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Subdural osteomas are extremely rare benign neoplasms. Here, we report the case of a 35-year-old female patient with a right frontal and parietal subdural osteoma. The patient presented with a 2-year history of intermittent headache and fatigue. Computerized tomography (CT) scan showed a high-density lesion attached to the inner surface of the right frontal and parietal skull. Magnetic resonance imaging (MRI) demonstrated T1 hyperintensity and T2 hypointensity of the lesion. Intraoperatively, the hard mass was located in subdural space and attached to the dura mater. Histopathological examination revealed lamellated bony trabeculae lined by osteoblasts and the intertrabecular marrow spaces occupied by adipose tissue. The patient underwent neurosurgical resection and recovered without complication. Surgical excision is recommended to extract the symptomatic lesions with overlying dura mater. [ABSTRACT FROM AUTHOR]

Background The computed tomography angiography (CTA) spot sign represents active contrast extravasation within acute primary intracerebral hemorrhage (ICH) and is an independent predictor of hematoma expansion (HE) and poor clinical outcomes. The spot sign could be detected on first-pass CTA (fpCTA) or delayed CTA (dCTA). Purpose To investigate the additional benefits of dCTA spot sign in primary ICH and hematoma size for predicting spot sign. Material and Methods This is a retrospective study of 100 patients who underwent non-contrast CT (NCCT) and CTA within 24 h of onset of primary ICH. The presence of spot sign on fpCTA or dCTA, and hematoma size on NCCT were recorded. The spot sign on fpCTA or dCTA for predicting significant HE, in-hospital mortality, and poor clinical outcomes (mRS ≥ 4) are calculated. The hematoma size for prediction of CTA spot sign was also analyzed. Results Only the spot sign on dCTA could predict high risk of significant HE and poor clinical outcomes as on fpCTA ( P < 0.05). With dCTA, there is increased sensitivity and negative predictive value (NPV) for predicting significant HE, in-hospital mortality, and poor clinical outcomes. The XY value (product of the two maximum perpendicular axial dimensions) is the best predictor (area under the curve [AUC] = 0.82) for predicting spot sign on fpCTA or dCTA in the absence of intraventricular and subarachnoid hemorrhage. Conclusion This study clarifies that dCTA imaging could improve predictive performance of CTA in primary ICH. Furthermore, the XY value is the best predictor for CTA spot sign. [ABSTRACT FROM AUTHOR]

Patients with traumatic intracranial hemorrhage (ICH) with a clinical indication for antithrombotic medication present a clinical dilemma, burdened by the task of weighing the risks of hemorrhage expansion against the risk of thrombosis. We sought to determine the effect of subdural hemorrhage on the risk of hemorrhage expansion after administration of antithrombotic medication. Medical records of 1626 trauma patients admitted with traumatic ICH between March 1, 2008, and March 31, 2013, to a Level I trauma center were retrospectively reviewed. The pharmacy database was queried to determine which patients were administered anticoagulant or antiplatelet medication during their hospitalization, leaving a sample of 97 patients that met inclusion criteria. Patients presenting with subdural hemorrhage were compared with patients without subdural hemorrhage. Demographic data, clinically significant expansion of hematoma, postinjury day of initiation, and mortality were analyzed. A total of 97 patients met inclusion criteria with 55 patients in the subdural hemorrhage group and 42 in the other ICH group. There were no significant differences in age, gender, injury severity score, admission Glasgow coma score, or mean hospital day of antithrombotic administration between the groups. Patients with subdural hemorrhage had a significantly higher rate of ICH expansion (9.1 vs 0%, P = 0.045). There was no difference in overall hospital mortality between the two groups. Incidence of ICH expansion was higher in patients with subdural hemorrhage. It may be prudent to use special caution when administering antiplatelet or anticoagulant medication in this group of patients after injury. [ABSTRACT FROM AUTHOR]

