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1
المؤلفون: Kristopher T. Kahle, Phan Q. Duy
المصدر: Neurology
مصطلحات موضوعية: medicine.medical_specialty, Meningomyelocele, Intracranial Pressure, NeuroImage, Physical examination, Neuroimaging, Cerebral Ventricles, medicine, Humans, Communicating hydrocephalus, Cortical atrophy, Intracranial pressure, medicine.diagnostic_test, business.industry, Infant, medicine.disease, Megalencephaly, Treatment Outcome, Female, Neurology (clinical), Radiology, business, Cognition Disorders, Meningitis, Shunt (electrical), Ventriculomegaly, Hydrocephalus
الوصف: A 3-year-old girl presented with progressive macrocephaly and a history of open myelomeningocele surgically repaired at birth. She had no history of intracranial hemorrhage or meningitis. Physical examination showed head circumference >99th percentile (54 cm) and decreased lower extremity motor function. Neuroimaging revealed extreme communicating ventriculomegaly and strikingly turbulent intraventricular CSF flow in the setting of diffuse cortical atrophy (figure, A–C). A ventriculoperitoneal shunt was placed. Intraoperatively, her intracranial pressure was 18 cm CSF (13.2 mm Hg) (normal in children: 3–7 mm Hg). Postoperative imaging showed complete resolution of intraventricular CSF turbulence with a mild decrease in ventriculomegaly (figure, D–F). The patient continued to exhibit mild neurocognitive impairments with arrest of progressive macrocephaly.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f51f8afb8603cd95ca7dc306198187c2Test
https://europepmc.org/articles/PMC8589266Test/ -
2
المؤلفون: Ge, Yuanhong, Lai, Qingjia, Wang, Wenyu, Xu, Xuejun
المصدر: Medicine
مصطلحات موضوعية: Computed Tomography Angiography, Aftercare, Intracranial Aneurysm, Aneurysm, Ruptured, Middle Aged, intraventricular hemorrhage, Diuretics, Osmotic, Embolization, Therapeutic, Blood Vessel Prosthesis, cerebral aneurysm, Treatment Outcome, obstructive hydrocephalus, Humans, Female, Mannitol, Clinical Case Report, Research Article, Hydrocephalus
الوصف: Rationale: Obstructive hydrocephalus (OH) frequently occurs in patients with a ruptured cerebral aneurysm (CA), and it may lead to severe neurological deficits, including life-threatening brain herniation. OH generally occurs in the early stage of CA rupture, rather than in the late stage, and rarely resolves without therapy. Patient concerns: A 64-year-old woman with a ruptured anterior communicating artery aneurysm was treated with coil embolization. Nineteen days after her CA rupture, because of the delayed transient OH, she experienced a dramatic cycle in consciousness over 9 hours: wakefulness–drowsiness–coma–drowsiness–wakefulness. Diagnosis: The patient was diagnosed with delayed transient obstructive hydrocephalus, which is a very rare condition. Interventions: Mannitol was administered to reduce intracranial pressure. Outcomes: The patient was discharged from the hospital 30 days after admission, with a final GCS score of 15 and without weaknesses. At follow-up 2 months after discharge, brain CT revealed non-recurrence of hydrocephalus. Lessons: A blood clot of any size in the ventricle is likely to lead to obstructive hydrocephalus. Prolonged bed rest for IVH patients may help to reduce the incidence of delayed OH.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::61e807df3c3442deccd151d586147e0bTest
http://europepmc.org/articles/PMC8183689Test -
3دورية أكاديمية
المؤلفون: Kuramatsu, Joji B, Gerner, Stefan T, Falcone, Guido J, Selim, Magdy H, Lioutas, Vasileios-Arsenios, Endres, Matthias, Zweynert, Sarah, Vajkoczy, Peter, Ringleb, Peter A, Purrucker, Jan C, Volkmann, Jens, Neugebauer, Hermann, Ziai, Wendy, Erbguth, Frank, Schellinger, Peter D, Knappe, Ulrich J, Fink, Gereon R, Dohmen, Christian, Minnerup, Jens, Reichmann, Heinz, Schneider, Hauke, Röther, Joachim, Reimann, Gernot, Bardutzky, Jürgen, Schwarz, Michael, Bäzner, Hansjörg, Claßen, Joseph, Michalski, Dominik, Witte, Otto W, Günther, Albrecht, Hamann, Gerhard F, Lücking, Hannes, Dörfler, Arnd, Ishfaq, Muhammad Fawad, Sembill, Jochen A, Chang, Jason J, Testai, Fernando D, Woo, Daniel, Alexandrov, Andrei V, Staykov, Dimitre, Goyal, Nitin, Tsivgoulis, Georgios, Sheth, Kevin N, Awad, Issam A, Schwab, Stefan, Sprügel, Maximilian I, Hanley, Daniel F, Huttner, Hagen B, Collaborators, Sansing, Lauren, Matouk, Charles C, Leasure, Audrey, Sobesky, Jan, Bauer, Miriam, Schurig, Johannes, Rizos, Timolaos, Mrochen, Anne, Haeusler, Karl Georg, Müllges, Wolfgang, Kraft, Peter, Schubert, Anna-Lena, Stösser, Sebastian, Ludolph, Albert, Nueckel, Martin, Glahn, Jörg, Stetefeld, Henning, Rahmig, Jan, Kölbl, Kathrin, Fisse, Anna Lena, Michels, Peter, Schwert, Henning, Hagemann, Georg, Rakers, Florian, Wöhrle, Johannes C, Alshammari, Fahid, Horn, Markus, Bahner, Dirk, Urbanek, Christian, Ram, Malathi, Palm, Frederick, Grau, Armin, Avadhani, Radhika
المصدر: Stroke 53(9), 2876 - 2886 (2022). doi:10.1161/STROKEAHA.121.038455
