31 results on '"hemorragia cerebral"'
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2. Intracranial hemorrhages in patients with COVID-19: a systematic review of the literature, regarding six cases in an Amazonian population.
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de Sousa Lima, William, Pereira Soares, Marcelo Henrique, Albuquerque Paschoal, Eric Homero, Sagica Fernandes Paschoal, Joelma Karin, Mendes Paschoal Jr., Fernando, and Bor-Seng-Shu, Edson
- Abstract
Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2023
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3. Anticoagulation and Stroke.
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TINONE, Gisela, HOSHINO, Mauricio, LUCATO, Leandro, and COMERLATTI, Luiz Roberto
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Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2022
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4. Intracerebral hemorrhage: update and future directions.
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ROCHA, Eva, ROUANET, Carolina, REGES, Danyelle, GAGLIARDI, Vivian, Bhim SINGHAL, Aneesh, and Sampaio SILVA, Gisele
- Abstract
Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2020
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5. Cerebral amyloid angiopathy: a cross-sectional study in a single center in Northeastern Brazil.
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de BARROS-ARAÚJO, Marx Lima, RICARTE, Irapuá Ferreira, MONTALVERNE FILHO, Edward, HOLANDA, Guilherme Marconi Guimarães Martins, de SOUSA, Ícaro Araújo, CORRÊA, Matheus Rodrigues, NOGUEIRA, Matheus Rocha de Seixas, and CRONEMBERGER, Pedro Jorge Luz Alves
- Abstract
Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2020
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6. Cerebrospinal fluid drainage options for posthemorrhagic hydrocephalus in premature neonates.
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Tude Melo, José Roberto, Passos, Rosane Klein, and Coelho Mendes de Carvalho, Marcelo Liberato
- Abstract
Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
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7. Stroke occurring in patients with cognitive impairment or dementia.
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Moulin, Solène and Leys, Didier
- Abstract
Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
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8. Active extravasation of contrast within the hemorrhage (spot sign): a multidetector computed tomography finding that predicts growth and a worse prognosis in non-traumatic intracerebral hemorrhage
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Marcos Rosa Junior, Antonio Jose da Rocha, Nelson Saade, Antonio Carlos Martins Maia Junior, and Rubens Jose Gagliardi
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spot sign ,angio-TC ,acidente vascular cerebral hemorragico ,hemorragia cerebral ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Intracerebral hemorrhage (ICH) causes high rates of disability and neurological sequelae Objective To evaluate spot signs as predictors of expansion and worse prognosis in non-traumatic ICH in a Brazilian cohort. Method We used multidetector computed tomography angiography to study 65 consecutive patients (40 men, 61.5%), with ages varying from 33 to 89 years (median age 55 years). Clinical and imaging findings were correlated with the findings based on the initial imaging. Results Of the individuals who presented a spot sign, 73.7% died (in-hospital mortality), whereas in the absence of a spot sign the mortality rate was 43.0%. Although expansion of ICH was detected in 75% of the patients with a spot sign, expansion was observed in only 9.0% of the patients who did not present a spot sign. Conclusions The spot sign strongly predicted expansion in non-traumatic ICH and an increased risk of in-hospital mortality.
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- 2013
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9. Hematoma volumes of spontaneous intracerebral hemorrhage: the ellipse (ABC/2) method yielded volumes smaller than those measured using the planimetric method
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Adriano Keijiro Maeda, Luiz Roberto Aguiar, Carolina Martins, Gerson Linck Bichinho, and Munir Antonio Gariba
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hemorragia cerebral ,tomografia ,estudos de avaliacao ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
OBJECTIVE: To compare two different methods for measuring intracerebral hemorrhage (ICH) volume: the ellipse volume (called ABC/2), and the software-aided planimetric. METHODS: Four observers evaluated 20 brain computed tomography (CT) scans with spontaneous ICH. Each professional measured the volume using the ABC/2 and the planimetric methods. The average volumes were obtained, and the intra- and inter-rater variability was determined. RESULTS: There is an absolute 2.24 cm3 average difference between both methodologies. Volumes yielded by the ABC/2 method were as much as 14.9% smaller than by the planimetric one. An intra-observer variability rate of 0.46% was found for the planimetric method and 0.18% for the ABC/2. The inter-observer rates were 1.69 and 1.11% respectively. CONCLUSIONS: Both methods are reproducible. The ABC/2 yielded hemorrhage volumes as much as 14.9% smaller than those measured using the planimetric methodology.
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- 2013
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10. Hyperglycemia in nondiabetic patients during the acute phase of stroke
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Daniel Agustin Godoy, Caridad Soler, Walter Videtta, Luis Castillo Fuenzalida, Jorge Paranhos, Marcelo Costilla, Gustavo Piñero, Manuel Jibaja, and Leonardo Jardim Vaz de Melo
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infarto cerebral ,hemorragia cerebral ,hiperglucemia ,insulina ,Latinoamérica ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
OBJECTIVE: To determine patterns of hyperglycemic (HG) control in acute stroke. METHODS: Anonymous survey through Internet questionnaire. Participants included Latin-American physicians specialized in neurocritical care. RESULTS: The response rate was 74%. HG definition varied widely. Fifty per cent considered it when values were >140 mg/dL (7.8 mmol/L). Intravenous (IV) regular insulin was the drug of choice for HG correction. One fifth of the respondents expressed adherence to a protocol. Intensive insulin therapy (IIT) was used by 23%. Glucose levels were measured in all participants at admission. Routine laboratory test was the preferred method for monitoring. Reactive strips were more frequently used when monitoring was intensive. Most practitioners (56.7%) monitored glucose more than two times daily throughout the Intensive Care Unit stay. CONCLUSIONS: There is considerable variability and heterogeneity in the management of elevated blood glucose during acute phase of stroke by the surveyed Latin-American physicians.
