Cerebrovascular Trauma
Traumatic basal subarachnoid hemorrhage due to rupture of the posterior inferior cerebellar artery--case report. (1/13)
A 20-year-old male presented with traumatic basal subarachnoid hemorrhage after being involved in a fight. Antemortem clinical examinations could not exclude the possibility of rupture of abnormal blood vessels because of the absence of external injuries. Careful postmortem examination of the head and neck regions and histological examination of the intracranial arteries demonstrated traumatic rupture of the left posterior inferior cerebellar artery due to a fist blow to the jaw. This case indicates the need for careful autopsy examination for the differentiation of traumatic and non-traumatic basal subarachnoid hemorrhages. (+info)Treatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography. (2/13)
OBJECTIVE: To assess the impact of routine follow-up arteriography on the management and outcome of patients with acute blunt cerebrovascular injuries (BCVI). SUMMARY BACKGROUND DATA: During the past 5 years there has been increasing recognition of BCVI, but the management of these lesions remains controversial. The authors previously proposed a grading system for BCVI, with grade-specific management guidelines. The authors have noted that a significant number of injuries evolve within 7 to 10 days, warranting alterations in therapy. METHODS: A prospective database of a regional trauma center's experience with BCVI has been maintained since 1990. A policy of arteriographic screening for BCVI based on injury mechanism (e.g., cervical hyperextension) and injury patterns (e.g., cervical and facial fractures) was instituted in 1996. A grading system was devised to develop management protocols: I = intimal irregularity; II = dissection/flap/thrombus; III = pseudoaneurysm; IV = occlusion; V = transection. RESULTS: From June 1990 to October 2001, 171 patients (115 male, age 36 +/- 1 years) were diagnosed with BCVI. Mean injury severity score was 28 +/- 1; associated injuries included brain (57%), spine (44%), chest (43%), and face (34%). Mechanism was motor vehicle crash in 50%, fall in 11%, pedestrian struck in 11%, and other in 29%. One hundred fourteen patients had 157 carotid artery injuries (43 bilateral), and 79 patients had 97 vertebral artery injuries (18 bilateral). The breakdown of injury grades was 137 grade I, 52 grade II, 32 grade III, 25 grade IV, and 8 grade V. One hundred fourteen (73%) carotid and 65 (67%) vertebral arteries were restudied with arteriography 7 to 10 days after the injury. Eight-two percent of grade IV and 93% of grade III injuries were unchanged. However, grade I and II lesions changed frequently. Fifty-seven percent of grade I and 8% of grade II injuries healed, allowing cessation of therapy, whereas 8% of grade I and 43% of grade II lesions progressed to pseudoaneurysm formation, prompting interventional treatment. There was no significant difference in healing or in progression of injuries whether treated with heparin or antiplatelet therapy or untreated. However, heparin may improve the neurologic outcome in patients with ischemic deficits and may prevent stroke in asymptomatic patients. CONCLUSIONS: Routine follow-up arteriography is warranted in patients with grade I and II BCVIs because most of these patients (61% in this series) will require a change in management. A prospective randomized trial will be necessary to identify the optimal treatment of BCVI. (+info)Periprocedural morbidity and mortality associated with endovascular treatment of intracranial aneurysms. (3/13)
