A case of a heterozygous ABCC6 mutation showing recurrent ischemic strokes and intracranial hemorrhages

2021 ◽  
Author(s):  
Emi Nomura ◽  
Yuko Kawahara ◽  
Yoshio Omote ◽  
Yoshiaki Takahashi ◽  
Namiko Matsumoto ◽  
...  
Keyword(s):  
Intracranial Hemorrhages

Clinical-neurosonographic parallels of intracranial hemorrhagies in early childhood

2019 ◽  
Vol 22 (6) ◽  
pp. 116-122
Author(s):  
Sh. Sh. Shamansurov ◽  
Sh. H. Saidazizova ◽  
S. O. Nazarova
Keyword(s):  
Early Childhood ◽  
Comparative Analysis ◽  
Subarachnoid Hemorrhage ◽  
Left Hemisphere ◽  
Intracranial Hemorrhage ◽  
Intraventricular Hemorrhage ◽  
Detailed Examination ◽  
Intracranial Hemorrhages ◽  
Risk Of Hemorrhage ◽  
Neurological State

Objective. Conduct a comparative analysis of clinical and neurosonographic indicators of intracranial hemorrhage in infants.Materials and methods. In the clinical part of the study, 68 patients took part in the acute / acute periods of intracranial hemorrhage, which we took for the study on the basis of the Tashkent City Children's Clinical Hospital No1. Gender ratios of which were 69.1% boys (47 children) and 30.9% girls (21 children), from birth to 2 months of life (average age at the time of hemorrhage is 36.28 ± 9.85 days). Diagnostic examination included neurosonography (NSG) of all children in the first 24 hours of the implementation of intracranial hemorrhages on admission to the clinic.Results. According to our study of 68 children with intracranial hemorrhage, it turned out that the average age of morbidity was 36.28 ± 9.85 days (p < 0.001) Neurosonographic indicators stated the presence of parenchymal hemorrhage (right and left hemisphere), SAH (subarachnoid hemorrhage), hemorrhage into the trunk, IVH (intraventricular hemorrhage) II, IVH III. According to neurosonography, parenchymal hemorrhage (right-16 or left hemisphere-21) was observed in 37 patients, SAH and IVH-II 21 (30.9%) patients, IVH III – in 17 (25%) patients, hemorrhage in 3 (4.4%) brain stem of patientsConclusion. Analysis of the implementation of hemorrhage showed that not always small gestational age is the risk of hemorrhage. Cases of less severe changes (27%) on NSG with a coarser clinical picture and vice versa (15%), necessitate (taking into account the severity of the neurological state), a more detailed examination, including visualization (CT, MRI).

scholarly journals Value of repeated imaging in patients with a stroke who are transferred for endovascular treatment

2021 ◽  
pp. neurintsurg-2020-017050
Author(s):  
Laura C C van Meenen ◽  
Nerea Arrarte Terreros ◽  
Adrien E Groot ◽  
Manon Kappelhof ◽  
Ludo F M Beenen ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Clinical Improvement ◽  
Treatment Delay ◽  
Clinical Deterioration ◽  
Large Vessel Occlusion ◽  
Intracranial Hemorrhages ◽  
Vessel Occlusion ◽  
Quality Outcomes ◽  
Comprehensive Stroke Center ◽  
Stroke Center

BackgroundPatients with a stroke who are transferred to a comprehensive stroke center for endovascular treatment (EVT) often undergo repeated neuroimaging prior to EVT.ObjectiveTo evaluate the yield of repeating imaging and its effect on treatment times.MethodsWe included adult patients with a large vessel occlusion (LVO) stroke who were referred to our hospital for EVT by primary stroke centers (2016–2019). We excluded patients who underwent repeated imaging because primary imaging was unavailable, incomplete, or of insufficient quality. Outcomes included treatment times and repeated imaging findings.ResultsOf 677 transferred LVO stroke, 551 were included. Imaging was repeated in 165/551 patients (30%), mostly because of clinical improvement (86/165 (52%)) or deterioration (40/165 (24%)). Patients who underwent repeated imaging had higher door-to-groin-times than patients without repeated imaging (median 43 vs 27 min, adjusted time difference: 20 min, 95% CI 15 to 25). Among patients who underwent repeated imaging because of clinical improvement, the LVO had resolved in 50/86 (58%). In patients with clinical deterioration, repeated imaging led to refrainment from EVT in 3/40 (8%). No symptomatic intracranial hemorrhages (sICH) were identified. Ultimately, 75/165 (45%) of patients with repeated imaging underwent EVT compared with 326/386 (84%) of patients without repeated imaging (p<0.01).ConclusionsNeuroimaging was repeated in 30% of patients with an LVO stroke and resulted in a median treatment delay of 20 minutes. In patients with clinical deterioration, no sICH were detected and repeated imaging rarely changed the indication for EVT. However, in more than half of patients with clinical improvement, the LVO had resolved, resulting in refrainment from EVT.

