Neurological research
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Neurological research · Apr 2014
Case ReportsTreatment of ophthalmic segment carotid aneurysms using the pipeline embolization device: clinical and angiographic follow-up.
Aneurysms of the ophthalmic segment of the internal carotid artery (ICA) often present unique challenges to endovascular treatment due to their proximity to or involvement of the ophthalmic artery, and the subsequent risk of post-operative visual complications. The pipeline embolization device (PED) represents a paradigm shift and promising new therapy in the treatment of intracranial aneurysms. We reviewed the ophthalmic segment ICA aneurysms treated with the PED at Barrow Neurological Institute (BNI) to report outcome data, including patency of the ophthalmic artery and visual complications. ⋯ Treatment of ophthalmic segment ICA aneurysms with the PED is safe and effective at short-term follow-up.
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Neurological research · Apr 2014
Review Case ReportsOversized self-expanding stents as an alternative to flow-diverters for blister-like aneurysms.
Blister-like aneurysms (BLAs) are challenging to treat. Their friable nature makes them high risk for both traditional microsurgical and endovascular treatments. We discuss employing a single oversized self-expanding stent in the treatment of these treacherous lesions. ⋯ In our experience, oversized self-expanding stents are a treatment option that should be considered for BLAs. This strategy avoids the need for dual antiplatelet therapy and therefore increases its utility in the case of subarachnoid hemorrhage (SAH).
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Endovascular techniques are well suited for the treatment of posterior circulation aneurysms. This review describes the endovascular management of these aneurysms and discusses relevant technical advances.
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Warfarin-associated intracerebral hemorrhage (WICH) is a serious neurological condition associated with significant mortality and morbidity. We aimed to study the clinical features and factors that predict clinical outcome of Chinese patients with WICH. ⋯ Warfarin-associated intracerebral hemorrhage is a very serious complication of warfarin therapy with high mortality and morbidity. Initial ICH volume, presence of intraventricular hemorrhage, and ND are independent predictors of clinical outcome.
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Neurological research · Feb 2014
Hourly neurologic assessments for traumatic brain injury in the ICU.
Hourly neurologic assessments for traumatic brain injury (TBI) in the critical care setting are common practice but prolonged use may actually be harming patients through sleep deprivation. We reviewed practice patterns at our institution in order to gain insight into the role of frequent neurological assessments. ⋯ Hourly neurologic checks are necessary in the acute period for patients with potentially expansible intracranial hemorrhages or malignant cerebral edema, but prolonged use may be harmful. Patients with a low probability of requiring neurosurgical intervention may benefit from reducing the total duration of hourly assessments.