BACKGROUND AND PURPOSE: Despite experience and technological improvements, endovascular treatment of intracranial aneurysms still has inherent risks. We evaluated cerebral complications associated with this treatment. METHODS: From October 1998 to October 2002, 180 consecutive patients underwent 131 procedures for 118 ruptured aneurysms and 79 procedures for 72 unruptured aneurysms. We retrospectively reviewed their records and images to evaluate their morbidity and mortality. RESULTS: Thirty-seven (17.6%) procedure-related complications occurred: 27 and six with initial embolization of ruptured and unruptured aneurysms, respectively, and four with re-treatment. Complications included 22 cerebral thromboembolisms, nine intraprocedural aneurysm perforations, two coil migrations, two parent vessel injuries, one postprocedural aneurysm rupture, and one cranial nerve palsy. Fourteen complications had no neurologic consequence. Three caused transient neurologic morbidity; 10, persistent neurologic morbidity; and 10, death. Procedure-related neurologic morbidity and mortality rates, respectively, were as follows: overall, 4.8% and 4.8%; ruptured aneurysms, 5.9% and 7.6%; unruptured aneurysms, 1.4% and 1.4%; and re-treated aneurysms, 10% and 0%. Combined procedure-related morbidity and mortality rates for ruptured, unruptured, and re-treated aneurysms were 13.5%, 2.8%, and 10%, respectively. Nonprocedural complications attributable to subarachnoid hemorrhage in 118 patients with ruptured aneurysm were early rebleeding before coil placement (0.9%), symptomatic vasospasm (5.9%), and shunt-dependent hydrocephalus (5.9%); mortality from complications of subarachnoid hemorrhage itself was 11.9%. CONCLUSION: Procedural morbidity and mortality rates were highest in ruptured aneurysms and lowest in unruptured aneurysms. Morbidity rates were highest in re-treated aneurysms and lowest in unruptured aneurysms. No procedural mortality occurred with re-treated aneurysms. The main cause of morbidity and mortality was thromboembolism. (+info)Reperfusion activates metalloproteinases that contribute to neurovascular injury. (4/13)
(+info)Influence of early antioxidant supplements on clinical evolution and organ function in critically ill cardiac surgery, major trauma, and subarachnoid hemorrhage patients. (5/13)
(+info)Association of MRI markers of vascular brain injury with incident stroke, mild cognitive impairment, dementia, and mortality: the Framingham Offspring Study. (6/13)
(+info)Chronic systemic infection exacerbates ischemic brain damage via a CCL5 (regulated on activation, normal T-cell expressed and secreted)-mediated proinflammatory response in mice. (7/13)
(+info)National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease: a practical approach. (8/13)
(+info)Cerebrovascular Trauma is often caused by external factors such as traffic accidents, falls, sports injuries, or assaults. It can also be caused by internal factors such as blood clots or atherosclerosis (the buildup of plaque in the arteries).
There are several types of cerebrovascular trauma, including:
1. Cerebral contusions: These are bruises that occur when the brain is jolted or shaken, often as a result of a head injury.
2. Cerebral lacerations: These are cuts or tears in the brain tissue caused by a sharp object, such as a knife or a broken glass.
3. Cerebral hemorrhages: These occur when a blood vessel in the brain ruptures and bleeds into the surrounding tissue.
4. Cerebral infarctions: These are areas of dead brain tissue caused by a lack of blood flow, often as a result of a blood clot or atherosclerosis.
Diagnosis of cerebrovascular trauma typically involves imaging tests such as CT or MRI scans, and may also involve lumbar puncture (spinal tap) to collect cerebrospinal fluid for further analysis. Treatment depends on the type and severity of the injury, and may include medication, surgery, or rehabilitation therapy.
In summary, Cerebrovascular Trauma is a serious medical condition that can result in long-term cognitive, emotional, and behavioral changes. It is important to seek immediate medical attention if symptoms persist or worsen over time.
