda señal de su existencia. Sin embargo, a partir de los años 60, la percepción social de lo que supone tener un hijo cambia significativamente y el duelo perinatal comienza a ser objeto de interés clínico y científico. El trabajo que nos ocupa hace r...

  6. Cytokines and perinatal brain injury.

    Science.gov (United States)

    Silverstein, F S; Barks, J D; Hagan, P; Liu, X H; Ivacko, J; Szaflarski, J

    1997-01-01

    A rapidly expanding body of data provides support for the hypothesis that pro-inflammatory cytokines including interleukin-1 beta (IL-1 beta), and tumor necrosis factor-alpha (TNF-alpha) are expressed acutely in injured brain and contribute to progressive neuronal damage. Little is known about the pathogenetic role of these cytokines in perinatal brain injury. Recent experimental studies have incorporated two closely related in vivo perinatal rodent brain injury models to evaluate the role(s) of pro-inflammatory cytokines in the progression of neuronal injury: a perinatal stroke model, elicited by unilateral carotid artery ligation and subsequent timed exposure to 8% oxygen in 7-day-old rats, and a model of excitotoxic injury, elicited by stereotactic intra-cerebral injection of the selective excitatory amino acid agonist NMDA. Each of these lesioning methods results in reproducible, quantifiable focal forebrain injury at this developmental stage. Acute brain injury, evoked by cerebral hypoxia-ischemia or excitotoxin lesioning, results in transient marked increases in expression of IL-1 beta, and TNF-alpha mRNA in brain regions susceptible to irreversible injury, and there is evidence that pharmacological antagonism of IL-1 receptors can attenuate injury in both models. Recent studies also suggest that complementary strategies, based on pharmacological antagonism of platelet activating factor and on neutrophil depletion can also limit the extent of irreversible injury. In summary, current data suggest that pro-inflammatory cytokines contribute to the progression of perinatal brain injury, and that these mediators are important targets for neuroprotective interventions in the acute post-injury period.

  7. [Evidence-based management of perinatal depression].

    Science.gov (United States)

    Chang, Mei-Yueh; Chen, Chung-Hey

    2008-04-01

    Perinatal depression, which may occur from pregnancy to one year after childbirth, is recognized by the World Health Organization as a significant health issue affecting women. Depression during the perinatal period can have enormous consequences, not only affecting the health of the woman herself but also influencing her interaction with her children and other family members. This article introduces several depression screening tools and evidence-based nonpharmacological managements of perinatal depression. There are some fairly valid and feasible screening methods, among which routinely screening perinatal women with EPDS (Edinburgh Perinatal Depression Scale) or BDI (Beck Depression Inventory) in the primary care setting is practicable. A survey of the limited literature available reveals that interpersonal psychotherapy, cognitive behavior therapy and listening to music provide quantifiable depression amelioration effects for perinatal women. More scientific research moderated by women's life experiences and preferences should be conducted, however, and applied to improve women's health.

  8. Marburg Hemorrhagic Fever (Marburg HF)

    Science.gov (United States)

    ... CDC Cancel Submit Search The CDC Marburg hemorrhagic fever (Marburg HF) Note: Javascript is disabled or is ... first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, ...

  9. Ebola hemorrhagic Fever.

    Science.gov (United States)

    Burnett, Mark W

    2014-01-01

    Ebola hemorrhagic fever is an often-fatal disease caused by a virus of the Filoviridae family, genus Ebolavirus. Initial signs and symptoms of the disease are nonspecific, often progressing on to a severe hemorrhagic illness. Special Operations Forces Medical Providers should be aware of this disease, which occurs in sporadic outbreaks throughout Africa. Treatment at the present time is mainly supportive. Special care should be taken to prevent contact with bodily fluids of those infected, which can transmit the virus to caregivers. 2014.

  10. RECURRENT PERINATAL LOSS: A CASE STUDY*

    OpenAIRE

    1999-01-01

    To date, investigators have not demonstrated a clear relationship between a parent’s history of prior perinatal losses and intensity of grief response following a subsequent perinatal loss. Examining this relationship for low-income, African-American parents is important because they are a vulnerable population due to the high incidence of perinatal mortality in Blacks and their other life stressors that can impact on grief response and caring needs. The purpose of this case study was to exam...

  11. Perinatal depression: implications for child mental health

    OpenAIRE

    Muzik, Maria; Borovska, Stefana

    2010-01-01

    Perinatal depression is common and primary care holds a crucial role for detecting, treating or, if necessary, providing referrals to mental health care for affected women. Family doctors should be aware of risk factors for peripartum depression, including previous history of depression, life events and interpersonal conflict. Perinatal depression has been associated with many poor outcomes, including maternal, child and family unit challenges. Infants and young children of perinatally depres...

  12. The minor symptoms of increased intracranial pressure: 101 patients with benign intracranial hypertension.

    Science.gov (United States)

    Round, R; Keane, J R

    1988-09-01

    Of 101 patients with benign intracranial hypertension not related to vasculitis, neck stiffness occurred in 31, tinnitus in 27, distal extremity paresthesias in 22, joint pains in 13, low back pain in 5, and gait "ataxia" in 4. Symptoms resolved promptly upon lowering the intracranial pressure by lumbar puncture, and were probably directly caused by intracranial hypertension. Awareness of these "minor" symptoms of increased intracranial pressure can facilitate diagnosis and management.

  13. Maternal and perinatal outcomes of dengue in PortSudan, Eastern Sudan

    Directory of Open Access Journals (Sweden)

    Elbashir Hagir M

    2010-07-01

    Full Text Available Abstract Aim To investigate maternal and perinatal outcomes (maternal death, preterm delivery, low birth weight and perinatal mortality of dengue at PortSudan and Elmawani hospitals in the eastern Sudan. Method This was a retrospective Cohort study where medical files of women with dengue were reviewed. Results There were 10820 deliveries and 78 (0.7% pregnant women with confirmed dengue IgM serology at the mean (SD gestational age of 29.4(8.2 weeks. While the majority of these women had dengue fever (46, 58.9%, hemorrhagic fever and dengue shock syndrome were the presentations in 18 (23.0% and 12, (15.3% of these women, respectively. There were 17(21.7% maternal deaths. Fourteen (17.9% of these 78 women had preterm deliveries and 19 (24.3% neonates were admitted to neonatal intensive care unit. Nineteen (24.3% women gave birth to low birth weight babies. There were seven (8.9% perinatal deaths. Eight (10.2% patients delivered by caesarean section due to various obstetrical indications. Conclusion Thus dengue has poor maternal and perinatal outcomes in this setting. Preventive measures against dengue should be employed in the region, and more research on dengue during pregnancy is needed.

  14. Acute brain hemorrhage in dengue

    Institute of Scientific and Technical Information of China (English)

    Somsri Wiwanitkit; Viroj Wiwanitkit

    2014-01-01

    Dengue is a tropical arboviral infection that can have severe hemorrhagic complication.Acute brain hemorrhage in dengue is rare and is a big challenge in neurosurgery.To perform surgery for management of acute brain hemorrhage in dengue is a controversial issue.Here, the authors try to summarize the previous reports on this topic and compare neurosurgery versus conservative management.

  15. Treatment of intracranial hydatid cysts

    Institute of Scientific and Technical Information of China (English)

    Sailike Duishanbai; WEN Hao; GENG Dangmurenjiafu; LIU Chen; GUO Huai-rong; HAO Yu-jun; LIU Bo; WANG Yong-xin; LUO Kun; ZHOU Kai

    2011-01-01

    Background Echinococcosis is still endemic in many countries, including China, where it is especially prevalent in the northwest. The aim of this study was to enrich the international literature about the treatment of intracranial hydatid cysts.Methods We retrospectively reviewed the clinical features, radiological manifestations, and surgical outcome of 97 patients with intracranial hydatid cysts, who received surgical treatment at the Neurosurgical Department of First Affiliated Hospital of Xinjiang Medical University from 1985 to 2010 and followed up the patient via sending a questionnaire or telephone contact. Clinical outcome was evaluated using the Karnofsky Performance Scale Index.Results Headache and vomiting were the most common initial symptoms in our patients. Neurological deficits caused by the mass effect of the cysts were seen in 82 cases. On the X-ray, significant bone erosion was seen in only two cases with epidural hydatid cysts. Round-shaped and thin-walled homogeneous low-density cystic lesions without surrounding edema and enhancement were the main findings on computerized tomography (CT) in 95 patients with intraparenchymal hydatid cysts, while two cases with epidural hydatid cysts presented as a heterodensity lesions. On magnetic resonance imaging (MRI), hydatid cyst presented as a round-shaped low signal lesion in T1-weighted images and high signal lesion in T2-weighted images, without enhancement after contrast media injection, while the two cases with epidural cysts presented as mixed signal masses. Surgical removal of cyst was performed in all cases. Total removal was achieved in 93 cases without rupturing the cyst wall. Only two cysts ruptured during the dissection, resulting in two surgery-related mortalities. There was no other additional neurological deficit caused directly by surgery. In 97.2% of the patients, the Karnofsky Performance Scale score was 80 to 90 at the last follow-up.Conclusions Intracranial hydatid cyst is still a

  16. The Safety and Efficacy of Triple Antiplatelet Therapy after Intracranial Stent-Assisted Coil Embolization.

    Science.gov (United States)

    Matsumoto, Yoshihisa; Iko, Minoru; Tsutsumi, Masanori; Mitsutake, Takahumi; Eto, Ayumu; Nii, Kouhei; Nakai, Kanji; Oishi, Hiromichi; Aikawa, Hiroshi; Kazekawa, Kiyoshi

    2015-07-01

    Stent-assisted coil embolization is effective for intracranial aneurysms, especially for wide-necked aneurysms; however, the optimal antiplatelet regimens for postoperative ischemic events have not yet been established. We aimed at determining the efficacy and safety of a triple antiplatelet therapy regimen after intracranial stent-assisted coil embolization. We retrospectively evaluated patients who underwent stent-assisted coil embolization for unruptured intracranial aneurysms or during the chronic phase of a ruptured intracranial aneurysm (≥ 4 weeks after subarachnoid hemorrhage onset). We recorded the incidence of ischemic and bleeding events 140 days postoperatively. We assessed 79 cases in patients who received either dual (n = 51) or triple (n = 28) antiplatelet therapy. The duration of triple antiplatelet therapy was 49 ± 29 days. Seven patients in the dual group experienced postoperative ischemic events. Compared to the dual group, the triple group had a similar incidence of postoperative bleeding events but a significantly lower incidence of postoperative ischemic events (P antiplatelet therapy had a significantly lower incidence of postoperative ischemic events and a similar incidence of postoperative bleeding events 140 days postoperatively. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. Massive antenatal fetomaternal hemorrhage

    DEFF Research Database (Denmark)

    Dziegiel, Morten Hanefeld; Koldkjaer, Ole; Berkowicz, Adela

    2005-01-01

    Massive fetomaternal hemorrhage (FMH) can lead to life-threatening anemia. Quantification based on flow cytometry with anti-hemoglobin F (HbF) is applicable in all cases but underestimation of large fetal bleeds has been reported. A large FMH from an ABO-compatible fetus allows an estimation...

  18. Major obstetric hemorrhage.

    Science.gov (United States)

    Mercier, Frederic J; Van de Velde, Marc

    2008-03-01

    Major obstetric hemorrhage remains the leading cause of maternal mortality and morbidity worldwide, and is associated with a high rate of substandard care. A well-defined and multidisciplinary approach that aims to act quickly and avoid omissions or conflicting strategies is key. The most common etiologies of hemorrhage are abruptio placenta, placenta previa/accreta, uterine rupture in the antepartum period and retained placenta, uterine atony, and genital-tract trauma in the postpartum period. Basic treatment of postpartum hemorrhage relies on manual removal of the placenta or manual exploration of the uterus plus bladder emptying and oxytocin administration. If this does not arrest bleeding, or if there is any suspicion of genital-tract trauma, examination of the vagina and cervix with appropriate valves and analgesia/anesthesia must follow quickly. Postpartum uterine atony resistant to oxytocin must be treated with prostaglandin within 15 to 30 minutes; uterine balloon tamponade can be also useful at this stage. Aggressive transfusion therapy and resuscitation are mandatory in major obstetric hemorrhage. Specific invasive treatment must be considered within no more than 30 to 60 minutes, if previous measures have failed -- and even earlier in some particular etiologies. The two main options are radiologic embolization and surgical artery ligations. Recombinant factor VIIa may also be considered, but should not delay the performance of a life-saving procedure such as embolization or surgery. Hysterectomy must be implemented when all other interventions have failed.

  19. Delayed Intraparenchymal and Intraventricular Hemorrhage Requiring Surgical Evacuation after MRI-Guided Laser Interstitial Thermal Therapy for Lesional Epilepsy.

    Science.gov (United States)

    Barber, Sean M; Tomycz, Luke; George, Timothy; Clarke, Dave F; Lee, Mark

    2017-01-01

    Symptomatic intracranial hemorrhage is a rare complication of laser interstitial thermal therapy (LITT). To present a unique case of delayed symptomatic intracranial hemorrhage occurring after a LITT procedure for epilepsy in a high-volume center (68 LITT procedures for pediatric epilepsy have been performed). An 18-year-old male with epilepsy underwent LITT to an area of heterotopia near the right lateral ventricle. He did well initially and was discharged home on postoperative day 1 but returned on postoperative day 9 with headache and left hemiparesis. He was found to have intraparenchymal and intraventricular hemorrhage in the region of the LITT catheter tract. CT angiography on admission revealed a small vascular abnormality near the focus of hemorrhage suspicious for pseudoaneurysm, although conventional angiography was negative. The patient declined neurologically and underwent craniotomy and hemorrhage evacuation. He eventually convalesced and was discharged to inpatient rehabilitation with persistent left hemiparesis. He has been seizure free since the intervention but remains on antiepileptic drugs. Evidence from the literature suggests that the pathophysiology of symptomatic hemorrhage after LITT may be related to vascular injury and pseudoaneurysm formation from LITT catheter placement and/or thermal injury from the ablation itself. © 2017 S. Karger AG, Basel.

  20. Circulatory Management Focusing on Preventing Intraventricular Hemorrhage and Pulmonary Hemorrhage in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Bai-Horng Su

    2016-12-01

    Full Text Available The goal of modern neonatal care of extremely preterm infants is to reduce mortality and long-term neurological impairments. Preterm infants frequently experience cerebral intraventricular or pulmonary hemorrhage, which usually occurs within 72 hours after birth and can lead to long-term neurological sequelae and mortality. These serious hemorrhagic complications are closely related to perinatal hemodynamic changes, including an increase in the afterload on the left ventricle of the heart after the infant is separated from the placenta, and an increased preload from a left-to-right shunt caused by a hemodynamically significant patent ductus arteriosus (PDA. The left ventricle of a preterm myocardium has limited ability to respond to such an increase in afterload and preload, and this can result in cardiac dysfunction and hemodynamic deterioration. We suggest that delayed umbilical cord clamping or umbilical cord milking to maintain optimal blood pressure and systemic blood flow (SBF, careful assessment to keep the afterload at an acceptable level, and a strategy of early targeted treatment of significant PDA to improve perfusion during this critical time period may reduce or prevent these serious complications in preterm infants.

  1. [Dolichoectatic intracranial arteries. Advances in images and therapeutics].

    Science.gov (United States)

    Casas Parera, I; Abruzzi, M; Lehkuniec, E; Schuster, G; Muchnik, S

    1995-01-01

    Dolichoectasia of intracranial arteries is an infrequent disease with an incidence less than 0.05% in general population. It represents 7% of all intracranial aneurysms. Commonly seen in middle age patients with severe atherosclerosis and hypertension, the affected arteries include the basilar artery, supraclinoid segment of the internal carotid artery, middle, anterior and posterior cerebral arteries; males are more frequently affected. The clinical features of these fusiform aneurysms are divided in three categories: ische-mic, cranial nerve compression and signs from mass effect. Hemorrhage may also occur. Nine patients with symptomatic cerebral blood vessel dolichoectasias are presented. Six of them were males with moderate or severe hypertension. Lesions were confined to the basilar artery in 3 cases, carotid arteries and the middle cerebral artery in 1 case, and both systems were affected in 4 patients. Middle cerebral arteries were affected in 5 cases and the anterior cerebral artery in one. An isolated fusiform aneurysm of the posterior cerebral artery is also presented (case 8) (Table 3). Motor or sensory deficits, ataxia, dementia, hemifacial spasm and parkinsonism were observed. One patient died from cerebro-meningeal hemorrhage (Table 2). All patients were studied with computerized axial tomography of the brain, 5 cases with four vessel cerebral angiography, 4 cases with magnetic resonance imaging (MRI) and case 5 with MRI angiography. Clinical symptoms depend on the affected vascular territory, size of the aneurysm and compression of adjacent structures. The histopathologic findings are atheromatous lesions, disruption of the internal elastic membrane and fibrosis of the muscular wall. The resultant is a diffuse deficiency of the muscular wall and the internal elastic membrane. Recent advances in neuroimaging such as better resolution of CT scan, magnetic resonance images (MRI) and MRI angiography increased the diagnosis of this pathology showing

  2. Multiple intracranial aneurysms and moyamoya disease associated with microcephalic osteodysplastic primordial dwarfism type II: surgical considerations.

    Science.gov (United States)

    Waldron, James S; Hetts, Steven W; Armstrong-Wells, Jennifer; Dowd, Christopher F; Fullerton, Heather J; Gupta, Nalin; Lawton, Michael T

    2009-11-01

    Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) is a rare genetic syndrome characterized by extremely small stature and microcephaly, and is associated in 25% of patients with intracranial aneurysms and moyamoya disease. Although aneurysmal subarachnoid hemorrhage and stroke are leading causes of morbidity and death in these patients, MOPD II is rarely examined in the neurosurgical literature. The authors report their experience with 3 patients who presented with MOPD II, which includes a patient with 8 aneurysms (the most aneurysms reported in the literature), and the first report of a patient with both moyamoya disease and multiple aneurysms. The poor natural history of these lesions indicates aggressive microsurgical and/or endovascular therapy. Microsurgery, whether for aneurysm clip placement or extracranial-intracranial bypass, is challenging due to tight surgical corridors and diminutive arteries in these patients, but is technically feasible and strongly indicated when multiple aneurysms must be treated or cerebral revascularization is needed.

  3. Clinical results of stereotactic heavy-charged-particle radiosurgery for intracranial angiographically occult vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Levy, R.P.; Fabrikant, J.I.; Phillips, M.H.; Frankel, K.A.; Steinberg, G.K.; Marks, M.P.; DeLaPaz, R.L.; Chuang, F.Y.S.; Lyman, J.T.

    1989-12-01

    Angiographically occult vascular malformations (AOVMs) of the brain have been recognized for many years to cause neurologic morbidity and mortality. They generally become symptomatic due to intracranial hemorrhage, focal mass effect, seizures or headaches. The true incidence of AOVMs is unknown, but autopsy studies suggest that they are more common than high-flow angiographically demonstrable arteriovenous malformations (AVMs). We have developed stereotactic heavy-charged-particle Bragg peak radiosurgery for the treatment of inoperable intracranial vascular malformations, using the helium ion beams at the Lawrence Berkeley Laboratory 184-inch Synchrocyclotron and Bevatron. This report describes the protocol for patient selection, radiosurgical treatment planning method, clinical and neuroradiologic results and complications encountered, and discusses the strengths and limitations of the method. 10 refs., 1 fig.