Consensus is lacking for ideal management of mild traumatic brain injury (mTBI) with intracranial hemorrhage (ICH). Patients are often monitored in the intensive care unit (ICU) without additional interventions. We sought to identify admission variables associated with a favorable outcome (ICU admission for 24 hours, no neurosurgical interventions, no complications or mortality) to divert these patients to a non-ICU setting in the future. We reviewed all patients with mTBI [Glasgow Coma Scale (GCS) = 13-15] and concomitant ICH between July 1, 2012, and June 30, 2015. Variables collected included demographics, vital signs, neurologic examination, imaging results, ICU course, mortality, and disposition. Of 201 patients, 78 (39%) had a favorable outcome. On univariate analysis, these patients were younger, more often had an isolated subarachnoid hemorrhage, and were more likely to have a GCS of 15 at admission. On multivariate regression analysis, after controlling for admission blood pressure, time to CT scan, and Marshall Score, age <55, GCS of 15 on arrival to the ICU, and isolated subarachnoid hemorrhage remained independent predictors of a favorable outcome. Patients meeting these criteria after mTBI with ICH likely do not require ICU-level care. [ABSTRACT FROM AUTHOR]

Background: Although the clinical presentation of intramural hematoma (IMH) and aortic double-lumen dissection (AD) is similar, the imaging results and subsequent clinical course of the two lesions differ.Purpose: To compare the clinical and radiological findings of IMH, AD, and mixed type lesions.Material and Methods: Forty-two patients with IMH, 38 with AD, and 10 with mixed type lesions were imaged with post-contrast-enhanced CT. The most proximal ulcer-like lesions and entry tears and the distal ends of the IMH and AD were evaluated. The interval change of the intramural hematoma, ulcer-like lesion, and false lumen was observed. The pathological findings of the aorta were evaluated in 15 patients.Results: The most proximal ulcer-like lesion and entry tear were located in the arch to the descending aorta in 27 (64.2%) of the 42 patients with IMH and in 24 (63.1%) of the 38 patients with AD. The distal extension was located at the iliac arteries in six (14.3%) patients with IMH and in 31 (81.6%) patients with AD (P < 0.001). The intramural hematomas regressed in 29 (93.5%) of 31 patients, and the ulcer-like lesion progressed in 14 (70%) of 20 patients with IMH. The clinical features of the mixed type lesions resembled those of AD, rather than IMH. The intramural hematoma or dissection was observed within the outer media in all lesion types on histopathology.Conclusion: There is a distinct difference between IMH and AD in distal extension; however, the locations of the lesions are pathologically the same in the media of the aorta. [ABSTRACT FROM AUTHOR]

Differential diagnosis of intracranial hemorrhage versus calcification on conventional magnetic resonance images (MRIs) is often challenging. Although computed tomography (CT) confirms calcification, phase information obtained during susceptibility-weighted imaging can be useful in distinguishing between 2 pathologies. Fourteen patients previously diagnosed to have hemorrhage or calcification with imaging were included in the study retrospectively. Phase shift values of hemorrhage and calcification were compared by using Student t test. The pathologies identified were tuberous sclerosis, Sturge-Weber syndrome, craniopharyngioma, congenital cytomegalovirus, subependymal hemorrhages, and hemorrhagic microembolic infarction. Calcifications appeared hypointense whereas hemorrhages were hyperintense on phase maps (left-handed magnetic resonance system). Statistical comparison of phase shift values yielded significant difference between hemorrhage versus calcification (P < .01). Phase maps were found to offer valuable data to differentiate 2 pathologies when used complementary to conventional magnetic resonance images. Considering the relatively higher risks of radiation exposure in children, susceptibility-weighted imaging with phase maps may help to waive radiation exposure from CT. [ABSTRACT FROM AUTHOR]