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Skull Base and Cerebrovascular Surgery1
- Dr. Bambakidis served his neurosurgery residency at UH Cleveland Medical Center, followed by fellowships in spinal neurosurgery and skull base and cerebrovascular surgery at Barrow Neurological Institute, Phoenix. (uhhospitals.org)
BCVI4
- Stroke secondary to blunt cerebrovascular injury (BCVI) most often occurs before initiation of antithrombotic therapy . (bvsalud.org)
- Rapid thromboelastography (TEG) was evaluated for patients with BCVI-attributed stroke at an urban Level I trauma center from 2011 to 2018. (bvsalud.org)
- Blunt cerebrovascular injuries (BCVI) have been a topic of interest to many researchers worldwide as evidenced by the vast amount of available literature. (elsevier.com)
- It detects more blunt cerebrovascular injuries (BCVI), which leads to more treatment, which reduces risk of stroke and mortality. (journalfeed.org)
Acute Care Surg1
- J Trauma Acute Care Surg;87(5): 1082-1087, 2019 11. (bvsalud.org)
Stroke6
- Not all in your head (and neck): Stroke after blunt cerebrovascular injury is associated with systemic hypercoagulability. (bvsalud.org)
- Blunt cerebrovascular injury was identified in 435 (3%) patients , of whom 28 experienced associated stroke and had a TEG within 24 hours of arrival. (bvsalud.org)
- There is evidence of DNA damage in experimental stroke and trauma, and neurodegenerative processes have been attributed to impairment in DNA repair mechanisms. (nih.gov)
- The application of the science of DNA injury and repair may yield new and important information on mechanisms of neuronal damage, and provide opportunities for the development of novel and effective therapies to reduce CNS injury in stroke, trauma, and neurodegenerative disorders. (nih.gov)
- Although the overall incidence is low, dissections remain a common cause of stroke in children, young adults, and trauma patients. (ebmedicine.net)
- This supplement reviews the application of advanced screening criteria, imaging options, and antithrombotic treatment for patients with blunt cerebrovascular injuries, with a focus on reducing the occurrence of ischemic stroke. (ebmedicine.net)
Injuries2
- Inaccurate assessment and diagnosis of cervical spine injuries is still a common problem in trauma medicine. (medscape.com)
- Blunt cerebrovascular injuries include cervical carotid dissections and vertebral artery dissections that are due to blunt trauma. (ebmedicine.net)
Injury3
- 8 An analysis of risk factors for ischemic events in the setting of blunt cerebrovascular injury would be exceedingly difficult in a single-center review, as blunt cerebrovascular injury occurs in 0.3% to 0.9% of the pediatric trauma population. (thejns.org)
- 8. Implementation of a dual cervical spine and blunt cerebrovascular injury assessment pathway for pediatric trauma patients. (nih.gov)
- Pediatric firearm-related traumatic brain injury in United States trauma centers. (pitt.edu)
Cervical spine12
- His special interests include cerebrovascular surgery, cervical spine surgery, endovascular surgery and skull base surgery. (uhhospitals.org)
- 2. An analysis of cervical spine magnetic resonance imaging findings after normal computed tomographic imaging findings in pediatric trauma patients: ten-year experience of a level I pediatric trauma center. (nih.gov)
- 4. Decreasing Radiation Exposure in Pediatric Trauma Related to Cervical Spine Clearance: A Quality Improvement Project. (nih.gov)
- 5. Variation in pediatric cervical spine imaging across trauma centers-A cause for concern? (nih.gov)
- 6. Implementation of pediatric cervical spine clearance guidelines at a combined trauma center: Twelve-month impact. (nih.gov)
- 7. Factors associated with the use of cervical spine computed tomography imaging in pediatric trauma patients. (nih.gov)
- 11. "Next Day" Examination Reduces Radiation Exposure in Cervical Spine Clearance at a Level 1 Pediatric Trauma Center: Preliminary Findings. (nih.gov)
- 14. Is radiography justified for the evaluation of patients presenting with cervical spine trauma? (nih.gov)
- 16. Cervical Spine Clearance in Pediatric Trauma Centers: The Need for Standardization and an Evidence-based Protocol. (nih.gov)
- 17. Cervical spine computed tomography utilization in pediatric trauma patients. (nih.gov)
- 19. Theoretical increase of thyroid cancer induction from cervical spine multidetector computed tomography in pediatric trauma patients. (nih.gov)
- 20. Examination of Pediatric Radiation Dose Delivered After Cervical Spine Trauma. (nih.gov)
Accident2
- They also reported exposure to other traumas, such as an accident, disaster, or unexpected death of a loved one. (nih.gov)
