Cerebral hemorrhage following heart surgery

1975 ◽  
Vol 43 (6) ◽  
pp. 671-675 ◽  
Author(s):  
Robin P. Humphreys ◽  
Harold J. Hoffman ◽  
William T. Mustard ◽  
George A. Trusler
Keyword(s):  
Cardiac Surgery ◽  
Intracranial Hemorrhage ◽  
Cerebral Hemorrhage ◽  
Heart Surgery ◽  
Reversible Process ◽  
Content Type ◽  
Pathological Review ◽  
Specific Factors ◽  
Space Occupying Lesion ◽  
Fine Print

✓ The authors report a study of the problem of intracranial hemorrhage in 16 children following cardiac surgery, four studied clinically, and 12 by postmortem pathological review. Eleven children sustained subdural hematomas of varying sizes, one had a massive extradural clot, and four had intracerebral clots. The pre-, intra-, and postoperative data of these 16 patients are presented, but the specific factors causing the intracranial hemorrhage remain unexplained. The neurological course was similar to that of patients with an intracranial space-occupying lesion, and fundamental neurosurgical management principles for the treatment of this potentially reversible process should be observed.

Intracranial hemorrhage in children and adolescents

1973 ◽  
Vol 38 (3) ◽  
pp. 269-281 ◽  
Author(s):  
Carol B. Sedzimir ◽  
Julian Robinson
Keyword(s):  
Mortality Rate ◽  
Children And Adolescents ◽  
Intracranial Hemorrhage ◽  
Cerebral Hemorrhage ◽  
Arteriovenous Malformations ◽  
Therapeutic Management ◽  
Content Type ◽  
Fine Print

✓ The authors report their experience with 124 cases of intracranial hemorrhage in children and adolescents; the study includes 25 cases first reported in 1958. Fifty aneurysms with a mortality rate of 28% and 33 arteriovenous malformations with a mortality rate of 21% are included; 32 cases had no angiographically demonstrable lesion, six had miscellaneous lesions, and three primary cerebral hemorrhage. Specific programs for therapeutic management based on this experience are discussed.

Giant aneurysm of anterior ethmoidal artery presenting with intracranial hemorrhage

1994 ◽  
Vol 81 (6) ◽  
pp. 934-936 ◽  
Author(s):  
Alok Ranjan ◽  
Thomas Joseph
Keyword(s):  
Intracranial Hemorrhage ◽  
Giant Aneurysm ◽  
Postoperative Recovery ◽  
Vascular Lesions ◽  
Feeding Artery ◽  
Neck Stiffness ◽  
Content Type ◽  
Ethmoidal Artery ◽  
Anterior Ethmoidal Artery ◽  
Fine Print

✓ This forty-five-year-old woman presented with a history suggestive of an intracranial hemorrhage. Clinical examination indicated mild right pyramidal signs and neck stiffness. Computerized tomography demonstrated contrast enhancement in the region of a left frontal intraparenchymal hematoma with an adjacent subdural hematoma. Angiography revealed the presence of a giant aneurysm on the left anterior ethmoidal artery. Surgical evacuation of the hematoma with excision of the aneurysm and coagulation of the feeding artery was achieved. Postoperative recovery was uneventful. Vascular lesions of the anterior ethmoidal artery and the rarity of a giant aneurysm at this site are discussed.

Surgical experiences with giant intracranial aneurysms

1984 ◽  
Vol 61 (6) ◽  
pp. 1009-1028 ◽  
Author(s):  
Lindsay Symon ◽  
Janos Vajda
Keyword(s):  
Blood Pressure ◽  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Intracranial Aneurysms ◽  
Visual Loss ◽  
Considerable Improvement ◽  
Brain Circulation ◽  
Content Type ◽  
Space Occupying Lesion ◽  
Fine Print

✓ A series of 35 patients with 36 giant aneurysms is presented. Thirteen patients presented following subarachnoid hemorrhage (SAH) and 22 with evidence of a space-occupying lesion without recent SAH. The preferred technique of temporary trapping of the aneurysm, evacuation of the contained thrombus, and occlusion of the neck by a suitable clip is described. The danger of attempted ligation in atheromatous vessels is stressed. Intraoperatively, blood pressure was adjusted to keep the general brain circulation within autoregulatory limits. Direct occlusion of the aneurysm was possible in over 80% of the cases. The mortality rate was 8% in 36 operations. Six percent of patients had a poor result. Considerable improvement in visual loss was evident in six of seven patients in whom this was a presenting feature, and in four of seven with disturbed eye movements.

