Authors: R. Bartoš1, D. Bejšovec2, A. Malucelli1, J. Prokšová3, J. Lodin1, Š. Čapek4, M. Sameš1 Authors - sphere of activity: 1 Neurochirurgická klinika UJEP a Krajská zdravotní a. s., Masarykova nemocnice v Ústí nad Labem, o. z., 2 KAPIM – Anesteziologická klinika UJEP a Krajská zdravotní a. s., Masarykova nemocnice v Ústí nad Labem, o. z., 3 Rehabilitační oddělení, Logopedie, Krajská zdravotní a. s., Masarykova nemocnice v Ústí nad Labem, o. z., 4 Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA Article: Cesk Slov Neurol N 2017; 80/113(2): 220-223 DOI: 10.14735/amcsnn2017220 Category: Case Report Number of articles displayed: 15x PDF PDF print print post comment post comment   previous article   zobrazit obsah  show contents     next article   Summary  Background: Lateral or supine positions are the traditional positions for cranial tumor resections performed with an “awake” component. These positions are used effectively for patients with tumors adjacent to speech centers or located in the superior frontal or precentral gyrus respectively. However, these may be unsatisfactory for tumors in a close proximity to the parieto-occipital region. In this case report, we describe “awake” surgery performed on a patient in semisitting position.  Case description: A 57-year-old patient suffered second recurrence of a glioblastoma multiforme tumor with subcortical invasion of the postcentral gyrus. Due to a high risk of severe neurological deficit, it was decided to perform an awake surgery with the semisitting position providing the best exposure to the lesion and the pyramidal tract. The pyramidal tract of the patient was mapped using motor responses to regular stimuli during which the surgeon recected the tumor. The patient was fully cooperative throughout the procedure and subjectively described the semisitting position as comfortable. Postoperatively, the patient showed no signs of new neurological deficits. Planned re-radiation therapy was not performed.  Conclusion: This clinical case demonstrates successful use of the semisitting position in “awake” surgery and we recommend considering its use for tumors in previously challenging locations, such as the lower parietal lobules or postcentral gyrus. This position could also be used during surgeries involving visual pathways mapping.  Key words: semisitting position – „awake“ surgery – glioma – parietal lobe – pyramidal tract – cortical stimulation mapping  The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.  The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers. Rate article:    Complete evaluation of the article:   0/5, evaluated 0x     Read more Assessment of Prospective Memory –  a Validity Study of Memory for Intentions Screening Test  Source: Czech and Slovak Neurology and Neurosurgery The Reasons and the Process of Amendment of the Czech Addenbrooke’s Cognitive Examination (ACE-CZ)  Source: Czech and Slovak Neurology and Neurosurgery Amendment of the Czech Addenbrooke’s Cognitive  Examination (ACE-CZ)  Source: Czech and Slovak Neurology and Neurosurgery The Bristol Activities of Daily Living Scale BADLS-CZ  for the Evaluation of Patients with Dementia  Source: Czech and Slovak Neurology and Neurosurgery Transient Ischemic Attack and Minor Stroke Management  Source: Czech and Slovak Neurology and Neurosurgery Cognition and Hemodynamics after Carotid Endarterectomy for Asymptomatic Stenosis  Source: Czech and Slovak Neurology and Neurosurgery Decubitus as a Cause of Death even  in the 21st Century  Source: Czech and Slovak Neurology and Neurosurgery   Reader discussion  Enter discussion Open Journal System   Subscription Subscribe the Journal  The subscription grants you full access to all the articles.  further information   Issue No.: 2 / 2017  show contents        Year 2017     Year 2016     Year 2015     Year 2014     Year 2013     Year 2012     Year 2011     Year 2010     Year 2009     Year 2008     Year 2007    Old archive      more    Most read      Neurorehabilitation of Sensorimotor Function after Spinal Cord Injury | views: 737     Pre-motor and Non-motor Symp­toms of Parkinson’s Disease –  Taxonomy, Clinical Manifestation and Neuropathological Correlates | views: 665     Gliomas of the Limbic and Paralimbic System, Technique  and Results of Resections | views: 527     Three Times of the Clock Drawing Test Rated with BaJa Scoring in Patients with Early Alzheimer‘s Disease | views: 491     Transient Ischemic Attack and Minor Stroke Management | views: 455

