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ESTUDIOS


02 octubre 2014

STROKE. Posttraumatic Stress Disorder After Cerebrovascular Events. Broadening the Landscape of Psychological Assessment in Stroke and Transient Ischemic Attack

Barbara G. Vickrey, MD, MPH; Linda S. Williams, MD

Posttraumatic stress disorder (PTSD) is defined based on exposure to actual or threatened death, injury, or violence and the presence for ≥30 days postevent of intrusive symptoms (eg, flashbacks), persistent avoidance of stimuli, negative alteration in mood and cognition, and marked alteration in arousal and reactivity (eg, hypervigilance).

07 octubre 2014

STROKE. Brief Report. Multimodal 3 Tesla MRI Confirms Intact Arterial Wall in Acute Stroke Patients After Stent-Retriever Thrombectomy

Kety Hsieh, MD; Rajeev K. Verma, MD; Gerhard Schroth, MD; Pascal P. Gratz, MD; Frauke Kellner-Weldon, MD; Jan Gralla, MD, MSc; Christoph Zubler, MD; Pasquale Mordasini, MD, MSc; Simon Jung, MD; Heinrich P. Mattle, MD; Marwan El-Koussy, MD

Background and Purpose: The aim of this prospective study was to assess vascular integrity after stent-retriever thrombectomy.

16 septiembre 2014

STROKE. Brief Report. Effects of Extracranial Carotid Stenosis on Intracranial Blood Flow

Sophia F. Shakur, MD; Tomas Hrbac, MD, PhD; Ali Alaraj, MD; Xinjian Du, MD; Victor A. Aletich, MD; Fady T. Charbel, MD; Sepideh Amin-Hanjani, MD

Background and Purpose: The hemodynamic effects of extracranial carotid stenosis on intracranial blood flow are not well characterized. We sought to determine the impact of degree of stenosis, stenosis length, and residual lumen on intracranial blood flow in patients with extracranial carotid stenosis.

28 agosto 2014

STROKE. Clinical Sciences. External Validation of the Boston Acute Stroke Imaging Scale and M1-BASIS in Thrombolyzed Patients

Leonard L.L. Yeo, MBBS; Prakash R. Paliwal, MBBS; Benjamin Wakerley, MBBS; Chin M. Khoo, MBBS; Hock L. Teoh, MBChB; Aftab Ahmad, MBBS; Eric Y. Ting, MBBS; Raymond C. Seet, MBBS; Venetia Ong, BN; Bernard P. Chan, MBBS; Kusama Yohanna, MBBS; Anil Gopinathan, MBBS; Rahul Rathakrishnan, BM; Vijay K. Sharma, MBBS

Background and Purpose: Radiological findings play an essential role in therapeutic decision making and prognostication in acute ischemic stroke (AIS). The Boston Acute Stroke Imaging Scale (BASIS) and Middle Cerebral Artery-BASIS (M1-BASIS) methodologies are rapid purely radiological instruments and easily applicable for patients with AIS. We validated these methods in patients with AIS treated with intravenous tissue-type plasminogen activator.

01 noviembre 2015

NEUROSURGERY. Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants vs Nonsurgical Management for Sacroiliac Joint Dysfunction: 12-Month Outcomes

Polly, David W. MD*; Cher, Daniel J. MD‡; Wine, Kathryn D. MPH‡; Whang, Peter G. MD§; Frank, Clay J. MD¶; Harvey, Charles F. MD‖; Lockstadt, Harry MD#; Glaser, John A. MD**; Limoni, Robert P. MD‡‡; Sembrano, Jonathan N. MD§§; for the INSITE Study Group

BACKGROUND: Sacroiliac joint (SIJ) dysfunction is a prevalent cause of chronic, unremitting lower back pain.

01 noviembre 2015

NEUROSURGERY. Elevated Baseline C-Reactive Protein as a Predictor of Outcome After Aneurysmal Subarachnoid Hemorrhage: Data From the Simvastatin in Aneurysmal Subarachnoid Hemorrhage (STASH) Trial

Turner, Carole L. MSc; Budohoski, Karol PhD; Smith, Christopher PhD; Hutchinson, Peter J. PhD; Kirkpatrick, Peter J. FMedSci; for the STASH collaborators

BACKGROUND: There remains a proportion of patients with unfavorable outcomes after aneurysmal subarachnoid hemorrhage, of particular relevance in those who present with a good clinical grade. A forewarning of those at risk provides an opportunity towards more intensive monitoring, investigation, and prophylactic treatment prior to the clinical manifestation of advancing cerebral injury.

01 noviembre 2015

NEUROSURGERY. The Recent Revolution in the Design and Manufacture of Cranial Implants: Modern Advancements and Future Directions

Bonda, David J. MD*; Manjila, Sunil MD*; Selman, Warren R. MD*; Dean, David PhD‡

Abstract: Large format (ie, >25 cm2) cranioplasty is a challenging procedure not only from a cosmesis standpoint, but also in terms of ensuring that the patient´s brain will be well-protected from direct trauma. Until recently, when a patient´s own cranial flap was unavailable, these goals were unattainable.

