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Pesquisa : C10.228.140.300.150.477.200.400 [Categoria DeCS]
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[PMID]:28765288
[Au] Autor:Ernst M; Boers AMM; Aigner A; Berkhemer OA; Yoo AJ; Roos YB; Dippel DWJ; van der Lugt A; van Oostenbrugge RJ; van Zwam WH; Fiehler J; Marquering HA; Majoie CBLM; MR CLEAN Trial Investigators (www.mrclean-trial.org)
[Ad] Endereço:From the Department of Diagnostic and Interventional Neuroradiology (M.E., J.F.) and Institute of Medical Biometry and Epidemiology (A.A.), University Medical Center Hamburg-Eppendorf, Germany; Departments of Radiology (A.M.M.B., O.A.B., H.A.M., C.B.L.M.M.), Biomedical Engineering and Physics (A.M.M
[Ti] Título:Association of Computed Tomography Ischemic Lesion Location With Functional Outcome in Acute Large Vessel Occlusion Ischemic Stroke.
[So] Source:Stroke;48(9):2426-2433, 2017 Sep.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Ischemic lesion volume (ILV) assessed by follow-up noncontrast computed tomography correlates only moderately with clinical end points, such as the modified Rankin Scale (mRS). We hypothesized that the association between follow-up noncontrast computed tomography ILV and outcome as assessed with mRS 3 months after stroke is strengthened when taking the mRS relevance of the infarct location into account. METHODS: An anatomic atlas with 66 areas was registered to the follow-up noncontrast computed tomographic images of 254 patients from the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands). The anatomic brain areas were divided into brain areas of high, moderate, and low mRS relevance as reported in the literature. Based on this distinction, the ILV in brain areas of high, moderate, and low mRS relevance was assessed for each patient. Binary and ordinal logistic regression analyses with and without adjustment for known confounders were performed to assess the association between the ILVs of different mRS relevance and outcome. RESULTS: The odds for a worse outcome (higher mRS) were markedly higher given an increase of ILV in brain areas of high mRS relevance (odds ratio, 1.42; 95% confidence interval, 1.31-1.55 per 10 mL) compared with an increase in total ILV (odds ratios, 1.16; 95% confidence interval, 1.12-1.19 per 10 mL). Regression models using ILV in brain areas of high mRS relevance instead of total ILV showed a higher quality. CONCLUSIONS: The association between follow-up noncontrast computed tomography ILV and outcome as assessed with mRS 3 months after stroke is strengthened by accounting for the mRS relevance of the affected brain areas. Future prediction models should account for the ILV in brain areas of high mRS relevance.
[Mh] Termos MeSH primário: Isquemia Encefálica/diagnóstico por imagem
Encéfalo/diagnóstico por imagem
Infarto da Artéria Cerebral Anterior/diagnóstico por imagem
Infarto da Artéria Cerebral Média/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Encéfalo/patologia
Isquemia Encefálica/patologia
Isquemia Encefálica/fisiopatologia
Isquemia Encefálica/cirurgia
Artéria Carótida Interna/cirurgia
Procedimentos Endovasculares
Feminino
Seres Humanos
Infarto da Artéria Cerebral Anterior/patologia
Infarto da Artéria Cerebral Anterior/fisiopatologia
Infarto da Artéria Cerebral Anterior/cirurgia
Infarto da Artéria Cerebral Média/patologia
Infarto da Artéria Cerebral Média/fisiopatologia
Infarto da Artéria Cerebral Média/cirurgia
Modelos Logísticos
Masculino
Meia-Idade
Artéria Cerebral Média/cirurgia
Tamanho do Órgão
Recuperação de Função Fisiológica
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/patologia
Acidente Vascular Cerebral/fisiopatologia
Acidente Vascular Cerebral/cirurgia
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.017513


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[PMID]:28234996
[Au] Autor:Gawlitza M; Böhme J; Maros M; Lobsien D; Michalski D; Groden C; Hoffmann KT; Förster A
[Ad] Endereço:Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany.
[Ti] Título:FLAIR vascular hyperintensities and 4D MR angiograms for the estimation of collateral blood flow in anterior cerebral artery ischemia.
