Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2008
Comparative StudySurgical outcome following decompressive craniectomy for poor-grade aneurysmal subarachnoid hemorrhage in patients with associated massive intracerebral or Sylvian hematomas.
Patients with poor-grade aneurysmal subarachnoid hemorrhage (SAH) presenting with large intracerebral (ICH) or sylvian hematomas (SylH) have poor outcomes due to the mass effect of significant brain stem compression following mass effect. On the other hand, decompressive craniectomy (DC) can reduce morbidity and mortality in critically ill patients with massive ischemic infarction and severe head injury. However, the role of DC in SAH patients is not fully understood. We investigated the outcome of DC in poor-grade SAH presenting with large ICH or SylH. ⋯ Several experimental studies have also indicated that DC significantly improves outcome due to reduced intracranial pressure or increased perfusion pressure. Urgent DC for poor-grade SAH with space-occupying hematoma can lead to survival with good recovery in some patients.
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Cerebrovascular diseases · Jan 2008
Stroke incidence in women under 60 years of age related to alcohol intake and smoking habit.
The association between alcohol intake, cigarette smoking and risk of stroke amongst women remains unclear, especially in young women. ⋯ Light to moderate alcohol intake, regardless of type of alcoholic beverage, reduces risk of stroke among women under 60 years of age, in particular those women who were never smokers. Smoking increases the risk of stroke, especially ischemic stroke.
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Cerebrovascular diseases · Jan 2008
Longitudinal investigations on the anterograde and retrograde degeneration in the pyramidal tract following pontine infarction with diffusion tensor imaging.
Secondary degeneration following supratentorial stroke has been detected by some studies using diffusion tensor imaging (DTI), but the anterograde and retrograde degeneration in pyramidal tract after pontine infarction and its potential clinical significance are not well understood. ⋯ Progressive anterograde and retrograde degeneration in pyramidal tract revealed by DTI may hinder the process of neurological recovery after a pontine infarct. To confirm the clinical significance, future studies with a longer observation period and a larger sample size of patients with more homogeneous pontine infarcts are still needed.
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Cerebrovascular diseases · Jan 2008
Clinical severity predicts time to hospital admission in patients with spontaneous intracerebral hemorrhage.
In this study we analyzed whether demographic, clinical and neuroradiological parameters are associated with time to hospital admission in patients with spontaneous intracerebral hemorrhage (ICH). We a priori hypothesized that the earlier a patient was admitted to hospital, the worse the clinical status would be. ⋯ Clinically more severely affected patients were admitted to hospital earlier. This highlights the importance of most rapid diagnosis of ICH. Efforts should be made to get less severely affected patients admitted earlier as they might be ideal candidates for emerging innovative treatments.
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Cerebrovascular diseases · Jan 2008
Incidental unruptured intracranial aneurysms in patients with acute ischemic stroke.
The management and clinical prognosis of incidental intracranial aneurysms in acute ischemic stroke patients have been understudied. We investigated the clinical outcome of acute ischemic stroke subjects with incidentally found intracranial aneurysms. ⋯ There was no rupture of the incidentally found aneurysms in the patients with acute ischemic stroke during their first 3 months. The 3-month mRS was not affected by the presence of incidental intracranial aneurysm. A large cohort study and long-term follow-up are required.