Background: We have reported 5-year risk of stroke and vascular events after a transient ischemic attack (TIA) or minor ischemic stroke in patients enrolled into the TIAregistry.org, which was an international multicenter-cooperative, prospective registry (N Engl J Med 2018;378:2182-90). We conducted subanalysis on the 5-year follow-up data of Japanese patients in comparison with non-Japanese patients. Methods: The patients were classified into two groups on ethnicity, Japanese (n=345) and non-Japanese (n=3502), and their 5-year event rates were compared. We also determined predictors of five-year stroke in both groups. Results: Death from vascular cause (0.9% vs 2.7%, HR 0.28, 95% CI 0.09-0.89, p=0.031) and death from any cause (7.8% vs 9.9%, HR 0.67, 95% CI 0.45-0.99, p=0.045) were fewer in Japanese patients than in non-Japanese patients, while stroke (13.9% vs 7.2%, HR 1.78, 95% CI 1.31-2.43, p<0.001) and intracranial hemorrhage (3.2% vs 0.8%, HR 3.61. 95% CI 1.78-7.30, p<0.001) were more common in Japanese than non-Japanese patients during five-year follow-up period. Caplan-Meyer curves at five-years showed that the rates of stroke was also significantly higher in Japanese than non-Japanese patients (log-rank test, p=0.001). Predictors for stroke recurrence at five years were large artery atherosclerosis (HR 1.81, 95% CI 1.31-2.52, p<0.001), cardioembolism (HR 1.71, 95% CI 1.18-2.47, p=0.004), multiple acute infarction (HR 1.77, 95% CI 1.27-2.45, p<0.001) and ABCD 2 score 6 or 7 (HR 1.96, 95% CI 1.38-2.78, p<0.001) in non-Japanese patients, although only large artery atherosclerosis (HR 3.28, 95% CI 1.13-9.54, p=0.029) was a predictor for stroke recurrence in Japanese patients. Conclusions: Recurrence of stroke and intracranial hemorrhage were more prevalent in Japanese than non-Japanese patients. Large artery atherosclerosis was a predictor for stroke recurrence not only in non-Japanese patients but also in Japanese patients.

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Simultaneous Bilateral Carotid Stenting under the Circumstance of Neuroprotection Device

Interventional Neuroradiology ◽

10.1177/159101990601200208 ◽

2006 ◽

Vol 12 (2) ◽

pp. 141-148 ◽

Cited By ~ 6

Author(s):

Y.H. Lee ◽

T.-K. Kim ◽

S.-I. Suh ◽

B.J. Kwon ◽

T.H. Lee ◽

...

Keyword(s):

Transient Ischemic Attack ◽

Carotid Stenting ◽

Neurological Impairment ◽

Hemodynamic Instability ◽

Minor Stroke ◽

Procedure Time ◽

Hyperperfusion Syndrome ◽

Bilateral Carotid ◽

Ischemic Attack ◽

Second Procedure

In this study, in order to evaluate the feasibility and outcomes of simultaneous bilateral carotid artery stenting (CAS) with the use of neuroprotection in symptomatic patients, we conducted a retrospective analysis of 27 patients (19 men, eight women; median age, 69.2 years), all of whom had been scheduled to undergo bilateral CAS in a single setting. All patients presented with severe atherosclerotic bilateral carotid stenosis (>50% for symptomatic side, >80% for asymptomatic side), exhibiting symptoms of either a cerebrovascular accident or of a transient ischemic attack on at least one side. 48 arteries were treated with self-expandable stents. Neuroprotection devices were utilized for bilateral CAS in 11 patients, and in 16 unilateral CAS patients. We did not perform the second procedure in six patients, in cases in which a patient exhibited (a) hemodynamic instability, (b) a new neurological impairment, or (c) restlessness after a prolonged time for the first CAS. The second procedure was postponed in a staged manner. We achieved a mean residual stenosis of 8.1 ± 5.0 % in the treated lesions. The mean procedural time for bilateral CAS was three hours and 18 minutes. 17 patients (63%) developed transient bradycardia during the balloon dilatation of one or both of the relevant arteries. Three patients (11%) exhibited persistent bradycardia and hypotension, which required the administration of intravenous vasopressors for several days (2!7 days). None of the patients ultimately required pacemakers, or any further therapy. Two of the patients (7%) developed transient ischemic attack during the periprocedural period, but recovered completely. One patient developed a new minor stroke after the first procedure, and the second procedure was delayed in a staged manner. We observed no periprocedural deaths, major strokes, or myocardial infarctions, nor did we detect any cases of hyperperfusion syndrome within 30 days. In summary, simultaneous bilateral CAS with neuroprotection can be performed in a single setting without increased concerns with regard to hyperperfusion syndrome, hemodynamic instability, thrombo-embolism, or procedure time, when the first CAS has been safely completed with no evidence of complications in a well-managed procedure time.