01 octubre 2015

NEUROSURGERY. New Guidelines for Spontaneous Intracranial Hemorrhage: A Roadmap for Optimizing Outcomes

Halasa, Tariq K. MD; Aoun, Rami James N. MD, MPH; Sattur, Mithun G. MD; Bendok, Bernard R. MD, MSCI

The American Heart Association has played a leadership role in the periodic assimilation and publication of high-quality multidisciplinary stroke-related guidelines. The spontaneous intracranial hemorrhage (ICH) guidelines were last published in 2010.1 Recent advances in our understanding of the pathophysiology of this disease and the recent publication of important clinical trials have prompted the need for an update to these guidelines. Spontaneous ICH is associated with significant morbidity and mortality, with an incidence of 16 to 33 cases per 100 000.2 The newly published guidelines in the July 2015 issue of Stroke have added a number of new recommendations, including 3 new Class I recommendations, compared with the 2010 guidelines.3 In classifying the level of certainty regarding recommendations, the guidelines follow the American Heart Association/American Stroke Association classification system. The writing team conducted a thorough PubMed search on all pertinent studies conducted between 2009 and August 2013; the outcomes from 2 essential phase 3 ICH trials were also integrated.

01 octubre 2015

NEUROSURGERY. Degenerative Spinal Deformity

Ailon, Tamir MD, MPH*; Smith, Justin S. MD, PhD*; Shaffrey, Christopher I. MD, FACS*; Lenke, Lawrence G. MD‡; Brodke, Darrel MD§; Harrop, James S. MD¶; Fehlings, Michael MD, PhD‖; Ames, Christopher P. MD#

Abstract Degenerative spinal deformity afflicts a significant portion of the elderly and is increasing in prevalence. Recent evidence has revealed sagittal plane malalignment to be a key driver of pain and disability in this population and has led to a significant shift toward a more evidence-based management paradigm. In this narrative review, we review the recent literature on the epidemiology, evaluation, management, and outcomes of degenerative adult spinal deformity (ASD).

01 octubre 2015

NEUROSURGERY. Management of Degenerative Lumbar Spinal Stenosis in the Elderly

Shamji, Mohammed F. MD, PhD, FRCSC, FAANS*,‡,§; Mroz, Thomas MD, FACS¶; Hsu, Wellington MD‖; Chutkan, Norman MD, FACS#

BACKGROUND: Lumbar spinal stenosis can cause symptomatic neurogenic claudication alongside radicular pain and weakness. In appropriately selected patients, surgical intervention has been demonstrated to provide for improvement in pain, disability, and quality of life. This systematic review sought to define the utility and safety of such decompression with or without arthrodesis in the management of symptomatic lumbar spinal stenosis for elderly patients older than 65 years of age.

01 octubre 2015

NEUROSURGERY. Optimal Timing of Surgical Decompression for Acute Traumatic Central Cord Syndrome: A Systematic Review of the Literature

Anderson, Karen K. BSc*; Tetreault, Lindsay BSc‡; Shamji, Mohammed F. MD, MSc, PhD, FRCSC§; Singh, Anoushka PhD, RN‖; Vukas, Rachel R. MA, MLS¶; Harrop, James S. MD#; Fehlings, Michael G. MD, PhD, FRCSC**; Vaccaro, Alexander R. MD, PhD‡‡; Hilibrand, Alan S. MD‡‡; Arnold, Paul M. MD**

BACKGROUND: Traumatic central cord syndrome (TCCS) is an incomplete spinal cord injury defined by greater weakness in upper versus lower extremities, variable sensory loss, and variable bladder, bowel, and sexual dysfunction. The optimal timing of surgery for TCCS remains controversial.

01 octubre 2015

NEUROSURGERY. Management of the Elderly With Vertebral Compression Fractures

Goldstein, Christina L. MD, FRCSC*; Chutkan, Norman B. MD‡; Choma, Theodore J. MD*; Orr, R. Douglas MD, FRCSC§

Abstract: Vertebral compression fractures (VCFs) are the most common type of fracture secondary to osteoporosis. These fractures are associated with significant rates of morbidity and mortality and annual direct medical expenditures of more than $1 billion in the United States.

22 octubre 2015

SPRINGER. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke

Emilie M. M. Santos, Albert J. Yoo, Ludo F. Beenen, Olvert A. Berkhemer, Mark D. den Blanken, Carrie Wismans, Wiro J. Niessen, Charles B. Majoie, Henk A. Marquering on behalf of the MR CLEAN investigators

Introduction: Thrombus density may be a predictor for acute ischemic stroke treatment success. However, only limited data on observer variability for thrombus density measurements exist. This study assesses the variability and bias of four common thrombus density measurement methods by expert and non-expert observers.

01 enero 2015

SPRINGER. Observer reliability of CT angiography in the assessment of acute ischaemic stroke: data from the Third International Stroke Trial

Grant Mair, Rüdiger von Kummer, Alessandro Adami, Philip M. White, Matthew E. Adams, Bernard Yan, Andrew M. Demchuk, Andrew J. Farrall, Robin J. Sellar, Rajesh Ramaswamy, Daisy Mollison, Elena V. Boyd, Mark A. Rodrigues, Karim Samji, Andrew J. Baird, Geoff Cohen, Eleni Sakka, Jeb Palmer, David Perry, Richard Lindley, Peter A. G. Sandercock, Joanna M. Wardlaw

Introduction: CT angiography (CTA) is often used for assessing patients with acute ischaemic stroke. Only limited observer reliability data exist. We tested inter- and intra-observer reliability for the assessment of CTA in acute ischaemic stroke.

01 septiembre 2015

SPRINGER. CT perfusion during delayed cerebral ischemia after subarachnoid hemorrhage: distinction between reversible ischemia and ischemia progressing to infarction

Charlotte H. P. Cremers , Pieter C. Vos, Irene C. van der Schaaf, Birgitta K. Velthuis, Mervyn D. I. Vergouwen, Gabriel J. E. Rinkel, Jan Willem Dankbaar

Introduction: Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be reversible or progress to cerebral infarction. In patients with a deterioration clinically diagnosed as DCI, we investigated whether CT perfusion (CTP) can distinguish between reversible ischemia and ischemia progressing to cerebral infarction.

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