  4. Detection of acute cerebral hemorrhage in rabbits by magnetic induction

    Energy Technology Data Exchange (ETDEWEB)

    Sun, J.; Jin, G.; Qin, M.X. [College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing (China); Wan, Z.B. [Experimental Animal Center, Third Military Medical University, Chongqing, China, Experimental Animal Center, Third Military Medical University, Chongqing (China); Wang, J.B.; Wang, C.; Guo, W.Y. [College of Electronic Engineering, Xidian University, Xi' an, China, College of Electronic Engineering, Xidian University, Xi' an (China); Xu, L.; Ning, X.; Xu, J.; Pu, X.J.; Chen, M.S. [College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing (China); Zhao, H.M. [Experimental Animal Center, Third Military Medical University, Chongqing, China, Experimental Animal Center, Third Military Medical University, Chongqing (China)

    2014-02-17

    Acute cerebral hemorrhage (ACH) is an important clinical problem that is often monitored and studied with expensive devices such as computed tomography, magnetic resonance imaging, and positron emission tomography. These devices are not readily available in economically underdeveloped regions of the world, emergency departments, and emergency zones. We have developed a less expensive tool for non-contact monitoring of ACH. The system measures the magnetic induction phase shift (MIPS) between the electromagnetic signals on two coils. ACH was induced in 6 experimental rabbits and edema was induced in 4 control rabbits by stereotactic methods, and their intracranial pressure and heart rate were monitored for 1 h. Signals were continuously monitored for up to 1 h at an exciting frequency of 10.7 MHz. Autologous blood was administered to the experimental group, and saline to the control group (1 to 3 mL) by injection of 1-mL every 5 min. The results showed a significant increase in MIPS as a function of the injection volume, but the heart rate was stable. In the experimental (ACH) group, there was a statistically significant positive correlation of the intracranial pressure and MIPS. The change of MIPS was greater in the ACH group than in the control group. This high-sensitivity system could detect a 1-mL change in blood volume. The MIPS was significantly related to the intracranial pressure. This observation suggests that the method could be valuable for detecting early warning signs in emergency medicine and critical care units.

  5. Intracranial stents in the endovascular treatment of acute ischemic stroke.

    Science.gov (United States)

    Delgado Acosta, F; Jiménez Gómez, E; Bravo Rey, I; Bravo Rodríguez, F A; Ochoa Sepúlveda, J J; Oteros Fernández, R

    To evaluate the efficacy and safety of intracranial stenting as a rescue therapy after failed mechanical thrombectomy in patients with acute ischemic stroke. We retrospectively studied 42 patients treated with intracranial stenting after failed mechanical thrombectomy between December 2008 and January 2016. We compared outcomes before and after the incorporation of stentrievers. We assessed the degree of recanalization in the carotid and basilar territories (modified TIMI score), prognostic factors, and outcome (modified Rankin Score at 3 months). Safety was evaluated in function of the appearance of symptomatic intracranial hemorrhage (SICH). Median NIHSS was 17 in patients with carotid territory strokes and 26 in those with vertebrobasilar territory strokes. Median time from onset of symptoms to treatment was 225minutes in carotid territory strokes and 390minutes in vertebrobasilar territory strokes. A total of 10 patients underwent intravenous fibrinolytic therapy before treatment with stentrievers. Two patients developed SICH; both had undergone intravenous fibrinolytic therapy (p=0.0523). Recanalization was effective in 30 (71.4%) in the entire series: in 7 (50%) of 14 patients treated before the incorporation of stentrievers and in 23 (82.1%) of 28 treated after the incorporation of stentrievers (p=0.0666). Outcome at 3 months was good in 2 (14.3%) patients in the earlier group and in 14 (50%) patients in the later group (p=0.042). We found significant associations between recanalization and outcome (p=0.0415) and between shorter time to treatment and outcome (p=0.002). Outcome was good in 14 (48.3%) of the 29 patients with carotid territory strokes and in 2 (15.4%) of the 13 patients with vertebrobasilar territory strokes (p=0.078). Intracranial stenting is the rescue treatment when the usual treatment fails. Stentrievers must be used to eliminate the clot burden before stenting. In our study, antiplatelet treatment did not seem to increase the risk of SICH

  6. PHENOBARBITAL FOR THE PREVENTION OF INTRACRANIAL DAMAGE IN CHINESE NEONATES WITH SEVERE ASPHYXIA

    Institute of Scientific and Technical Information of China (English)

    陈惠金; 吴圣楣; 黄萍; 孙建华; 陈冠仪; 储凇雯

    2000-01-01

    Objective To evaluate the effect of phenobarbital on preventing intracranial damage and seizure in Chinese neonates with severe asphyxia. Methods A control trial was carried out in 60 Chinese neonates with severe asphyxia. 30 neonates received loading dose of phenobarbital on an average of 5.6h of age. Results The mean value of phenobarbital serum level obtained at the 4th day after birth was 21.9μg/ml. No significant difference was observed in the two groups in terms of birth weight, gestational age, Apgar scores, sex, etc. The imaging diagnosis within 3d of age in all subjects showed normal brain in 14, brain edema in 9 and intraventricular hemorrhage (IVH) in 7 in the treated group with a 53.3% of total complication rate, and normal brain in 5, brain edema in 15, IVH in 9 and subarachnoid hemorrhage (SAH) in 1 in the untreated group with a 83.3% of total complication rate. The incidence of intracranial damage in the untreated group was significantly higher than that in the treated group (83.3% vs 53.3%, P<0.05). In the treated group, 4 neonates with seizure symptom were effectively controlled soon, and none of the other 26 developed seizure. The period of seizure in the treated group was significantly shorter than that in the untreated group (P<0. 05). Other clinical symptoms were also sooner improved and no side effects were observed among the neonates treated with phenobarbital. Conclusion The incidence of postasphyxiated intracranial damage was obviously decreased, and seizure could be prophylactically intervened by phenobarbital. It is recommended that early application of preventive phenobarbitalin severely asphyxiated neonates is reasonable in reducing the incidence of intracranial lesions and subsequent seizures.

  7. Value of the perinatal autopsy : Critique

    NARCIS (Netherlands)

    Gordijn, SJ; Erwich, JJHM; Khong, TY

    2002-01-01

    In consenting to a perinatal autopsy, the primary motive of parents may be to find the exact cause of death. A critical review on the value of perinatal autopsies was performed to see whether parents could be counseled regarding their main motive. A literature search was performed in MEDLINE, EXCERP

  8. Perinatal depression: implications for child mental health.

    Science.gov (United States)

    Muzik, Maria; Borovska, Stefana

    2010-12-01

    Perinatal depression is common and primary care holds a crucial role for detecting, treating or, if necessary, providing referrals to mental health care for affected women. Family doctors should be aware of risk factors for peripartum depression, including previous history of depression, life events and interpersonal conflict. Perinatal depression has been associated with many poor outcomes, including maternal, child and family unit challenges. Infants and young children of perinatally depressed mothers are more likely to have a difficult temperament, as well as cognitive and emotional delays. The primary care setting is uniquely poised to be the screening and treatment site for perinatal depression; however, several obstacles, both at patient and systems level, have been identified that interfere with women's treatment engagement. Current published treatment guidelines favour psychotherapy above medicines as first line treatment for mild to moderate perinatal depression, while pharmacotherapy is first choice for severe depression, often in combination with psychosocial or integrative approaches. Among mothers who decide to stop taking their antidepressants despite ongoing depression during the perinatal period, the majority suffer from relapsing symptoms. If depression continues post-partum, there is an increased risk of poor mother-infant attachment, delayed cognitive and linguistic skills in the infant, impaired emotional development and risk for behavioural problems in later life. Complex, comprehensive and multilevel algorithms are warranted to treat perinatal depression. Primary care doctors are best suited to initiate, carry out and evaluate the effectiveness of such interventions designed to prevent adverse outcomes of maternal perinatal depression on mother and child wellbeing.

  9. Remote hemorrhage from the site of craniotomy Hemorragia à distância da área da craniotomia

    Directory of Open Access Journals (Sweden)

    José Alberto Landeiro

    2004-09-01

    Full Text Available Postoperative intracranial hemorrhage is a serious and sometimes a fatal neurosurgical complication. Hemorrhage occurring at regions remote from the site of intracranial operations comprises an uncommon affection, most ignored by the assistant physicians. It bares a still incomprehensive pathophysiology, despite several theories trying to explain it. Looks like a common sense that the presence of the remote site hemorrhage cannot be related to concomitant presence of hypertension, coagulopathy or undiscovered lesions. We report three cases of postoperative hemorrhages occurring in a remote site of supratentorial craniotomies, two patients presented cavernous sinus meningeoma and one patient was submitted to intracranial vascular surgery.Hemorragia intracraniana de ocorrência em pós-operatório é grave complicação das cirurgias intracranianas. O aparecimento de foco hemorrágico em regiões distantes ao sítio operatório original é considerado incomum, e muitas vezes ignorado pelos médicos assistentes. A fisiopatologia envolvida no processo não é de todo compreendida, apesar das diversas teorias já propostas. São apresentados três casos de hemorragia á distancia da área cirúrgica, no pós-operatório de dois pacientes portadores de meningeoma do seio cavernoso e de um submetido à clipagem de aneurisma intracraniano.

  10. Maternidad tras una muerte perinatal

    OpenAIRE

    Rozas García, M. Rosa; Francés Ribera, Lidia

    2001-01-01

    La nueva gestación tras una muerte perinatal está llena de dudas, miedos e inseguridades, y es una situación que va a suponer un desgaste físico y emocional para la familia, especialmente para la mujer. Esta gestación se caracteriza por un aumento de la ansiedad, que puede continuar después del nacimiento y manifestarse mediante conductas de sobreprotección del nuevo hijo. Las matronas deben conocer las posibles respuestas emocionales de la mujer y proporcionar cuidados y apoyo específicos du...

  11. Maternidad tras una muerte perinatal

    OpenAIRE

    Rozas García, M. Rosa; Francés Ribera, Lidia

    2001-01-01

    La nueva gestación tras una muerte perinatal está llena de dudas, miedos e inseguridades, y es una situación que va a suponer un desgaste físico y emocional para la familia, especialmente para la mujer. Esta gestación se caracteriza por un aumento de la ansiedad, que puede continuar después del nacimiento y manifestarse mediante conductas de sobreprotección del nuevo hijo. Las matronas deben conocer las posibles respuestas emocionales de la mujer y proporcionar cuidados y apoyo específicos du...

  12. Mortalidad perinatal y duelo materno

    OpenAIRE

    Laverde Rubio, Eduardo

    2011-01-01

    Se investigaron desde el punto de vista médico-psicológico dos grupos de madres cuyos hijos murieran durante el periodo perinatal (entre 28 semanas de gestación y 28 días de nacido). EI primer grupo de estudio lo configuraban 20 pacientes que reaccionaron con un duelo prolongado ante la perdida de su hijo. EI segundo grupo esta conformado por 20 pacientes (grupo de comparación) que elaboraron la perdida de su hijo mediante un duelo no complicado. La hipótesis general que obtento este trabajo ...

  13. Multifocal fibrosclerosis with intracranial pachymeningitis.

    Science.gov (United States)

    Kitano, A; Shimomura, T; Okada, A; Takahashi, K

    1995-04-01

    A 29-year-old woman with a 4-year history of multifocal fibrosclerosis showed unique neurologic complications. Episcleritis, orbital pseudotumor, and eosinophilic phlegmon preceded intracranial inflammatory pachymeningitis. The pachymeningitis was associated with disturbance of the visual field, incomplete Gerstmann's syndrome, and pseudotumor cerebri. T2-weighted magnetic resonance images revealed a high signal intensity lesion in the left temporal and occipital lobes, and gadolinium-enhanced T1-weighted images revealed the enhancement of the thickened left tentorial leaf. The laboratory data suggested that the etiology might be autoimmunological. The disease and MRI abnormalities improved following administration of corticosteroids.

  14. Traumatic and alternating delayed intracranial hematomas

    Energy Technology Data Exchange (ETDEWEB)

    Lesoin, F.; Redford, H.; Jomin, M.; Viaud, C.; Pruvo, J.

    1984-11-01

    Repeat computed tomography has enabled us to confirm the concept of delayed hematomas. With this in mind we report two cases of alternating, post-traumatic intracranial hematomas; confirming also the role of tamponade after surgical removal of an intracranial hematoma.

  15. Acute surgical management in idiopathic intracranial hypertension.

    LENUS (Irish Health Repository)

    Zakaria, Zaitun

    2012-01-01

    Idiopathic intracranial hypertension is a headache syndrome with progressive symptoms of raised intracranial pressure. Most commonly, it is a slow process where surveillance and medical management are the main treatment modalities. We describe herein an acute presentation with bilateral sixth nerve palsies, papilloedema and visual deterioration, where acute surgical intervention was a vision-saving operation.

  16. Migraine before rupture of intracranial aneurysms

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Gurary, Natalia M; Sakovich, Vladimir P

    2013-01-01

    Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA.......Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA....

  17. Intracranial alveolar echinococcosis: CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Bensaid, A.H. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Dietemann, J.L. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Filippi de la Palavesa, M.M. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Klinkert, A. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Kastler, B. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Gangi, A. (Dept. of Radiology B, Univ. Hospital, Strasbourg (France)); Jacquet, G. (Dept. of Neurosurgery, Univ. Hospital, Besancon (France)); Cattin, F. (Dept. of Radiology, Univ. Hospital, Besancon (France))

    1994-05-01

    Intracranial alveolar echinococcosis is uncommon. We report a patient with right frontal lobe and palpebral lesions secondary to a primary hepatic focus with secondary lesion in the lung. The intracranial and palpebral cystic masses were totally removed and both proved to be alveolar hydatid cysts. An unusual feature in this case is CT and MRI demonstration of dural and bony extension. (orig.)

  18. Intracranial pial arteriovenous fistula in infancy: a case report and literature review.

    Science.gov (United States)

    Kraneburg, U M; Nga, V D W; Ting, E Y S; Hui, F K H; Lwin, S; Teo, C; Chou, N; Yeo, T T

    2014-02-01

    Intracranial pial arteriovenous fistulas (AVF) are rare vascular malformation especially in the first 2 years of life. The pathology in this age group is associated with greater morbidity and mortality. We report a rare case of 36-day-old male infant with a pial AVF associated with an arterial aneurysm, who presented with intraventricular hemorrhage and hydrocephalus. In addition, an online review of the literatures on pediatric pial AVF was performed using PubMed on published case reports and articles from 1980 to April 2013.

  19. Safety and efficacy of a new prophylactic tirofiban protocol without oral intraoperative antiplatelet therapy for endovascular treatment of ruptured intracranial aneurysms.

    Science.gov (United States)

    Liang, Xiao-Dong; Wang, Zi-Liang; Li, Tian-Xiao; He, Ying-Kun; Bai, Wei-Xing; Wang, Yang-Yang; Zhou, Guo-Yu

    2016-11-01

    Coil embolization of intracranial aneurysms is being increasingly used; however, thromboembolic events have become a major periprocedural complication. To determine the safety and efficacy of prophylactic tirofiban in patients with ruptured intracranial aneurysms. Tirofiban was administered as an intravenous bolus (8.0 μg/kg over 3 min) followed by a maintenance infusion (0.10 μg/kg/min) before stent deployment or after completion of single coiling. Dual oral antiplatelet therapy (loading doses) was overlapped with half the tirofiban dose 2 h before cessation of the tirofiban infusion. Cases of intracranial hemorrhage or thromboembolism were recorded. Tirofiban was prophylactically used in 221 patients, including 175 (79.19%) who underwent stent-assisted coiling and 46 (20.81%) who underwent single coiling, all in the setting of aneurysmal subarachnoid hemorrhage. Six (2.71%) cases of intracranial hemorrhage occurred, including four (1.81%) tirofiban-related cases and two (0.90%) antiplatelet therapy-related cases. There were two (0.90%) cases of fatal hemorrhage, one related to tirofiban and the other related to dual antiplatelet therapy. Thromboembolic events occurred in seven (3.17%) patients (6 stent-assisted embolization, 1 single coiling), of which one (0.45%) event occurred during stenting and six (2.72%) occurred during intravenous tirofiban maintenance. No thromboembolic events related to dual antiplatelet therapy were found. Tirofiban bolus over 3 min followed by maintenance infusion appears to be a safe and efficient prophylactic protocol for the endovascular treatment of ruptured intracranial aneurysms and may be an alternative to intraoperative oral antiplatelet therapy, especially in the case of stent-assisted embolization. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Intracranial arteriopathy in tuberous sclerosis complex.

    Science.gov (United States)

    Boronat, Susana; Shaaya, Elias A; Auladell, Maria; Thiele, Elizabeth A; Caruso, Paul

    2014-07-01

    Arterial aneurysms, mostly aortic and intracranial, have been occasionally reported in patients with tuberous sclerosis complex. Brain magnetic resonance imaging reports of 404 patients with definite and 16 patients with either probable or possible tuberous sclerosis complex were revised for intracranial aneurysms. Among these patients, brain images of 220 patients with definite and 16 with probable or possible tuberous sclerosis complex were reviewed. Intracranial aneurysms were reported in 3 of 404 patients with a definite diagnosis (0.74%) (general population: 0.35%), including 2 children. A fourth intracranial aneurysm was found in a patient with probable tuberous sclerosis complex, who did not have tubers or subependymal nodules but had clinical manifestations related to neural crest derivatives, including lymphangioleiomyomatosis and extrarenal angiomyolipomas. The authors hypothesize that neural crest dysfunction can have a major role in intracranial arteriopathy in tuberous sclerosis complex, as smooth muscle cells in the forebrain vessels are of neural crest origin.

  1. Intracranial metastases: spectrum of MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Kyoung; Lee, Eun Ja; Lee, Yong Seok [Department of Radiology, Dongguk University Ilsan Hospital, Goyang-shi (Korea, Republic of)], E-mail: ejl1048@hanmail.net; Kim, Mi Sung; Park, No Hyuck [Department of Radiology, Kwandong University, College of Medicine, Myongji Hospital, Goyang-shi (Korea, Republic of); Park, Hee-Jin [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); II, Sung Park [Department of Diagnostic Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2012-12-15

    Intracranial metastatic lesions arise through a number of routes. Therefore, they can involve any part of the central nervous system and their imaging appearances vary. Magnetic resonance imaging (MRI) plays a key role in lesion detection, lesion delineation, and differentiation of metastases from other intracranial disease processes. This article is a reasoned pictorial review illustrating the many faces of intracranial metastatic lesions based on the location - intra-axial metastases, calvarial metastases, dural metastases, leptomeningeal metastases, secondary invasion of the meninges by metastatic disease involving the calvarium and skull base, direct or perineural intracranial extension of head and neck neoplasm, and other unusual manifestations of intracranial metastases. We also review the role of advanced MRI to distinguish metastases from high-grade gliomas, tumor-mimicking lesions such as brain abscesses, and delayed post-radiation changes in radiosurgically treated patients.

  2. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann

    2013-01-01

    OBJECTIVE: To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. METHODS: Thirty-day case fatality was stratified by age, sex, and calendar year after ICH...... during the first year of follow-up compared with controls (ICH: hazard ratio [HR] 2.60, 95% confidence interval [CI] 2.09-3.24, p year (ICH: HR 2.02, 95% CI 1.75-2.32, p ... and SAH using logistic regression. Cox proportional hazards regression analyses were used to estimate the risk of death during the first year of follow-up and survivors at 1 year. RESULTS: Case fatality after ICH was 42.0%, compared with 28.7% after SAH. It increased with age (ICH: 29.7% for 20-49 years...

