Cerebellar Necrosectomy Instead of Suboccipital Decompression: A Suitable Alternative for Patients with Space-Occupying Cerebellar Infarction

2020 ◽  
Vol 144 ◽  
pp. e723-e733
Author(s):  
Silvia Hernández-Durán ◽  
Christina Wolfert ◽  
Veit Rohde ◽  
Dorothee Mielke
Keyword(s):  
Cerebellar Infarction ◽  
Suitable Alternative ◽  
Suboccipital Decompression

scholarly journals Rapid closure technique in suboccipital decompression

2021 ◽  
Author(s):  
Martin Vychopen ◽  
Alexis Hadjiathanasiou ◽  
Simon Brandecker ◽  
Valeri Borger ◽  
Patrick Schuss ◽  
...  
Keyword(s):  
Fibrin Sealant ◽  
Operative Time ◽  
Surgical Techniques ◽  
Mass Effect ◽  
Cerebrospinal Fluid Leakage ◽  
Cerebellar Infarction ◽  
Complication Rates ◽  
Closure Technique ◽  
Dural Closure ◽  
Suboccipital Decompression

Abstract Objective Suboccipital decompression has been established as standard therapeutic procedure for raised intracranial pressure caused by mass-effect associated pathologies in posterior fossa. Several different surgical techniques of dural closure have been postulated to achieve safe decompression. The aim of this study was to examine the differences between fibrin sealant patch (FSP) and dural reconstruction (DR) in suboccipital decompression for acute mass-effect lesions. Methods We retrospectively analyzed our institutional data of patients who underwent suboccipital decompression due to spontaneous intracerebellar hemorrhage, cerebellar infarction and acute traumatic subdural hematoma between 2010 and 2019. Two different dural reconstruction techniques were performed according to the attending neurosurgeon: (1) fibrin sealant patch (FSP), and (2) dural reconstruction (DR) including the use of dural patch. Complications, operative time, functional outcome and the necessity of a ventriculoperitoneal shunt (VP Shunt) were assessed and further analyzed. Results Overall, 87 patients were treated at the authors’ institution (44 in FSP group, 43 in DR group). Glasgow coma scale on admission and preoperative coagulation state did not differ between the groups. Postoperatively, we found no difference in cerebrospinal fluid leakage or chronic hydrocephalus between the groups (p = 0.47). Revision rates were 2.27% (1/44 patients) in the FSP group, compared to 16.27% (7/43) in the DR group (p < 0.023). Operative time was significantly shorter in the FSP group (90.3 ± 31.0 min vs. 199.0 ± 48.8 min, p < 0.0001). Conclusion Rapid closure technique in suboccipital decompression is feasible and safe. Operative time is hereby reduced, without increasing complication rates.

A Comparison of Simple Structure Rotation Criteria in Temporal Exploratory Factor Analysis for Event-Related Potential Data

Methodology ◽  
2019 ◽  
Vol 15 (Supplement 1) ◽  
pp. 43-60 ◽  
Author(s):  
Florian Scharf ◽  
Steffen Nestler
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Simple Structure ◽  
Ground Truth ◽  
Event Related Potential ◽  
Suitable Alternative ◽  
Factor Rotation ◽  
Rotation Methods ◽  
Simple Structure Rotation ◽  
Temporal Overlap

Abstract. It is challenging to apply exploratory factor analysis (EFA) to event-related potential (ERP) data because such data are characterized by substantial temporal overlap (i.e., large cross-loadings) between the factors, and, because researchers are typically interested in the results of subsequent analyses (e.g., experimental condition effects on the level of the factor scores). In this context, relatively small deviations in the estimated factor solution from the unknown ground truth may result in substantially biased estimates of condition effects (rotation bias). Thus, in order to apply EFA to ERP data researchers need rotation methods that are able to both recover perfect simple structure where it exists and to tolerate substantial cross-loadings between the factors where appropriate. We had two aims in the present paper. First, to extend previous research, we wanted to better understand the behavior of the rotation bias for typical ERP data. To this end, we compared the performance of a variety of factor rotation methods under conditions of varying amounts of temporal overlap between the factors. Second, we wanted to investigate whether the recently proposed component loss rotation is better able to decrease the bias than traditional simple structure rotation. The results showed that no single rotation method was generally superior across all conditions. Component loss rotation showed the best all-round performance across the investigated conditions. We conclude that Component loss rotation is a suitable alternative to simple structure rotation. We discuss this result in the light of recently proposed sparse factor analysis approaches.