[So] Source:PLoS One;12(2):e0172570, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To assess FLAIR vascular hyperintensities (FVH) and dynamic (4D) angiograms derived from perfusion raw data as proposed magnetic resonance (MR) imaging markers of leptomeningeal collateral circulation in patients with ischemia in the territory of the anterior cerebral artery (ACA). METHODS: Forty patients from two tertiary care university hospitals were included. Infarct volumes and perfusion deficits were manually measured on DWI images and TTP maps, respectively. FVH and collateral flow on 4D MR angiograms were assessed and graded as previously specified. RESULTS: Forty-one hemispheres were affected. Mean DWI lesion volume was 8.2 (± 13.9; range 0-76.9) ml, mean TTP lesion volume was 24.5 (± 17.2, range 0-76.7) ml. FVH were observed in 26/41 (63.4%) hemispheres. Significant correlations were detected between FVH and TTP lesion volume (ρ = 0.4; P<0.01) absolute (ρ = 0.37; P<0.05) and relative mismatch volume (ρ = 0.35; P<0.05). The modified ASITN/SIR score correlated inversely with DWI lesion volume (ρ = -0.58; P<0.01) and positively with relative mismatch (ρ = 0.29; P< 0.05). ANOVA of the ASITN/SIR score revealed significant inter-group differences for DWI (P<0.001) and TTP lesion volumes (P<0.05). No correlation was observed between FVH scores and modified ASITH/SIR scores (ρ = -0.16; P = 0.32). CONCLUSIONS: FVH and flow patterns on 4D MR angiograms are markers of perfusion deficits and tissue at risk. As both methods did not show a correlation between each other, they seem to provide complimentary instead of redundant information. Previously shown evidence for the meaning of these specific MR signs in internal carotid and middle cerebral artery stroke seems to be transferrable to ischemic stroke in the ACA territory.
[Mh] Termos MeSH primário: Artéria Cerebral Anterior/diagnóstico por imagem
Isquemia Encefálica/diagnóstico por imagem
Circulação Colateral
Infarto da Artéria Cerebral Anterior/diagnóstico por imagem
Angiografia por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Artéria Cerebral Anterior/patologia
Isquemia Encefálica/patologia
Circulação Cerebrovascular
Feminino
Seres Humanos
Infarto da Artéria Cerebral Anterior/patologia
Angiografia por Ressonância Magnética/instrumentação
Masculino
Meia-Idade
Estudos Retrospectivos
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0172570


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[PMID]:28131184
[Au] Autor:Honig A; Eliahou R; Auriel E
[Ad] Endereço:Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address: asaf.honig2@gmail.com.
[Ti] Título:Confined anterior cerebral artery infarction manifesting as isolated unilateral axial weakness.
[So] Source:J Neurol Sci;373:18-20, 2017 Feb 15.
[Is] ISSN:1878-5883
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:We describe isolated unilateral axial weakness in three patients eventually diagnosed with anterior cerebral artery infarction (ACAI), a new clinical observation. Files of three ACAI patients (2 females, 1 male, ages 55-80) were retrospectively reviewed. All three presented to the ED with sudden unsteadiness. On initial neurological examination, all three patients manifested unilateral truncal deviation to the side contralateral to the weakness, even while seated. There was significant unilateral hypotonia due to substantial paravertebral weakness. None had pyramidal signs or increased limb tone. Speech, language, and cognitive performance were intact during admission examination. In all three patients, initial diffusion-weighted imaging (DWI) MRI showed small confined regions of restriction involving the posterolateral border of ACA territory; CT angiography was normal in one patient with a newly diagnosed atrial fibrillation but showed atherosclerotic vasculature with severe narrowing of the A3 segment of the ACA in two. Awareness of ACAI presenting as unilateral axial weakness is warranted. We suggest that optimal diagnostic management should include examination of axial tone. Ischemic involvement of distal ACA branches may herald a more extensive ACAI. Prompt diagnosis may enable thrombolysis or endovascular treatment, and blood pressure maintenance may allow adequate perfusion to damaged tissue.