  3. Phenylpropanolamine and cerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    McDowell, J.R.; LeBlanc, H.J.

    1985-05-01

    Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures.

  4. Computed tomography of intracranial tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yong Lan; Lee, Jung Suk; Eun, Chung Kie; Kim, Soon Yong [School of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    1981-09-15

    CT is a valuable method in determining number, location and extent of lesions, although a definite diagnosis is often not possible on CT. In intracranial tuberculosis, CT was helpful in the diagnosis, assessing the degree of hydrocephalus and evaluating the effectiveness of antituberculous therapy. Twenty-one cases of clinically proven intracranial tuberculosis were studied by CT in our hospital during last 3 years. Of them, eighteen cases were tuberculous meningitis and the rests were tuberculoma. The results were as follows: 1. Tuberculous meningitis presented the following three patterns of CT findings according to its disease process. a. In early stage of the disease, suspicious multiple isodense small nodules in the cerebral and cerebellar hemispheres showed dense enhancement in postcontrast scan representing miliary tubercles. b. In later stage of the disease, precontrast scan showed partial or total obliteration of the basal and sylvian cisterns with mild dilatation of ventricular system. Postcontrast scan showed dense enhancement of basal and sylvian cisterns. This type of finding was the most common in our series. c. Moderate to marked dilatation of ventricle with or without a cluster of calcifications in suprsella area on precontrast scan was seen in far later stage of as a sequellae of the disease. No enhancement was noted in postcontrast study. 2. Tuberculoma showed an isodense or slightly hyperdense area in the cerebral or cerebellar hemisphere with associated minimal edema in precontrast study. Postcontrast scan showed a small ring enhancement with central lucent area.

  5. Stereotactic radiosurgery for intracranial meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Kida, Yoshihisa; Kobayashi, Tatsuya; Tanaka, Takayuki; Oyama, Hirofumi; Iwakoshi, Takayasu (Komaki City Hospital, Hokkaido (Japan))

    1994-07-01

    Stereotactic radiosurgery for intracranial meningiomas was attempted using a 201-source cobalt gamma knife. Forty patients bearing 42 tumors were involved in this study. Their ages ranged from 30 to 91 years, with an average of 55.1 years. The most frequent sites of origin were the parasellar and petroclival regions. The mean tumor diameter was 27.2 mm and the marginal tumor dose of radiosurgery ranged from 10 to 20 Gy, depending on tumor location and size. Serial imaging studies with MRI were obtained in all 40 cases, in which minor tumor shrinkage was demonstrated in 7.9%, 40.0% and 53.3% at 6, 12 and 18 months after radiosurgery respectively. Only two tumors became enlarged after the treatment. Obvious low signal intensity on MRI, indicating central tumor necrosis, was found in 32% at 12 months and 40% at 18 months. Four large tumors over 40 mm in mean diameter were treated by staged radiosurgery with intervals of 1.5 to 7 months. A similar good response was able to be obtained in all 4 cases, even though they were treated with a marginal dose less than 12 Gy. Symptomatic edema occurred in 5 cases (12.5%) within 12 months and required corticosteroid therapy and hyperosmotic diuresis. In conclusion stereotactic radiosurgery has proved to be an effective and relatively safe method for the treatment of intracranial meningiomas. (author).

  6. Desmopressin Acetate in Intracranial Haemorrhage

    Directory of Open Access Journals (Sweden)

    Thomas Kapapa

    2014-01-01

    Full Text Available Introduction. The secondary increase in the size of intracranial haematomas as a result of spontaneous haemorrhage or trauma is of particular relevance in the event of prior intake of platelet aggregation inhibitors. We describe the effect of desmopressin acetate as a means of temporarily stabilising the platelet function. Patients and Methods. The platelet function was analysed in 10 patients who had received single (N=4 or multiple (N=6 doses of acetylsalicylic acid and 3 patients (control group who had not taken acetylsalicylic acid. All subjects had suffered intracranial haemorrhage. Analysis was performed before, half an hour and three hours after administration of desmopressin acetate. Statistical analysis was performed by applying a level of significance of P≤0.05. Results. (1 Platelet function returned to normal 30 minutes after administration of desmopressin acetate. (2 The platelet function worsened again after three hours. (3 There were no complications related to electrolytes or fluid balance. Conclusion. Desmopressin acetate can stabilise the platelet function in neurosurgical patients who have received acetylsalicylic acid prior to surgery without causing transfusion-related side effects or a loss of time. The effect is, however, limited and influenced by the frequency of drug intake. Further controls are needed in neurosurgical patients.

  7. Perinatal stroke: a six-year experience in a level-III maternity

    Directory of Open Access Journals (Sweden)

    Joana Teixeira

    2017-09-01

    Full Text Available Aims: To study the incidence of perinatal stroke in a level-III maternity as well as potential risk factors, clinical presentation, neuroimaging, classification and clinical outcome of children with a minimum follow-up of 24 months.Methods: Historical prospective follow-up of all term and late preterm newborns diagnosed with perinatal stroke from January 2008 to December 2013.Results: Fifteen perinatal strokes were diagnosed in a total of 17,056 newborns (incidence 0.9/1,000. Thirteen had potential risk factors and fourteen were symptomatic. Median age at diagnosis was two days. Seizures were the most frequent symptom (14/15, being three focal-clonic, one multifocal-clonic, two generalized-tonic, three focal-tonic and five subtle. Cerebral ultrasound was performed in eleven newborns at an early stage, suggesting the diagnosis in six. Cerebral magnetic resonance imaging (MRI confirmed the diagnosis in fifteen. Six had an arterial ischemic stroke, eight a cerebral venous thrombosis and one a hemorrhagic stroke. An electroencephalogram was obtained in all newborns with seizures revealing epileptic activity in eight. Search for prothrombotic disorders (in newborn and both parents showed four newborns heterozygous methylene tetrahydrofolate reductase mutation and two neonatal alloimune thrombocytopenia. No recurrence of stroke was reported. Formal development evaluation was performed in thirteen and was normal in eleven, while in two revealed delayed psychomotor development, both of which with epilepsy. On the neonatology outpatient clinic follow-up, the current median age is 3 years and 11 months.Conclusions: This study reinforces the need to maintain high level of suspicion for perinatal stroke and the importance of MRI in the classification and etiological study. Our follow-up supported a good outcome of perinatal stroke.

  8. Diagnosis and evaluation of surveying examination by intracranial tumor in dogs CT; Diagnostico e avaliacao topografica de neoplasias intracranianas pelo exame de TC em caes

    Energy Technology Data Exchange (ETDEWEB)

    Romaldini, Andre Fonseca; Santos, Debora Rodrigues dos; Oliveira, Juliana Messias; Abreu, Felipe Andrei Suarez; Wallace, Verena; Pacheco, Eduardo Nelson da Silva, E-mail: andreromaldini@gmail.com [Hospital Santa Ines de Sao Paulo, Santana, SP (Brazil)

    2012-07-01

    The use of computed tomography (CT) revolutionized image diagnostic in veterinary medicine and currently can be considered one of the most useful tools for the imaging evaluation of intracranial tumor in dogs. Computed tomography of the brain in small animals allows visualization of intracranial tumor, compression of adjacent structures such as cerebral parenchyma, falx or lateral ventricles, and evaluate secondary hemorrhages and edema. The CT imaging provides essential information to indicate the surgical approach for a possible tumor resection or biopsy, including the correct location and boundaries structures involved, and also can be used to monitor the clinical treatment. However, only histopathological examination is able to confirm the final diagnosis. (author)

  9. Multiple hemorrhages in brain after spine surgery supra- and infra-tentorial components together

    Directory of Open Access Journals (Sweden)

    Baran Yilmaz

    2015-01-01

    Full Text Available Remote cerebellar hemorrhage after cranial and spinal surgeries is a well-documented entity, so far concomitant supra- and infra-tentorial hemorrhage after spine surgery has rarely been reported in the literature. A 57-year-old woman presented with intractable low back pain and severely impaired mobility. One year ago, she underwent lumbar laminectomy and fusion with posterior spinal instrumentation between L2 and S1. She developed adjacent segment disease at the upper level of the instrumented vertebra. She had a revision surgery and underwent posterior laminectomy and fusion with bilateral transpedicular instrumentation between T10 and S1. She had severe headache, somnolence, and left hemiparesia 48 h after the surgery. Her emergent head computed tomography depicted intra-parenchymal hemorrhage in the right parietal lobe accompanying with subarachnoid hemorrhage, bilateral symmetrical cerebellar hemorrhages and pneumocephalus. She was treated nonsurgically and she got better despite some residual deficits. Symptoms including constant headache, nausea, vomiting, impaired consciousness, new onset seizure, and focal neurological deficit after spine surgeries should raise suspicion for intracranial intra-parenchymal hemorrhage.

  10. Multiple hemorrhages in brain after spine surgery supra- and infra-tentorial components together.

    Science.gov (United States)

    Yılmaz, Baran; Işık, Semra; Ekşi, Murat Şakir; Ekşi, Emel Ece Özcan; Akakın, Akın; Toktaş, Zafer Orkun; Konya, Deniz

    2015-01-01

    Remote cerebellar hemorrhage after cranial and spinal surgeries is a well-documented entity, so far concomitant supra- and infra-tentorial hemorrhage after spine surgery has rarely been reported in the literature. A 57-year-old woman presented with intractable low back pain and severely impaired mobility. One year ago, she underwent lumbar laminectomy and fusion with posterior spinal instrumentation between L2 and S1. She developed adjacent segment disease at the upper level of the instrumented vertebra. She had a revision surgery and underwent posterior laminectomy and fusion with bilateral transpedicular instrumentation between T10 and S1. She had severe headache, somnolence, and left hemiparesia 48 h after the surgery. Her emergent head computed tomography depicted intra-parenchymal hemorrhage in the right parietal lobe accompanying with subarachnoid hemorrhage, bilateral symmetrical cerebellar hemorrhages and pneumocephalus. She was treated nonsurgically and she got better despite some residual deficits. Symptoms including constant headache, nausea, vomiting, impaired consciousness, new onset seizure, and focal neurological deficit after spine surgeries should raise suspicion for intracranial intra-parenchymal hemorrhage.

  11. A systematic review of pipeline embolization device for giant intracranial aneurysms

    Directory of Open Access Journals (Sweden)

    Xianli Lv

    2017-01-01

    Full Text Available The experience with respect to the treatment of giant intracranial aneurysms with flow-diversion devices is limited. The aim of the present systematic review was to evaluate the effect of the pipeline embolization device (PED on giant intracranial aneurysms. Eligible related articles were identified by searching the PubMed, Web of Science, Springer, ScienceDirect, and OVID databases using “giant aneurysm” and “pipeline” as the search items. The date of the last search was November 20, 2015. This systematic review adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In a total of 9 eligible studies with 200 patients and 215 aneurysms, 40 (18.6% giant (aneurysm diameter >25mm intracranial aneurysms treated with PED were analyzed. During a 6 to 34 month follow-up, complete occlusion was achieved in 23 (57.5% cases. Seven patients (17.5% developed intracranial hemorrhage, 5 developed ischemic attack (12.5%, and 13 (32.5% developed a mass effect after PED treatment. The complication rate was 77.8% in PED for giant vertebrobasilar artery aneurysms. The cumulative mortality rate for giant paraclinoid carotid artery and middle cerebral artery aneurysms was 13.3% and increased up to 50% for giant vertebrobasilar artery aneurysms. The complete obliteration rate of PED for giant intracranial aneurysms was approximately 60%. Mass effect is the most mechanism of complications. Complication and mortality rates associated with PED for giant vertebrobasilar artery aneurysms are still extremely high.

  12. Right putamen hemorrhage manifesting as apraxia of eyelid opening

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    Lin YH

    2013-09-01

    Full Text Available Yi-Hui Lin,1 Li-Min Liou,2,3 Chiou-Lian Lai,1,2 Yang-Pei Chang1,2 1Department of Neurology, Kaohsiung Medical University Hospital, 2Department of Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 3Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Purpose: The purpose of this report is to demonstrate a rare clinical manifestation of apraxia eyelid opening related to a basal ganglia lesion. Case report: In this study, we report a 91-year-old woman suffering from difficulty in eyelid opening after being treated for myocardial ischemia with dual antiplatelet medications. She could open her eyelid with fingers touching her forehead. Brain computed tomography revealed a right putamen hemorrhage. Surface electromyography revealed persistent frontalis muscle contraction during relaxation of orbicularis oculi muscles. Apraxia of eyelid opening was diagnosed. Her eyelid symptom resolved 2 months later. Conclusion: Apraxia of eyelid opening may be caused by subcortical hemorrhage of the basal ganglia. In addition to the primary motor cortex and supplemental motor area, the basal ganglia may also play a role in eyelid opening. Keywords: intracranial hemorrhage, basal ganglia, orbicularis oculi muscle, frontalis muscle

  13. Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage

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    Yan Liu

    2013-01-01

    Full Text Available Paroxysmal sympathetic storming (PSS is a rare disorder characterized by acute onset of nonstimulated tachycardia, hypertension, tachypnea, hyperthermia, external posturing, and diaphoresis. It is most frequently associated with severe traumatic brain injuries and has been reported in intracranial tumors, hydrocephalous, severe hypoxic brain injury, and intracerebral hemorrhage. Although excessive release of catecholamine and therefore increased sympathetic activities have been reported in subarachnoid hemorrhage (SAH, there is no descriptive report of PSS primarily caused by spontaneous SAH up to date. Here, we report a case of prolonged PSS in a patient with spontaneous subarachnoid hemorrhage and consequent vasospasm. The sympathetic storming started shortly after patient was rewarmed from hypothermia protocol and symptoms responded to Labetalol, but intermittent recurrence did not resolve until 3 weeks later with treatment involving Midazolam, Fentanyl, Dexmedetomidine, Propofol, Bromocriptine, and minimizing frequency of neurological and vital checks. In conclusion, prolonged sympathetic storming can also be caused by spontaneous SAH. In this case, vasospasm might be a precipitating factor. Paralytics and hypothermia could mask the manifestations of PSS. The treatment of the refractory case will need both timely adjustment of medications and minimization of exogenous stressors or stimuli.

  14. Operation treatment research progress of intracranial aneurysm rupture%颅内动脉瘤破裂出血的手术治疗的进展研究

    Institute of Scientific and Technical Information of China (English)

    宋洋; 王宏勤

    2015-01-01

    颅内动脉瘤是血管壁的局部病理性扩张引起的。在受到外力或精神紧张引起的颅内压增高情况下很容易发生破裂出血。颅内动脉瘤破裂造成蛛网膜下腔出血,产生颅内占位效应,造成患者偏瘫,严重时危及患者生命。颅内动脉瘤出血病死率随着时间的推移而增加,动脉瘤破裂出血后早期闭塞与相关治疗很有必要的。该研究从颅内动脉瘤出血的多种手术方式及我国动脉瘤手术治疗现状研究做一下相关介绍。%Intracranial aneurysm is caused by localized pathological dilatation of the vessel wall. Under increased intracranial press, intracranial aneurysm are prone to rupture.The rupture of intracranial aneurysm causes subarachnoid hemorrhage,which pro-duces intracranial mass effect, results in paralysis , even losses lives. Intracranial aneurysm bleeding over time the cumulative The mortality of ruptured intracranial aneurysm is gradually increasing with the time gone on. It is pretty necessary to do early occlu-sion and corresponding treatment for the rupture of intracranial aneurysm.This article will introduce a variety of surgical ways and our country status about intracranial aneurysm surgery.

  15. The perinatal loss and parental reflection

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    Kamile Kukulu

    2010-12-01

    Full Text Available In this review, the causes of prenatal losses, pregnancy termination and reflection of this situation for the parents were investigated. Despite great attention in improving perinatal care, perinatal loss (fetal loss and newborn death continues to occur. According to the World Health Organization (WHO, the perinatal period extends from the 20th gestational week through 1 month after birth. However, researchers who study perinatal loss use a broader definition that includes early (during the first 12 weeks following conception as well as late fetal loss (>20 weeks’ gestation. Of all known pregnancies, an estimated ratio of 12% to 20% ends in an early fetal loss. The most recent available data have revealed that the rates translate to about 1.03 million annual fetal losses and, for 2004, 18.602 newborn deaths. According to the results of 2008, infant mortality rate decreased very rapidly in Turkey. Of the many parents who suffer a perinatal loss, at least 80% become pregnant again, an event that occurs within 18 months. Therefore, it is important for nurses and health care professionals to understand the impact of a perinatal loss on a subsequent pregnancy. The purpose of this article is to perform an investigation on parental, primarily maternal, responses to pregnancy subsequent to perinatal loss, and to describe nursing implications for parents during the subsequent pregnancy.

  16. Perinatal Complications and Aging Indicators by Midlife

    Science.gov (United States)

    Caspi, Avshalom; Ambler, Antony; Belsky, Daniel W.; Chapple, Simon; Cohen, Harvey Jay; Israel, Salomon; Poulton, Richie; Ramrakha, Sandhya; Rivera, Christine D.; Sugden, Karen; Williams, Benjamin; Wolke, Dieter; Moffitt, Terrie E.

    2014-01-01

    BACKGROUND: Perinatal complications predict increased risk for morbidity and early mortality. Evidence of perinatal programming of adult mortality raises the question of what mechanisms embed this long-term effect. We tested a hypothesis related to the theory of developmental origins of health and disease: that perinatal complications assessed at birth predict indicators of accelerated aging by midlife. METHODS: Perinatal complications, including both maternal and neonatal complications, were assessed in the Dunedin Multidisciplinary Health and Development Study cohort (N = 1037), a 38-year, prospective longitudinal study of a representative birth cohort. Two aging indicators were assessed at age 38 years, objectively by leukocyte telomere length (TL) and subjectively by perceived facial age. RESULTS: Perinatal complications predicted both leukocyte TL (β = −0.101; 95% confidence interval, −0.169 to −0.033; P = .004) and perceived age (β = 0.097; 95% confidence interval, 0.029 to 0.165; P = .005) by midlife. We repeated analyses with controls for measures of family history and social risk that could predispose to perinatal complications and accelerated aging, and for measures of poor health taken in between birth and the age-38 follow-up. These covariates attenuated, but did not fully explain the associations observed between perinatal complications and aging indicators. CONCLUSIONS: Our findings provide support for early-life developmental programming by linking newborns’ perinatal complications to accelerated aging at midlife. We observed indications of accelerated aging “inside,” as measured by leukocyte TL, an indicator of cellular aging, and “outside,” as measured by perceived age, an indicator of declining tissue integrity. A better understanding of mechanisms underlying perinatal programming of adult aging is needed. PMID:25349321

  17. Unpredicted Sudden Death due to Recurrent Infratentorial Hemangiopericytoma Presenting as Massive Intratumoral Hemorrhage: A Case Report and Review of the Literature.

    Science.gov (United States)

    Tanaka, Toshihide; Kato, Naoki; Hasegawa, Yuzuru; Murayama, Yuichi

    2014-01-01

    Unpredicted sudden death arising from hemangiopericytoma with massive intracranial hemorrhage is quite rare. We encountered a patient with recurrent infratentorial hemangiopericytoma presenting as life-threatening massive intracerebral hemorrhage. A 43-year-old man who had undergone craniotomy for total resection of an infratentorial hemangiopericytoma 17 months earlier presented with morning headache and generalized convulsions. Computed tomography revealed a massive hematoma in the right infratentorial region causing tonsillar herniation and emergency surgery was performed to evacuate the hematoma. Histological findings revealed hemangiopericytoma with hemorrhage. Neurological status remained unimproved and brain death was confirmed postoperatively. Hemangiopericytoma presenting as massive hemorrhage is quite rare. Since the risk of life-threatening massive hemorrhage should be considered, careful postoperative long-term follow-up is very important to identify tumor recurrences, particularly in the posterior cranial fossa, even if the tumor is completely removed.