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- 2012
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11. Central nervous system hemorrhage in thrombocytopenic patients: computed tomographic findings in 21 cases Hemorragia do sistema nervoso central em pacientes trombocitopênicos: achados por tomografia computadorizada em 21 casos
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Emerson L. Gasparetto, Paulo R. Benites Filho, Taísa Davaus, and Arnolfo de Carvalho Neto
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tomografia computadorizada ,plaquetopenia ,hemorragia cerebral ,computed tomography ,thrombocytopenia ,cerebral hemorrhage ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
OBJETIVE: To describe the CT scan findings of 21 thrombocytopenic patients with central nervous system (CNS) hemorrhage. METHOD: Retrospective study of the computed tomography (CT) of 21 platelet-depleted patients with CNS hemorrhage. One patient presented two episodes of hemorrhagic episode with different intervals. The clinical data were obtained by the review of the medical records. Two radiologists analyzed the films and reached the decisions by consensus. The following findings were studied: type of bleeding, number of lesions, topography, laterality, size and associated findings. RESULTS: Intraparenchymal hemorrhage (IPH) was the most common findings, found in 20 cases, being six of them associated with subarachnoid and intraventricular hemorrhages. The size of the lesions varied between 1.8 and 10.5 cm. The parietal lobes were more commonly affected (n=11, 50%), followed by the temporal (n=7, 31.8%), frontal (n=7, 31.8%) and occipital (n=2, 9.09%) lobes. In 15 cases (68.2%) there was a single area of hemorrhage and in the remaining cases there were multiple hemorrhages. Associated findings were found in 20 cases. The most prevalent were edema (n=17, 77.3%), hydrocephalus (10, 45.4%) and midline shift (n=9, 41%). CONCLUSION: The most frequent CT scan findings in thrombocytopenic patients with CNS hemorrhage are single IPH, located mostly in the parietal, temporal and frontal lobes, with varied sizes and associated with edema, hydrocephalus and midline shift.OBJETIVO: Descrever os achados tomográficos de 21 pacientes trombocitopênicos com hemorragia no sistema nervoso central (SNC). MÉTODO: Estudo retrospectivo das tomografias computadorizadas (TC) de 21 pacientes trombocitopênicos que apresentaram hemorragia no SNC. Um dos pacientes apresentou 2 episódios hemorrágicos em épocas diferentes. Os dados clínicos foram obtidos por revisão de prontuários médicos. Dois radiologistas analisaram os exames e estabeleceram os achados por consenso. Os seguintes achados foram estudados: tipo de sangramento, número de lesões, topografia, lateralidade, tamanho e achados associados. RESULTADOS: A hemorragia intraparenquimatosa foi o achado mais comum, observada em 20 casos, sendo que em seis deles apresentavam hemorragia subaracnóidea e intraventricular associadas. O tamanho das lesões variou entre 1,8 e 10,5 cm (mediana= 4,5 cm). Os lobos parietais foram mais acometidos (n=11, 50%), seguidos pelos temporais (n=7, 31,8%), frontais (n=7, 31,8%) e occipitais (n=2, 9,09%). Em 15 casos (68,2%) houve uma única área de hemorragia, e nos demais múltiplas áreas foram observadas. Em 20 casos foram encontrados achados associados, sendo mais comum edema (n=17, 77,3%), hidrocefalia (n=10, 45,4%) e desvio da linha média (n=9, 41%). CONCLUSÃO: Os achados tomográficos mais freqüentes em pacientes trombocitopênicos com hemorragia cerebral são lesões intraparenquimatosas únicas acometendo principalmente os lobos parietais, temporais e frontais, com tamanhos variados e associadas a edema, hidrocefalia e desvio da linha média.