REVASCAT is a prospective, multicenter, randomized trial seeking to establish whether subjects meeting following main inclusion criteria: age 18-80, baseline National Institutes of Health Stroke Scale ≥6, evidence of intracranial internal carotid artery or proximal (M1 segment) middle cerebral artery occlusion, Alberta Stroke Program Early Computed Tomography score of >7 on non-contrast CT or >6 on diffusion-weighted magnetic resonance imaging , ineligible for or with persistent occlusion after intravenous alteplase and procedure start within 8 hours from symptom onset, have higher rates of favorable outcome when treated with the SolitaireTM FR embolectomy device compared to standard medical therapy alone The primary end-point, based on intention-to-treat criteria is the distribution of modified Rankin Scale scores at 90 days. Projected sample size is 690 patients. Estimated common odds ratio is 1●615. Randomization is performed under a minimization process using age, baseline NIHSS, therapeutic window, occlusion location and investigational center. The study follows a sequential analysis (triangular model) with the first approach to test efficacy at 174 patients and subsequent analyses (if necessary) at 346, 518, and 690 subjects. Secondary end-points are infarct volume evaluated on CT at 24 h, dramatic early favorable response, defined as NIHSS of 0-2 or NIHSS improvement ≥8 points at 24 h and successful recanalization in the Solitaire arm according to the thrombolysis in cerebral infarction ( TICI) classification defined as TICI 2b or 3. Safety variables are mortality at 90 days, symptomatic intracranial haemorrhage rates at 24 hours and procedure related complications. [ABSTRACT FROM AUTHOR]

Background In the ALIAS ( Albumin in Acute Stroke) Part 2 Multicenter Trial, 85% of subjects received standard-of-care intravenous tissue plasminogen activator, and 21% received some form of endovascular thrombolysis. The overall rate of symptomatic intracranial hemorrhage was within the expected range but was higher in albumin-treated subjects than in saline-treated subjects. Aims and Methods Using the trial's Public Use Dataset, we analyzed factors contributing to symptomatic and asymptomatic intracranial hemorrhage in the 'safety sample' of 830 subjects. Results Four hundred sixteen subjects received albumin therapy, and 414 received saline. Intravenous tissue plasminogen activator was given to 68·2%; intravenous tissue plasminogen activator plus endovascular intervention in 16·4%; and endovascular therapy alone in 4·3%. Symptomatic intracranial hemorrhage occurred in 41 subjects - within the first 12 h in one-third of cases, and within the first day in ∼60%. Intravenous tissue plasminogen activator had been used in 78% of symptomatic intracranial hemorrhage subjects - no higher than in the overall cohort. In contrast, 48·8% of subjects with symptomatic intracranial hemorrhage had received endovascular therapy - a rate markedly higher than the 20·7% rate for the entire cohort ( P = 0·0001). Sixty-eight point three percent of subjects with symptomatic intracranial hemorrhage had received albumin, and 31·7% saline (risk ratio 2·14, P = 0·025). Other factors associated with symptomatic intracranial hemorrhage were baseline NIHSS and ASPECTS scores and the SEDAN score. Forty-one point four percent of subjects with symptomatic intracranial hemorrhage died. The odds ratio for symptomatic intracranial hemorrhage was 3·89 (95% confidence interval 2·04-7·41) with endovascular therapy and 2·15 (confidence interval 1·08-4·25) with albumin. Conclusions Endovascular thrombolysis was the major factor predisposing to symptomatic intracranial hemorrhage, and albumin contributed to this predisposition. The latter may be mediated by albumin's influence on platelet aggregation or collateral perfusion. [ABSTRACT FROM AUTHOR]