  18. Unpredicted Sudden Death due to Recurrent Infratentorial Hemangiopericytoma Presenting as Massive Intratumoral Hemorrhage: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Toshihide Tanaka

    2014-01-01

    Full Text Available Unpredicted sudden death arising from hemangiopericytoma with massive intracranial hemorrhage is quite rare. We encountered a patient with recurrent infratentorial hemangiopericytoma presenting as life-threatening massive intracerebral hemorrhage. A 43-year-old man who had undergone craniotomy for total resection of an infratentorial hemangiopericytoma 17 months earlier presented with morning headache and generalized convulsions. Computed tomography revealed a massive hematoma in the right infratentorial region causing tonsillar herniation and emergency surgery was performed to evacuate the hematoma. Histological findings revealed hemangiopericytoma with hemorrhage. Neurological status remained unimproved and brain death was confirmed postoperatively. Hemangiopericytoma presenting as massive hemorrhage is quite rare. Since the risk of life-threatening massive hemorrhage should be considered, careful postoperative long-term follow-up is very important to identify tumor recurrences, particularly in the posterior cranial fossa, even if the tumor is completely removed.

  19. 颅内动脉瘤遗传学研究进展%Advances in genetics of intracranial aneurysm

    Institute of Scientific and Technical Information of China (English)

    高涢; 王雄伟

    2016-01-01

    Intracranial aneurysm is an abnormal bulging of intracranial artery wall. Its rupture can lead to subarachnoid hemorrhage. About 50% of patients with aneurysmal subarachnoid hemorrhage will die or have poor outcomes. At present, intracranial aneurysm is considered as a complex disease associated with genetic and environmental factors. Although the etiology of intracranial aneurysm is not completely clear, a lot of evidence has shown that the genetic factor plays an important role in the processes of its occurrence, development and rupture. This article reviews the advances in gene linkage research, genome wide association studies, and gene expression research in intracranial aneurysm in recent years.%颅内动脉瘤是颅内动脉管壁的异常膨出,其破裂可导致蛛网膜下腔出血,约50%的动脉瘤性蛛网膜下腔出血患者死亡或转归不良。目前认为,颅内动脉瘤是一种与遗传和环境因素相关的复杂疾病。尽管颅内动脉瘤的病因尚不完全清楚,但诸多证据表明遗传因素在其发生、发展和破裂过程中起着重要作用。文章对近年来颅内动脉瘤的基因连锁研究、全基因组关联研究以及基因表达研究的进展进行了综述。

  20. Cerebral venous etiology of intracranial hypertension and differentiation from idiopathic intracranial hypertension

    Directory of Open Access Journals (Sweden)

    Stefan Mircea Iencean

    2015-03-01

    Full Text Available This study presents the characteristics that distinguish between idiopathic intracranial hypertension (ICH and ICH caused by intracranial vascular damage. Twenty-one patients with ICH were included in this study. The analysis of the symptomatology correlated with the values of intracranial pressure, and the imaging findings revealed significant differences between these two types of ICH. ICH caused by intracranial venous vascular damage is named vascular ICH. Vascular ICH has a known etiology, such as cerebral vascular illness, and a relatively rapid increase in intracranial pressure of approximately 21 cmH2O and imaging findings show characteristic images of thrombosis or stenosis of the intracranial venous system, while all brain images (computed tomography, magnetic resonance imaging, angio-magnetic resonance imaging are normal in idiopathic ICH. The treatment of vascular ICH is etiologic, pathogenic, and symptomatic, but that of idiopathic ICH is only symptomatic.

  1. Cerebral venous etiology of intracranial hypertension and differentiation from idiopathic intracranial hypertension.

    Science.gov (United States)

    Iencean, Stefan Mircea; Poeata, Ion; Iencean, Andrei Stefan; Tascu, Alexandru

    2015-03-01

    This study presents the characteristics that distinguish between idiopathic intracranial hypertension (ICH) and ICH caused by intracranial vascular damage. Twenty-one patients with ICH were included in this study. The analysis of the symptomatology correlated with the values of intracranial pressure, and the imaging findings revealed significant differences between these two types of ICH. ICH caused by intracranial venous vascular damage is named vascular ICH. Vascular ICH has a known etiology, such as cerebral vascular illness, and a relatively rapid increase in intracranial pressure of approximately 21 cmH2O and imaging findings show characteristic images of thrombosis or stenosis of the intracranial venous system, while all brain images (computed tomography, magnetic resonance imaging, angio-magnetic resonance imaging) are normal in idiopathic ICH. The treatment of vascular ICH is etiologic, pathogenic, and symptomatic, but that of idiopathic ICH is only symptomatic. Copyright © 2015. Published by Elsevier Taiwan.

  2. Pediatric intracranial primary anaplastic ganglioglioma.

    Science.gov (United States)

    Lüdemann, Wolf; Banan, Rouzbeh; Hartmann, Christian; Bertalanffy, Helmut; Di Rocco, Concezio

    2017-02-01

    Primary intracranial anaplastic gangliogliomas are rare tumors in the pediatric patient group. Most of them present with symptoms of elevated pressure or symptomatic epilepsy. Extraaxial location is far more common than axial location. On MRI examination, they mimic pilocytic astrocytomas. The outcome after surgery depends mainly on the possible amount of surgical resection, and oncological therapy is necessary to prevent recurrence of the disease. An 11-year-old boy presented with headache and double vision due to obstructive hydrocephalus. MRI of the brain revealed an axial partially contrast enhancing lesion in the quadrigeminal plate extending from the cerebellum to the pineal gland and causing hydrocephalus. Subtotal removal of the lesion was performed, and the diagnosis of an anaplastic ganglioglioma was established and confirmed by the reference center. At the latest follow up (3 months), the boy is without any neurological symptoms and scheduled for radiation therapy as well as chemotherapy.

  3. Intracranial manifestations of malignant lymphomas

    Energy Technology Data Exchange (ETDEWEB)

    Galanski, M.; Fahrendorf, G.; Urbanitz, D.; Beckmann, A.; Elger, C.

    1985-06-01

    Approximately 10% of patients with malignant lymphoma will show neurological symptoms at some time during the course of their illness. In non-Hodgkin lymphoma, CNS involvement is more frequent than in Hodgkin's disease. Diffuse histiocytic and poorly differentiated lymphomas, bone marrow involvement, advanced tumor stage and hematogenous spread are particular risk factors. Invasion of the spinal canal is the most common type of CNS involvement. Intracranial lesions, which are comparatively rare, may present as intracerebral metastases, epi- or subdural masses or focal or diffuse leptomeningeal disease. Lymphomatous leptomeningitis usually cannot be demonstrated by CT. On the other hand, dural and cerebral parenchymal lesions are sometimes highly characteristic of lymphoma as a result of their features and location.

  4. Evaluation of pituitary and thyroid hormones in patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm Avaliação dos hormônios hipofisários e tireoidianos em pacientes com hemorragia subaracnoidea devido a ruptura de aneurisma intracraniano

    Directory of Open Access Journals (Sweden)

    Paola Mangieri

    2003-03-01

    Full Text Available It is well known that the central nervous system (CNS influences the pituitary hormone secretions and that diseases of CNS are frequently associated with an altered endocrine function. The aim of this study has been the evaluation of the serum concentrations of the pituitary and thyroid hormones in a series of patients with subarachnoid hemorrhage due to a ruptured cerebral aneurysm. Thirty-five patients (23 females and 12 males, aged 51.9±13.3 years on the mean were admitted. They were evaluated to assess the clinical severity of the subarachnoid hemorrhage by Hunt & Hess scale: nine patients were in the grade I, 14 in the grade II, and 12 in the grade III. Blood samples were obtained between 8:00 and 9:00 a.m. and serum hormones were measured by commercial kits (IRMA or MEIA methods. Cortisol serum levels (normal range (NR = 5 to 18 µg/dL were increased in all the patients (mean ± standard deviation = 31.4±12.4 µg/dL. Mean prolactin levels (NR É bem conhecido que o sistema nervoso central (SNC influencia as secreções dos hormônios hipofisários e que doenças do SNC são frequentemene associadas com função endócrina alterada. O objetivo deste estudo foi avaliar as concentrações séricas dos hormônios hipofisários e tireoidianos em uma série de pacientes acometidos de hemorragia subaracnóidea devida a ruptura de aneurisma cerebral. Foram avaliados 35 pacientes (23 mulheres e 12 homens, com média de idade de 51,9±13,3 anos. Foram avaliados para a severidade da doença pela escala de Hunt & Hess: nove deles estavam no grau I, 14 no grau II e 12 no grau III. As amostras de sangue foram obtidas entre 8:00 e 9:00 horas e os hormônios foram medidos pelos métodos de IRMA ou de MEIA. Os níveis séricos de cortisol (valor normal (VN 5 a 18 µg/dl estavam aumentados em todos os pacientes (média±desvio padrão = 31,4±12,4 µg/dl. Os níveis de prolactina (VN <20 ng/ml foram de 18,6±17,1 ng/ml e cinco (14,2% tiveram n

  5. Hemorrhagic Fever with Renal Syndrome (HFRS)

    Science.gov (United States)

    ... this page: About CDC.gov . Share Compartir Hemorrhagic Fever with Renal Syndrome (HFRS) On this Page What ... is HFRS prevented? Suggested Reading What is hemorrhagic fever with renal syndrome? Hemorrhagic fever with renal syndrome ( ...

  6. Headache following intracranial neuroendovascular procedures.

    Science.gov (United States)

    Baron, Eric P; Moskowitz, Shaye I; Tepper, Stewart J; Gupta, Rishi; Novak, Eric; Hussain, Muhammad Shazam; Stillman, Mark J

    2012-05-01

    Predicting who will develop post-procedure headache (PPH) following intracranial endovascular procedures (IEPs) would be clinically useful and potentially could assist in reducing the excessive diagnostic testing so often obtained in these patients. Although limited safety data exist, the use of triptans or dihydroergotamine (DHE) often raise concern when used with pre/post-coiled aneurysms. We sought to determine risk factors for PPH following IEP, to evaluate the utility of diagnostic testing in patients with post-coil acute headache (HA), and to record whether triptans and DHE have been used safely in this clinical setting. We conducted a retrospective chart review of adult patients undergoing IEPs. Bivariate analyses were conducted to compare patients who did and did not develop PPH. We reviewed records pertaining to 372 patients, of whom 263 underwent intracranial coil embolizations, 21 acrylic glue embolizations, and 88 stent placements. PPH occurred in 72% of coil patients, 33% of glue patients, and 14% of stent patients. Significant risk factors for post-coil HA were female gender, any pre-coil HA history, smoking, and anxiety/depression. A pre-stent history of HA exceeding 1 year's duration, and smoking were risk factors for post-stent HA. A pre-glue history of HA exceeding 1 year was the only risk factor for post-glue HA. In the small subgroup available for study, treatment with triptans or DHE was not associated with adverse events in pre/post-coiled aneurysms. Diagnostic testing was low yield. Occurrence of PPH was common after IEPs and especially so with coiling and in women, smokers, and those with anxiety/depression, and was often of longer duration than allowed by current International Classification of Headache Disorders-II criteria. The yield of diagnostic testing was low, and in a small subgroup treatment with triptans or DHE did not cause adverse events in pre/post-coiled aneurysms. Prospective studies are needed to confirm these findings.

  7. STUDY OF MATERNAL AND PERINATAL OUTCOME IN REFERRED OBSTETRICS CASES

    Directory of Open Access Journals (Sweden)

    Umesh

    2015-03-01

    Full Text Available OBJECTIVE: To review the referred obstetric cases for reason of referral and to study the maternal and perinatal outcome. DESIGN: Prospective Observational study . STUDY POPULATION: 380 cases referred from periphery to tertiary care institute in one year duration. METHODS: INCLUSION C RITERIA : All referred ANC cases to our tertiary care institute >20 weeks gestation. The total number of deliveries during this period were 11106. The total number of referred cases in above study period was 1980. Out of these 1520 met the inclusion criteria & according to the sample size calculated 380 cases were selected for the study. Selection of cases were done by systematic sampling technique. RESULTS: The proportion of referral cases to the tertiary care institute is 17.83%. Majority (42.37% of referred cases were from district level hospitals showing lacunae in the emergency obstetric care given at the district level hospitals. In present study, there was unavailability of ambulance in 65.26% of cases for transport. Most (92.89% of the patients were not accompanied by any medical assistance during transport. Major complication during immediate postpartum period was postpartum hemorrhage (19.99%. In our study, 31.84% of the patients required blood/blood products transfusion. There were 3(0.79% maternal mortalities in present study & behind these there were total 70(18.42% near miss cases which provide valuable information on the quality of antenatal care at the periphery. 54.87% of all neonates had low birth weight in this study. In present study, 45.90% babies were p reterm. Total NICU admission rate was 14.36%. Neonatal mortality documented in present study was 5.38%. CONCLUSION: The present study has shown that improper antenatal & intranatal care at the periphery level is responsible for poor maternal & perinatal outcome. Rural women have very poor access to MCH services. There is lack of Transportation facilities for referral patients & they have to

  8. Hypertensive response to raised intracranial pressure in infancy.

    OpenAIRE

    Kaiser, A M; Whitelaw, A G

    1988-01-01

    Mean arterial pressure and intracranial pressure were measured serially in six infants with intracranial hypertension (intracranial pressure greater than 20 mm Hg), and cerebral perfusion pressure was calculated from their difference. Overall, mean arterial pressure increased with rising intracranial pressure at a mean rate of 0.20 mm Hg/mm Hg. This caused a fall in cerebral perfusion pressure with increasing intracranial pressure at a mean rate of 0.80 mm Hg/mm Hg overall, although cerebral ...

  9. Post-tonsillectomy hemorrhage

    DEFF Research Database (Denmark)

    Heidemann, Christian; Wallén, Mia; Aakesson, Marie;

    2008-01-01

    Post-tonsillectomy hemorrhage (PTH) is a relatively common and potentially life-threatening complication. The objective of this study was to examine the rate of PTH and identify risk factors. A retrospective cohort study was carried out including all tonsillectomies (430 patients) performed...... as surgical technique" [relative risk (RR) = 5.3], "peritonsillar abscess as indication for surgery" (RR = 0.3) and "age equal to or above 15 years at the time of surgery" (RR = 5.4). It is concluded that patient age, PTA as indication for surgery and the use of coblation significantly affect the occurrence...

  10. Primary hemorrhagic stroke in a 12-year-old female with sickle cell disease and normal transcranial Doppler.

    Science.gov (United States)

    Wolf, Michael; Cangemi, Carla; Drachtman, Richard; Masterson, Margaret

    2008-06-01

    Stroke is a well-known complication of sickle cell disease (SCD). It is estimated to occur in approximately 11% of patients with SCD by the age of 20. The most frequent cause of cerebrovascular accident (CVA) is blockage of the intracranial internal carotid and middle cerebral arteries. Hemorrhagic stroke is less common, occurring in approximately 3% of children by age 20. Transcranial Doppler (TCD) is the standard test for prediction of stroke risk in children with sickle cell anemia. The authors present a case of a 12-year-old female with SCD transferred to their institution after suffering a catastrophic intracranial hemorrhage. Her most recent TCD was normal 6 months prior to her admission.

  11. Massive fetomaternal transplacental hemorrhage as a perinatology problem, role of ABO fetomaternal compatibility--case studies.

    Science.gov (United States)

    Zizka, Z; Calda, P; Zlatohlavkova, B; Haakova, L; Cerna, M; Jirasek, J E; Fait, T; Hajek, Z; Kvasnicka, J

    2001-01-01

    Massive fetomaternal transplacental hemorrhage is not simply a problem of possible alloimunization in Rh incompatibility but also endangers the fetus (newborn) by massive anemization. Bleeding from placental vessels can occur after small trauma to the gravid uterus with mild or no clinical signs (bleeding or spotting, pain, hypertonus). The rupture of anchoring villi related to early uterine contractions is also possible. In the case of slow blood loss, the fetus reacts by adequate or inadequate compensatory reactions (hydrops fetus). Rapid and massive blood loss is followed by perinatal hypoxic damage and finally death. Our goal was to map out the diagnostic and therapeutic possibilities in regard to specific neonatal care. We evaluated four cases of fetomaternal transfusion during a 2-year period with special regard to postpartum adaptation of the newborn and the perinatal outcome. The incidence of adverse outcomes following massive fetomaternal transplacental hemorrhage was 50% (2 of 4). There was one perinatal death and one infant was affected by spastic quadriplegia. For diagnosis, it is possible to use cardiotocography (decreased variability, sinusoid pattern), ultrasound (biophysical profile) and special hematological tests for quantitative determination of fetal erythrocytes in the maternal blood. For the treatment of such cases one should consider premature termination of pregnancy or intraumbilical transfusion.

  12. MR angiography after coiling of intracranial aneurysms

    NARCIS (Netherlands)

    Schaafsma, J.D.

    2012-01-01

    Introduction Endovascular occlusion with detachable coils has become an alternative treatment to neurosurgical clipping of intracranial aneurysms over the last two decades. Its minimal invasiveness is the most important advantage of this treatment compared to clipping. The disadvantage of occlusion

  13. Rapid natural resolution of intracranial hematoma

    Institute of Scientific and Technical Information of China (English)

    吴明灿; 刘建雄; 罗国才; 张志文; 闵杰; 余辉; 姚远

    2004-01-01

    Objective:To investigate the clinical characteristics of intracranial hematoma and the mechanism involved in its rapid natural resolution. Methods:Seventeen cases of intracranial hematoma with typical clinical and CT manifestations were retrospectively studied. Results: Intracranial hematoma was found obviously decreased in size within 72 h after its occurrence in 8 cases. The rest 9 cases presented complete resolution. Conclusions: Rapid natural resolution of acute epidural hematoma is mostly found in teenagers and the resolution is correlated with cranial fracture at the hematoma site. As for acute subdural hematoma, its rapid resolution is associated with the transfer of cerebrospinal fluid toward subdural space, the lavage effect, and the compression caused by the increased intracranial pressure or the space left resulting from redistribution of the hematoma in brain atrophy.

  14. Atypical imaging appearances of intracranial meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    O' Leary, S. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom); Adams, W.M. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom); Parrish, R.W. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom); Mukonoweshuro, W. [Radiology Department, Derriford Hospital, Plymouth (United Kingdom)]. E-mail: William.mukonoweshuro@phnt.swest.nhs.uk

    2007-01-15

    Meningiomas are the commonest primary, non-glial intracranial tumours. The diagnosis is often correctly predicted from characteristic imaging appearances. This paper presents some examples of atypical imaging appearances that may cause diagnostic confusion.

  15. Intracranial aneurysm associated with relapsing polychondritis

    Energy Technology Data Exchange (ETDEWEB)

    Coumbaras, M.; Boulin, A.; Pierot, L. [Dept. of Neuroradiology, Hopital Foch, Suresnes (France); Piette, A.M.; Bletry, O. [Dept. of Medicine, Hopital Foch, Suresnes (France); Graveleau, P. [Dept. of Neurology, Hopital Foch, Suresnes (France)

    2001-07-01

    We describe a 50-year-old man with relapsing polychondritis (RP) involving auricular cartilage, uveitis and hearing loss, who had an aneurysm of the anterior cerebral artery. Intracranial aneurysm is a rare manifestation of RP. (orig.)