A metaanalysis comparing the results of pallidotomy performed using microelectrode recording or macroelectrode stimulation

2002 ◽  
Vol 96 (6) ◽  
pp. 1058-1062 ◽  
Author(s):  
Ravikant S. Palur ◽  
Caglar Berk ◽  
Michael Schulzer ◽  
Christopher R. Honey
Keyword(s):  
Intracranial Hemorrhage ◽  
Rating Scale ◽  
Complication Rates ◽  
Microelectrode Recording ◽  
Content Type ◽  
Medline Search ◽  
Significant Difference ◽  
Active Debate ◽  
Unilateral Pallidotomy ◽  
Fine Print

Object. There is an active debate regarding whether pallidotomy should be performed using macroelectrode stimulation or the more sophisticated and expensive method of microelectrode recording. No prospective, randomized trial results have answered this question, although personnel at many centers claim one method is superior. In their metaanalysis the authors reviewed published reports of both methods to determine if there is a significant difference in clinical outcomes or complication rates associated with these methods. Methods. A metaanalysis was performed with data from reports on the use of unilateral pallidotomy in patients with Parkinson disease (PD) that were published between 1992 and 2000. A Medline search was conducted for the key word “pallidotomy” and additional studies were added following a review of the references. Only those studies dealing with unilateral procedures performed in patients with PD were included. Papers were excluded if they described a cohort smaller than 10 patients or a follow-up period shorter than 3 months or included cases that previously had been reported. The primary end points for outcome were the percentages of improvement in dyskinesias and in motor scores determined by the Unified PD Rating Scale (UPDRS). Complications were categorized as mortality, intracranial hemorrhage, visual deficit, speech deficit, cognitive decline, weakness, and other. There were no significant differences between the two methods with respect to improvements in dyskinesias (p = 0.66) or UPDRS motor scores (p = 0.62). Microelectrode recording was associated with a significantly higher (p = 0.012) intracranial hemorrhage rate (1.3 ± 0.4%), compared with macroelectrode stimulation (0.25 ± 0.2%). Conclusions. In reports of patients with PD who underwent unilateral pallidotomy, operations that included microelectrode recording were associated with a small, but significantly higher rate of symptomatic intracranial hemorrhage; however, there was no difference in postoperative reduction of dyskinesia or bradykinesia compared with operations that included macroelectrode stimulation.

Metastatic choriocarcinoma with neoplastic aneurysms cured by aneurysm resection and chemotherapy

1992 ◽  
Vol 76 (1) ◽  
pp. 148-151 ◽  
Author(s):  
Takashi Fujiwara ◽  
Shogo Mino ◽  
Seigo Nagao ◽  
Takashi Ohmoto
Keyword(s):  
Surgical Treatment ◽  
Lung Metastasis ◽  
Cerebral Hemorrhage ◽  
Intensive Chemotherapy ◽  
Content Type ◽  
Metastatic Lesions ◽  
Aneurysm Resection ◽  
Fine Print

✓ A case of choriocarcinoma with brain and lung metastasis is reported. The patient was admitted for treatment of a cerebral hemorrhage from neoplastic aneurysms and, following removal of the hematoma and resection of the aneurysms, her carcinoma was successfully managed with chemotherapy. She has survived for 6 years after onset without neuroimaging evidence of recurrence. Surgical treatment of metastatic lesions followed by prolonged intensive chemotherapy are indicated for the improved prognosis of choriocarcinoma.

Surgical treatment of multiple aneurysms and of incidentally-discovered unruptured aneurysms

1971 ◽  
Vol 35 (3) ◽  
pp. 291-295 ◽  
Author(s):  
Peter D. Moyes
Keyword(s):  
Surgical Treatment ◽  
Intracranial Hemorrhage ◽  
Content Type ◽  
Unruptured Aneurysms ◽  
Multiple Aneurysms ◽  
Spontaneous Intracranial Hemorrhage ◽  
Fine Print

✓ Review of a series of 460 patients with spontaneous intracranial hemorrhage showed that 241 had demonstrable aneurysms and 38 had multiple aneurysms. The importance of demonstrating the entire circulation following ligation of one aneurysm is emphasized. Treatment of the 38 patients with multiple aneurysms is described. Ligation of unruptured aneurysms that are incidentally discovered is advocated in patients who are Grade 1 on the Botterell scale and who are well informed as to the risks.

Clinical application of functional magnetic resonance imaging in presurgical identification of the central sulcus

1998 ◽  
Vol 88 (5) ◽  
pp. 863-869 ◽  
Author(s):  
Jesús Pujol ◽  
Gerardo Conesa ◽  
Joan Deus ◽  
Luis López-Obarrio ◽  
Fabián Isamat ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Three Dimensional ◽  
Functional Magnetic Resonance ◽  
Central Sulcus ◽  
Clinical Context ◽  
Content Type ◽  
Sensorimotor Region ◽  
Specific Factors ◽  
Eloquent Cortex ◽  
Fine Print

Object. The authors sought to evaluate the advantages and limitations of functional magnetic resonance (fMR) imaging when it was used regularly in the clinical context to identify the central sulcus. Methods. A 1.5-tesla MR system comprising a spoiled gradient recalled acquisition in the steady-state functional sequence and a cross-hand cancellation analysis method were used to evaluate 50 surgical candidates with centrally located space-occupying lesions in the brain. Three-dimensional (3-D) models of the patient's head and brain showing the relative position of the tumor and the eloquent cortex were obtained in each case. A selective and reproducible focal activation was found, indicating the probable central sulcus position in 41 patients (82%). Direct cortical stimulation confirmed the fMR findings in 100% of 22 intraoperatively assessed patients. Failure to identify the central sulcus occurred in 18% of cases and was mainly a consequence of intrinsic damage in the primary sensorimotor region that resulted in severe hand paresis. Conclusions. Although specific factors were identified that contributed to reduced sensitivity of fMR imaging in the clinical context, the present study supports functional assessment and 3-D representation of specific surgical situations as generally feasible in common practice.

Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study

2003 ◽  
Vol 99 (4) ◽  
pp. 661-665 ◽  
Author(s):  
Sergey Spektor ◽  
Samuel Agus ◽  
Vladimir Merkin ◽  
Shlomo Constantini
Keyword(s):  
Head Injury ◽  
Intracranial Hemorrhage ◽  
Ct Scanning ◽  
Treated Group ◽  
Control Group ◽  
Content Type ◽  
Significant Difference ◽  
Traumatic Intracranial Hemorrhage ◽  
Gcs Score ◽  
Fine Print

Object. The goal of this paper was to investigate a possible relationship between the consumption of low-dose aspirin (LDA) and traumatic intracranial hemorrhage in an attempt to determine whether older patients receiving prophylactic LDA require special treatment following an incidence of mild-to-moderate head trauma. Methods. Two hundred thirty-one patients older than 60 years of age, who arrived at the emergency department with a mild or moderate head injury (Glasgow Coma Scale [GCS] Scores 13–15 and 9–12, respectively), were included in the study. One hundred ten patients were receiving prophylactic LDA (100 mg/day) and these formed the aspirin-treated group. One hundred twenty-one patients were receiving no aspirin, and these formed the control group. There was no statistically significant difference between the two groups with respect to age, sex, mechanism of trauma, or GCS score on arrival at the emergency department. Most of the patients sustained the head injury from falls (88.2% of patients in the aspirin-treated group and 85.1% of patients in the control group), and had external signs of head trauma such as bruising or scalp laceration (80.9% of patients in the aspirin-treated group and 86.8% of patients in the control group). All patients underwent similar neurological examinations and computerized tomography (CT) scanning of the head. The CT scans revealed evidence of traumatic intracranial hemorrhage in 27 (24.5%) patients in the aspirin-treated group and in 31 patients (25.6%) in the control group. Surgical intervention was required for five patients in each group (4.5% of patients in the aspirin-treated group and 4.1% of patients in the control group). A surprising number of the patients who arrived with GCS Score 15 were found to have traumatic intracranial hemorrhage, as revealed by CT scanning (11.5% of patients in the aspirin-treated group and 16.5% of patients in the control group). Surgery, however, was not necessary for any of these patients. Conclusions. There was no statistically significant difference in the frequency or types of traumatic intracranial hemorrhage between patients who had received aspirin prophylaxis and those who had not. The authors conclude that LDA does not increase surgically relevant parenchymal or meningeal bleeding following moderate and minor head injury in patients older than 60 years of age.

Cerebral aspergillosis

1973 ◽  
Vol 38 (4) ◽  
pp. 472-476 ◽  
Author(s):  
Pongsakdi Visudhiphan ◽  
Sira Bunyaratavej ◽  
Suwarindr Khantanaphar
Keyword(s):  
Brain Abscess ◽  
Intracranial Hemorrhage ◽  
Basilar Artery ◽  
Artery Aneurysm ◽  
Diagnosis And Treatment ◽  
Content Type ◽  
Basilar Artery Aneurysm ◽  
Fine Print

✓ Three patients with cerebral aspergillosis are reported. Each patient had a different lesion: a solitary brain abscess, a mycotic basilar artery aneurysm, and a massive infective intracranial hemorrhage. Aspergillosis is discussed, including its diagnosis and treatment.

Tuberculous brain abscess and its appearance on computerized tomography

1982 ◽  
Vol 56 (4) ◽  
pp. 597-600 ◽  
Author(s):  
Eli Reichenthal ◽  
Mathias L. Cohen ◽  
Elias Schujman ◽  
Nachman Eynan ◽  
Mordechai Shalit
Keyword(s):  
Ct Scan ◽  
Brain Abscess ◽  
Computerized Tomography ◽  
Clinical History ◽  
Content Type ◽  
Parietal Area ◽  
Tuberculous Brain Abscess ◽  
The Right ◽  
Space Occupying Lesion ◽  
Fine Print

✓ A case of tuberculous brain abscess in a 52-year-old woman is presented. The computerized tomographic (CT) scan demonstrated a multilocular space-occupying lesion in the right parietal area, surrounded by a thick hyperdense enhancing rim. It is suggested that a relatively long clinical history together with the appearance of a thick-walled abscess-like lesion on the CT scan may indicate the diagnosis of a tuberculous brain abscess.

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