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- 2007
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12. Trends of stroke subtypes mortality in Sao Paulo, Brazil (1996-2003) Tendência da mortalidade pelos subtipos da doença cerebrovascular (1996-2003)
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Paulo A. Lotufo and Isabela M. Benseñor
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doença cerebrovascular ,mortalidade ,infarto cerebral ,hemorragia cerebral ,epidemiologia ,cerebrovascular disorders ,mortality ,cerebral infarction ,intracerebral hemorrhage ,epidemiology ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
The decline of stroke mortality rates has been described in Brazil; however, there is no data about stroke subtypes. We described the changes of stroke mortality rates in the city of Sao Paulo (1996-2003) emphasizing intracerebral hemorrhage and cerebral infarction. We categorized mortality data by gender and 10-year age-strata from 30 to 79 years-old. For men, an annual reduction of all types of stroke (-3.9%), and of stroke subtypes as intracerebral hemorrhage (-3.0%) and cerebral infarction was observed (-2.7%) as well as, a decline of ill-defined stroke (-7.4%). For women, a decline was observed for all types of stroke (-3.3%) and for ill-defined stroke (-12%). However, the switch of ill-defined cases to stroke subtype categories due to a better clinical diagnosis blurred a real decline of both cerebral infarction and intracerebral hemorrhagic stroke among women.O declínio da mortalidade pela doença cerebrovascular no Brasil é conhecido, porém há poucos dados sobre a evolução temporal dos dois principais subtipos, a hemorragia parenquimatosa e o infarto cerebral. As modificações temporais dos subtipos de doença cerebrovascular foram estudadas na cidade de São Paulo entre 1996 e 2003 por gênero e faixa etária decenal entre os 30 e 79 anos. Para os homens detectou-se redução anual para todo os tipos (-3,9%), para hemorragia parenquimatosa (-3,0%), para infarto cerebral (-2,7%) bem como para os casos mal definidos (-7.4%). Para as mulheres somente houve variação significativa para todos os tipos da doença cerebrovascular (-3,3%) e para os casos mal definidos (-12%). Concluindo, as taxas de doença cerebrovascular estão em queda, porém entre as mulheres devido à melhoria do diagnóstico clínico houve migração de casos mal definidos para casos bem definidos. Devido a isso não foi possível detectar declínio nas taxas de mortalidade pelos subtipos de doença cerebrovascular.
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- 2005
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13. Outcomes from intracerebral hemorrhage among patients pre-treated with statins
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Flávio Ramalho Romero, Eduardo de Freitas Bertolini, Vanessa Nogueira Veloso, Leandro Venturini, and Eberval G. Figueiredo
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hemorragia cerebral ,inibidores de hidroximetilglutaril-CoA redutases ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
OBJECTIVE: 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins, have been associated with improved clinical outcomes after ischemic stroke and subarachnoid hemorrhage, but with an increased risk of incidental spontaneous intracerebral hemorrhage (ICH). We investigated whether the statin use before ICH, was associated with functional independence, 90 days after treatment. METHOD: We analyzed 124 consecutive ICH patients with 90-day outcome data who were enrolled in a prospective cohort study between 2006 and 2009. Eighty-three patients were included in this study. Among ICH survivors, univariate Cox regression models and Kaplan-Meier plots were used to determine subject characteristics that were associated with an increased risk of recurrence. Statin usage was determined through interviewing the patient at the time of ICH and confirmed by reviewing their medical records. Independent status was defined as Glasgow Outcome Scale grades 4 or 5. RESULTS: Statins were used by 20 out of 83 patients (24%) before ICH onset. There was no effect from pre-ICH statin use on functional independence rates (28% versus 29%, P=0.84) or mortality (46% versus 45%, P=0.93). CONCLUSION: Pre-ICH statin use is not associated with changes to ICH functional outcome or mortality.
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- 2011
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14. Malformações arteriovenosas do sistema nervoso central: análise de 53 casos
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CÉSAR M. GUIOTOKU, WALTER O. ARRUDA, RICARDO RAMINA, ARI A. PEDROZO, and MURILO S. MENESES
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malformação arteriovenosa ,hemorragia cerebral ,neurocirurgia ,embolização ,radiocirurgia ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Analisamos 53 casos de malformações arteriovenosas (MAV) admitidos no Serviço de agosto de 1986 a março de 1998. A distribuição por sexo foi masculino 1,9:1 feminino, com faixa etária média de 32,5±11,5 anos. A apresentação clínica inicial incluiu, em ordem de frequência, hemorragia intracraniana, sinais neurológicos focais, cefaléia, epilepsia, e coma profundo agudo. As MAV supratentoriais tiveram a seguinte distribuição: 10 temporais, 9 parietais, 6 frontais, 3 occipitais, 3 fronto-parietais, 4 corpo caloso/pericalosas, 1 têmporo-occipital, 1 têmporo-parieto-occipital e 6 profundas. As MAV de acordo com a classificação de Spetzler-Martin, distribuiram-se em: grau II 17 casos (32%), grau III 21 casos (39%) e grau IV 10 casos (19%). Em 3 pacientes (5,6%) havia presença concomitante de aneurisma intracraniano. Trinta e sete pacientes foram operados, 12 dos quais, com embolização parcial prévia. Em somente um caso a ressecção cirúrgica foi parcial. Onze pacientes foram somente embolizados, sendo a embolização parcial em 3 casos. Dois pacientes não foram embolizados e nem operados (1 caso devido a pneumonite intersticial por AIDS e outro por problemas administrativos). Três casos foram encaminhados para radiocirurgia. Houve somente um óbito por embolia pulmonar aguda (1,8%). Concluímos que a abordagem multidisciplinar individualizada, envolvendo as especialidades de neurorradiologia intervencionista, neurologia e neurocirurgia, oferece a possiblidade de indicar a terapia mais adequada para cada caso, com bons resultados.