Rationale Patients with atrial fibrillation ( AF) in the acute stage of ischemic stroke or transient ischemic attack ( TIA) are at high risk of recurrent stroke, but the optimal anticoagulation strategy remains unclear due to the concern of intracranial bleeding. Novel oral anticoagulants compared to warfarin might be more safe and efficacious in patients suitable for early anticoagulation. Aims This trial is to evaluate the feasibility of early anticoagulation with rivaroxaban in acute ischemic stroke or TIA patients with nonvalvular AF. Design This is a randomized, open-label, blinded endpoint evaluation trial. Inclusion criteria are (1) nonvalvular AF, (2) presumed cardioembolic stroke or transient ischemic attack ( TIA) confirmed by MRI within five-days from onset, and (3) mild to moderate stroke severity. We will randomize 196 patients to either rivaroxaban (10 mg once daily for five-days followed by 15 mg or 20 mg once daily) or dose-adjusted warfarin (coadministration of aspirin 100 mg per day until achieving international normalized ratio of 1·7). The study is registered in ClinicalTrials.gov ( NCT02042534). Study outcomes The primary endpoint is the composite of recurrent ischemic lesion and intracranial bleeding on MRI at four-weeks. Secondary endpoints are recurrent ischemic lesions, intracranial bleeding, major bleeding, major vascular events, four-week modified Rankin Scale score, and duration of hospitalization after randomization. Discussion The results of this proof-of-concept trial will guide go/no-go decision to a large phase 3 confirmatory trial. [ABSTRACT FROM AUTHOR]

Background Limited studies exist on the outcome of thrombolytic therapy of acute ischemic stroke patients outside of clinical trials. Aim To assess the possible risk factors associated with in-hospital death and symptomatic intracerebral hemorrhage among patients who received intravenous tissue plasminogen activator. Methods A total of 7193 patients with a clinical diagnosis of acute ischemic stroke and a documented National Institutes of Health Stroke Scale score were treated with intravenous tissue plasminogen activator within 4·5 hours of time last known to be well. Generalized estimating equations modeling was used to assess the associations of in-hospital death and symptomatic intracerebral hemorrhage with clinical characteristics. Results Among 7193 patients treated with intravenous tissue plasminogen activator, 516 (7·2%) died during hospitalization. Factors associated with in-hospital death were older age, male gender, National Institutes of Health Stroke Scale score, history of myocardial infarction or coronary artery disease, and history of nonvalvular atrial fibrillation. Increasing age, higher National Institutes of Health Stroke Scale score, and history of dyslipidemia were associated with symptomatic intracerebral hemorrhage. There was no difference in the rates of in-hospital death or symptomatic intracerebral hemorrhage among patients treated with intravenous tissue plasminogen activator within three-hours of time last known to be well and those treated between three and 4·5 hours after this time. Conclusions In this study of acute ischemic stroke patients, older age, male gender, National Institutes of Health Stroke Scale score, history of myocardial infarction or coronary artery disease, and history of atrial fibrillation were associated with increased in-hospital death among patients receiving intravenous tissue plasminogen activator. Among patients treated with intravenous tissue plasminogen activator, in-hospital mortality and symptomatic intracerebral hemorrhage rates were similar between those treated within three-hours of time last known to be well and those treated between three and 4·5 hours after this time. [ABSTRACT FROM AUTHOR]

We investigated the causes, management and outcome of head injuries in paediatric patients admitted to the paediatric surgery unit at King Edward VIII Hospital overa 3-year period, from 1999 to 2001. There were 506 patients (331 male; M:F ratio 2:1) and the mean age was 71.99 + 36.8 months (2 weeks to180 months).The injuries were due to: motor vehicle crashes (324); falls (121); assault (30); inadvertent injury (23); and unknown (11). Forty nine patients (9%) were admitted with a Glasgow Coma Scale ≦8. The most common intracranial pathology on computed tomography was: intracranial haematoma/haemorrhage (44); contusion (16); and brain oedema (10). Nineteen patients (3.4%) underwent neurosurgical intervention and the rest were managed conservatively. Eighteen died in hospital (3.6%).Themean hospital stay was 5 ± 12 days. Twenty-three patients (4.5%) were discharged with neurological sequelae. Few paediatric patients are admitted with severe head injury: themajority fromblunt injury caused bymotor vehicle crashes. Management mainly requires simple neurological observation in a general ward with a surprisingly good prognosis. Specific protocols for paediatric head injuries have been proposed based on these findings. [ABSTRACT FROM AUTHOR]