  16. Anosmia After Perimesencephalic Nonaneurysmal Hemorrhage

    NARCIS (Netherlands)

    Greebe, Paut; Rinkel, Gabriel J. E.; Algra, Ale

    2009-01-01

    Background and Purpose-Anosmia frequently occurs after aneurysmal subarachnoid hemorrhage not only after clipping, but also after endovascular coiling. Thus, at least in part, anosmia is caused by the hemorrhage itself and not only by surgical treatment. However, it is unknown whether anosmia is rel

  17. Factores de Accesibilidad Relacionados con Muerte Perinatal

    Directory of Open Access Journals (Sweden)

    Vilma del Socorro Catalán Álvarez

    2010-12-01

    Full Text Available Introducción: Objetivo Describir diferencias de factores relacionados con accesibilidad a servicios de salud, entre un grupo de mujeres que tuvieron parto en instituciones prestadoras de servicios de salud de Bucaramanga, cuyos productos sufrieron muerte perinatal y otro grupo con productos vivos, procedentes de Lebrija Santander año 2004. Materiales y métodos: estudio de caso descriptivo, retrospectivo. De 15 muerte perinatal reportadas, sólo 7 cumplían criterios de inclusión. Por cada muerte perinatal, se seleccionaron por conveniencia, 3 madres con niños vivos. Las variables estudiadas, mediante frecuencia absoluta y relativa, fueron: Características de la madre, del niño, Oportunidad, Percepción de atención, Funcionalidad, Costos. Resultados: 6 muerte perinatal previsibles, 1 no previsible. 3 pertenecían al régimen subsidiado, 1 al contributivo, 3 no aseguradas. Se observó, falta de oportunidad para remisión de madres e intervención del parto. Mujeres con 3 ó más controles, presentaron mayor frecuencia relativa de muerte perinatal. También se observó insatisfacción en la percepción de atención, en 3 aspectos estudiados, en 3 niveles de atención. Discusión y Conclusiones: Implementar políticas encaminadas a mejorar la oportunidad de atención materna-perinatal, facilitando acceso oportuno para prestación de servicios de salud. Controles prenatales enfocados en búsqueda de factores relacionados con muerte perinatal. Fortalecer Sistemas de Vigilancia Epidemiológica y Centro Regulador de Urgencias. (Rev Cuid 2010;1(1:26-34.Palabras clave: Mortalidad perinatal, Accesibilidad, Servicios de Salud. (Fuente DeCs, BIREME.

  18. Genetic and perinatal effects of abused substances

    Energy Technology Data Exchange (ETDEWEB)

    Brande, M.C.; Zimmerman, A.M.

    1987-01-01

    This book provides an overview of the effects of several abused drugs, including opiates, cannabinoids, alcohol, nicotine, and cocaine, with special emphasis on the actions of these substances at the molecular and cellular levels. The first half deals with genetic effects, including molecular genetics, biochemical genetics, pharmacogenetics, cytogenetics, and genetic toxicity. The second half focuses on perinatal effects and covers: drug abuse during pregnancy; biochemical aspects of marihuana on male reproduction; and long-term behavioral and neuroendocrine effects of perinatal alcohol exposure.

  19. Intrapartum fever and the risk for perinatal complications - the effect of fever duration and positive cultures.

    Science.gov (United States)

    Ashwal, Eran; Salman, Lina; Tzur, Yossi; Aviram, Amir; Ben-Mayor Bashi, Tali; Yogev, Yariv; Hiersch, Liran

    2017-04-24

    To estimate the association between intrapartum fever and adverse perinatal outcome. A retrospective cohort study of women attempting vaginal delivery at term in a tertiary hospital (2012-2015). Perinatal outcome of deliveries complicated by intrapartum fever (≥38.0 °C) were compared to women with no intrapartum fever matched by parity and gestational age at delivery in a 1:2 ratio. Maternal outcome included cesarean section (CS), operative vaginal delivery (OVD), retained placenta or post-partum hemorrhage. Neonatal outcome included 5-minute Apgar score fever and 618 served as controls. Women with intrapartum fever had higher rates of OVD (34.3 versus 19.6%, p fever was independently associated with adverse maternal (3.75, 95%CI 2.65-5.30, p fever duration was related to maternal complications, specifically to CS. In addition, maternal bacteremia and positive placental cultures were risk factors for neonatal complications compared to those with negative cultures (23.3 versus 9.8%, p = .01). Intrapartum fever was associated with adverse perinatal complications. The duration of intrapartum fever, maternal bacteremia, and positive cultures further increase this risk.

  20. Intracranial chondroma of the occipital lobe

    Energy Technology Data Exchange (ETDEWEB)

    Mobbs, R.J.; Narula, S.; Berger, M.; Kwok, B.C.T. [Prince of Wales Hospital, Sydney, NSW (Australia). Departments of Neurosurgery and Radiology

    1998-02-01

    A case report of an intracranial chondroma is discussed with emphasis on magnetic resonance imaging. A case is presented of a chondroma originating in the left occipital pole close to the vertex in a 29-year-old female. Pathologic and radiologic findings with emphasis on the MR appearances are reported, followed by a brief discussion of the recent literature involving solitary intracranial chondroma. Copyright (1998) Blackwell Science Pty Ltd 12 refs., 3 figs.

  1. Intracranial leiomyosarcoma in a patient with AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Brown, H.G.; Burger, P.C. [Johns Hopkins Medical Institutions, Baltimore, MD (United States). Dept. of Pathology; Olivi, A.; Sills, A.K. [Department of Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, MD (United States); Barditch-Crovo, P.A. [Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD (United States); Lee, R.R. [Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD (United States)

    1999-01-01

    We report an intracranial leiomyosarcoma in the pontine cistern of a 34-year-old woman infected with the human immunodeficiency virus (HIV). The clinical, radiological and pathological data are reviewed. The tumor was Epstein-Barr virus (EBV) positive by in situ hybridization. This case emphasizes that smooth muscle neoplasms arising in the setting of immunocompromise can occur intracranially, and corroborates a hypothesis that EBV coinfection may have a role in development of these tumors. (orig.) (orig.) With 6 figs., 22 refs.

  2. Cognitive function in idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne Maria; Fagerlund, Birgitte; Forchhammer, Hysse Birgitte;

    2014-01-01

    OBJECTIVE: To explore the extent and nature of cognitive deficits in patients with idiopathic intracranial hypertension (IIH) at the time of diagnosis and after 3 months of treatment. DESIGN: Prospective case-control study. SETTING: Neurological department, ophthalmological department and a terti......OBJECTIVE: To explore the extent and nature of cognitive deficits in patients with idiopathic intracranial hypertension (IIH) at the time of diagnosis and after 3 months of treatment. DESIGN: Prospective case-control study. SETTING: Neurological department, ophthalmological department...

  3. Mucocele and pyocele with marked intracranial extension

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, Kazuhiro; Machida, Tohru; Iio, Masahiro

    1984-08-01

    Two cases are presented with frontal sinus pyocele and fronto-ethmoid sinus mucocele in which marked intracranial extension is shown. Their intracranial part appeared as a large biconvex mass, which showed iso or slightly low density homogeneously and had gross calcification in the posterior rim. The findings of the paranasal sinuses and the orbit in tomograms and CT scans are thought to be useful in the differential diagnosis of chronic subdural hematoma.

  4. Recurrent perinatal loss: a case study.

    Science.gov (United States)

    Kavanaugh, K; Robertson, P A

    1999-01-01

    To date, investigators have not demonstrated a clear relationship between a parent's history of prior perinatal losses and intensity of grief response following a subsequent perinatal loss. Examining this relationship for low-income, African-American parents is important because they are a vulnerable population due to the high incidence of perinatal mortality in Blacks and their other life stressors that can impact on grief response and caring needs. The purpose of this case study was to examine the impact of recurrent perinatal loss on a low-income African-American parent. The research design for this study was case report, using interview data collected from a mother who had recently experienced her fourth perinatal loss, which occurred at twenty-five weeks of gestation. Transcripts from two open-ended interviews were analyzed. The theoretical framework used to guide analysis of this case study was Lazarus and Folkman's stress and coping theory. Results demonstrated that the prior perinatal losses did not appear as critical components of the way the mother responded to her most recent loss. Instead, perception of the care she received from healthcare providers and how that care related to her experiences with her one living child who was born at the same gestational age was an important determinant in how she responded to her loss. The results of this case study demonstrate the importance assessing a person's perception of their experience and those factors which contribute to the way they respond.

  5. Prevention of perinatal HIV transmission: the Perinatal HIV Hotline perspective.

    Science.gov (United States)

    Waldura, Jess Fogler

    2011-01-01

    Among the most frequently asked questions by callers to the National Perinatal HIV Hotline are those on the use of hormonal contraception in women receiving antiretroviral therapy. Estradiol levels are reduced by ritonavir-boosted protease inhibitors (PIs), nelfinavir, and nevirapine and increased by non-ritonavir-boosted PIs (except nelfinavir), efavirenz, and etravirine. Oral contraceptives do not affect antiretroviral drug levels, and several options are available for hormonal contraception that can compensate for or avoid the effects of antiretroviral drugs on estrogen levels. Other common questions on the hotline involve interpretation and management issues that arise from indeterminate Western blot test results early and late in pregnancy and from positive rapid test results during labor. Many questions focus on appropriate selection of antiretroviral drugs in pregnancy and the need to change regimens to reduce risk of birth defects in the child. This articlesummarizes a presentation by Jess Fogler Waldura, MD, at the 13th Annual Clinical Conference for the Ryan White HIV/AIDS Program held in August 2010 in Washington, DC.

  6. Increased Intracranial Pressure Following Removal of Intracranial Lesions

    Directory of Open Access Journals (Sweden)

    B. Ramamurthi

    1964-01-01

    Full Text Available Increased intracramal tension may 0 ise some days or ''leeks the problem may ari 1 of lrelUova "nt r a cra nial tumours or . lfter operation. , ""n" . " such increased tensicn raises the pOSS1- In the immed.',iate postoperat1ve perlOd" " f eopenino- Unrelieved tentorial -" d f c the dec1s10n or r O' lility of a clot rormattcn an ore ~ "e"ln .or the so called third day post " f thrombus Into a ma](Ir v .' , herniation. extenslOn 0 a f h raised intracranial pressure,. th common causes 0 sue operative oede~a. are e dematous blockage of ventricular system may When the ventnclc' has been opened. oe have to be tackled by repeated ventricular puncture. the fear of this postoperative oedema is the reason In posterior fossa surgery. '. - ' h many neurosuTgeons leave the dura open. w y " ommoner in posterior fossa " " tracranial presurc1 1S c Late onset of mcreased in f ttbromae or after excision of " b-total removal 0 neuro . operations spec1ally after su ti t the site of surgery or adheslOns block- " cyst forma ion a tubercnlomas. The cause :s Following air studies. a shunt procedure or a ing the cerebrospinal flUld "pa~hWay. tentorial incision would be md1cated.

  7. Experience of nursing care in patients with intracranial aneurysm caused by intracranial aneurysm%栓塞术治疗颅内动脉瘤所致的蛛网膜下腔出血术前护理体会

    Institute of Scientific and Technical Information of China (English)

    田琴; 葸红; 贺艳君

    2015-01-01

    目的:探讨血管内介入弹簧圈栓塞术治疗颅内动脉瘤所致的蛛网膜下腔出血术前护理。方法对20例经血管介入弹簧圈栓塞术治疗颅内动脉瘤所致的蛛网膜下腔出血患者加强术前降压、镇静、密切观察意识、瞳孔及生命体征的变化,防止引起颅内再出血。结果20例颅内动脉瘤所致的蛛网膜下腔出血患者给予血管内介入弹簧圈栓塞后取得满意效果。结论对颅内动脉瘤所致的蛛网膜下腔出血患者进行血管内介入弹簧圈栓塞术治疗,术前进行相应的护理干预措施,减少了颅内再次出血,为手术治疗争取时间。%Objective To investigate the nursing care of patients with intracranial aneurysm caused by endovascular embolization treatment of intracranial aneurysms. Methods 20 cases of intracranial aneurysms treated with endovascular embolization of intracranial aneurysms were treated with endovascular embolization, and the changes of blood pressure, sedation, close observation of the consciousness, pupil and vital signs were observed. Results 20 cases of intracranial aneurysms caused by subarachnoid hemorrhage were treated with endovascular embolization in the spring coil to obtain satisfactory results. Conclusion endovascular embolization treatment for patients with subarachnoid hemorrhage caused by intracranial aneurysms, and the corresponding nursing intervention measures, reduce the intracranial bleeding again, for the surgical treatment of time.

  8. Subarachnoid hemorrhage after aneurysm surgery

    Directory of Open Access Journals (Sweden)

    Carlos Gilberto Carlotti Junior

    1996-06-01

    Full Text Available The surgical treatment of intracranial aneurysms by clipping is recognized as effective and definitive. However some cases that suffered a new subarachnoid hemorrhage (SAH some time after they were submitted to aneurysm clipping have raised doubts about the concept of "cure"after this treatment. Eleven patients previously submitted to aneurysm clipping who presented a new SAH were analyzed. The time elapsed from surgery to SAH varied from 3 to 10 years. After SAH four patients had a poor outcome. The new episode of SAH occurred due to intrinsic factors of the cerebral vasculature: 1. a weak point of the vessel wall near the previous aneurysm, 2. a weak point of another vessel far from the previous aneurysm, 3. a previous infundibular dilation of the posterior communicating artery; and due to technical problems: 1. aneurysm not identified during the previous treatment, 2. aneurysm deliberately left untreated, 3. persistence of the aneurysm due to inappropriate surgery, 4. persistency of part of the aneurysm neck after clipping and 5. slipping of the clip from the neck of the aneurysm. The measures to prevent new SAH after surgery start with adequate preoperative angiographic studies, a careful inspection of the position of the clip and emptying of the aneurysm. Early angiography studies may reveal a persistent neck and later ones may reveal newly developed aneurysms. In conclusion, SAH after aneurysm clipping is a late and severe phenomenon and the concept of "cure" after this surgery should be interpreted with caution.O tratamento cirúrgico dos aneurismas cerebrais através de sua clipagem é reconhecido como eficaz e definitivo. Entretanto alguns casos sofrem nova hemorragia algum tempo após a cirurgia, deixando dúvidas sobre a "cura" pelo tratamento. Onze pacientes submetidos anteriormente a clipagem do aneurisma e que apresentaram nova hemorragia foram analisados. O intervalo de tempo da cirurgia para a nova hemorragia foi de 3 a 10 anos

  9. Analysis of the mechanisms of rabbit's brainstem hemorrhage complicated with irritable changes in the alvine mucous membrane

    Institute of Scientific and Technical Information of China (English)

    Xue-Long Jin; Yang Zheng; Hai-Ming Shen; Wen-Li Jing; Zhao-Qiang Zhang; Jian-Zhong Huang; Qing-Lin Tan

    2005-01-01

    AIM: To explore the dynamic changes in the pressure of the lateral ventricle during acute brainstem hemorrhage and the changes of neural discharge of vagus nerve under the load of intracranial hypertension, so as to analyze their effects on the congestive degree of intestinal mucous membrane and the morphologic changes of intestinal mucous membrane.METHODS: An operation was made to open the skull to obtain an acute brainstem hemorrhage animal model.Microcirculatory microscope photography device and video recording system were used to determine the changes continuously in the caliber of jejunal mesenteric artery during brainstem hemorrhage and the changes with time in the congestion of jejunal mucosal villi. We used HE stain morphology to analyze the changes of duodenal mucosal villi. A recording electrode was used to calculate and measure the electric discharge activities of cervical vagus nerve.RESULTS: (1) We observed that the pressure of lateral cerebral ventricle increased transiently during acute brainstem hemorrhage; (2) The caliber of the jejunal mesenteric artery increased during brainstem hemorrhage.Analysis of red color coordinate values indicated transient increase in the congestion of jejunal mucous membrane during acute brainstem hemorrhage; (3) Through the analysis of the pathologic slice, we found enlarged blood vessels, stagnant blood, and transudatory red blood cells in the duodenal submucous layer; (4) Electric discharge of vagus nerve increased and sporadic hemorrhage spots occurred in duodenal mucous and submucous layer, when the lateral ventricle was under pressure.CONCLUSION: Brainstem hemorrhage could causeintracranial hypertension, which would increase the neural discharge of vagus nerve and cause the transient congestion of jejunal mucous membrane. It could cause hyperemia and diffused hemorrhage in the duodenal submucous layer 48 h after brainstem hemorrhage.

  10. Intraparenchymal intracranial pressure monitoring in patients with acute liver failure Monitoreo intraparenquimatoso de presión intracraneana en pacientes con falla hepática aguda

    OpenAIRE

    Rabadán, Alejandra T.; Natalia Spaho; Diego Hernández; Adrián Gadano; Eduardo de Santibañes

    2008-01-01

    BACKGROUND: Elevated intracranial pressure (ICP) is a common cause of death in acute liver failure (ALF) and is determinant for decision-making regarding the timing of liver transplantation. The recommended type ICP monitoring device is controversial in ALF patients. Epidural devices had less risk of hemorrhagic complications, but they are less reliable than intraparenchymal ones. METHOD: Twenty-three patients with ALF were treated, and 19 of them received a liver transplant. Seventeen patien...

  11. Perinatal Risk Factors and Later Social, Thought, and Attention Problems after Perinatal Stroke

    Directory of Open Access Journals (Sweden)

    Mary J. Harbert

    2012-01-01

    Full Text Available Objective. Survivors of perinatal stroke may be at risk for behavioral problems. Perinatal risk factors that might increase the likelihood of later behavior problems have not been identified. The goal of this study was to explore whether perinatal factors might contribute to behavior problems after perinatal stroke. Methods. 79 children with unilateral perinatal stroke were studied. Perinatal factors included gender, gestational age, neonatal seizures, instrumented delivery, fetal distress, acute birth problems, birth weight, and time of diagnosis. Subjects with evidence of hypoxic ischemic encephalopathy were excluded. Parents completed the Achenbach Child Behavior Checklist (CBCL (Achenbach 1985. The CBCL yields T-scores in several symptom scales. We focused on Social, Thought, and Attention Problems scates. Results. Gestational age and the presence of uteroplacental insufficiency were associated with significant differences on the Thought Problems scale; Attention Problems scores approached significance for these variables. Fetal distress, neonatal seizures, or neonatal diagnosis was associated with 25–30% incidence of clinically significant T-scores on Social, Thought, and Attention Problems scales. Conclusions. Several perinatal factors were associated with a high incidence of social, thought, and behavior problems in children with perinatal stroke. These findings may be useful in anticipatory guidance to parents and physicians caring for these children.