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- 1999
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15. Gravidez, puerpério e doença vascular cerebral Pregnancy, puerperium and cerebrovascular disease
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Márcia Maiumi Fukujima, Roberto de Magalhães Carneiro de Oliveira, Jean Carlos Shimazaki, and José Geraldo de Camargo Lima
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gravidez ,puerpério ,acidente vascular cerebral ,infarto cerebral ,hemorragia cerebral ,trombose venosa cerebral ,doença de Chagas ,pregnancy ,puerperium ,stroke ,cerebral infarction ,cerebral hemorrhage ,cerebral venous thrombosis ,Chagas¹ disease ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Foram estudadas seis pacientes com doenças cerebrovasculares no período gravídico-puerperal. Uma apresentou hemorragia cerebral, três apresentaram infarto cerebral e duas trombose de seio venoso cerebral. A associação de fatores clínicos ao estado peculiar produzido pela gravidez parece ter resultado nas doenças apresentadas, com especial ênfase à doença de Chagas presente em todos os infartos cerebrais.Six patients who presented cerebrovascular disease during puerperium or pregnancy were studied. One of them presented hemorrhagic stroke caused by intracerebral bleeding due to pre-eclampsia. Three patients presented ischemic stroke, they all had positive serologic reactions for Chagas' disease, but only two of them had clinical cardiopathy; one of these patients had anticardiolipin antibody. The other two patients presented cerebral venous thrombosis of sagittal sinus. Both were smokers and one of them used oral contraceptive. We emphasize the importance of clinical investigation to seek for the common causes of cerebrovascular disease in young people, with special attention to Chagas disease in Brazil.
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- 1996
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16. Angioma cavernoso intracraniano
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José Carlos Lynch, Ricardo Andrade, Celestino Pereira, J. Francisco Salomão, Francisco Duarte, Francisca Gonçalves Carvalho, and Edla Chadrycki
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angioma cavernoso ,mal formação vascular ,crise convulsiva ,hemorragia cerebral ,microcirurgia ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Os autores apresentam dados clínicos, achados radiológicos, aspectos histopatológicos e resultados do tratamento de oito pacientes com angioma cavernoso intracraniano. Cinco apresentavam crise convulsiva; dois, manifestação de efeito de massa; um, hemorragia cerebral. A tomografia computadorizada de crânio e a ressonância magnética detectaram a lesão em todos os casos. Entretanto, não há uma imagem patognomômica para os angiomas cavernosos. Todos os pacientes foram submetidos a remoção microcirúrgica das suas lesões. Obtivemos remoção total da lesão em sete pacientes e subtotal em um. Não ocorreu óbito nesta série e somente um paciente apresentou novo deficit neurológico.
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- 1994
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17. Electrocardiographic findings in acute cerebrovascular hemorrhage a prospective study of 70 patients
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Walter Oleschko Arruda and Flávio Suplicy de Lacerda Jr.
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hemorragia cerebral ,eletrocardiograma ,prolongamento do intervalo ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Seventy patients with hemorrhagic stroke were prospectively evaluated regarding the electrocardiographic abnormalities observed within the first 48 hours of the ictus. Group I comprised 55 patients with spontaneous cerebral hemorrhage, and group II 15 patients with subarachnoid hemorrhage. Patients taking cardiac drugs (beta blockers, calcium-channel blockers, inotropic drugs) or with severe metabolic/electrolyte disturbances were excluded. The most common ECG abnormality was a prolonged Q-Tc interval: group I, 37 (67.2%); group II, 8 (53.3%). Only 4 (7.2% patients of group I and no patient of group II had a normal ECG. No relation was found between the site of the intracerebral hematoma and the occurrence of any particular ECG change. A prolonged Q-Tc may be related to the development of severe cardiac arrhythmias observed in some patients with acute cerebral hemorrhage.
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- 1992
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18. Active extravasation of contrast within the hemorrhage (spot sign): a muItidetector computed tomography finding that predicts growth and a worse prognosis in non-traumatic intracerebral hemorrhage.
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Rosa Júnior, Marcos, José da Rocha, Antônio, Saade, Nelson, Martins Maia Júnior, Antônio Cartos, and José Gagíiardi, Rubens
- Abstract
Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2013
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19. Hematoma volumes of spontaneous intracerebral hemorrhage: the ellipse (ABC/2) method yielded volumes smaller than those measured using the planimetric method.
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Keijiro Maeda, Adriano, Roberto Aguiar, Luiz, Martins, Carolina, Linck Bichinho, Gerson, and António Gariba, Munir
- Abstract
Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2013
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20. Hyperglycemia in nondiabetic patients during the acute phase of stroke.