Cerebellar Infarction and Coarctation of the Aorta - causal relation or coincidence?

2012 ◽  
Vol 43 (02) ◽  
Author(s):  
A Bertsche ◽  
S Syrbe ◽  
M Bernhard ◽  
C Schober ◽  
W Siekmeyer ◽  
...  
Keyword(s):  
Causal Relation ◽  
Coarctation Of The Aorta ◽  
Cerebellar Infarction

Cerebellar Infarction with Acute Onset of Vertigo and Cochlear Symptoms; A Case Report.

1993 ◽  
Vol 52 (3) ◽  
pp. 401-410
Author(s):  
Tsutomu Yamazaki ◽  
Chihiro Harada ◽  
Munetaka Yamakawa ◽  
Tsutomu Sohma
Keyword(s):  
Case Report ◽  
Acute Onset ◽  
Cerebellar Infarction

A Batch Activated Sludge Study of Pineapple Wastewater Using a Bioaugmentation Process

1991 ◽  
Vol 24 (5) ◽  
pp. 233-240 ◽  
Author(s):  
Nik Fuaad Nik Abllah ◽  
Aik Heng Lee
Keyword(s):  
Activated Sludge ◽  
Removal Efficiency ◽  
Treatment Plant ◽  
Domestic Wastewater ◽  
Ammonia Nitrogen ◽  
Batch Reactors ◽  
Organic Loading ◽  
Suitable Alternative ◽  
Organic Removal ◽  
Sludge Production

A laboratory study was conducted to determine the feasibility of batch activated sludge reactor for treating pineapple wastewater and to examine the effects of bioaugmentation on treatment performance. The experimental set-up consists of eleven batch reactors. Activated sludge obtained from a wastewater treatment plant treating domestic wastewater was used as seed for the reactors. Synthetic pineapple wastewater was used as feed for the reactors. The eleven reactors were arranged to evaluate the total organic removal, nitrification, and sludge production by bioaugmentation process. Three major factors considered were influent organic loading, ammonia-nitrogen, and dosage of bacterial-culture-product addition. Removal of TOG (total organic carbon), sludge production in terms of SS(suspended solids), and ammonia-nitrogen removal variation are used as evaluation parameters. The TOC removal efficiency after the end of a 48 hour reactor run, for influent TOC of 350.14 to 363.30 mg/l, and 145.92 to 169.66 mg/l, was 94.41 to 95.89%, and 93.72 to 94.73% respectively. Higher organic removal was observed in the bioaugmented reactors with higher organic loading. The better organic removal efficiency in the bioaugmented reactors was probably due to activities of bacteria added. The test results also indicated that sludge yield was enhanced by the bacteria additive and high bacteria dosage produced less sludge. Bioaugmentation was observed to be a suitable alternative for enhancing the biological treatment of pineapple wastewater.

Exploiting Anti-Inflammation Effects of Flavonoids in Chronic Inflammatory Diseases

2020 ◽  
Vol 26 (22) ◽  
pp. 2610-2619 ◽  
Author(s):  
Tarique Hussain ◽  
Ghulam Murtaza ◽  
Huansheng Yang ◽  
Muhammad S. Kalhoro ◽  
Dildar H. Kalhoro
Keyword(s):  
Oxidative Stress ◽  
Chronic Diseases ◽  
Inflammatory Diseases ◽  
Therapeutic Option ◽  
Cellular Level ◽  
Antiinflammatory Drugs ◽  
Suitable Alternative ◽  
Chronic Inflammatory Diseases

Background: Inflammation is a complex response of the host defense system to different internal and external stimuli. It is believed that persistent inflammation may lead to chronic inflammatory diseases such as, inflammatory bowel disease, neurological and cardiovascular diseases. Oxidative stress is the main factor responsible for the augmentation of inflammation via various molecular pathways. Therefore, alleviating oxidative stress is effective a therapeutic option against chronic inflammatory diseases. Methods: This review article extends the knowledge of the regulatory mechanisms of flavonoids targeting inflammatory pathways in chronic diseases, which would be the best approach for the development of suitable therapeutic agents against chronic diseases. Results: Since the inflammatory response is initiated by numerous signaling molecules like NF-κB, MAPK, and Arachidonic acid pathways, their encountering function can be evaluated with the activation of Nrf2 pathway, a promising approach to inhibit/prevent chronic inflammatory diseases by flavonoids. Over the last few decades, flavonoids drew much attention as a potent alternative therapeutic agent. Recent clinical evidence has shown significant impacts of flavonoids on chronic diseases in different in-vivo and in-vitro models. Conclusion: Flavonoid compounds can interact with chronic inflammatory diseases at the cellular level and modulate the response of protein pathways. A promising approach is needed to overlook suitable alternative compounds providing more therapeutic efficacy and exerting fewer side effects than commercially available antiinflammatory drugs.