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

2015 ◽  
Vol 57 (12) ◽  
pp. 1263-1268 ◽  
Author(s):  
Stacey Langford ◽  
Ashok Panigrahy ◽  
Srikala Narayanan ◽  
Misun Hwang ◽  
Charles Fitz ◽  
...  
Keyword(s):  
Head Trauma ◽  
Ct Images ◽  
Intracranial Hemorrhages ◽  
Pediatric Head Trauma

FRACTURES OF THE CLIVUS

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. 1063-1069 ◽  
Author(s):  
Pawel G. Ochalski ◽  
Richard M. Spiro ◽  
Anthony Fabio ◽  
Amin B. Kassam ◽  
David O. Okonkwo
Keyword(s):  
Vascular Complications ◽  
Cranial Base ◽  
High Rate ◽  
Intracranial Hemorrhages ◽  
Neurological Sequelae ◽  
Head Injured ◽  
Boolean Search ◽  
Management Approaches ◽  
Injured Patients ◽  
Electronic Medical Record Database

Abstract OBJECTIVE We report the morbidity and mortality associated with fractures of the clivus and discuss management approaches specific to this unique diagnostic entity. METHODS We performed a boolean search of our electronic medical record database to identify patients with fractures of the clivus that were diagnosed using computed tomography of the head. A retrospective imaging and chart analysis was completed to further characterize the fractures and to analyze outcomes. RESULTS Between January 1999 and December 2007, 41 patients were identified with fractures of the clivus. We found a 0.21% overall incidence among all head-injured patients presenting to our institution and a 2.3% incidence among those patients with a cranial fracture. Ten of 41 patients (24.4%) died, and neurological and vascular complications associated with central cranial base fractures were observed in 19 of 41 patients (46%). Furthermore, associated cranial fractures remote from the central cranial base and associated intracranial hemorrhages were observed in 40 of 41 (97.6%) and 33 of 41 (80.5%) patients, respectively. In terms of outcomes, 26 of 41 patients (63.5%) had a Glasgow Coma Scale score of 12 or greater at the time of discharge from the hospital. CONCLUSION We demonstrate a lower than previously reported mortality rate in patients with clival fractures. Nevertheless, as a result of location, fractures of the clivus were frequently associated with a high rate of complications and neurological sequelae.

Review of Prothrombin Complex Concentrates Use in Apixaban and Rivaroxaban Associated Intracranial Hemorrhages

2021 ◽  
pp. 089719002110150
Author(s):  
Francisco Ibarra
Keyword(s):  
Thromboembolic Event ◽  
Prothrombin Complex Concentrate ◽  
Factor Xa ◽  
Mortality Rates ◽  
Intracranial Hemorrhages ◽  
Prothrombin Complex Concentrates ◽  
Title 1 ◽  
Study Objective ◽  
Scale Scores ◽  
Event Rates