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Godoy, Daniel Agustin, Soler, Caridad, Videtta, Walter, Fuenzalida, Luis Castillo, Paranhos, Jorge, Costilla, Marcelo, Piñero, Gustavo, Jibaja, Manuel, and De Melo, Leonardo Jardim Vaz
- Abstract
Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2012
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21. Stroke occurring in patients with cognitive impairment or dementia
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Didier Leys and Solène Moulin
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medicine.medical_specialty ,infarto cerebral ,030204 cardiovascular system & hematology ,lcsh:RC321-571 ,03 medical and health sciences ,mild cognitive impairment ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Dementia ,In patient ,Cognitive impairment ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Stroke ,Gynecology ,cerebral hemorrhage ,comprometimento cognitivo leve ,business.industry ,hemorragia cerebral ,demência ,acidente vascular cerebral ,Prognosis ,cerebral infarction ,medicine.disease ,stroke ,Neurology ,Neurology (clinical) ,Cognition Disorders ,business ,030217 neurology & neurosurgery ,dementia - Abstract
One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods Literature search. Results (i) A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii) Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii) Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv) Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others. Conclusion Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others. RESUMO Um em cada seis pacientes internados em decorrência de acidente vascular cerebral (AVC) apresenta diagnóstico prévio de demência. Estes indivíduos têm menor acesso à assistência recomendada para pacientes com AVC, mas pouco ainda se sabe em relação aos cuidados médicos ideais que devem receber. Objetivo Determinar como o comprometimento cognitivo prévio ao AVC pode ser detectado, qual o mecanismo etiológico subjacente, e as consequências para o prognóstico e para o acompanhamento clínico. Método Pesquisa bibliográfica. Resultados (i) O rastreamento sistemático com o Informant Questionnaire of Cognitive Decline in the Elderly é recomendado; (ii) O comprometimento cognitivo preexistente pode ser devido a lesões cerebrais de origem vascular, degenerativa ou mista; (iii) Pacientes com demência prévia ao AVC têm pior prognóstico, maior frequência de crises epilépticas, de delirium e depressão, além de taxas de mortalidade mais altas; eles frequentemente são institucionalizados após o AVC; (iv) Embora a tolerabilidade às medicações não seja tão boa quanto a de pacientes com AVC sem comprometimento cognitivo, a relação risco/benefício é a favor de tratamento similar àquele oferecido aos demais pacientes. Conclusão Pacientes com comprometimento cognitivo que apresentam AVC têm pior prognóstico, porém eles devem ser tratados de modo semelhante aos demais casos.
- Published
- 2017
22. Outcomes from intracerebral hemorrhage among patients pre-treated with statins.
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Romero, Fláio Ramalho, de Freitas Bertolini, Eduardo, Veloso, Vanessa Nogueira, Venturini, Leandro, and Figueiredo, Eberval G.
- Abstract
Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2011
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23. Hiperglucemia en no diabéticos durante fase aguda del ictus
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Walter Videtta, Daniel Agustin Godoy, Luis Castillo Fuenzalida, Manuel Jibaja, Caridad Soler, Jorge Paranhos, Marcelo Costilla, Leonardo Jardim Vaz de Melo, and Gustavo Piñero
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Blood Glucose ,insulin ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,infarto cerebral ,law.invention ,lcsh:RC321-571 ,law ,Surveys and Questionnaires ,Internal medicine ,medicine ,Humans ,Hypoglycemic Agents ,Insulin ,insulina ,Intensive care medicine ,hiperglucemia ,Stroke ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Response rate (survey) ,cerebral hemorrhage ,Cerebral infarction ,business.industry ,hemorragia cerebral ,Routine laboratory ,Neurointensive care ,cerebral infarction ,medicine.disease ,Intensive care unit ,Intensive Care Units ,Latin America ,Neurology ,Health Care Surveys ,Hyperglycemia ,Acute Disease ,Regular insulin ,hyperglycemia ,Neurology (clinical) ,Latinoamérica ,business - Abstract
OBJECTIVE: To determine patterns of hyperglycemic (HG) control in acute stroke. METHODS: Anonymous survey through Internet questionnaire. Participants included Latin-American physicians specialized in neurocritical care. RESULTS: The response rate was 74%. HG definition varied widely. Fifty per cent considered it when values were >140 mg/dL (7.8 mmol/L). Intravenous (IV) regular insulin was the drug of choice for HG correction. One fifth of the respondents expressed adherence to a protocol. Intensive insulin therapy (IIT) was used by 23%. Glucose levels were measured in all participants at admission. Routine laboratory test was the preferred method for monitoring. Reactive strips were more frequently used when monitoring was intensive. Most practitioners (56.7%) monitored glucose more than two times daily throughout the Intensive Care Unit stay. CONCLUSIONS: There is considerable variability and heterogeneity in the management of elevated blood glucose during acute phase of stroke by the surveyed Latin-American physicians. OBJETIVO: Determinar patrones de control de hiperglucemia (HG) en el ictus agudo. MÉTODOS: Encuesta anónima, mediante cuestionario vía Internet. Los participantes incluyan médicos latinoamericanos especializados en cuidados neurocríticos. RESULTADOS: Las encuestas fueron respondidas por el 74% de los convocados. Las definiciones de hiperglucemia fueron variadas. El 50% de los que respondieron consideran HG cuando glucemia >140 mg/dL (7.8 mmol/L). Insulina regular intravenosa fue la droga de elección para su control. Solo la quinta parte de los encuestados manifestaron adherencia a un protocolo. El 23% emplea el régimen insulínico intensivo (TII). Glucemia fue obtenida a la admisión a la Unidad de Terapia Intensiva (UCI) por el total de los participantes. Test rutinario de laboratorio fue el método preferido para la monitorización. Tiras reactivas fueron utilizadas con mayor frecuencia cuando se aplicó monitoreo intensivo. El 56.7% monitoriza glucemia más de dos veces al día durante la estadía en UCI. CONCLUSIONES: Existe una considerable variabilidad y heterogeneidad en el manejo de la hiperglucemia durante la fase aguda del ictus entre los médicos latinoamericanos encuestados.