  12. Cllnical analysis on 80 cases with hypertensive cerebral hemorrhage compllcating upper digestive tract hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Yang Y1chao; Wang Jian; Ye Bin; Li Honghong

    2000-01-01

    Objective: To irrvestigate the treatment and prognosis of the hypertensive cerebral hemorrhage (HCH)With upper dgest tract hemorrhage (UDDIH). Scence:I a surey of 760 cases randomely with HCH in nerve department betweem Jaruarry 1995 and October 1999, including 80 cases wuth UDTH (9.5%). Of the 80 cases 55 were males and25 were fenales, mean age of 60.2 years andrange of 45 to 80 years. Methods:To analyze the clinical materials of 80 cases with HCH complicating UDTH and HCH without UDTH for the same time. Results: Of the 80 cases 52 were cled during the treatment, death rate was 65%, but the death rate of cases without UDTH was 30.2% at the sane time. The death rate of HCH complicating UDTH was significantly ligher than that without UDTH Discussion The nosogeny of HCH complicating UDTH was more likely related to thalanic and brain-stem Lew is thought that thalemric and brain-stem were stimulated to secret CRF and made pituitany gland release ACTH, futhet secret advencortirn These factors gave rise to UDTH by incriesed to secretion of gastic acid Therefore, original ciseases wre Primarily be predcted and treated Patients with intracranial lypenrtension should be inmediately treated by using manniol or glyceric co, and antiacid, anticholinergic drugs. If all kinds of methods shouldn′t control UDTH, thrombin and noradrenaline bitarlrate with cold Natrii Chlori de would be giwn by nostril There have bettertherapeutic efficiency. Conclusion: HCH with UDTH belongs to severe cases, death rates are higher, original diseases and complication should be actively treated

  13. Moyamoya disease associated with asymptomatic mosaic Turner syndrome: a rare cause of hemorrhagic stroke.

    Science.gov (United States)

    Manjila, Sunil; Miller, Benjamin R; Rao-Frisch, Anitha; Otvos, Balint; Mitchell, Anna; Bambakidis, Nicholas C; De Georgia, Michael A

    2014-01-01

    Moyamoya disease is a rare cerebrovascular anomaly involving the intracranial carotid arteries that can present clinically with either ischemic or hemorrhagic disease. Moyamoya syndrome, indistinguishable from moyamoya disease at presentation, is associated with multiple clinical conditions including neurofibromatosis type 1, autoimmune disease, prior radiation therapy, Down syndrome, and Turner syndrome. We present the first reported case of an adult patient with previously unrecognized mosaic Turner syndrome with acute subarachnoid and intracerebral hemorrhage as the initial manifestation of moyamoya syndrome. A 52-year-old woman was admitted with a subarachnoid hemorrhage with associated flame-shaped intracerebral hemorrhage in the left frontal lobe. Physical examination revealed short stature, pectus excavatum, small fingers, micrognathia, and mild facial dysmorphism. Cerebral angiography showed features consistent with bilateral moyamoya disease, aberrant intrathoracic vessels, and an unruptured 4-mm right superior hypophyseal aneurysm. Genetic analysis confirmed a diagnosis of mosaic Turner syndrome. Our case report is the first documented presentation of adult moyamoya syndrome with subarachnoid and intracerebral hemorrhage as the initial presentation of mosaic Turner syndrome. It illustrates the utility of genetic evaluation in patients with cerebrovascular disease and dysmorphism.

  14. Risk Factors Affecting the Severity of Full-Term Neonatal Retinal Hemorrhage

    Directory of Open Access Journals (Sweden)

    Zhang Yanli

    2017-01-01

    Full Text Available Objective. The purpose of this study was to explore the underlying clinical factors associated with the degree of retinal hemorrhage (RH in full-term newborns. Methods. A total of 3054 full-term infants were included in this study. Eye examinations were performed with RetCamIII within one week of birth for all infants. Maternal, obstetric, and neonatal parameters were compared between newborns with RH and controls. The RH group was divided into three sections (I, II, and III based on the degree of RH. Results. RH was observed in 1202 of 3054 infants (39.36% in this study. The quantity and proportion of newborns in groups I, II, and III were 408 (13.36%, 610 (19.97%, and 184 (6.03%, respectively. Spontaneous vaginal delivery (SVD, prolonged duration of second stage of labor, advanced maternal age, and neonatal intracranial hemorrhage positively correlated with aggravation of the degree of RH in newborns. Conversely, cesarean section was protective against the incidence of RH. Conclusions. SVD, prolonged duration of second stage of labor, advanced maternal age, and neonatal intracranial hemorrhage were potential risk factors for aggravation of the degree of RH in full-term infants. Accordingly, infants with these risk factors may require greater attention with respect to RH development.

  15. Congenital and perinatal cytomegalovirus infection

    Directory of Open Access Journals (Sweden)

    Chun Soo Kim

    2010-01-01

    Full Text Available Cytomegalovirus (CMV is currently the most common agent of congenital infection and the leading infectious cause of brain damage and hearing loss in children. Symptomatic congenital CMV infections usually result from maternal primary infection during early pregnancy. One half of symptomatic infants have cytomegalic inclusion disease (CID, which is characterized by involvement of multiple organs, in particular, the reticuloendothelial and central nervous system (CNS. Moreover, such involvement may or may not include ocular and auditory damage. Approximately 90% of infants with congenital infection are asymptomatic at birth. Preterm infants with perinatal CMV infection can have symptomatic diseases such as pneumonia, hepatitis, and thrombocytopenia. Microcephaly and abnormal neuroradiologic imaging are associated with a poor prognosis. Hearing loss may occur in both symptomatic and asymptomatic infants with congenital infection and may progress through childhood. Congenital infection is defined by the isolation of CMV from infants within the first 3 weeks of life. Ganciclovir therapy can be considered for infants with symptomatic congenital CMV infection involving the CNS. Pregnant women of seronegative state should be counseled on the importance of good hand washing and other control measures to prevent CMV infection. Heat treatment of infected breast milk at 72?#608;for 5 seconds can eliminate CMV completely.

  16. PLACENTAL SIZE AND PERINATAL OUTCOMES

    Directory of Open Access Journals (Sweden)

    Nagamani

    2015-03-01

    Full Text Available BACKGROUND : The human placenta, a transient organ or pregnancy provides information about fetal well - being and pregnancy outcome . AIMS: To study the placental ultrasound characters in relation to perinatal outcomes . SETTINGS: Tertiary care hospital in southern India . METHODS AND MATERIAL S: The study sample comprised 500 consecutive women who presented to the Depart ment of Obstetrics and Gynecology at the King George Hospital who met the inclusion criteria. Ultrasonographic study was performed using a transabdominal 3.5 MHz volume transducer. Post natally the weight of the baby and of the placenta was recorded. Perina tal outcome was assessed by birth weight, APGAR score and the need for admission in neonatal intensive care unit. STATISTICAL ANALYSIS : Pearson’s correlation analysis and Chi square test was used. Statistical significance was considered at a p value <0.05 . RESULTS: The mean placental thickness was 3.10 cm; 76% (n:380 had normal thickness. Mean placental diameter was 21.306 cm, and its weight varied from 310 women 62% (n:310. Correlation of placental thickness (normal and abnormal, with birth weight, the difference was significant ( <0.001. CONCLUSION: Ultrasound forms a readily available, fairly safe, effective non - invasive method to identify and prevent fetal malnutrition in a cost - effective way.

  17. Hurricane Katrina and perinatal health.

    Science.gov (United States)

    Harville, Emily W; Xiong, Xu; Buekens, Pierre

    2009-12-01

    We review the literature on the effects of Hurricane Katrina on perinatal health, and providing data from our own research on pregnant and postpartum women. After Katrina, obstetric, prenatal, and neonatal care was compromised in the short term, but increases in adverse birth outcomes such as preterm birth, low birthweight, and maternal complications were mostly limited to highly exposed women. Both pregnant and postpartum women had rates of post-traumatic stress disorder similar to, or lower than, others exposed to Katrina, and rates of depression similar to other pregnant and postpartum populations. Health behaviors, such as smoking and breastfeeding, may have been somewhat negatively affected by the disaster, whereas effects on nutrition were likely associated with limited time, money, and food choices, and indicated by both weight gain and loss. We conclude that, with a few specific exceptions, postdisaster concerns and health outcomes for pregnant and postpartum women were similar to those of other people exposed to Hurricane Katrina. In such situations, disaster planners and researchers should focus on providing care and support for the normal concerns of the peripartum period, such as breastfeeding, depression, and smoking cessation. Contraception needs to be available for those who do not want to become pregnant. Although additional physical and mental health care needs to be provided for the most severely exposed women and their babies, many women are capable of surviving and thriving in postdisaster environments.

  18. Occurrence studies of intracranial tumours

    Energy Technology Data Exchange (ETDEWEB)

    Larjavaara, S.

    2011-07-01

    Intracranial tumours are a histopathologically heterogeneous group of tumours. This thesis focused on three types of intracranial tumours; gliomas, meningiomas and vestibular schwannomas (VS). The main objectives of the dissertation were to estimate the occurrence of intracranial tumours by different subtypes, and to assess the validity and completeness of the cancer registry data. The specific aims of the publications were to evaluate the validity of reported incidence rates of meningioma cases, to describe the trends of VS incidence in four Nordic countries, and to define the anatomic distribution of gliomas and to investigate their location in relation to mobile phone use. Completeness of meningioma registration was examined by comparing five separate sources of information, and by defining the frequencies of cases reported to the Finnish Cancer Registry (FCR). Incidence trends of VS were assessed in the four Nordic countries over a twenty-one-year period (1987 - 2007) using cancer registry data. The anatomic site of gliomas was evaluated using both crude locations in the cerebral lobes and, in more detail, a three-dimensional (3D) distribution in the brain. In addition, a study on specific locations of gliomas in relation to the typical position of mobile phones was conducted using two separate approaches: a case-case and a case-specular analysis. The thesis was based on four sets of materials. Data from the international Interphone study were used for the studies on gliomas, while the two other studies were register-based. The dataset for meningiomas included meningioma cases from the FCR and four clinical data sources in Tampere University Hospital (neurosurgical clinic, pathology database, hospital discharge register and autopsy register). The data on VS were obtained from the national cancer registries of Denmark, Finland, Norway and Sweden. The coverage of meningiomas was not comprehensive in any of the data sources. The completeness of FCR was

  19. Embolization for gastrointestinal hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, S.C.; Goerich, J.; Rilinger, N.; Aschoff, A.J.; Vogel, J.; Brambs, H.J. [Dept. of Diagnostic Radiology, University of Ulm (Germany); Siech, M. [Dept. of Abdominal Surgery, University of Ulm (Germany)

    2000-05-01

    Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18-89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications. (orig.)

  20. A case report of intracranial infection caused by Shewanella putrefaciens.

    Science.gov (United States)

    Duan, Mengxi; Wang, Dali; Wang, Jing; Xiao, Xiaoguang; Han, Lixia; Zhang, Fenghua

    2015-04-01

    Shewanella putrefaciens is as yet reputed to be a rare conditional pathogen. In recent years, some clinical infections caused by Shewanella putrefaciens came into view, and it was possible for the bacteria to be isolated from blood, pus, urine, sputum, and wound secretions, etc. A transferred patient who suffered from intracranial infection after operation of cerebral hemorrhage was admitted in the First Affiliated Hospital of Dalian Medical University. To ascertain the cause, we assessed her blood, cerebrospinal fluid and sputum specimen, and succeeded in isolating one strain of bacteria from her cerebrospinal fluid. To circumvent the potential problem, further detection by Dade Behring Microscan WalkAway 96SI system and drug sensitivity identification plate was performed. Corresponding results indicated that the bacteria were certain pseudomonas with high drug resistance, only sensitive to ticarcillin/clavulanic acid and Imipenem. Eventually by 16S rDNA amplification assay, a new technique to identify pathogens genome, Shewanella putrefaciens infection was confirmed with 99 % coincidence rate. This is the first time in our hospital that Shewanella putrefaciens in the cerebrospinal fluid specimen was detected. When considering the increase of opportunistic infection, it is noteworthy to pay more attention to such situations in clinical diagnoses.

  1. Bilateral Traumatic Intracranial Hematomas and its Outcome: a Retrospective Study.

    Science.gov (United States)

    Pandey, Sharad; Sharma, Vivek; Singh, Kulwant; Pandey, Deepa; Sharma, Mukesh; Patil, Deepak Bhanudas; Shende, Neeraj; Chauhan, Richa Singh

    2017-02-01

    The objective of this study was to evaluate the age distribution, mode of injury, type of hematomas, and their surgical outcome in patients with bilateral traumatic head injuries. The present study included 669 cases of traumatic head injury who presented at the neurosurgery emergency out of which 94 cases had bilateral head injuries from the period of August 2009 to April 2014. The data from the hospital computerized database were retrospectively analysed. Cases of bilateral traumatic head injury included 94 patients out of which 88.29 % (n = 83) were males and 11.70 % (n = 11) were females. Commonest mode of injury was road traffic accident in 56.38 % (n = 53) followed by fall from height in 29.78 % (n = 28). In our study, 25.53 % patients had epidural hematoma (EDH) with intracerebral hematoma (ICH) or contusion (n = 24), followed by EDH with subarachnoid hemorrhage (SAH) in 18.08 % (n = 17). At the time of discharge, all those patients managed conservatively had good Glasgow outcome scale (GOS) while with surgical intervention 58 % patients had good GOS, 19 % had moderate disability, and 9 % remained with severe disability. In cases of bilateral hematomas, EDH is most common and should be managed in neurosurgical emergency. Other combinations of bilateral intracranial hematomas should be managed according to the surgical indication and serial CT imaging.

  2. Treatment of ruptured intracranial aneurysms yesterday and now

    Science.gov (United States)

    Hammer, Alexander; Steiner, Anahi; Kerry, Ghassan; Ranaie, Gholamreza; Baer, Ingrid; Hammer, Christian M.; Kunze, Stefan; Steiner, Hans-Herbert

    2017-01-01

    Objective This prospective study is designed to detect changes in the treatment of ruptured intracranial aneurysms over a period of 17 years. Methods We compared 361 treated cases of aneurysm occlusion after subarachnoid hemorrhage from 1997 to 2003 with 281 cases from 2006 to 2014. Specialists of neuroradiology and vascular neurosurgery decided over the modality assignment. We established a prospective data acquisition in both groups to detect significant differences within a follow-up time of one year. With this setting we evaluated the treatment methods over time and compared endovascular with microsurgical treatment. Results When compared to the earlier group, microsurgical treatment was less frequently chosen in the more recent collective because of neck-configuration. Endovascular treatment was chosen more frequently over time (31.9% versus 48.8%). Occurrence of initial symptomatic ischemic stroke was significantly lower in the clipping group compared to the endovascular group and remained stable over time. The number of reinterventions due to refilled treated aneurysms significantly decreased in the endovascular group at one-year follow-up, but the significantly better occlusion- and reintervention-rate of the microsurgical group persisted. The rebleeding rate in the endovascular group at one year follow-up decreased from 6.1% to 2.2% and showed no statistically significant difference to the microsurgical group, anymore (endovascular 2.2% versus microsurgical 0.0%, p = 0.11). Conclusion Microsurgical clipping still has some advantages, however endovascular treatment is improving rapidly. PMID:28257502

  3. Biotelemetric Wireless Intracranial Pressure Monitoring: An In Vitro Study

    Directory of Open Access Journals (Sweden)

    Mohammad H. Behfar

    2015-01-01

    Full Text Available Assessment of intracranial pressure (ICP is of great importance in management of traumatic brain injuries (TBIs. The existing clinically established ICP measurement methods require catheter insertion in the cranial cavity. This increases the risk of infection and hemorrhage. Thus, noninvasive but accurate techniques are attractive. In this paper, we present two wireless, batteryless, and minimally invasive implantable sensors for continuous ICP monitoring. The implants comprise ultrathin (50 μm flexible spiral coils connected in parallel to a capacitive microelectromechanical systems (MEMS pressure sensor. The implantable sensors are inductively coupled to an external on-body reader antenna. The ICP variation can be detected wirelessly through measuring the reader antenna’s input impedance. This paper also proposes novel implant placement to improve the efficiency of the inductive link. In this study, the performance of the proposed telemetry system was evaluated in a hydrostatic pressure measurement setup. The impact of the human tissues on the inductive link was simulated using a 5 mm layer of pig skin. The results from the in vitro measurement proved the capability of our developed sensors to detect ICP variations ranging from 0 to 70 mmHg at 2.5 mmHg intervals.

  4. Detection of acute cerebral hemorrhage in rabbits by magnetic induction

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    J. Sun

    2014-02-01

    Full Text Available Acute cerebral hemorrhage (ACH is an important clinical problem that is often monitored and studied with expensive devices such as computed tomography, magnetic resonance imaging, and positron emission tomography. These devices are not readily available in economically underdeveloped regions of the world, emergency departments, and emergency zones. We have developed a less expensive tool for non-contact monitoring of ACH. The system measures the magnetic induction phase shift (MIPS between the electromagnetic signals on two coils. ACH was induced in 6 experimental rabbits and edema was induced in 4 control rabbits by stereotactic methods, and their intracranial pressure and heart rate were monitored for 1 h. Signals were continuously monitored for up to 1 h at an exciting frequency of 10.7 MHz. Autologous blood was administered to the experimental group, and saline to the control group (1 to 3 mL by injection of 1-mL every 5 min. The results showed a significant increase in MIPS as a function of the injection volume, but the heart rate was stable. In the experimental (ACH group, there was a statistically significant positive correlation of the intracranial pressure and MIPS. The change of MIPS was greater in the ACH group than in the control group. This high-sensitivity system could detect a 1-mL change in blood volume. The MIPS was significantly related to the intracranial pressure. This observation suggests that the method could be valuable for detecting early warning signs in emergency medicine and critical care units.

  5. Hemorrhagic Lacrimation and Epistaxis in Acute Hemorrhagic Edema of Infancy

    Directory of Open Access Journals (Sweden)

    Shireen Mreish

    2016-01-01

    Full Text Available Acute hemorrhagic edema of infancy is an uncommon benign cutaneous vasculitis. Despite its worrisome presentation, it carries good prognosis with rarely reported systemic involvement. Management of these cases has been an area of debate with majority of physicians adopting conservative modalities. We report a case that presented with classic triad of rash, low grade fever, and peripheral edema along with two rarely reported manifestations in literature: hemorrhagic lacrimation and epistaxis.

  6. The risk of hemorrhagic complications in hospital in-patients who fall while receiving antithrombotic therapy

    Directory of Open Access Journals (Sweden)

    Li Marilyn

    2005-01-01

    Full Text Available Abstract Background The use of antithrombotic agents and falls are independently associated with an increased risk of hemorrhagic injury. However, few studies have delineated the risk of fall-related hemorrhagic complications in persons who are taking antithrombotic therapy. The objective of this study was to compare the rates of fall-related hemorrhagic injury in hospital in-patients who are taking and not taking antithrombotic therapy. Methods A 4-year retrospective chart review of consecutive patients who fell during admission to a 500-bed tertiary-care teaching hospital was conducted. Major hemorrhagic injuries including subdural hematomas and major bleeding/cuts, patients' use of antithrombotic medication (warfarin, aspirin, clopidogrel and heparin and their anticoagulation status at the time of their fall were recorded. Results A total of 2635 falls in 1861 patients were reviewed. Approximately 10% of falls caused major hemorrhagic injury. One fall resulted in a subdural hematoma. Persons taking warfarin were less likely to suffer a fall-related major hemorrhagic injury compared with persons not taking antithrombotic therapy (warfarin, 6%; no therapy, 11%; p = 0.01. Logistic regression showed that fall-related major hemorrhagic injury was associated with female gender (odds ratio 1.6; 95% CI 1.3, 2.1, use of aspirin (odds ratio 1.4; 95% CI 1.1, 1.8 and use of clopidogrel (odds ratio 2.2; 95% CI 1.1, 4.8, but not with the use of warfarin or heparin, or the intensity of anticoagulation. Conclusions In this study, compared with persons taking no antithrombotic therapy, those taking warfarin had lower rates of fall-related hemorrhagic injuries. The absolute rate of the development of fall-related intracranial hemorrhagic injury such as subdural hematomas was low, even in persons taking warfarin. These counter-intuitive results may be due to selection bias, and suggest that physicians are very conservative in selecting patients for warfarin

  7. Autosomal Dominant Inheritance of a Predisposition to Thoracic Aortic Aneurysms and Dissections and Intracranial Saccular Aneurysms

    Science.gov (United States)

    Regalado, Ellen; Medrek, Sarah; Tran-Fadulu, Van; Guo, Dong-Chuan; Pannu, Hariyadarshi; Golabbakhsh, Hossein; Smart, Suzanne; Chen, Julia H.; Shete, Sanjay; Kim, Dong H.; Stern, Ralph; Braverman, Alan C.; Milewicz, Dianna M.