Nontraumatic coma in childhood is an important pediatric emergency with a wide range of primary etiologies. This prospective descriptive study of 100 consecutive pediatric nontraumatic coma cases was done to identify etiology, clinical profile, and predictive outcome in a pediatric emergency department at a tertiary care university hospital. Most frequent etiologies were metabolic (33%), central nervous system infections (28%), and intracranial hemorrhage (13%). In the emergency department, 50% of those patients died. Hypothermia, hypotension, flaccidity, and poor Glasgow coma scale at admission correlated significantly with mortality. After 48 hours of admission, poor pulse volume, poor Glasgow coma scale, abnormal respiratory pattern/apnea, and seizures correlated significantly with mortality. On logistic regression, poor Glasgow coma scale at admission, abnormal respiratory pattern, and seizures after 48 hours of admission were independent significant predictors of mortality. Metabolic causes are the most common etiology in pediatrics nontraumatic coma. Simple clinical signs were good predictors of outcome. [ABSTRACT FROM AUTHOR]

Vestibular schwannomas are benign neoplasms that arise from Schwann cells of the eighth cranial nerve. Most manifest clinically with tinnitus, unilateral sensorineural hearing loss, and dysequilibrium secondary to compression of the vestibulocochlear nerve; major adverse events such as intratumoral hemorrhage causing acute neurologic deterioration are rare. We report the case of a 69-year-old man with a large vestibular schwannoma who required anticoagulation for several medical comorbidities. The patient began having progressively worsening neurologic symptoms, including facial nerve paralysis and dysequilibrium. which confined him to a wheelchair. After presentation, the patient was admitted to the hospital. Several days after alteration of his anticoagulation therapy in preparation for surgery, he developed intracranial hemorrhage. Attempts were made to stabilize the patient, including posterior fossa craniectomy and evacuation of hematoma; however, the intracranial hemorrhage ultimately resulted in a fatal outcome. During this procedure, a biopsy specimen was obtained, showing benign vestibular schwannoma. The literature for intratumoral hemorrhage into vestibular schwannoma and the pathologic findings in our case are reviewed. [ABSTRACT FROM AUTHOR]

In most instances, infants and children with moderate to severe head trauma undergo a head computed tomography (CT) scan as part of their initial evaluation. Several authors have advocated a routine second head CT after traumatic brain injury (TBI) to identify progressive lesions that may require surgical intervention. However, recent studies have challenged the need for a routine second brain imaging study after TBI. In addition, recent reports have raised concerns about the potential for malignancy following CT scanning, especially in pediatric patients. The authors performed a retrospective case series of all patients, aged 0 to 21 years, who presented to their 2 emergency departments (EDs) and received an International Classification of Disease-9th revision code related to intracranial injury. Out of 47 children, 5 (11%) underwent neurosurgical intervention following their second imaging study, and 1 of these interventions was unplanned after the first study. Compared with children who did not require an intervention following their second scan, children who received an intervention were more likely to have been subjected to nonaccidental trauma and to have presented to the ED more than 4 hours after the injury. Most children with intracranial injury following blunt trauma who did not require immediate neurosurgical intervention but instead underwent a follow-up brain imaging study did not require subsequent unplanned neurosurgical intervention. Serial brain imaging may not be required for all children with intracranial injury. [ABSTRACT FROM AUTHOR]

Controversy still exists on surgical management of acute stroke. Even if surgical therapy represents often a life-saving measure, the issue of acceptable outcome remains open. Persuasive evidence for outcome benefit is limited. For large ischaemic strokes, recent convincing data suggest that decompressive surgery significantly reduces mortality and improves outcome quality. On the other hand, despite the long tradition in surgical removal of intracranial haematomas, the recent evidence has not been sufficient to resolve the basic argument whether to operate or not. Most recently, hopeful preliminary data have emerged on new approaches in the treatment of intraventricular haemorrhage. In this article, we review the current neurosurgical options in acute ischaemic and haemorrhagic stroke. [ABSTRACT FROM AUTHOR]

The article describes the case of the perioperative management of a seven-year-old child with acute intestinal obstruction secondary to bowel malrotation after an intracranial haemorrhage associated with an intracranial arteriovenous malformation (AVM). The patient was referred to Bristol Children's Hospital in England. There was an improvement in the bowel colour after Ladd's procedure and appendicectomy. Frequent non-invasive blood pressure monitoring was performed on the patient.