[Mh] Termos MeSH primário: Infarto da Artéria Cerebral Anterior/diagnóstico
Debilidade Muscular/diagnóstico
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Encéfalo/diagnóstico por imagem
Angiografia Cerebral
Diagnóstico Diferencial
Imagem de Difusão por Ressonância Magnética
Progressão da Doença
Feminino
Seguimentos
Lateralidade Funcional
Seres Humanos
Infarto da Artéria Cerebral Anterior/complicações
Infarto da Artéria Cerebral Anterior/tratamento farmacológico
Infarto da Artéria Cerebral Anterior/fisiopatologia
Arteriosclerose Intracraniana/complicações
Arteriosclerose Intracraniana/diagnóstico
Arteriosclerose Intracraniana/tratamento farmacológico
Arteriosclerose Intracraniana/fisiopatologia
Masculino
Meia-Idade
Debilidade Muscular/complicações
Debilidade Muscular/fisiopatologia
Exame Neurológico
Inibidores da Agregação de Plaquetas/uso terapêutico
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170130
[St] Status:MEDLINE


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[PMID]:28079797
[Au] Autor:Yang WH; Lin SP; Chang ST
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan.
[Ti] Título:Case report: Rapid improvement of crossed cerebellar diaschisis after intravascular laser irradiation of blood in a case of stroke.
[So] Source:Medicine (Baltimore);96(2):e5646, 2017 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Crossed cerebellar diaschisis (CCD) is a poor prognostic factor after stroke because without immediate cerebral reperfusion no further improvements in the patient's condition can be achieved. We investigated the clinical effects of intravascular laser irradiation therapy (ILIB) on CCD and evaluated the therapeutic effect in the sub-acute post-stroke stage. PATIENT CONCERNS: The 77-year-old male with cerebral infarction in the territory of the right anterior cerebral artery only underwent conservative treatment including hydration and aspirin in the acute post-stroke stage. DIAGNOSIS: He was diagnosed as stroke based on the clinical presentations and imaging findings. INTERVENTION: Once the patient was in stable condition, he underwent a daily hour-long ILIB (He-Ne laser) for ten consecutive days during the sub-acute post-stroke stage. OUTCOMES: We used single-photon emission computed tomography (SPECT) before and after intravascular laser irradiation to detect changes in cerebral and cerebellar perfusion. Then, we compared the two images. CCD was detected using the first SPECT. After intervention by ILIB, the second SPECT showed greater perfusion in the affected cerebellar hemisphere. LESSONS: We found that ILIB helped eliminate CCD, which was previously shown to be an untreatable condition using any intervention during the sub-acute post-stroke stage. Stroke patients could therefore greatly benefit from ILIB.
[Mh] Termos MeSH primário: Doenças Cerebelares/terapia
Infarto da Artéria Cerebral Anterior/complicações
Terapia com Luz de Baixa Intensidade
[Mh] Termos MeSH secundário: Idoso
Doenças Cerebelares/etiologia
Procedimentos Endovasculares
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170227
[Lr] Data última revisão:
170227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000005646


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[PMID]:27922461
[Au] Autor:Ragam A; Agemy SA; Dave SB; Khorsandi AS; Banik R
[Ad] Endereço:The Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York.
[Ti] Título:Ipsilateral Ophthalmic and Cerebral Infarctions After Cosmetic Polylactic Acid Injection Into the Forehead.
[So] Source:J Neuroophthalmol;37(1):77-80, 2017 Mar.
[Is] ISSN:1536-5166
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 55-year-old woman developed no light perception vision in her right eye 5 days after an injection of polylactic acid cosmetic filler into her right forehead. Diffuse corneal edema and anterior chamber inflammation prohibited any view to the posterior segment to identify the cause of her profound vision loss. MRI of the orbits with diffusion-weighted imaging showed hyperintensity of the right optic nerve with signal reduction on apparent diffusion coefficient mapping, consistent with ischemia. Our patient also was found to have acute infarctions in the distribution of the right anterior cerebral artery on MRI of the brain despite having no permanent focal neurologic deficits aside from vision loss.
[Mh] Termos MeSH primário: Técnicas Cosméticas/efeitos adversos
Infarto da Artéria Cerebral Anterior/induzido quimicamente
Neuropatia Óptica Isquêmica/induzido quimicamente
Poliésteres/efeitos adversos
[Mh] Termos MeSH secundário: Implantes Absorvíveis
Feminino
Testa
Seres Humanos
Infarto da Artéria Cerebral Anterior/diagnóstico
Injeções Subcutâneas
Imagem por Ressonância Magnética
Meia-Idade
Neuropatia Óptica Isquêmica/diagnóstico
Poliésteres/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Polyesters); 459TN2L5F5 (poly(lactide))
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161207
[St] Status:MEDLINE
[do] DOI:10.1097/WNO.0000000000000459


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[PMID]:27526099
[Au] Autor:Calis M; Oz Z; Isikay I; Konas E; Bilginer B; Tuncbilek G
[Ad] Endereço:Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University, Ankara, Turkey. mertcalis@gmail.com.
