SUMMARY: Elastase incubation was performed in the LCCA in 13 New Zealand white rabbits. Three weeks after incubation, DSA demonstrated that 10 (10/13, 77%) bifurcation-type aneurysms at the origin of the LCCA were present; mean aneurysm neck, width, and height values were 3.7 ± 1.1, 3.8 ± 0.9, and 8.7 ± 2.3 mm, respectively. The LCCA can be used to create bifurcation aneurysms in rabbits. Published online before print September 8, 2011, doi: 10.3174/ajnr.A2666. Copyright © 2011 American Society of Neuroradiology
BACKGROUND: The International Subarachnoid Aneurysm Trial (ISAT) showed that for ruptured aneurysms suitable for both techniques, coiling should be the first-choice treatment. Only a small proportion of patients (22%) with ruptured aneurysms were included in that trial. Operators were selected on their experience. One could then criticize the impact of the ISAT on clinical practice as a result of recruitment biases and operators selection. OBJECTIVE: To evaluate the morbidity and mortality of coiling when used as first-choice treatment in a consecutive population of patients with ruptured aneurysms treated by nonselected operators. Neurosurgery: October 2011 - Volume 69 - Issue 4 - pp 837-842 doi: 10.1227/NEU.0b013e3182257b30. Copyright © by the Congress of Neurological Surgeons
We report the experience of a case of acute stroke in a patient affected by Rendu Osler syndrome and atrial fibrillation. The combination of dynamic computerized tomography perfusion scans and the use of a highcompliance balloon allowed increasing the treatment window for intra-arterial recanalization over 6 h after stroke onset in a patient with middle cerebral artery occlusion. Saletti et al. International Journal of Emergency Medicine 2011, 4:23 http://www.intjem.com/content/4/1/23. Copytight © 2011 Saletti et al; licensee Springer.
The acute management of patients on warfarin with spontaneous or traumatic intracranial hemorrhage continues to be debated in the medical literature. The objective of this paper was to conduct a structured review of the medical literature and summarize the advantages and risks of the available treatment options for reversing warfarin anticoagulation in patients who present to the emergency department with acute intracranial hemorrhage. Bechtel et al. International Journal of Emergency Medicine 2011, 4:40 http://www.intjem.com/content/4/1/40. Copyright © 2011 Bechtel et al; licensee Springer.
This study characterizes the distribution and components of plaque structure by presenting a threedimensional blood-vessel modelling with the aim of determining mechanical properties due to the effect of lipid core and calcification within a plaque. Numerical simulation has been used to answer how cap thickness and calcium distribution in lipids influence the biomechanical stress on the plaque. Wong et al. BMC Cardiovascular Disorders 2012, 12:7 http://www.biomedcentral.com/1471-2261/12/7. Copyright © 2012 Wong et al; licensee BioMed Central Ltd.
A case of communicating carotid-cavernous sinus fistula (CCF) after minor closed head injury is presented. Kaplan et al. International Journal of Emergency Medicine 2012, 5:10 http://www.intjem.com/content/5/1/10. Copyright © 2012 Kaplan et al; licensee Springer.
Safety and efficacy of intravenous thrombolysis in stroke patients with recent transient ischemic attack are hotly debated. Patients suffering transient ischemic attack may present with diffusion-weighted imaging lesions, and although normal computed tomography would not preclude thrombolysis, the concern is that they may be at higher risk for hemorrhage postthrombolysis treatment. Prior ipsilateral transient ischemic attack might provide protection due to ischemic preconditioning. We assessed post-thrombolysis outcomes in stroke patients who had prior transient ischemic attack. © 2011 The Authors. International Journal of Stroke. Copyright © 2011 World Stroke Organization Vol 7, April 2012, 213–218.
Small clinical series have reported the safety of intravenous thrombolysis in ischemic stroke related to extracranial internal carotid dissection. However, no studies specifically analyzing the effects on stroke outcome are available. Aims Our goal was to evaluate whether patients with ischemic stroke related to extracranial internal carotid dissection obtain any benefit from intravenous thrombolysis. Copyright © 2011 The Authors. International Journal of Stroke. Copyright © 2011 World Stroke Organization Vol 7, January 2012, 7–13.