    2013-01-01

    A genetic predisposition for thoracic aortic aneurysms and dissections (TAAD) can be inherited in an autosomal dominant manner with decreased penetrance and variable expression. Four genes identified to date for familial TAAD account for approximately 20% of the heritable predisposition. In a cohort of 514 families with two or more members with presumed autosomal dominant TAAD, 48 (9.3%) families have one or more members who were at 50% risk to inherit the presumptive gene causing TAAD had an intracranial vascular event. In these families, gender is significantly associated with disease presentation (p <0.001), with intracranial events being more common in women (65.4%) while TAAD events occurred more in men (64.2%,). Twenty-nine of these families had intracranial aneurysms (ICA) that could not be designated as saccular or fusiform due to incomplete data. TGFBR1, TGFBR2, and ACTA2 mutations were found in 4 families with TAAD and predominantly fusiform ICAs. In 15 families, of which 14 tested negative for 3 known TAAD genes, 17 family members who were at risk for inheriting TAAD had saccular ICAs. In 2 families, women who harbored the genetic mutation causing TAAD had ICAs. In 2 additional families, intracranial, thoracic and abdominal aortic aneurysms were observed. This study documents the autosomal dominant inheritance of TAADs with saccular ICAs, a previously recognized association that has not been adequately characterized as heritable.I these families, routine cerebral and aortic imaging for at risk members could prove beneficial for timely medical and surgical management to prevent a cerebral hemorrhage or aortic dissection. PMID:21815248

  8. Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Dae, E-mail: aronnn@naver.com [Department of Radiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 425 Sindaebang-dong, Dongjak-gu, Seoul 156-707 (Korea, Republic of); Lee, Jong Young, E-mail: gen78@naver.com [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Seo, Jung Hwa, E-mail: jhseo34@gmail.com [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Hyun-Seung, E-mail: hsk4428@yahoo.com [Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Kim, Jeong Eun, E-mail: eunkim@snu.ac.kr [Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Jung, Keun Hwa, E-mail: jungkh@gmail.com [Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Han, Moon Hee, E-mail: hanmh@snuh.org [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)

    2012-10-15

    Introduction: Intra-arterial (IA) thrombolytic intervention for acute thrombosis has been challenged due to the risk of bleeding during the endovascular treatment of ruptured aneurysms. We present the results of IA tirofiban infusion for thromboembolic complications during coil embolization in patients with ruptured intracranial aneurysms. Methods: Thromboembolic events requiring thrombolytic intervention occurred in 39 (10.5%) cases during coil embolization of 372 consecutive ruptured intracranial aneurysms. Maximal aneurysm diameters of 39 patients (mean age, 54.7 ± 13.2 years; 23 female, 16 male) ranged from 2.1 to 13.1 mm (mean, 6.6 ± 3.0 mm). The anterior communicating artery was the most common site (n = 13), followed by the middle cerebral artery (n = 9) and the posterior communicating artery (n = 7). In this series, we used intracranial stents in 10 patients during the procedure. Superselective IA tirofiban infusion through a microcatheter was performed to resolve thrombi and emboli. We assessed the efficacy and safety of IA tirofiban infusion in patients with ruptured aneurysms. Results: Intraarterially administered tirofiban doses ranged from 0.25 to 1.25 mg (mean, 0.71 ± 0.26 mg). Effective thrombolysis or recanalization was achieved in 34 patients (87.2%), and three patients (7.7%) suffered distal migration of clots with partial recanalization. The rest (5.1%) had no recanalization. Nonconsequent intracerebral hemorrhage occurred in two patients (5.1%) after the procedure. Thromboemboli-related cerebral infarction developed in eight patients, and only two patients remained infarction related disabilities. Conclusion: IA tirofiban infusion seems to be efficacious and safe for thrombolysis during coil embolization in patients with ruptured intracranial aneurysms.

  9. [Temporary occlusion in surgical management of intracranial aneurysm. Report of 54 cases].

    Science.gov (United States)

    Samaha, E; Rizk, T; Nohra, G; Mohasseb, G; Okais, N

    1999-03-01

    Temporary arterial occlusion (TAO) is commonly used in the surgery of intracranial giant aneurysms. Its usefulness and safety in the surgical management of all cases of aneurysms remains to be proved. We report a series of 54 patients operated on for an intracranial aneurysm with the use of TAO. Among the 27 patients, admitted before the 4th day following post subarachnoid hemorrhage with I or II on WFNS score clinically, 24 had early aneurysm surgery. The size of the aneurysm was small in 16 cases, medium in 22, large in 13 and giant in 3 cases. The protocol proposed by Batjer in 1988 for large and giant aneurysms (etomidate, normotention and hypervolemia) was used without any electrophysiological monitoring. All patients underwent a post-operative cerebral CT scan to evaluate the incidence of a cerebral ischemia. Serial transcranial doppler was used to evaluate the severity of vasospasm. Clinical results were assessed using the GOS. TAO was elective in 51 patients and done after peroperative aneurysm rupture in 3 patients. The duration of TAO was less than 5 mn in 25 patients, between 5 and 10 min in 12, between 10 and 15 in 11, between 15 and 20 in 5 and more than 20 min in one patient. The last one developed a reversible neurological deficit secondary to ischemia attribuated to TAO. Intracranial aneurysm peroperative rupture was noted in 3 patients, clinical vasospam in 13 patients. These results allow us to recommend the routine use of TAO in the surgery of intracranial aneurysm. When application time is limited and cerebral protection used, TAO is safe. It decreases the risk of intraoperative rupture from a 18% rate in literature to 4.2% in our present experience and the risk of symptomatic vasospasm is not increased.

  10. Perinatal mortality and socio-spatial inequalities

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    Eunice Francisca Martins

    2013-09-01

    Full Text Available OBJECTIVE: to analyze the social inequalities in the distribution of perinatal mortality in Belo Horizonte. MATERIAL AND METHODS: the perinatal deaths of residents in Belo Horizonte in the period 2003 to 2007 were studied on the basis of the Information Systems on Mortality and Newborns. The space analysis and the Health Vulnerability Index were used to identify existing inequalities in the sanitary districts regarding coverage and risk, determined by the Odds Ratio and a value p<0.05. The multivariate analysis was used to describe a model for perinatal mortality. RESULTS: there was a proved variation in the numbers of perinatal mortality per one thousand total births in the sanitary districts (12.5 to 19.4, coverage areas (5.3 to 49.4 and areas of risk (13.2 to 20.7. The mortality rate diminished as the maternal schooling increased. The death rates deriving from asphyxia/hypoxia and non-specified fetal death grew with the increase of risk in the area. CONCLUSION: it was verified that the perinatal deaths are distributed in a differentiated form in relation to the space and the social vulnerabilities. The confrontation of this complex problem requires the establishment of intersecting partnerships.

  11. High cervical spinal subdural hemorrhage as a harbinger of craniocervical arteriovenous fistula: an unusual clinical presentation.

    Science.gov (United States)

    Kasliwal, Manish K; Moftakhar, Roham; O'Toole, John E; Lopes, Demetrius K

    2015-05-01

    Craniocervical dural arteriovenous fistula (dAVF) is rare as compared with the typical thoracolumbar dAVFs of the spine and usually presents with hemorrhagic manifestation, predominantly intracranial subarachnoid hemorrhage. We describe the first case of craniocervical dAVF with initial presentation as neck pain and spinal subdural hemorrhage. Case report. We present the case of a 59-year-old woman who presented with sudden onset of neck pain at an outside institution emergency department (ED) and was discharged after negative cervical spine radiographs. Magnetic resonance imaging of the cervical spine performed because of persistent pain demonstrated presence of high cervical spinal subdural hematoma and she was managed conservatively. She subsequently presented to our ED a week later with headache and was found to have an intraventricular hemorrhage on computed tomography scan of the head, which on subsequent workup with an angiography revealed the presence of a craniocervical dAVF. Surgical obliteration of the fistula was performed with use of intraoperative angiography as an adjunct to confirm complete fistula obliteration. She had an excellent clinical outcome with no deficits at her last follow-up at 9 months. Even though hemorrhagic presentation is fairly common in craniocervical dAVFs, there is no report of a craniocervical dAVF presenting with spinal subdural hemorrhage. The present case further highlights the propensity of these vascular lesions to bleed and emphasizes the clinical importance of including these lesions in the differential diagnosis of hemorrhage in the vicinity of foramen magnum region, whether subarachnoid or subdural in location. Physicians treating spinal pathologies should be aware of this entity and clinical presentation, as an angiography needs to be considered in these cases to direct appropriate referral and treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. [The psychosocial aspects of perinatal care and their relationship to selected medical interventions and health complications during parturition].

    Science.gov (United States)

    Takacs, L; Kodyšová, E; Seidlerová, J

    2012-06-01

    Find association between psychosocial factors of perinatal care and selected childbirth complications and interventions. Original study. Department of Psychology, Faculty of Arts and Philosophy, Charles University, Prague. Statistical data analysis of questionnaire survey of low-risk parturients (n=657) was carried out. Respondents were divided into experimental groups (EG) according to experienced interventions and complications (hemorrhage, failure to progress, fetal distress, forceps/VEX delivery, caesarean birth, failure to progress followed by caesarean birth, labour acceleration infusion, other infusion, epidural anesthesia, other form of pharmacological analgesia, episiotomy, amniotomy). EG were compared with a control group (CG) of women with no complications and interventions (n=107) in evaluation of psychosocial factors of perinatal care (healthcare provider attitude; control; communication; woman-friendliness of hospital rules) and physical comfort and services, presence of other persons at birth, prevailing emotional reaction and overall satisfaction with maternity care. The interpretation of results draws from qualitative analysis of open-ended question answers. EG and CG differed significantly in control (all EGs scored lower) and healthcare provider attitude evaluation (significantly more negative perception at EGs: hemorrhage, failure to progress, fetal distress, forceps/VEX delivery, labour acceleration infusion, episiotomy). Significant differences were noted also for woman-friendliness of hospital rules (lower scores for EGs: hemorrhage, failure to progress, failure to progress followed by caesarean birth) and for presence of other persons at birth. Possible interpretations of the above results are discussed. Psychosocial factors of perinatal care constitute important childbirth process determinants, while playing a key role for parturients ability to cope with anxiety and stress connected with childbirth complications and interventions

  13. Intracranial aneurysms in an African country

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    Ogeng'o Julius

    2009-12-01

    Full Text Available Background : Characteristics of intracranial aneurysms display ethnic variations. Data on this disease from the African continent is scarce and often conflicting. Aim : To describe site, age and gender distribution of intracranial aneurysms among Kenyans. Study Design and Setting : Retrospective study at Kenyatta National Hospital, Kenya. Materials and Methods: All records of black African patients with a diagnosis of intracranial aneurysms seen at Kenyatta National Hospital, the largest referral hospital in the Eastern and Central African region, over the period from January 1998 to December 2007 were examined for site, age and gender distribution. The data gathered were coded, analyzed with SPSS 11.50. Results : Fifty-six cases of intracranial aneurysms were analyzed. The posterior communicating artery was the most affected (35.7%, followed by the anterior communicating artery (26.8%, while the posterior cerebral artery was the least affected (2%. Multiple aneurysms were present in 2%. The mean age at presentation was 50.9 years (range 21-80 years and the gender distribution was equal. Conclusions : Intracranial aneurysms among Kenyans occur most commonly on the posterior communicating artery, in young individuals, and without gender bias. The distribution differs from that described in the literature and this requires search for risk factors.

  14. Hyperprolactinemia due to spontaneous intracranial hypotension.

    Science.gov (United States)

    Schievink, Wouter I; Nuño, Miriam; Rozen, Todd D; Maya, M Marcel; Mamelak, Adam N; Carmichael, John; Bonert, Vivien S

    2015-05-01

    OBJECT Spontaneous intracranial hypotension is an increasingly recognized cause of headaches. Pituitary enlargement and brain sagging are common findings on MRI in patients with this disorder. The authors therefore investigated pituitary function in patients with spontaneous intracranial hypotension. METHODS Pituitary hormones were measured in a group of 42 consecutive patients with spontaneous intracranial hypotension. For patients with hyperprolactinemia, prolactin levels also were measured following treatment. Magnetic resonance imaging was performed prior to and following treatment. RESULTS The study group consisted of 27 women and 15 men with a mean age at onset of symptoms of 52.2 ± 10.7 years (mean ± SD; range 17-72 years). Hyperprolactinemia was detected in 10 patients (24%), ranging from 16 ng/ml to 96.6 ng/ml in men (normal range 3-14.7 ng/ml) and from 31.3 ng/ml to 102.5 ng/ml in women (normal range 3.8-23.2 ng/ml). In a multivariate analysis, only brain sagging on MRI was associated with hyperprolactinemia. Brain sagging was present in 60% of patients with hyperprolactinemia and in 19% of patients with normal prolactin levels (p = 0.02). Following successful treatment of the spontaneous intracranial hypotension, hyperprolactinemia resolved, along with normalization of brain MRI findings in all 10 patients. CONCLUSIONS Spontaneous intracranial hypotension is a previously undescribed cause of hyperprolactinemia. Brain sagging causing distortion of the pituitary stalk (stalk effect) may be responsible for the hyperprolactinemia.

  15. Neonatal-perinatal medicine: Diseases of the fetus and infant

    Energy Technology Data Exchange (ETDEWEB)

    Fanaroff, A.A.; Martin, R.J.

    1987-01-01

    This book consists of 40 chapters. Some of the chapter titles are: Perinatal services and resources; Diabetes in pregnancy; Erythroblastosis fetalis; Placental pathology; Genetic disease and chromosomal abnormalities; Perinatal ultrasound; and Diagnostic imaging.

  16. Methadone and perinatal outcomes: a prospective cohort study.

    LENUS (Irish Health Repository)

    Cleary, Brian J

    2012-08-01

      Methadone use in pregnancy has been associated with adverse perinatal outcomes and neonatal abstinence syndrome (NAS). This study aimed to examine perinatal outcomes and NAS in relation to (i) concomitant drug use and (ii) methadone dose.

  17. Pathogenesis of arenavirus hemorrhagic fevers.

    Science.gov (United States)

    Moraz, Marie-Laurence; Kunz, Stefan

    2011-01-01

    Viral hemorrhagic fevers (VHFs) caused by arenaviruses belong to the most devastating emerging human diseases and represent serious public health problems. Arenavirus VHFs in humans are acute diseases characterized by fever and, in severe cases, different degrees of hemorrhages associated with a shock syndrome in the terminal stage. Over the past years, much has been learned about the pathogenesis of arenaviruses at the cellular level, in particular their ability to subvert the host cell's innate antiviral defenses. Clinical studies and novel animal models have provided important new information about the interaction of hemorrhagic arenaviruses with the host's adaptive immune system, in particular virus-induced immunosuppression, and have provided the first hints towards an understanding of the terminal hemorrhagic shock syndrome. The scope of this article is to review our current knowledge on arenavirus VHF pathogenesis with an emphasis on recent developments.

  18. Let's Talk about Hemorrhagic Stroke

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Let's Talk About Hemorrhagic Stroke Updated:Dec 9,2015 About 13 percent of ... Should I Limit Sodium? How Do I Understand "Nutrition Facts" Labels? How Can I Quit Smoking? How ...

  19. Hyperbaric oxygen in the treatment of hypertension- induced cerebral hemorrhage on 34 cases%高血压脑出血术后高压氧治疗34例

    Institute of Scientific and Technical Information of China (English)

    程晋成; 沈月萍; 王水平; 吴杨

    2003-01-01

    @@ INTRODUCTION In this study,we investigated effect of hyperbaric oxygen(HBO) on the hypertension- induced basio- cerebral hemorrhage.The affected patients often showed signs of cerebral circulation disorder,spasm of vessels,insufficiency of cerebral blood supply and intracranial hypertension.

  20. Perinatal Health Statistics as the Basis for Perinatal Quality Assessment in Croatia

    Directory of Open Access Journals (Sweden)

    Urelija Rodin

    2015-01-01

    Full Text Available Context. Perinatal mortality indicators are considered the most important measures of perinatal outcome. The indicators reliability depends on births and deaths reporting and recording. Many publications focus on perinatal deaths underreporting and misclassification, disabling proper international comparisons. Objective. Description of perinatal health care quality assessment key indicators in Croatia. Methods. Retrospective review of reports from all maternities from 2001 to 2014. Results. According to reporting criteria for birth weight ≥500 g, perinatal mortality (PNM was reduced by 31%, fetal mortality (FM by 32%, and early neonatal mortality (ENM by 29%. According to reporting criteria for ≥1000 g, PNM was reduced by 43%, FM by 36%, and ENM by 54%. PNM in ≥22 weeks’ (wks gestational age (GA was reduced by 28%, FM by 30%, and ENM by 26%. The proportion of FM at 32–36 wks GA and at term was the highest between all GA subgroups, as opposed to ENM with the highest proportion in 22–27 wks GA. Through the period, the maternal mortality ratio varied from 2.4 to 14.3/100,000 live births. The process indicators have been increased in number by more than half since 2001, the caesarean deliveries from 11.9% in 2001 to 19.6% in 2014. Conclusions. The comprehensive perinatal health monitoring represents the basis for the perinatal quality assessment.

  1. Intraventricular Hemorrhage of the Newborn

    OpenAIRE

    1999-01-01

    Intraventricular hemorrhage IVH of the premature newborn is an important complication which determines its prognosis Intravascular vascular and extravascular factors should be considered in its etiology Cranial ultrasonography is the most suitable medical imagery technique IVH is graded from 1 to 4 according to its severity Prevention is the most crucial point in its management The literature and the management of IVH is reviewed Key words: Newborn Premature Intraventricular Hemorrhage

  2. Hemorrhagic complications in dermatologic surgery

    Science.gov (United States)

    Bunick, Christopher G.; Aasi, Sumaira Z.

    2014-01-01

    The ability to recognize, manage, and, most importantly, prevent hemorrhagic complications is critical to performing dermatologic procedures that have safe and high quality outcomes. This article reviews the preoperative, intraoperative, and postoperative factors and patient dynamics that are central to preventing such an adverse outcome. Specifically, the role that anticoagulants and antiplatelet agents, hypertension, and other medical conditions play in the development of postoperative hemorrhage are discussed. In addition, this article provides practical guidelines on managing bleeding during and after surgery. PMID:22515669

  3. Focal Intracranial Suppuration: Clinical Features and Outcome of 21 ...

    African Journals Online (AJOL)

    Alasia Datonye

    Page 06. Type of Article: Original ... Focal intracranial suppurations are localised infections of .... Streptococcus species were the commonest organisms isolated. ... Facial skin infections 1. 7.7 ... Adeloye A. Intracranial pyogenic abscess. In:.