Background In ischemic stroke, functional outcomes vary depending on site of intracranial occlusion. We tested the prognostic value of a semiquantitative computed tomography angiography-based clot burden score. Methods Clot burden score allots major anterior circulation arteries 10 points for presence of contrast opacification on computed tomography angiography. Two points each are subtracted for thrombus preventing contrast opacification in the proximal M1, distal M1 or supraclinoid internal carotid artery and one point each for M2 branches, A1 and infraclinoid internal carotid artery. We retrospectively studied patients with disabling neurological deficits (National Institute of Health Stroke Scale score ≥5) and computed tomography angiography within 24-hours from symptom onset. We analyzed percentages independent functional outcome (modified Rankin Scale score ≤2), final infarct Alberta Stroke Program Early Computed Tomography Score and parenchymal hematoma rates across categorized clot burden score groups and performed multivariable analysis. Results We identified 263 patients (median age 73-years, National Institute of Health Stroke Scale score 10, onset-to-computed tomography angiography time 165 min). Clot burden score<10 was associated with reduced odds of independent functional outcome (odds ratio 0·09 for clot burden score≤5; odds ratio 0·22 for clot burden score 6–7; odds ratio 0·48 for clot burden score 8–9; all versus clot burden score 10; P<0·02 for all). Lower clot burden scores were associated with lower follow-up Alberta Stroke Program Early Computed Tomography Scores (P<0·02 for all). Lower clot burden scores were associated with lower follow-up Alberta Stroke Program Early CT Scores (P<0·001) and higher parenchymal hematoma rates (P=0·008). Inter-rater reliability for clot burden score was 0·87 (lower 95% confidence interval 0·71) and intra-rater reliability 0·96 (lower 95% confidence interval 0·92). Conclusion The quantification of intracranial thrombus extent with the clot burden score predicts functional outcome, final infarct size and parenchymal hematoma risk acutely. The score needs external validation and could be useful for patient stratification in stroke trials. [ABSTRACT FROM AUTHOR]

Spontaneous intracranial hypotension is a rare syndrome of low cerebrospinal fluid pressure due to spontaneous cerebrospinal fluid leaks. The main feature is orthostatic headache. We describe a case of spontaneous intracranial hypotension in a 5-year-old girl with a 1-month history of headache, sudden onset hearing loss, and ataxia. Magnetic resonance imaging (MRI) showed an enlargement of cervical venous plexus and lumbar puncture revealed a low opening pressure. Magnetic resonance myelography showed leakage of the contrast material at the level of the third and fourth lumbar vertebra. Bed rest and caffeine treatment yielded no resolution of symptoms. Following a lumbar epidural blood patch, her headache and ataxia resolved completely without any improvement in hearing. A second blood patch also yielded no effect on hearing. Spontaneous intracranial hypotension should be considered in the differential diagnosis of headache, also in the pediatric age group. [ABSTRACT FROM AUTHOR]

Neurogenesis occurs in discrete regions of normal brains of adult mammals including humans, and is induced in response to brain injury and neurodegenerative disease. Whether intracerebral hemorrhage can also induce neurogenesis in human brain is unknown. Specimens were obtained from patients with primary intracerebral hemorrhage undergoing surgical evacuation of an intracerebral hematoma, and evaluated by two-photon laser scanning confocal microscopy. We found that neural stem/progenitor cell-specific protein markers were expressed in cells located in the perihematomal regions of the basal ganglia and parietal lobe of the adult human brain after primary intracerebral hemorrhage (n=5). Cells in this region also expressed cell proliferation markers, which colocalized to the same cells that expressed neural stem/progenitor cell-specific proteins. Our data suggest that intracerebral hemorrhage induces neurogenesis in the adult human brain.Journal of Cerebral Blood Flow & Metabolism (2008) 28, 1460–1468; doi:10.1038/jcbfm.2008.37; published online 30 April 2008 [ABSTRACT FROM AUTHOR]