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- 2012
24. Outcomes from intracerebral hemorrhage among patients pre-treated with statins
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Leandro Venturini, Eberval Gadelha Figueiredo, Eduardo de Freitas Bertolini, Flávio Ramalho Romero, and Vanessa Nogueira Veloso
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medicine.medical_specialty ,Statin ,Subarachnoid hemorrhage ,medicine.drug_class ,Glasgow Outcome Scale ,lcsh:RC321-571 ,Disability Evaluation ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Prospective cohort study ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Aged ,Cerebral Hemorrhage ,Retrospective Studies ,Intracerebral hemorrhage ,cerebral hemorrhage ,business.industry ,Proportional hazards model ,inibidores de hidroximetilglutaril-CoA redutases ,Medical record ,hemorragia cerebral ,Recovery of Function ,Statin treatment ,Prognosis ,medicine.disease ,nervous system diseases ,Neurology ,Anesthesia ,Neurology (clinical) ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,hydroxymethylglutaryl-CoA reductase inhibitors ,Follow-Up Studies - Abstract
OBJECTIVE: 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins, have been associated with improved clinical outcomes after ischemic stroke and subarachnoid hemorrhage, but with an increased risk of incidental spontaneous intracerebral hemorrhage (ICH). We investigated whether the statin use before ICH, was associated with functional independence, 90 days after treatment. METHOD: We analyzed 124 consecutive ICH patients with 90-day outcome data who were enrolled in a prospective cohort study between 2006 and 2009. Eighty-three patients were included in this study. Among ICH survivors, univariate Cox regression models and Kaplan-Meier plots were used to determine subject characteristics that were associated with an increased risk of recurrence. Statin usage was determined through interviewing the patient at the time of ICH and confirmed by reviewing their medical records. Independent status was defined as Glasgow Outcome Scale grades 4 or 5. RESULTS: Statins were used by 20 out of 83 patients (24%) before ICH onset. There was no effect from pre-ICH statin use on functional independence rates (28% versus 29%, P=0.84) or mortality (46% versus 45%, P=0.93). CONCLUSION: Pre-ICH statin use is not associated with changes to ICH functional outcome or mortality.
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- 2011
25. Malformações arteriovenosas do sistema nervoso central: análise de 53 casos
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GUIOTOKU CÉSAR M., ARRUDA WALTER O., RAMINA RICARDO, PEDROZO ARI A., and MENESES MURILO S.
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neurocirurgia ,radiocirurgia ,hemorragia cerebral ,malformação arteriovenosa ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,embolização ,lcsh:RC321-571 - Abstract
Analisamos 53 casos de malformações arteriovenosas (MAV) admitidos no Serviço de agosto de 1986 a março de 1998. A distribuição por sexo foi masculino 1,9:1 feminino, com faixa etária média de 32,5±11,5 anos. A apresentação clínica inicial incluiu, em ordem de frequência, hemorragia intracraniana, sinais neurológicos focais, cefaléia, epilepsia, e coma profundo agudo. As MAV supratentoriais tiveram a seguinte distribuição: 10 temporais, 9 parietais, 6 frontais, 3 occipitais, 3 fronto-parietais, 4 corpo caloso/pericalosas, 1 têmporo-occipital, 1 têmporo-parieto-occipital e 6 profundas. As MAV de acordo com a classificação de Spetzler-Martin, distribuiram-se em: grau II 17 casos (32%), grau III 21 casos (39%) e grau IV 10 casos (19%). Em 3 pacientes (5,6%) havia presença concomitante de aneurisma intracraniano. Trinta e sete pacientes foram operados, 12 dos quais, com embolização parcial prévia. Em somente um caso a ressecção cirúrgica foi parcial. Onze pacientes foram somente embolizados, sendo a embolização parcial em 3 casos. Dois pacientes não foram embolizados e nem operados (1 caso devido a pneumonite intersticial por AIDS e outro por problemas administrativos). Três casos foram encaminhados para radiocirurgia. Houve somente um óbito por embolia pulmonar aguda (1,8%). Concluímos que a abordagem multidisciplinar individualizada, envolvendo as especialidades de neurorradiologia intervencionista, neurologia e neurocirurgia, oferece a possiblidade de indicar a terapia mais adequada para cada caso, com bons resultados.
- Published
- 1999
26. Terson's syndrome: report of a case with favorable outcome Síndrome de Terson: relato de caso com evolução favorável
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GIULIO CESARE PINNOLA, SÉRGIO MURILO CORRÊA, SÔNIA BEATRIZ F. RIBEIRO, ALFREDO LEBOREIRO-FERNANDEZ, and JAIME OLAVO MARQUEZ
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retinal and vitreous hemorrhage ,hemorragia retiniana e vítrea ,prognóstico ,hemorragia cerebral ,aneurysm ,prognosis ,brain bleeding ,aneurisma ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,lcsh:RC321-571 - Abstract
Terson's syndrome is characterized by the presence of a subarachnoid hemorrhage accompanied by retinal and vitreous hemorrhage leading to a not very favorable prognosis. We describe a case with a good outcome, probably because of a early diagnosis and medical intervention. We emphasize the routine optician's check up as very important in the evaluation of a prognosis in the cases of a suspect intracranial hemorrhage .A síndrome de Terson caracteriza-se por presença de hemorragia subaracnoídea com hemorragia vítrea e retiniana de prognóstico geralmente desfavorável. Descrevemos um caso com boa evolução provavelmente decorrente do diagnóstico e intervenções precoces. Enfatizamos a avaliação oftalmológica rotineira como de importância para avaliar o prognóstico naqueles casos com suspeita de hemorragia intracraniana.