  4. Predictors of severe complications in intracranial meningioma surgery

    DEFF Research Database (Denmark)

    Bartek, Jiri; Sjåvik, Kristin; Förander, Petter

    2015-01-01

    OBJECTIVE: To investigate predictors of complications after intracranial meningioma resection using a standardized reporting system for adverse events. METHODS: A retrospective review was conducted in a Scandinavian population-based cohort of 979 adult operations for intracranial meningioma perfo...

  5. Trends in perinatal health after assisted reproduction

    DEFF Research Database (Denmark)

    Henningsen, Anna-Karina Aaris; Gissler, M.; Skjaerven, R.

    2015-01-01

    STUDY QUESTIONS Has the perinatal outcome of children conceived after assisted reproductive technology (ART) improved over time? SUMMARY ANSWER The perinatal outcomes in children born after ART have improved over the last 20 years, mainly due to the reduction of multiple births. WHAT IS KNOWN...... AND WHAT THIS PAPER ADDS A Swedish study has shown a reduction in unwanted outcomes over time in children conceived after ART. Our analyses based on data from more than 92 000 ART children born in four Nordic countries confirm these findings. STUDY DESIGN Nordic population-based matched cohort study...... with ART outcome and health data from Denmark, Finland, Norway and Sweden. PARTICIPANTS, SETTING AND METHODS We analysed the perinatal outcome of 62 379 ART singletons and 29 758 ART twins, born from 1988 to 2007 in four Nordic countries. The ART singletons were compared with a control group of 362 215...

  6. Perinatal Chicken Pox (Varicella Zoster Virus Infection

    Directory of Open Access Journals (Sweden)

    Ali Annagur

    2013-04-01

    Full Text Available Chickenpox is due to infection with the varicella zoster virus (VZV, a human alphaherpervirus found worldwide. Classically, the cinical disease is a febrile illness with a pruritic vesicular rash. Maternal chickenpox between 5 days before delivery to 2 days after delivery (perinatal varicella can cause severe and even fatal illness in the newborn. A 7-day old girl baby presented on day 4 of postnatal with the complaints of widespread vesicular rash and non-suckling. Mother of the baby also had a similar eruption four day prior to delivery, which was clinically characteristic of varicella. Considering history and clinical presentation, a diagnosis of perinatal chickenpox was considered and the baby was treated with acyclovir which she responded and recovered. Herein, the clinical feasures and treatment of chickenpox infection in the perinatal period have been emphasized with this case report. [Cukurova Med J 2013; 38(2.000: 311-314

  7. Does computed tomography permeability predict hemorrhagic transformation after ischemic stroke?

    Institute of Scientific and Technical Information of China (English)

    Peggy Yen; Allison Cobb; Jai Jai Shiva Shankar

    2016-01-01

    AIM: To use perfusion-derived permeability-surface area product maps to predict hemorrhagic transformation following thrombolytic treatment for acute ischemic stroke.METHODS: We retrospectively analyzed our prospectively kept acute stroke database over five consecutive months for patients with symptoms of acute ischemic stroke(AIS) who had computed tomography(CT) perfusion(CTP) done at arrival. Patients included in the analyses also had to have a follow-up CT. The permeability-surface area product maps(PS) was calculated for the side of the ischemia and/or infarction and for the contralateral unaffected side at the same level. The cerebral blood flow map was used to delineate the ischemic territory. Next, a region of interest was drawn at the centre of this territory on the PS parametric map. Finally, a mirror region of interest was created on the contralateral side at the same level. The relative permeability-surface area product maps(r PS) provided an internal control and was calculated as the ratio of the PS on the side of the AIS to the PS on the contralateral side. A student t-test was performed after log conversion of r PS between patients with and without hemorrhagic transformation. Log conversion was used to convert the data into normal distribution to use t-test. For the group of patients who experienced intracranial bleed, a student t-test was performed between those with only petechial hemorrhage and those with more severe parenchymal hematoma with subarachnoid haemorrhage.RESULTS: Of 84 patients with AIS and CTP at admission, only 42 patients had a follow-up CT. The r PSderived using the normal side as the internal control was significantly higher(P = 0.003) for the 15 cases of hemorrhagic transformation(1.71 + 1.64) compared to 27 cases that did not have any(1.07 + 1.30). Patients with values above the overall mean r PS of 1.3 had an increased likelihood of subsequent hemorrhagic transformation. The sensitivity of using this score to predict

  8. Subarachnoid hemorrhage with blister aneurysms: Endovascular management

    Directory of Open Access Journals (Sweden)

    Swati Dayanand Chinchure

    2014-01-01

    Full Text Available Blister aneurysms of are rare lesions representing a real challenge for diagnosis and management. They typically show small size, hemispherical shape, fragile wall, broad neck, and are arising from non-branching sites of intracranial arteries. Materials and Methods: We retrospectively reviewed all aneurysms treated at our institution. Seventeen patients (6 male, 11 female with 17 blister aneurysms were identified (mean age 53.3, range 41-63 years. Clinical, procedural, angiographic data as well as follow up data were evaluated. Results: All patients presented with aneurysmal subarachnoid hemorrhage. Majority of the blister aneurysms were located in ICA while 1 was located at posterior cerebral artery, 1 at vertebral and 1 involving basilar artery. All patients were treated using single or overlapping stents and if possible additional coiling. There was no intra-operative rupture. Good outcome (mrs 0-2 was seen in 14 patients. Poor clinical outcome (mrs 3-5 was seen in 2 patients due to vasospasm induced ischemic deficits at discharge, both of them improved on follow up (mrs 1 on follow up. There were 3 mortalities, One patient died of rebleeding while other 2 died due to SAH induced complications. Follow-up angiography was available in 16 patients (one patient died before follow up angiogram and revealed complete or near complete aneurysm occlusion in 11, incomplete obliteration in 1 and no change in 2 cases. Two cases showed post-treatment angiographic aneurysm recurrence. Both cases were managed with repeat coiling and overlapping stent placement. Conclusion: Endovascular management using single/overlapping stent and if possible coil placement is technically safe and feasible in blister aneurysms. Overlapping stents lead to better aneurysm occlusion than a single stent. Blister aneurysm in dorso-medial ICA showed higher tendency of continued growth/recurrence, higher incidence of clinical vasospasm and in these cases early angiographic follow

  9. Neurogenic Pulmonary Edema in Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    Saracen, A; Kotwica, Z; Woźniak-Kosek, A; Kasprzak, P

    2016-01-01

    Neurogenic pulmonary edema (NPE) is observed in cerebral injuries and has an impact on treatment results, being a predictor of fatal prognosis. In this study we retrospectively reviewed medical records of 250 consecutive patients with aneurysmal subarachnoid hemorrhage (SAH) for the frequency and treatment results of NPE. The following factors were taken under consideration: clinical status, aneurysm location, presence of NPE, intracranial pressure (ICP), and mortality. All patients had plain- and angio-computer tomography performed. NPE developed most frequently in case of the aneurysm located in the anterior communicating artery. The patients with grades I-III of SAH, according to the World Federation of Neurosurgeons staging, were immediately operated on, while those with poor grades IV and V had only an ICP sensor's implantation procedure performed. A hundred and eighty five patients (74.4 %) were admitted with grades I to III and 32 patients (12.8 %) were with grade IV and V each. NPE was not observed in SAH patients with grade I to III, but it developed in nine patients with grade IV and 11 patients with grade V. Of the 20 patients with NPE, 19 died. Of the 44 poor grade patients (grades IV-V) without NPE, 20 died. All poor grade patients had elevated ICP in a range of 24-56 mmHg. The patients with NPE had a greater ICP than those without NPE. Gender and age had no influence on the occurrence of NPE. We conclude that the development of neurogenic pulmonary edema in SAH patients with poor grades is a fatal prognostic as it about doubles the death rate to almost hundred percent.

  10. Intracranial hypertension without headache in children.

    Science.gov (United States)

    Aylward, Shawn C; Aronowitz, Catherine; Reem, Rachel; Rogers, David; Roach, E Steve

    2015-05-01

    We aimed to determine the frequency of intracranial hypertension without headache in children. We retrospectively analyzed patients evaluated in a pediatric intracranial hypertension referral center. Patients were divided into 2 groups depending on whether they complained of headache at the time of presentation. Age, body mass index, and opening cerebrospinal fluid pressures were considered continuous variables and compared by Wilcoxon rank-sum test because of non-normality. A P value of .05 was considered significant. A total of 228 charts were reviewed; 152 patients met the criteria for intracranial hypertension and 22/152 patients (14.5%) met the criteria of optic nerve edema without headache. There were clinically significant differences in age and body mass index between the 2 groups. The group without headache was typically younger and not obese. The opening pressure and modified opening pressure were not clinically significant between the 2 groups. © The Author(s) 2014.

  11. Are the Intracranial Lipomas Always Asymptomatic?

    Directory of Open Access Journals (Sweden)

    Mustafa Yilmaz

    2014-02-01

    Full Text Available Intracranial lipomas are rarely observed, and accepted as the congenital lesion of central nervous system. Intracranial lipomas are usually based centrally and have benign character. In the brain, it is mostly localized in pericallosal region, quadrigeminal system, and suprasellar region and cerebellopontine angles. As being mostly asymptomatic, the patients occasionally constitute clinical symptoms according to localization area. These symptoms are systemic symptoms such as cephalalgia, drowsiness, crisis and ataxy. In this article, we aimed to present the intracranial lipomas phenomenon which was diagnosed to have caused ptosis and upper lateral sight problem, namely causing localized neurological symptom, situated in mesencephalon and having pressure effect, regarding a 57-year old male patient brought to the emergency service with the nausea, throwing up and cephalalgia ailments.

  12. Design and evaluation of a regional perinatal audit

    NARCIS (Netherlands)

    Alderliesten, Marianne E.; Stronks, Karien; Bonsel, Gouke J.; Smit, Bert J.; van Campen, Maarten M. J.; van Lith, Jan M. M.; Bleker, Otto P.

    2008-01-01

    Objective: To describe the experiences of a regional audit of perinatal deaths, including the experiences of the audit members, to discuss similarities and differences with other, existing perinatal audits and to summarize the implications for future implementation. Study design: Perinatal audit wit

  13. [Tobacco control policies and perinatal health].

    Science.gov (United States)

    Peelen, M J; Sheikh, A; Kok, M; Hajenius, P; Zimmermann, L J; Kramer, B W; Hukkelhoven, C W; Reiss, I K; Mol, B W; Been, J V

    2017-01-01

    Study the association between the introduction of tobacco control policies in the Netherlands and changes in perinatal outcomes. National quasi-experimental study. We used Netherlands Perinatal Registry data (now called Perined) for the period 2000-2011. We studied whether the introduction of smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign in January 2004, and extension of the smoke-free law to the hospitality industry accompanied by another tax increase and media campaign in July 2008, was associated with changes in perinatal outcomes. We studied all singleton births (gestational age: 24+0 to 42+6 weeks). Our primary outcome measures were: perinatal mortality, preterm birth and being small-for-gestational-age (SGA). Interrupted time series logistic regression analyses were performed to investigate changes in these outcomes occurred after the introduction of the aforementioned tobacco control policies (ClinicalTrials.gov: NCT02189265). Among 2,069,695 singleton births, 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births were observed. The policies introduced in January 2004 were not associated with significant changes in any of the primary outcome measures. A -4.4% (95% CI: -6.4 to -2.4; p hospitality industry, a further tax increase and another media campaign. This translates to an estimated over 500 cases of SGA being averted per year. A reduction in SGA births, but not preterm birth or perinatal mortality, was observed in the Netherlands after extension of the smoke-free workplace law to include bars and restaurants, in conjunction with a tax increase and media campaign in 2008.

  14. Unusual Initial Manifestation of Acquired Hemophilia A: A Normal Activated Partial Thromboplastin Time, Intramuscular Hematoma and Cerebral Hemorrhage

    Science.gov (United States)

    Tsuyama, Nobuaki; Ichiba, Toshihisa; Naito, Hiroshi

    2016-01-01

    We herein present a case of acquired hemophilia A with a normal activated partial thromboplastin (aPTT), intramuscular hematoma and cerebral hemorrhage occurring in a 73-year-old man. The patient visited our emergency department with gait disturbance, pain and swelling in his right leg. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed intramuscular hematoma and intracranial hemorrhage. The results of initial coagulation studies were normal, but repeated coagulation studies revealed an isolated prolongation of the aPTT. Additional laboratory tests confirmed the diagnosis of acquired hemophilia A. If the initial aPTT is normal, we should therefore repeat the aPTT and also perform other coagulation studies including a mixing study, factor VIII level and inhibitor, to investigate the underlying diseases in elderly patients with spontaneous hemorrhaging of unknown etiology. PMID:27853081

  15. Small subdural hemorrhages: is routine intensive care unit admission necessary?

    Science.gov (United States)

    Albertine, Paul; Borofsky, Samuel; Brown, Derek; Patel, Smita; Lee, Woojin; Caputy, Anthony; Taheri, M Reza

    2016-03-01

    With advancing technology, the sensitivity of computed tomography (CT) for the detection of subdural hematoma (SDH) continues to improve. In some cases, the finding is limited to one or 2 images of the CT examination. At our institution, all patients with an SDH require intensive care unit (ICU) admission, regardless of size. In this report, we tested the hypothesis that patients with a small traumatic SDH on their presenting CT examination do not require the intensive monitoring offered in the ICU and can instead be managed on a hospital unit with a lower level of monitoring. This is a retrospective study of patients evaluated and treated at a level I trauma center for acute traumatic intracranial hemorrhage between 2011 and 2014. The clinical and imaging profile of 87 patients with traumatic SDH were studied. Patients with small isolated traumatic subdural hemorrhage (tSDH) (medical stability during hospitalization, and did not require any neurosurgical intervention. It is our recommendation that patients with isolated tSDH (medical decline (4%) and neurologic decline (4%) but may still benefit from ICU observation. Patients with tSDH greater than 10 cm(3) overall demonstrated poor clinical courses and outcome and would benefit ICU monitoring.

  16. MECHANISM OF PATHOLOGICAL CHANGES OF INTRAVENTRICULAR HEMORRHAGE IN DOGS

    Institute of Scientific and Technical Information of China (English)

    戴炯; 李善泉; 李骁雄; 徐斌斌; 熊文浩; 王勇; 张晓华; 沈加林

    2004-01-01

    Objective To probe the mechanism of pathological changes of intraventricular hemorrhage (IVH). Methods The evaluation of neurological status, serial CT scans and pathological examination were ap plied on the canine model of lVH. The ventricular volume and blood clot volume were measured based on the CT images. Results The normal adult canine ventricle tend to be slitlike. After injection, the ventricle was obviously dilated by the blood clot. The linear regression of ventricular volume against blood clot volume was significant in the first week. From then on, however, while the clots continued to shrink, the ventricular volume showed progressive enlargement. The clots were lysed completely within 3 to 4 weeks. The linear regression of the degree of ventricular dilatation against the first clot volume was also significant. In the pathological examination, we found the ependymal lining of ventricular system was destroyed and neurons in the subependymal areas developed acidophil necrosis, which was prominent around Sylvian aqueduct. Conclusion Hemorrhagic ventricular dilatation(HVD) is a prominent feature of IVH and also is a strong indicator for poor prognosis. lschemic changes of periventricular neurons in some important structures may be the most direct cause for poor outcome of IVH. It may be induced by periventricular vascular structures compressed by HVD, increased intracranial pressure ,cerebral vasospasm and others.

  17. Effect of N-acetylcysteine on vasospasm in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Nelson de Azambuja Pereira Filho

    2010-12-01

    Full Text Available Vasospasm remains an extremely serious complication that affects patients presenting with subarachnoid hemorrhage (SAH due to ruptured intracranial aneurysms. The current therapeutic armamentarium is still insufficient in many cases, and the search for new therapies is necessary. In this study, we evaluated the effect of N-acetylcysteine (NAC on cerebral arterial vasospasm using an experimental model. Twenty-four wistar rats were divided into 4 groups: [1] Control, [2] SAH, [3] SAH+NAC and [4] SAH+Placebo. The experimental model employed double subarachnoid injections of autologous blood. The proposed dose of NAC was 250 mg/kg intraperitoneally per day. We analyzed the inner area of the basilar artery to assess the action of NAC. The experimental model proved to be very adequate, with a mortality rate of 4%. The inner area of the basilar artery in the SAH group showed significant difference to the control group (p=0.009. The use of NAC significantly reduced vasospasm as compared to the untreated group (p=0.048 and established no significant difference to the control group (p=0.098. There was no significant improvement with the administration of placebo (p=0.97. The model of the dual hemorrhage proved to be very useful for vasospasm simulation, with overall low mortality. The administration of NAC significantly reduced vasospasm resulting from SAH, and may represent a new therapeutic alternative.

  18. Growth and subsequent disappearance of a ruptured small saccular intracranial aneurysm: A morphometric and flow-dynamic analysis.

    Science.gov (United States)

    Peruvumba, Jayakumar Narayan; Paul, Divyan; Verghese, Renjan

    2016-10-01

    The growth of a ruptured small saccular aneurysm has rarely been documented. Also rare are reports of spontaneous thrombosis of ruptured small intracranial saccular aneurysms. However, there are no reported instances of ruptured small saccular aneurysms that have demonstrated an increase in size after rupture, subsequently thrombosed and disappeared from circulation. We report one such aneurysm in a patient who presented with subarachnoid hemorrhage from a ruptured small saccular aneurysm of the anterior communicating artery. The possible reasons for the initial growth and subsequent thrombosis of the aneurysm from morphometric and flow dynamic points of view are discussed.

  19. Intracranial Aneurysms in Sickle-Cell Disease Are Associated With the Hemoglobin SS Genotype But Not With Moyamoya Syndrome

    DEFF Research Database (Denmark)

    Birkeland, Peter; Gardner, Kate; Kesse-Adu, Rachel

    2016-01-01

    BACKGROUND AND PURPOSE: Intracranial aneurysms and aneurysmal subarachnoid hemorrhage may occur more frequently in sickle-cell disease (SCD), and this could be related to the sickle genotype and moyamoya syndrome seen in SCD. METHODS: Records from a total of 1002 patients with SCD attending 2...... had imaging data; the prevalence was significantly higher in patients with HbSS genotype compared with other sickle genotypes with the highest prevalence (15%) observed in women in the age group 30 to 39 years. Fifty-one HbSS patients had a moyamoya vasculopathy, but only 3 of these had concomitant...

  20. Statins and intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Zheng Haiping; Hu Zhiping; Lu Wei

    2014-01-01

    Objective To briefly review the literature regarding the impact of statins on the prevention and treatment of stroke,especially on intracerebral hemorrhage (ICH).We described statins' effects,mechanism of ICH,serum total cholesterol and ICH,and the relationship between statins and ICH.Data sources All articles used in this review were mainly searched from the PubMed database with no limitations of language and year of publication.Study selection Randomized controlled studies,prospective cohort studies,animal experiments,and meta-analysis articles related to this topic in the past decade were selected.Results Statins play an important role in the primary and secondary prevention of cardiovascular diseases and also have an impact on the treatment of vascular diseases.There still exist controversies about the relationship between statins and ICH.More clinical and experimental trials indicate that statins do not increase the risk of ICH.Conclusion A low or a regular dose of statins would not increase the risk of ICH.