[Ti] Título:An extremely rare complication following frontoorbital advancement: infarction of the recurrent artery of Heubner.
[So] Source:Childs Nerv Syst;33(1):197-199, 2017 Jan.
[Is] ISSN:1433-0350
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Many intracranial as well as extracranial complications can be seen following craniosynostosis surgeries. In this article, we would like to share an extremely rare complication of the infarction of the recurrent artery of Heubner, occurred following frontoorbital advancement. In this case, an 18-month-old male patient underwent supraorbital bar and frontal bone remodeling surgery for nonsyndromic metopic suture synostosis. The preoperative neurosurgical evaluation revealed no signs of increased intracranial pressure. On the 3rd postoperative day, the patient developed asymmetric smile and weakness on the left extremities. Computerized tomography showed a hypodense infarction region around the right basal ganglia and internal capsule, concordant with the region supplied by the recurrent artery of Heubner. The patient's symptoms started to regress on the 2nd day of enoxaparine treatment and he was discharged on 12th postoperative day with almost no signs of the event. In this paper, we presented an unlikely complication after frontoorbital advancement. Keeping in mind the long operating time and the proximity of the procedure to the central nervous system, assessment of the neurological function of the patients both before and after the operation and rapid intervention in case of development of neurologic symptoms are of great importance.
[Mh] Termos MeSH primário: Craniossinostoses/cirurgia
Craniotomia/efeitos adversos
Infarto da Artéria Cerebral Anterior/etiologia
[Mh] Termos MeSH secundário: Osso Frontal/cirurgia
Seres Humanos
Lactente
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160816
[St] Status:MEDLINE
[do] DOI:10.1007/s00381-016-3211-2


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[PMID]:27382125
[Au] Autor:Dabus G; Grossberg JA; Cawley CM; Dion JE; Puri AS; Wakhloo AK; Gonsales D; Aguilar-Salinas P; Sauvageau E; Linfante I; Hanel RA
[Ad] Endereço:Miami Cardiac & Vascular Institute, Florida International University, Miami, Florida, USA.
[Ti] Título:Treatment of complex anterior cerebral artery aneurysms with Pipeline flow diversion: mid-term results.
[So] Source:J Neurointerv Surg;9(2):147-151, 2017 Feb.
[Is] ISSN:1759-8486
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The off-label use of flow diverters in the treatment of distal aneurysms continues to be debated. OBJECTIVE: To report our multicenter experience in the treatment of complex anterior cerebral artery aneurysms with the Pipeline embolization device (PED). METHODS: The neurointerventional databases of the four participating institutions were retrospectively reviewed for aneurysms treated with PED between October 2011 and January of 2016. All patients treated for anterior cerebral artery aneurysms were included in the analysis. Clinical presentation, location, type, vessel size, procedural complications, clinical and imaging follow-up were included in the analysis. RESULTS: Twenty patients (13 female) with 20 aneurysms met the inclusion criteria in our study. Fifteen aneurysms were classified as saccular and five as fusiform (mean size 7.3 mm). Thirteen aneurysms were located in the anterior communicating region (ACOM or A1/2 junction), six were A2-pericallosal, and one was located in the A1 segment. Six patients had presented previously with subarachnoid hemorrhage and had their aneurysms initially clipped or coiled. There was one minor event (a small caudate infarct) and one major event (intraparenchymal hemorrhage). Sixteen of the 20 patients had angiographic follow-up (mean 10 months). Eleven aneurysms were completely occluded, one had residual neck, and four had residual aneurysm filling. CONCLUSIONS: The treatment of complex anterior cerebral artery aneurysms with the PED as an alternative for patients who are not good candidates for conventional methods is technically feasible and safe. Mid-term results are promising but larger series with long-term follow-up are required to assess its effectiveness.