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- 1998
27. Cerebral amyloid angiopathy: a cross-sectional study in a single center in Northeastern Brazil
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Marx Lima de BARROS-ARAÚJO, Irapuá Ferreira RICARTE, Edward MONTALVERNE FILHO, Guilherme Marconi Guimarães Martins HOLANDA, Ícaro Araújo de SOUSA, Matheus Rodrigues CORRÊA, Matheus Rocha de Seixas NOGUEIRA, and Pedro Jorge Luz Alves CRONEMBERGER
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angiopatia amiloide cerebral ,hemorragia cerebral ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
ABSTRACT Background: Cerebral amyloid angiopathy (CAA) is a cerebrovascular disorder caused by progressive deposition of β-amyloid peptides in the walls of small and medium-sized cortical and leptomeningeal vessels. Until today, the prevalence of CAA is unknown in our region. Objective: This study aims to analyze the prevalence of this entity in a specific elderly population in a tertiary hospital in Northeastern Brazil. Methods: A cross-sectional, retrospective study with the enrollment of patients aged 65 or older followed in the neurological outpatient service of the Universidade Federal do Piauí, Brazil, who underwent brain magnetic resonance imaging (MRI) from July 2016 to June 2018. Results: One hundred and seventy-four patients were enrolled, of whom 100 were women (57.4%) and 74, men (42.6%), aged from 65 to 91 years old (median age 73.27). Nine patients were excluded from the study due to unavailability of MRI sequences needed for an appropriate analysis. Out of the 165 remaining patients, 12 (7.2%) had established the diagnosis of CAA, according to the modified Boston criteria. Conclusion: The prevalence of CAA in our study was like those of medical literature, with a progressive age-related increase.
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28. Stroke occurring in patients with cognitive impairment or dementia
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Solène Moulin and Didier Leys
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acidente vascular cerebral ,infarto cerebral ,hemorragia cerebral ,demência ,comprometimento cognitivo leve ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
ABSTRACT One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods Literature search. Results (i) A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii) Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii) Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv) Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others. Conclusion Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others.
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29. Active extravasation of contrast within the hemorrhage (spot sign): a multidetector computed tomography finding that predicts growth and a worse prognosis in non-traumatic intracerebral hemorrhage
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Nelson Saade, Antônio José da Rocha, Rubens José Gagliardi, Marcos Rosa Júnior, and Antonio Carlos Martins Maia Junior
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Adult ,Male ,medicine.medical_specialty ,spot sign ,Time Factors ,multidetector computed tomography angiography ,media_common.quotation_subject ,angio-TC ,Sensitivity and Specificity ,Statistics, Nonparametric ,acidente vascular cerebral hemorragico ,lcsh:RC321-571 ,Predictive Value of Tests ,Reference Values ,Risk Factors ,Multidetector Computed Tomography ,medicine ,hemorrhagic stroke ,Contrast (vision) ,Humans ,cardiovascular diseases ,Hospital Mortality ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,media_common ,Aged ,Cerebral Hemorrhage ,Intracerebral hemorrhage ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Mortality rate ,hemorragia cerebral ,Middle Aged ,medicine.disease ,Prognosis ,Extravasation ,Surgery ,Cerebral Angiography ,Neurology ,Predictive value of tests ,Cohort ,Angiography ,brain hemorrhage ,Female ,Neurology (clinical) ,Radiology ,business ,Cerebral angiography ,Extravasation of Diagnostic and Therapeutic Materials - Abstract
Intracerebral hemorrhage (ICH) causes high rates of disability and neurological sequelae Objective To evaluate spot signs as predictors of expansion and worse prognosis in non-traumatic ICH in a Brazilian cohort. Method We used multidetector computed tomography angiography to study 65 consecutive patients (40 men, 61.5%), with ages varying from 33 to 89 years (median age 55 years). Clinical and imaging findings were correlated with the findings based on the initial imaging. Results Of the individuals who presented a spot sign, 73.7% died (in-hospital mortality), whereas in the absence of a spot sign the mortality rate was 43.0%. Although expansion of ICH was detected in 75% of the patients with a spot sign, expansion was observed in only 9.0% of the patients who did not present a spot sign. Conclusions The spot sign strongly predicted expansion in non-traumatic ICH and an increased risk of in-hospital mortality.