مصطلحات موضوعية: info:eu-repo/classification/ddc/610, Cerebral Hemorrhage: diagnostic imaging, Cerebral Hemorrhage: drug therapy, Drainage: methods, Fibrinolysis, Fibrinolytic Agents, Humans, Hydrocephalus, Observational Studies as Topic, Treatment Outcome, intracerebral hemorrhage, mortality, standard of care
جغرافية الموضوع: DE
الوصف: In patients with intracerebral hemorrhage (ICH), the presence of intraventricular hemorrhage constitutes a promising therapeutic target. Intraventricular fibrinolysis (IVF) reduces mortality, yet impact on functional disability remains unclear. Thus, we aimed to determine the influence of IVF on functional outcomes.This individual participant data meta-analysis pooled 1501 patients from 2 randomized trials and 7 observational studies enrolled during 2004 to 2015. We compared IVF versus standard of care (including placebo) in patients treated with external ventricular drainage due to acute hydrocephalus caused by ICH with intraventricular hemorrhage. The primary outcome was functional disability evaluated by the modified Rankin Scale (mRS; range: 0-6, lower scores indicating less disability) at 6 months, dichotomized into mRS score: 0 to 3 versus mRS: 4 to 6. Secondary outcomes included ordinal-shift analysis, all-cause mortality, and intracranial adverse events. Confounding and bias were adjusted by random effects and doubly robust models to calculate odds ratios and absolute treatment effects (ATE).Comparing treatment of 596 with IVF to 905 with standard of care resulted in an ATE to achieve the primary outcome of 9.3% (95% CI, 4.4-14.1). IVF treatment showed a significant shift towards improved outcome across the entire range of mRS estimates, common odds ratio, 1.75 (95% CI, 1.39-2.17), reduced mortality, odds ratio, 0.47 (95% CI, 0.35-0.64), without increased adverse events, absolute difference, 1.0% (95% CI, -2.7 to 4.8). Exploratory analyses provided that early IVF treatment (≤48 hours) after symptom onset was associated with an ATE, 15.2% (95% CI, 8.6-21.8) to achieve the primary outcome.As compared to standard of care, the administration of IVF in patients with acute hydrocephalus caused by intracerebral and intraventricular hemorrhage was significantly associated with improved functional outcome at 6 months. The treatment effect was linked to an early time window <48 hours, specifying a target ...
العلاقة: info:eu-repo/semantics/altIdentifier/pmid/pmid:35521958; info:eu-repo/semantics/altIdentifier/issn/1524-4628; info:eu-repo/semantics/altIdentifier/issn/0039-2499; https://pub.dzne.de/record/165155Test; https://pub.dzne.de/search?p=id:%22DZNE-2022-01460%22Test
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المؤلفون: Maldaner, Nicolai, Visser, Victoria, Hostettler, Isabel Charlotte, Bijlenga, Philippe, Haemmerli, Julien, Roethlisberger, Michel, Guzman, Raphael, Daniel, Roy Thomas, Giammattei, Lorenzo, Stienen, Martin Nikolaus, Regli, Luca, Verbaan, Dagmar, Post, René, Germans, Menno Robbert
المساهمون: University of Zurich
مصطلحات موضوعية: Cohort Studies, 10180 Clinic for Neurosurgery, Treatment Outcome, Humans, 610 Medicine & health, Surgery, Neurology (clinical), Prospective Studies, Subarachnoid Hemorrhage, Prognosis, Hydrocephalus
الوصف: The Hemorrhage, Age, Treatment, Clinical State, Hydrocephalus (HATCH) Score has previously shown to predict functional outcome in aneurysmal subarachnoid hemorrhage (aSAH).To validate the HATCH score.This is a pooled cohort study including prospective collected data on 761 patients with aSAH from 4 different hospitals. The HATCH score for prediction of functional outcome was validated using calibration and discrimination analysis (area under the curve). HATCH score model performance was compared with the World Federation of Neurosurgical Societies and Barrow Neurological Institute score.At the follow-up of at least 6 months, favorable (Glasgow Outcome Score 4-5) and unfavorable functional outcomes (Glasgow Outcome Score 1-3) were observed in 512 (73%) and 189 (27%) patients, respectively. A higher HATCH score was associated with an increased risk of unfavorable outcome with a score of 1 showing a risk of 1.3% and a score of 12 yielding a risk of 67%. External validation showed a calibration intercept of -0.07 and slope of 0.60 with a Brier score of 0.157 indicating good model calibration and accuracy. With an area under the curve of 0.81 (95% CI 0.77-0.84), the HATCH score demonstrated superior discriminative ability to detect favorable outcome at follow-up compared with the World Federation of Neurosurgical Societies and Barrow Neurological Institute score with 0.72 (95% CI 0.67-0.75) and 0.63 (95% CI 0.59-0.68), respectively.This multicenter external validation analysis confirms the HATCH score to be a strong independent predictor for functional outcome. Its incorporation into daily practice may be of benefit for goal-directed patient care in aSAH.
وصف الملف: External_Validation_of_the_HATCH__Hemorrhage__Age_.361.pdf - application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::27c39a818dc6a13c1ed24169ae241564Test