[Mh] Termos MeSH primário: Prótese Vascular
Hemorragia Cerebral/cirurgia
Infarto da Artéria Cerebral Anterior/cirurgia
Aneurisma Intracraniano/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Artéria Cerebral Anterior/diagnóstico por imagem
Artéria Cerebral Anterior/cirurgia
Implante de Prótese Vascular
Angiografia Cerebral
Hemorragia Cerebral/diagnóstico por imagem
Infarto Cerebral/etiologia
Infarto Cerebral/cirurgia
Feminino
Seres Humanos
Infarto da Artéria Cerebral Anterior/diagnóstico por imagem
Aneurisma Intracraniano/diagnóstico por imagem
Angiografia por Ressonância Magnética
Masculino
Meia-Idade
Procedimentos Neurocirúrgicos/métodos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170324
[Lr] Data última revisão:
170324
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160707
[St] Status:MEDLINE
[do] DOI:10.1136/neurintsurg-2016-012519


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[PMID]:27930555
[Au] Autor:Cheng Y; He W
[Ad] Endereço:Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
[Ti] Título:Establishment of the intracranial hemodynamic model based on contrast medium and clinical applications.
[So] Source:Medicine (Baltimore);95(49):e5550, 2016 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ischemic cerebrovascular diseases are one of the most common vascular diseases in aged people and CT perfusion (CTP) is a very popular tool to detect the ischemic changes in brain vascular. The present study aims to establish a novel intracranial hemodynamic model to simulate anterior cerebral artery blood flow, and compare the actual and simulated hemodynamic parameters of healthy people and patients with carotid stenosis or occlusion.A mathematical model of the intracranial hemodynamic was generated using MATLAB software, and data from patients with or without infarct disease (57 and 44 cases, respectively) were retrospectively collected to test the new model. The actual time-density curve (TDC) of anterior cerebral artery was obtained from the original intracranial CTP data, and simulated TDC was calculated from our intracranial hemodynamic model. All model parameters were adjusted according to patients' sex, height, and weight. Time to peak enhancement (TTP), maximum enhancement (ME), and mean transit time (MTT) were selected to evaluate the status of hemodynamics.In healthy people, there were no significant differences of TTP and ME between actual and simulated curves. For patients with infarct symptoms, ME was significantly decreased in actual data compared with simulated curve, while there was no obvious difference of TTP between actual and simulated data. Moreover, MTT was delayed in infarct patients compared with healthy people.Our group generated a computer-based, physiologic model to simulate intracranial hemodynamics. The model successfully simulated anterior cerebral artery hemodynamics in normal healthy people and showed noncompliant ME and MTT in infarct patients, reflecting their abnormal cerebral hemodynamic status. The digital model is reliable and may help optimize the protocol of contrast medium enhancement in intracranial CT, and provide a solid tool to study intracranial hemodynamics.
[Mh] Termos MeSH primário: Artéria Cerebral Anterior/fisiopatologia
Infarto da Artéria Cerebral Anterior/diagnóstico por imagem
Modelos Teóricos
[Mh] Termos MeSH secundário: Velocidade do Fluxo Sanguíneo/fisiologia
Estudos de Casos e Controles
Angiografia por Tomografia Computadorizada
Meios de Contraste
Feminino
Hemodinâmica
Seres Humanos
Infarto da Artéria Cerebral Anterior/fisiopatologia
Masculino
Meia-Idade
Fluxo Sanguíneo Regional/fisiologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161209
[St] Status:MEDLINE


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[PMID]:27693107
[Au] Autor:Olivato S; Nizzoli S; Cavazzuti M; Casoni F; Nichelli PF; Zini A
[Ad] Endereço:Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Department of Neuroscience, Neurology Clinic, Modena, Italy.
[Ti] Título:e-NIHSS: an Expanded National Institutes of Health Stroke Scale Weighted for Anterior and Posterior Circulation Strokes.
[So] Source:J Stroke Cerebrovasc Dis;25(12):2953-2957, 2016 Dec.