The article examines the effectiveness of recombinant factor VIIa for the treatment of intracerebral hemorrhage. A brief description of spontaneous intracerebral hemorrhage (ICH) is presented, along with its risk factors. The article discusses the evidence and consequences of hematoma expansion. Research shows that recombinant factor VIIa is effective in preventing hematoma expansion.

A retrospective analysis of clinico-hematologic parameters of 18 factor Xlll-deficient patients was carded out. The hematologic tests included activated partial thromboplastin time (APTT), prothrombin time (PT), and clot solubility. Laboratory diagnosis of FXIII deficiency was made where bleeding time, PT, APTT, and thrombin time were normal and the clot solubility test result with 5M urea was positive. Factor XIII level with family screening was performed using commercially available kits. History of prolonged bleeding from the umbilical stump was present in four (22.2%) patients. The most common site of bleeding was the skin (11 of 18 patients). Three patients were given prophylaxis (FFP in two, factor XIII in one). A high prevalence of recurrent abortion in female patients with FXIII deficiency (two of the three patients in this study) was observed. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the detectability and appearance of small experimental intracranial hemorrhages on MR at 0.5 T and 1.5 T in a long-term follow-up.Material and Methods: Autologous blood (1 ml) was injected into the brain of 7 rabbits to create intraparenchymal hematomas. The injected blood leaked partially into the cerebrospinal fluid (CSF) spaces. MR imaging at 0.5 T and 1.5 T were performed immediately before and after hematoma creation, at 2 weeks and monthly up to 6 or 7 months using T1-, proton density- and T2-weighted (w) spin-echo (SE), FLAIR and T2*-w gradient echo (GE) pulse sequences.Results: Blood was detected both in the brain and in the CSF spaces of all animals during the first hours after hematoma creation at 1.5 T. In the last examination after 6-7 months, the T2*-w GE sequences still showed residues of the intraparenchymal hematomas in all the rabbits at 1.5 T, but the signal pattern was not specific for the age of the hematomas. SE and FLAIR sequences were insensitive. The histopathology revealed iron deposits in all brains.Conclusion: Residues of small intraparenchymal hematomas can be seen for months with T2*-w GE sequences on brain MR imaging at 1.5 T. The age of the microhematomas cannot be estimated with MR imaging. [ABSTRACT FROM AUTHOR]

Compares the pulse sequences in revealing intracranial bleeding from the hyperacute to subacute phase. Types of pulse sequences; Injection of autologous blood into the brain of rabbits; Detection of blood in the cerebrospinal fluid space.

Amphetamines taken by any route can cause cerebral vasculitis and intracranial haemorrhage. 8 cases seen in a neurosurgical unit over 3.5 years. The published work indicates that those who experience these complications, mainly young adults, have poor outcomes. [ABSTRACT FROM AUTHOR]

The article reassesses the clinical concepts for evaluating and managing acute head traumas in children of all ages. The availability of computerized axial tomography (CAT) scans has markedly altered the care of the head-injured child, particularly the unconscious child, by allowing and immediate diagnosis of intracranial abnormalities to be made. It is quite easy to define the role of the CAT scan in the patient with severe head injuries, but it is difficult to decide which children with minor head injuries require CAT scanning. The cost of CAT scanning is comparable to the cost of one-day's stay in the hospital, and, certainly, the scan is a much more effective way to rule out the possibility of an intracranial hematoma than is overnight hospitalization. It explores whether all children who are hospitalized following trauma require CAT scanning as well as whether all children who have evidence of unconsciousness following head injury require CAT scanning. It discusses how history and the neurologic examination can help a great deal in making the decision as to whether or not CAT scanning is required.