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- 2013
30. Achados eletrocardiogrráficos em hemorragia cérebro vascular aguda: estudo prospectivo de 70 casos
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Flávio Suplicy de Lacerda Jr. and Walter Oleschko Arruda
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Inotrope ,Adult ,Male ,Subarachnoid hemorrhage ,eletrocardiograma ,Adolescent ,electrocardiogram ,lcsh:RC321-571 ,Ecg change ,Electrocardiography ,prolongamento do intervalo ,Medicine ,Humans ,Prospective Studies ,cardiovascular diseases ,Prospective cohort study ,Stroke ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Aged ,Cerebral Hemorrhage ,Aged, 80 and over ,cerebral hemorrhage ,medicine.diagnostic_test ,business.industry ,hemorragia cerebral ,Q-Tc prolongation ,Middle Aged ,Subarachnoid Hemorrhage ,medicine.disease ,Intracerebral hematoma ,Electrocardiographic Finding ,Neurology ,Anesthesia ,Acute Disease ,Female ,Neurology (clinical) ,business - Abstract
Seventy patients with hemorrhagic stroke were prospectively evaluated regarding the electrocardiographic abnormalities observed within the first 48 hours of the ictus. Group I comprised 55 patients with spontaneous cerebral hemorrhage, and group II 15 patients with subarachnoid hemorrhage. Patients taking cardiac drugs (beta blockers, calcium-channel blockers, inotropic drugs) or with severe metabolic/electrolyte disturbances were excluded. The most common ECG abnormality was a prolonged Q-Tc interval: group I, 37 (67.2%); group II, 8 (53.3%). Only 4 (7.2% patients of group I and no patient of group II had a normal ECG. No relation was found between the site of the intracerebral hematoma and the occurrence of any particular ECG change. A prolonged Q-Tc may be related to the development of severe cardiac arrhythmias observed in some patients with acute cerebral hemorrhage. Foram analisados os achados eletrocardiográficos obtidos dentro das primeiras 48 horas de instalação de acidente vascular cerebral hemorrágico em 70 pacientes. O grupo I foi composto de 55 pacientes com hematoma intracerebral espontâneo e o grupo II, de 15 pacientes com hemorragia subaracnóidea. Pacientes em uso de drogas cardíacas (beta bloqueadores, bloqueadores de cálcio, drogas inotrópicas) e/ou distúrbios metabólico/eletrolíticos graves foram excluídos. A alteração eletrocardiográfica mais comum em ambos os grupos foi o prolongamento do intervalo Q-Tc: grupo I, 37 (67,2%); grupo II, 8 (53,3%). Os eletroctardiogramas foram normais em 4 (7,2%) pacientes do grupo I e em nenhum paciente do grupo II. Não houve correlação significativa entre o local do hematoma cerebral e a ocorrência de alguma alteração específica do eletrocardiograma. O prolongamento do intervalo Q-Tc pode representar fator de risco potencial para o desenvolvimento súbito de arritmias cardíacas graves, observado em alguns pacientes com acidentes vasculares cerebrais hemorrágicos.
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- 1992
31. Opções de drenagem liquórica em neonatos prematuros com hidrocefalia pós hemorrágica
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Rosane Klein Passos, Marcelo Liberato Coelho Mendes de Carvalho, and José Roberto Tude Melo
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Male ,medicine.medical_specialty ,Ultrasonography, Doppler, Transcranial ,Cerebrospinal Fluid Drainage ,cerebrospinal fluid ,030218 nuclear medicine & medical imaging ,lcsh:RC321-571 ,03 medical and health sciences ,0302 clinical medicine ,Cerebrospinal fluid ,Posthemorrhagic hydrocephalus ,hidrocefalia ,Cerebrospinal fluid diversion ,Humans ,Medicine ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Retrospective Studies ,líquido cefalorraquidiano ,cerebral hemorrhage ,medicine.diagnostic_test ,business.industry ,Lumbar puncture ,hemorragia cerebral ,Infant, Newborn ,Csf drainage ,medicine.disease ,Cerebrospinal Fluid Shunts ,Shunt (medical) ,Surgery ,Hydrocephalus ,Treatment Outcome ,Neurology ,Female ,Neurology (clinical) ,business ,hydrocephalus ,Infant, Premature ,030217 neurology & neurosurgery - Abstract
Objective The literature describes various cerebrospinal fluid (CSF) drainage techniques to alleviate posthemorrhagic hydrocephalus in preterm newborns; however, consensus has not been reached. The scope of this study was describing a case series of premature neonates with posthemorrhagic hydrocephalus and assessing the outcomes of different approaches used for CSF diversion. Methods A consecutive review of the medical records of neonates with posthemorrhagic hydrocephalus treated with CSF drainage was conducted. Results Forty premature neonates were included. Serial lumbar puncture, ventriculosubgaleal shunt, and ventriculoperitoneal shunt were the treatments of choice in 25%, 37.5% and 37.5% of the cases, respectively. Conclusion Cerebrospinal fluid diversion should be tailored to each case with preference given to temporary CSF drainage in neonates with lower age and lower birth-weight, while the permanent ventriculoperitoneal shunt should be considered in healthier, higher birth-weight neonates born closer to term. RESUMO Objetivo A literatura descreve várias opções de drenagem liquórica (DL) para alivio da hidrocefalia pós-hemorrágica (HPH) em neonatos prematuros; contudo, não existe um consenso sobre a melhor abordagem. O escopo deste estudo foi descrever uma série de casos de neonatos prematuros, portadores de HPH, verificando os resultados de diferentes técnicas utilizadas para DL. Métodos Revisão consecutiva dos prontuários de neonatos com diagnostico de HPH submetidos a DL. Resultados Quarenta recém-nascidos prematuros foram incluídos. A punção lombar seriada (PL), a derivação ventriculosubgaleal (VSG) e a derivação ventrículo peritoneal (VP) foram o tratamento escolhido em 25%, 37,5% e 37,5% dos casos, respectivamente. Conclusão As opções de DL devem ser avaliadas caso a caso, sendo dada preferência às drenagens temporária em prematuros com idade e peso mais baixos ao nascer, enquanto o shunt definitivo (derivação VP) pode ser considerado naqueles prematuros mais saudáveis, com idade e peso superiores.
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