Study Objective: Summarize the studies evaluating the use of 4-factor prothrombin complex concentrates in the management of apixaban and rivaroxaban associated intracranial hemorrhages. Methods: A PubMed literature search was conducted for articles published between 2013 and 2020 which contained the following terms in their title: (1) apixaban, rivaroxaban, or factor Xa inhibitor*, and (2) prothrombin complex concentrate*. Results: Eighteen observational studies were included. When a ∼25 units/kg (range: 25-26.9 units/kg) non-activated 4 factor prothrombin complex concentrate dose was administered, the hemostatic effectiveness rates were ≥ 79% in 2/4 studies that utilized the Sarode et al criteria, in comparison to 4/5 studies that administered a 50 units/kg dose. The mortality rates were < 20% in 7/9 studies with hemostatic effectiveness rates ≥ 79%. Mortality rates were lower in the studies demonstrating higher hemostatic effectiveness rates and including patients with higher Glasgow coma scale scores and lower intracerebral hemorrhage volumes. Overall, the thromboembolic event rates were 0-18%, with 16/18 studies demonstrating rates ≤ 10%. The thromboembolic event rates were not dose or agent dependent. Conclusion: Rates of hemostatic effectiveness were influenced by the definition of hemostatic effectiveness, dose administered, and patient severity. Studies suggest that higher doses may result in higher hemostatic effectiveness rates without increasing the risk of experiencing a thromboembolic event. This review may be used by providers to modify or validate their reversal strategy approach until well designed studies are available.

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

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Kyle M. Ware ◽  
Douglas L. Feinstein ◽  
Israel Rubinstein ◽  
Prudhvi Battula ◽  
Jose Otero ◽  
...  
Keyword(s):  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Factor Xa ◽  
Hemoglobin Concentration ◽  
Thrombin Inhibitor ◽  
Free Hemoglobin ◽  
Intracranial Hemorrhages ◽  
The Brain

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.

scholarly journals Epidural hematoma in newborn: literature review

2020 ◽  
pp. e402020
Author(s):  
Isabela do Prado Nascimento ◽  
Gabriela Ferreira Kalkmann ◽  
Leticia Adrielle Dos Santos ◽  
Letícia Novak Crestani ◽  
Carlos Umberto Pereira
Keyword(s):  
High Risk ◽  
Literature Review ◽  
Brain Damage ◽  
Epidural Hematoma ◽  
Clinical Presentation ◽  
Rapid Identification ◽  
Intracranial Hemorrhages ◽  
Neurological Sequelae ◽  
Type Of Delivery

Introduction: Newborn represent a population at high risk for brain damage. Intracranial hemorrhages in newborn are uncommon, and epidural hematoma (EH) is rare. Material and methods: The authors present a literature review about EH in newborn. Results: EH in newborn occurs in only 2% and is frequently associated with the type of delivery. The clinical presentation is asymptomatic or heterogeneous. The diagnosis is made from anamnesis and imaging exams, and the treatment depends on the size of the EH. Conclusion: The knowledge of neurosurgeons, obstetricians and pediatricians about the occurrence of EH in newborn is extremely important. The rapid identification and management of the case is of paramount importance, to reduce neurological sequelae.

scholarly journals Covid-19 Associated Subdural Hematoma: A Case Report Intracranial Hemorrhage in the Setting of Covid-19

2021 ◽  
pp. 1-2
Author(s):  
Kirill Alekseyev ◽  
Keyword(s):  
Mental Status ◽  
Intracranial Hemorrhage ◽  
Subdural Hematoma ◽  
Altered Mental Status ◽  
Shortness Of Breath ◽  
Intracranial Hemorrhages ◽  
Angiotensin Converting Enzyme 2 ◽  
Global Spread ◽  
Thrombotic Complications ◽  
Possible Cause

Coronavirus disease 2019 (COVID-19) is a pandemic that began in December 2019 as a result of the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We frequently associate COVID-19 with symptoms of fever, shortness of breath, and pneumonia; however, we are slowly uncovering the fact that systems other than the respiratory are being affected. We present a 60-year-old female who presented with altered mental status and was found to have COVID-19 induced subdural hematoma. Although intracranial hemorrhages are extremely rare in the setting of COVID-19, it is known that the affinity of SARS-CoV-2 to the angiotensin-converting enzyme 2 receptors, in addition to the cytokine storm, predisposes infected individuals to intracranial hemorrhages. Thus, it is crucial to consider intracranial hemorrhage as a possible cause of altered mental status in patients infected with COVID-19 and weigh the potential risk versus benefits of utilizing anticoagulants when managing the thrombotic complications of this virus.

Sign in / Sign up

Export Citation Format

Share Document