Awareness Under Anesthesia.

You begin to hear distant rock music playing, people conversing about their weekend. Then the scalpel is requested-incision. Pain sends you reeling and you attempt to muster a scream.

Longitudinal Volume Quantification of Deep Medullary Veins in Patients with Cerebral Venous Sinus Thrombosis : Venous Volume Assessment in Cerebral Venous Sinus Thrombosis Using SWI.

Purpose: Susceptibility-weighted imaging (SWI) visualizes small cerebral veins with high sensitivity and could, thus, enable quantification of hemodynamics of deep medullary veins. We aimed to evaluate volume changes of deep medullary veins in patients with acute cerebral venous sinus thrombosis (CVST) over time in comparison to healthy controls.

Methods: All magnetic resonance imaging (MRI) experiments were executed at 3 T using a 32-channel head coil.

[Idiopathic intracranial hypertension].

This review describes the clinical findings as well as thes diagnostic and therapeutic options for idiopathic intracranial hypertension (pseudotumor cerebri). Furthermore, the pathophysiological concepts are discussed. Idiopathic intracranial hypertension is characterized by signs and symptoms of raised intracranial pressure with no established pathogenesis.

Enlarged Optic Nerve Sheath in Aneurysmal Subarachnoid Hemorrhage despite Normal Intracranial Pressure.

Introduction: This study investigates the diagnostic value of optic nerve sheath diameter (ONSD) assessed by transorbital sonography for estimation of intracranial pressure (ICP) in patients with aneurysmal subarachnoid hemorrhage (SAH).

Methods: Simultaneous measurements of the ONSD and ICP in 27 patients suffering from SAH and acute hydrocephalus after placement of an extraventricular drain.

Results: Despite normal mean ICP values ONSD was significantly higher in patients with SAH compared with healthy volunteers and no relevant decline of ONSD over time could be identified.

Terson's Syndrome: Diagnostic Comparison of Ocular Sonography and CT.

Background And Purpose: To assess the accuracy of ocular B-mode sonography and of standard head computed tomography (CT) as screening tools for intraocular hemorrhages related to subarachnoid hemorrhage (SAH).

Methods: 46 patients with spontaneous SAH were examined using ocular B-mode sonography and underwent funduscopy as gold standard for detection of ocular hemorrhages (OH). Additionally, all head CT scans done during the hospital stay of the study population were rated by a neuroradiologist for the presence of OH.

In vivo analysis of physiological 3D blood flow of cerebral veins.

Objectives: To visualize and quantify physiological blood flow of intracranial veins in vivo using time-resolved, 3D phase-contrast MRI (4D flow MRI), and to test measurement accuracy.

Methods: Fifteen healthy volunteers underwent repeated ECG-triggered 4D flow MRI (3 Tesla, 32-channel head coil). Intracranial venous blood flow was analysed using dedicated software allowing for blood flow visualization and quantification in analysis planes at the superior sagittal, straight, and transverse sinuses.

The great imitator--still today! A case of meningovascular syphilis affecting the posterior circulation.

Cerebral ischemia due to meningovascular syphilis is rare and more frequently affects the anterior circulation than the posterior circulation. We describe clinical features and imaging studies of a 50-year-old patient with Parinaud syndrome and a syphilitic dorsal midbrain infarction. Brain magnetic resonance imaging indicated vasculitis of the posterior circulation.

Reproducibility and accuracy of optic nerve sheath diameter assessment using ultrasound compared to magnetic resonance imaging.

Background: Quantification of the optic nerve sheath diameter (ONSD) by transbulbar sonography is a promising non-invasive technique for the detection of altered intracranial pressure. In order to establish this method as follow-up tool in diseases with intracranial hyper- or hypotension scan-rescan reproducibility and accuracy need to be systematically investigated.

Methods: The right ONSD of 15 healthy volunteers (mean age 24.

Therapeutic hypothermia in cerebral air embolism: a case report.

Background: Cerebral air embolism is a life-threatening complication of various diagnostic and therapeutic procedures. Hyperbaric oxygenation is considered to be the cornerstone of its treatment.

Case Description: We report a patient with cerebral air embolism after endoscopy of a perineal abscess.

Primary Epstein-Barr virus infection with polyradiculitis: a case report.

Background: Nervous system complications of primary Epstein-Barr virus (EBV) infection in adults are rare, but may occur with encephalitis, meningitis, myelitis, cranial and peripheral neuropathies, or radiculitis.