scholarly journals Perfusion in hand arthritis on dynamic contrast-enhanced computed tomography: a randomized prospective study using MRI as a standard of reference

2020 ◽  
Vol 50 (1) ◽  
pp. 59-68
Author(s):  
Sevtap Tugce Ulas ◽  
Kay Geert Hermann ◽  
Marcus R. Makowski ◽  
Robert Biesen ◽  
Fabian Proft ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Mean Transit Time ◽  
Region Of Interest ◽  
T Test ◽  
Dose Length Product ◽  
Suitable Alternative ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced

Abstract Objective To evaluate the performance of dynamic contrast-enhanced CT (DCE-CT) in detecting and quantitatively assessing perfusion parameters in patients with arthritis of the hand compared with dynamic contrast-enhanced MRI (DCE-MRI) as a standard of reference. Materials and methods In this IRB-approved randomized prospective single-centre study, 36 consecutive patients with suspected rheumatoid arthritis underwent DCE-CT (320-row, tube voltage 80 kVp, tube current 8.25 mAs) and DCE-MRI (1.5 T) of the hand. Perfusion maps were calculated separately for mean transit time (MTT), time to peak (TTP), relative blood volume (rBV), and relative blood flow (rBF) using four different decomposition techniques. Region of interest (ROI) analysis was performed in metacarpophalangeal joints II–V and in the wrist. Pairs of perfusion parameters in DCE-CT and DCE-MRI were compared using a two-tailed t test for paired samples and interpreted for effect size (Cohen’s d). According to the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) scoring results, differentiation of synovitis-positive and synovitis-negative joints with both modalities was assessed with the independent t test. Results The two modalities yielded similar perfusion parameters. Identified differences had small effects (d 0.01–0.4). DCE-CT additionally differentiates inflamed and noninflamed joints based on rBF and rBV but tends to underestimate these parameters in severe inflammation. The total dose-length product (DLP) was 48 mGy*cm with an estimated effective dose of 0.038 mSv. Conclusion DCE-CT is a promising imaging technique in arthritis. In patients with a contraindication to MRI or when MRI is not available, DCE-CT is a suitable alternative to detect and assess arthritis.

Posterior circulation stroke: an easily overlooked complication of catheter ablation of atrial fibrillation

2020 ◽  
Vol 13 (8) ◽  
pp. e234661
Author(s):  
Tahir Nazir ◽  
Mohiuddin Sharief ◽  
James Farthing ◽  
Irfan M Ahmed
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Treatment Options ◽  
Posterior Circulation ◽  
Diagnosis And Treatment ◽  
Neurological Deficits ◽  
Cerebellar Infarction ◽  
Af Ablation ◽  
Posterior Circulation Stroke ◽  
Ventricular Response

Catheter ablation of atrial fibrillation (AF) has established itself as a safe and proven rhythm control strategy for selected patients with AF over the past decade. Thromboembolic complications of catheter ablation are becoming rare in anticoagulated patients with a risk of stroke reported as 0.3%. A particular challenge is posed by clinical presentation due to ischaemic stroke involving the posterior circulation following catheter ablation because of its substantial differences from the carotid territory stroke, making the timely diagnosis and treatment very difficult. It is crucial to keep an index of clinical suspicion in patients presenting with neurological deficits related to vertebrobasilar circulation following ablation. We describe the case of a man who presented with dizziness and palpitations after radiofrequency catheter ablation of AF. He was found to be in AF with a rapid ventricular response. His dizziness was initially attributed to the cardiac dysrhythmia. As his symptoms continued despite heart rate control, he underwent further investigations and was eventually diagnosed with a posterior circulation stroke resulting in left cerebellar infarction. He was treated with antiplatelet therapy and improved significantly over the following few days. We review and present an up-to-date brief literature review on the complications of catheter ablation of AF and describe pathophysiology, clinical features, diagnosis and treatment options for posterior circulation stroke after AF ablation. This case aims to raise awareness among clinicians about posterior circulation stroke after AF ablation.

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