A chart survey of 139 newborns with cephalhematoma showed the majority were associated with primiparity, forceps delivery, or prolonged labor. The. complications included jaundice, central nervous system symptoms, localized infection, anemia and subdural hematoma. Neonatal jaundice was frequently associated. Underlying skull fractures were found in 7.1 per cent of the 84 infants in whom skull x-rays were taken, a lower incidence than that reported by others. [ABSTRACT FROM AUTHOR]

This case report details a patient treated for a gangrenous toe by angioplasty, sympathectomy, and aortobifemoral grafting who arrived at the hospital with acute renal dysfunction and an occluded bypass graft. The patient had no abnormal results from coagulation studies and no absolute contraindications to urokinase therapy but died from intracranial hemorrhage. The authors believe that hemostatic system impairments related to renal dysfunction act synergistically with thrombolytic agents to produce abnormal bleeding. This case report suggests a synergistic interaction between acute renal dysfunction and urokinase therapy. [ABSTRACT FROM AUTHOR]

A seventeen-year-old man with hemophilia A developed nausea, vomiting, and unsteady gait after mild head trauma. Magnetic resonance imaging clearly demonstrated localized bleeding in cerebellar vermis. Quick administration of factor VIII concentrates prevented further extension of the bleeding and the patient completely recovered without neurologic impairment. In hemophiliac patients, careful evaluation of intracranial lesions is desired after head trauma even if they show only nonspecific symptoms. [ABSTRACT FROM AUTHOR]

A case of intracerebral hemorrhage that developed some time after severe headache is reported in a relatively young woman. It is proposed that hemorrhage may also be included among the causes of so-called migraine-related stroke, which has generally been known to result from infarction. [ABSTRACT FROM AUTHOR]

This article focuses on a study related to intracranial hemorrhage in infancy and childhood. These are the least common of all the intiacranial hemorrhages in neonates. They preferentially affect large, full-term infants born after a prolonged labor or a difficult instrumental delivery. Multiple petechiae or perivascular hemorrhages are noted at autopsy. This type of bleeding is particularly common in premature infants born by spontaneous delivery. The clinical course of intraventicular hemorrhage in newborn infants may follow one of two patterns.

The article discusses a treatment of a 48 year-old man with a spontaneous intracerebral haematoma with deteriorating level of consciousness by a mobile neurosurgeon . Neurosurgical consultation was done through telephone and immediate surgical decompression was initiated enabling the patient to recover. The advantages of mobile neurosurgeon is discussed as well as facilities and equipment necessary to carry out a successful neurosurgical service.

The article presents a case study of a 50-year-old man who undergone conservative treatment for his spontaneous pontine hemorrhage (PH). It mentions the complain of the patient for severe post-stroke hypersomnia (PSH). Diffusion tensor imaging confirms that the patient has ascending reticular activating system (ARAS) injuries in both dorsal and ventral sides which could be the pathogenic mechanism of PSH.

The article presents a study that examines the condition of inferior vena cava that was compressed by a hematoma. It cites the case 72-year-old woman who underwent L3-L4 laminectomy due to lower back and right leg pain. It also mentions the causes of the condition, which illustrates the unique case of a massive retroperitoneal hematoma, and the treatments that were given to the patient.

The article focuses on the trials and clinical practices of stroke magnetic resonance imaging (MRI). The use of MRI approach is to replace an arbitrary time-window with an individual tissue-window defined for a single patient based on the findings of imaging. According to the author, it is shown that MRI is sufficient to exclude intracranial hemorrhages (ICH) in the emergency setting.

The article presents a case of stroke in a 24-year old male patient due to the misuse of amphetamine. The patient had a left hemisphere stroke. Thin layer chromatography revealed amphetamine abuse by the patient. Amphetamine misuse is rare but solid reason for intracranial hemorrhage in young adults. In the purview of unreliability of clinical history, urinary chromatography could be a valuable tool in the diagnosis of the disease.