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Transient Ischemic Attack and Nephrotic Syndrome: Case Report and Review of Literature

The American Journal of the Medical Sciences ◽

10.1097/00000441-200607000-00006 ◽

2006 ◽

Vol 332 (1) ◽

pp. 32-35 ◽

Cited By ~ 11

Author(s):

Shailesh S. Nandish ◽

Romesh Khardori ◽

Elamin M. Elamin

Keyword(s):

Nephrotic Syndrome ◽

Case Report ◽

Transient Ischemic Attack ◽

Review Of Literature ◽

Ischemic Attack

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Canadian Stroke Best Practice Recommendations for Acute Stroke Management: Prehospital, Emergency Department, and Acute Inpatient Stroke Care, 6th Edition, Update 2018

International Journal of Stroke ◽

10.1177/1747493018786616 ◽

2018 ◽

Vol 13 (9) ◽

pp. 949-984 ◽

Cited By ~ 73

Author(s):

JM Boulanger ◽

MP Lindsay ◽

G Gubitz ◽

EE Smith ◽

G Stotts ◽

...

Keyword(s):

Emergency Department ◽

Ischemic Stroke ◽

Acute Stroke ◽

Transient Ischemic Attack ◽

Best Practice ◽

Stroke Care ◽

Stroke Management ◽

Practice Recommendations ◽

Prehospital Emergency ◽

Ischemic Attack

The 2018 update of the Canadian Stroke Best Practice Recommendations for Acute Stroke Management, 6th edition, is a comprehensive summary of current evidence-based recommendations, appropriate for use by healthcare providers and system planners caring for persons with very recent symptoms of acute stroke or transient ischemic attack. The recommendations are intended for use by a interdisciplinary team of clinicians across a wide range of settings and highlight key elements involved in prehospital and Emergency Department care, acute treatments for ischemic stroke, and acute inpatient care. The most notable changes included in this 6th edition are the renaming of the module and its integration of the formerly separate modules on prehospital and emergency care and acute inpatient stroke care. The new module, Acute Stroke Management: Prehospital, Emergency Department, and Acute Inpatient Stroke Care is now a single, comprehensive module addressing the most important aspects of acute stroke care delivery. Other notable changes include the removal of two sections related to the emergency management of intracerebral hemorrhage and subarachnoid hemorrhage. These topics are covered in a new, dedicated module, to be released later this year. The most significant recommendation updates are for neuroimaging; the extension of the time window for endovascular thrombectomy treatment out to 24 h; considerations for treating a highly selected group of people with stroke of unknown time of onset; and recommendations for dual antiplatelet therapy for a limited duration after acute minor ischemic stroke and transient ischemic attack. This module also emphasizes the need for increased public and healthcare provider’s recognition of the signs of stroke and immediate actions to take; the important expanding role of paramedics and all emergency medical services personnel; arriving at a stroke-enabled Emergency Department without delay; and launching local healthcare institution code stroke protocols. Revisions have also been made to the recommendations for the triage and assessment of risk of recurrent stroke after transient ischemic attack/minor stroke and suggested urgency levels for investigations and initiation of management strategies. The goal of this updated guideline is to optimize stroke care across Canada, by reducing practice variations and reducing the gap between current knowledge and clinical practice.

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