[Is] ISSN:1532-8511
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The National Institutes of Health Stroke Scale (NIHSS) is the most widespread clinical scale used in patients presenting with acute stroke. The merits of the NIHSS include simplicity, quickness, and agreement between clinicians. The clinical evaluation on posterior circulation stroke remains still a limit of NIHSS. METHODS: We assessed the application of a new version of NIHSS, the e-NIHSS (expanded NIHSS), adding specific elements in existing items to explore signs/symptoms of a posterior circulation stroke. A total of 22 consecutive patients with suspected vertebrobasilar stroke were compared with 25 patients with anterior circulation stroke using NIHSS and e-NIHSS. RESULTS: We compared the NIHSS and e-NIHSS scores obtained by the 2 examiners, in patients with posterior circulation infarct (POCI), using the Wilcoxon test. Patients with POCI evaluated with e-NIHSS had an average of 2 points higher than patients evaluated with classical NIHSS. The difference was statistically significant (P < .05), weighted by the new expanded items. CONCLUSIONS: The NIHSS is a practical scale model, with high reproducibility between trained, different examiners, focused on posterior circulation strokes, with the same total score and number of items of the existing NIHSS. The e-NHISS could improve the sensitivity of NIHSS in posterior circulation stroke and could have an impact on clinical trials, as well as on outcomes. Further studies are needed to investigate a larger number of patients and the correlation between the e-NIHSS score and neuroimaging findings.
[Mh] Termos MeSH primário: Circulação Cerebrovascular
Avaliação da Deficiência
Infarto da Artéria Cerebral Anterior/diagnóstico
Infarto da Artéria Cerebral Posterior/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Nível de Saúde
Seres Humanos
Infarto da Artéria Cerebral Anterior/fisiopatologia
Infarto da Artéria Cerebral Anterior/psicologia
Infarto da Artéria Cerebral Posterior/fisiopatologia
Infarto da Artéria Cerebral Posterior/psicologia
Masculino
Meia-Idade
Exame Neurológico
Testes Neuropsicológicos
Variações Dependentes do Observador
Valor Preditivo dos Testes
Prognóstico
Reprodutibilidade dos Testes
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170410
[Lr] Data última revisão:
170410
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161004
[St] Status:MEDLINE


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[PMID]:27651410
[Au] Autor:Jenkins JM; Norton J; Hampton T; Weeks R
[Ad] Endereço:King's College Hospital, London, UK.
[Ti] Título:Rare case of bilateral traumatic internal carotid artery dissection.
[So] Source:BMJ Case Rep;2016, 2016 Sep 20.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A 55-year-old man was working in a trench when the wall collapsed in on him, pinning him to the wall. On arrival in the emergency department the patient began reporting of right-sided headache. Neurological examination revealed left-sided reduced sensation with weakness. Whole-body CT scan showed right-sided flail chest and bilateral haemothorax as well as loss of flow and thinning of the distal right internal carotid artery (ICA) and loss of grey white matter differentiation in keeping with traumatic ICA dissection with a right middle cerebral artery (MCA) infarct. He was started on aspirin 300 mg once daily. 3 days postadmission the patient experienced worsening of vision and expressive dysphasia. CT angiogram showed bilateral ICA dissections extending from C2 to the skull base. The patient was managed conservatively in the stroke unit for infarction and was discharged home for follow-up in stroke clinic.
[Mh] Termos MeSH primário: Dissecação da Artéria Carótida Interna/diagnóstico
Cefaleia/fisiopatologia
Infarto da Artéria Cerebral Anterior/diagnóstico
Doenças do Nervo Oculomotor/fisiopatologia
[Mh] Termos MeSH secundário: Aspirina/uso terapêutico
Dissecação da Artéria Carótida Interna/tratamento farmacológico
Dissecação da Artéria Carótida Interna/fisiopatologia
Cefaleia/etiologia
Seres Humanos
Infarto da Artéria Cerebral Anterior/tratamento farmacológico
Infarto da Artéria Cerebral Anterior/fisiopatologia
Masculino
Meia-Idade
Exame Neurológico
Doenças do Nervo Oculomotor/diagnóstico
Doenças do Nervo Oculomotor/etiologia
Inibidores da Agregação de Plaquetas/uso terapêutico
Ticlopidina/análogos & derivados
Ticlopidina/uso terapêutico
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Imagem Corporal Total
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors); A74586SNO7 (clopidogrel); OM90ZUW7M1 (Ticlopidine); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170510
[Lr] Data última revisão:
170510
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160922
[St] Status:MEDLINE



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