Acute occlusions of the large intracranial arteries are relatively resistant to intravenous thrombolysis. Therefore, multimodal approaches combining intravenous thrombolysis with endovascular mechanical recanalization are increasingly being applied. In this setting, intravenous thrombolysis may facilitate subsequent mechanical thrombectomy. To test this hypothesis, we analyzed the influence of intravenous thrombolysis on net intervention time in subsequent endovascular mechanical recanalization. Methods In this retrospective single-center analysis,wecompared net intervention time with and without preceding intravenous thrombolysis in patients treated by endovascular mechanical recanalization between 01/2003 and 06/2010. The net intervention timewas defined as the interval between the onset of endovascular thrombus manipulation and successful vessel recanalization. Copyright © 2011 The Authors. 14 International Journal of Stroke. Copyright © 2011 World Stroke Organization Vol 7, January 2012, 14–18.
Cerebral small vessel disease is difficult to directly visualize in vivo. Therefore, we rely on radiological phenotypes as surrogate markers of disease. The principal phenotypes of clinical interest are small, deep brain infarcts, cerebral white matter lesions, deep brain haemorrhages, and cerebral microbleeds. The causes or mechanisms underlying these phenotypes are understood in varying degrees of detail. This review aims to summarize recent knowledge regarding these phenotypes and place it in context with classical clinicopathological observations to provide mechanistic, clinical, and therapeutic insights into small vessel disease. Copyright © 2011 The Authors. International Journal of Stroke. Copyright © 2011 World Stroke Organization Vol 7, January 2012, 36–46.
Background and Purpose—Significantly increased blood pressure (BP) is common in patients receiving intravenous thrombolysis (IVT). We aimed to investigate frequency of pre- and post-treatment elevated BP and its relation to intracerebral hemorrhage (ICH) and symptomatic ICH (sICH), respectively. Stroke. 2011; 42: 1702-1706 Published online before print April 28, 2011. Copyright © 2011 American Heart Association, Inc. All rights reserved. Print ISSN: 0039-2499. Online ISSN: 1524-4628
BACKGROUND AND PURPOSE: Carotid IPH can be detected with MR imaging. The aim of this study was to determine the safety of CAS using an emboli protection device in patients with severe carotid artery stenosis and MR imaging–depicted carotid IPH. Published online before print January 12, 2012, doi: 10.3174/ajnr.A2911. Copyright © 2012 American Society of Neuroradiology
BACKGROUND: It is not clear whether treatment modality (clipping or coiling) affects the risk of seizures after treatment for cerebral aneurysms. OBJECTIVE: To determine whether there is an increased risk of seizures after clipping vs coiling. Neurosurgery: September 2011 - Volume 69 - Issue 3 - pp 644-650 doi: 10.1227/NEU.0b013e31821bc46d. Copyright © by the Congress of Neurological Surgeons
SUMMARY: The Outreach DAC is an intermediate-sized catheter designed for use with the Merci clot retriever in acute stroke. We investigated its utility as an adjunctive device during AVM pedicle embolization. In the author s opinion, the DAC provided additional guide-catheter and microcatheter support, improved selective angiographic visualization of AVM angioarchitecture, aided microcatheter removal from its embedded position in the AVM Onyx cast, and enhanced local microcatheter control and safety, compared with embolization with the guide and microcatheter alone. Copyright © 2011 American Society of Neuroradiology
BACKGROUND AND PURPOSE: In clinical practice, durability of occlusion following coil embolization is superior in densely packed, compared with loosely packed, aneurysms. In a rabbit model, we probed, by using proteomics tools, the biologic mechanisms associated with densely packed and completely occluded aneurysms, compared with loosely packed and incompletely occluded aneurysms, to explore the biologic mechanisms of intra-aneurysmal healing following embolization. Published online before print February 9, 2012, doi: 10.3174/ajnr.A2940. Copyright © 2012 American Society of Neuroradiology
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