Case Presentation: We describe an immune competent adult with a primary EBV infection complicated by lumbosacral polyradiculitis with pure radicular pain. Prior to the onset of radicular pain the 35-year-old woman had been suffering from infectious mononucleosis misdiagnosed for streptococcal tonsillitis.

Adora2b adenosine receptor signaling protects during acute kidney injury via inhibition of neutrophil-dependent TNF-α release.

Renal ischemia is among the leading causes of acute kidney injury (AKI). Previous studies have shown that extracellular adenosine is a prominent tissue-protective cue elicited during ischemia, including signaling events through the adenosine receptor 2b (Adora2b). To investigate the functional role of Adora2b signaling in cytokine-mediated inflammatory pathways, we screened wild-type and Adora2b-deficient mice undergoing renal ischemia for expression of a range of inflammatory cytokines.

Sonographic assessment of the optic nerve sheath and transorbital monitoring of treatment effects in a patient with spontaneous intracranial hypotension: case report.

Objective: To investigate the potential of the ultrasound-based evaluation of the optic nerve sheath in a patient with spontaneous intracranial hypotension due to cervical cerebrospinal fluid (CSF) leakage.

Methods: Repeated measurements of the optic nerve sheath diameter (ONSD) using B-mode sonography were performed before treatment initiation, during medical treatment, and during a course of repeated placement of epidural blood patches.

Results: On admission, transorbital sonography revealed a decreased ONSD of 4.

HIV testing in emergency departments in the United States: a national survey.

Objectives: In 2006, the Centers for Disease Control and Prevention (CDC) published recommendations for HIV testing in health care settings, calling for nontargeted opt-out rapid HIV screening in most settings, including emergency departments (EDs). Although a number of ED-based testing strategies exist, it is unclear to what extent they are used. The objective of this study is to survey academic and community EDs throughout the United States to determine ED-based HIV testing practices.

Sonographic assessment of the optic nerve sheath in idiopathic intracranial hypertension.

The aim of this work was to investigate the potential of ultrasound-based optic nerve sheath diameter (ONSD) measurements in detecting raised intracranial pressure in patients with idiopathic intracranial hypertension (IIH) and to describe ONSD response to lumbar puncture. In ten patients with newly diagnosed IIH, transorbital sonography was carried out to assess ONSD, OND (optic nerve diameter), and optic disc elevation before and after lumbar puncture. Twenty-five patients with other neurological disorders served as controls.

Alcohol-related vehicular death rates for college students in the Commonwealth of Virginia.

Objective: Determine rate of college student alcohol-related vehicular traffic fatalities in Virginia during 2007.

Participants: 17- to 24-year-old cohort [corrected] at colleges and universities in Virginia.

Methods: Institutions with membership in the American College Health Association were invited to participate in a survey.

Adenosine generation and signaling during acute kidney injury.

Acute kidney injury (AKI) is among the leading causes of morbidity and mortality in hospitalized patients. Particularly in the perioperative period, the most common cause of AKI is renal ischemia. At present, therapeutic modalities to prevent or treat AKI are extremely limited and the search for novel therapeutic interventions for ischemic AKI is an area of intense investigation.

Intra- and interobsever reliability of sonographic assessment of the optic nerve sheath diameter in healthy adults.

Background: The use of an ultrasound-based evaluation of the optic nerve sheath diameter (ONSD) has previously been demonstrated for detecting raised intracranial pressure. In order to be feasible in clinical workup, the test qualities of transorbital ultrasonography need to be determined. The aim of this study was therefore to establish normal values and to assess the intra- and interobserver reliability of this method.

The longitudinal pattern of alcohol-related injury in a college population: emergency department data compared to self-reported data.

Background: Self-report survey is the most common method of obtaining information from college students on substance use and its consequences. However, the validity and reliability of self-report data, especially in relationship to harmful substance use, is frequently called into question.

Objectives: To establish the convergent validity of self-reported alcohol-related injury data and data from a university-affiliated hospital Emergency Department (ED) across a seven year period.

Using a logic model to relate the strategic to the tactical in program planning and evaluation: an illustration based on social norms interventions.

Logic models are a ubiquitous tool for specifying the tactics--including implementation and evaluation--of interventions in the public health, health and social behaviors arenas. Similarly, social norms interventions are a common strategy, particularly in college settings, to address hazardous drinking and other dangerous or asocial behaviors. This paper illustrates an extension of logic models to include strategic as well as tactical components, using a specific example developed for social norms interventions.