- 3 CK is sometimes increased with cerebrovascular accident. (labcorp.com)
Setting of blunt1
- It's often a quandary which patient to order CTA of the neck in the setting of blunt trauma. (journalfeed.org)
Brain2
- C3891 Color Blindness C118464 Adverse Events Terminology C98803 Acquired Hydrocephalus Acquired Hydrocephalus Hydrocephalus that results from head trauma, brain tumors, intracranial hemorrhage, or meningitis. (nih.gov)
- At the Brain Trauma Research Center, he investigates the role that genetic factors can play in the secondary pathophysiology of neurotrauma. (pitt.edu)
Pediatric2
- The Alberta Children's Hospital Trauma Program is opening up their monthly Pediatric Trauma Rounds to TAC members at no cost. (traumacanada.org)
- 1. Performance improvement and patient safety program-guided quality improvement initiatives can significantly reduce computed tomography imaging in pediatric trauma patients. (nih.gov)
Disease2
- They also excluded women who had a history of cardiovascular or cerebrovascular disease. (nih.gov)
- 1 CK is increased in female carriers of this X-linked disease, and in muscular stress, in polymyositis, dermatomyositis, and with muscle trauma. (labcorp.com)
Cerebral1
- Therefore, the intent of this announcement is to encourage investigator-initiated applications to study the mechanisms of DNA damage and repair in cerebral ischemia and CNS trauma. (nih.gov)
Diseases2
- [2] , [3] On the other hand, the relation between the heart and cerebrovascular diseases has been well studied. (neurologyindia.com)
- The control group included 87 patients admitted to other wards for some ailment other than cerebrovascular diseases and patients were matched by age. (neurologyindia.com)
Neck2
- Symptoms of dissection, such as headache, neck pain, and dizziness, are commonly seen in the emergency department, but may not be apparent in the obtunded trauma patient or may not be recognized as being due to a dissection. (ebmedicine.net)
- Use a screening protocol to determine which trauma patients to order CTA of the head and neck. (journalfeed.org)
Computed Tomography1
- 15. Computed tomography rates and estimated radiation-associated cancer risk among injured children treated at different trauma center types. (nih.gov)
Ischemic1
- Hemorrhagic strokes, brainstem ischemic strokes, and strokes related to trauma were excluded from the study. (neurologyindia.com)
Patients1
- During the study period, 15,347 patients were admitted following blunt trauma . (bvsalud.org)
Critical Care1
- Chair, Guidelines Committee, Joint Section for Trauma and Critical Care. (bvsalud.org)
Imaging3
- When cervical trauma exists, it may be at multiple levels, justifying the fact that if treatment is to be instituted, imaging should include the upper and lower cervical hinges. (medscape.com)
- ICG-VA gives us intraoperative real-time high definition functional imaging of the cerebrovascular tree, thereby allowing immediate quality assessment and control of aneurysm obliteration and parent vessel optimisation. (lww.com)
- Dr Chakraborty and Dr Prall are partners at their respective in- Imaging, R Adams Cowley Shock Trauma Center. (bvsalud.org)
Emergency1
- Center, Baltimore, Maryland, Vice Chair of Community Radiology, Uni- they have no conflict of interest related to the material discussed in this versity of Maryland Medical Center, Chief of Emergency and Trauma article. (bvsalud.org)
Study1
- Strengths of this study include the fact that the researchers were able to examine multiple types of sexual violence and a range of other possible variables, including other types of trauma. (nih.gov)
Center1
- Dr. Liebeskind reports other support from Cerenovus, Genentech, Med- mR. Adams Cowley Shock Trauma Center, University of Maryland Medical tronic, Stryker, outside the submitted work. (bvsalud.org)
Journal1
- Thought you might appreciate this item(s) I saw in Journal of Cerebrovascular Sciences. (lww.com)
Blood2
- Lawn and colleagues analyzed associations between lifetime exposure to sexual violence and blood pressure while accounting for the possible impacts of exposure to other types of trauma. (nih.gov)
- Compared with women who had never experienced any type of trauma, women who had experienced sexual assault at any point in their lifetime were more likely to develop high blood pressure, as were women who had experienced workplace sexual harassment. (nih.gov)
Patient1
- Any patient who presents with altered mental status (AMS) needs a complete physical examination, with particular attention to general appearance, vital signs, hydration status, evidence of physical trauma, and neurologic signs. (medscape.com)