Intracranial hemorrhage remains an important factor of premature newborns' morbidity. Its incidence is significantly influenced by adequate perinatal care and safe neonatal transport. Risk factors for the development of intracranial hemorrhage in premature newborns after neonatal transport were analyzed in the retrospective transversal clinical study. Out of 150 study subjects, 60% (n = 90/150) had intracranial hemorrhage with a statistically significant difference in relation to Apgar score, gestational age, birth weight, age at the moment of transport and the prophylactic use of surfactant. In this group, grades I/II intracranial hemorrhage were detected in 77% (n = 69/90), while grades III/IV intracranial hemorrhage were diagnosed in 23% (n = 21/90). A statistically significant difference was observed in relation to gestational age, birth weight, antenatal use of tocolytics and steroids, delivery mode and age in the time of transport between these groups. All patients were transferred to Intensive Care Unit, the duration of transport was less than 5 minutes in 71% 9n = 107/150), whereas longer transport was recorded in 29% (n = 43/150). In the group of longer transport, prophylactic surfactant was less frequently used with a higher incidence of grades III/IV intracranial hemorrhage. In order to prevent the development of intracranial hemorrhage in premature newborns, the most important measures are the antenatal use of steroids and postnatal prophylactic use of surfactant.
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http://dx.doi.org/10.2298/mpns1008454s | DOI Listing |
JAMA Netw Open
January 2025
Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Importance: The net clinical effect of early vs later direct oral anticoagulant (DOAC) initiation after atrial fibrillation-associated ischemic stroke is unclear.
Objective: To investigate whether early DOAC treatment is associated with a net clinical benefit (NCB).
Design, Setting, And Participants: This was a post hoc analysis of the Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischaemic Stroke Patients With Atrial Fibrillation (ELAN) open-label randomized clinical trial conducted across 103 sites in 15 countries in Europe, the Middle East, and Asia between November 6, 2017, and September 12, 2022, with a 90-day follow-up.
JAMA Netw Open
January 2025
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Importance: Nelonemdaz selectively antagonizes the 2B subunit of the N-methyl-d-aspartate glutamate receptor and scavenges free radical species.
Objective: To evaluate whether nelonemdaz enhances the clinical outcomes of patients with acute ischemic stroke undergoing emergent reperfusion therapy.
Design, Setting, And Participants: This multicenter double-blind placebo-controlled randomized phase 3 trial (December 25, 2021, to June 30, 2023, in South Korea) recruited patients with acute ischemic stroke who met the following criteria: National Institutes of Health Stroke Scale score greater than or equal to 8, Alberta Stroke Program Early Computed Tomography score greater than or equal to 4, and endovascular thrombectomy within 12 hours after stroke onset.
Trauma Case Rep
February 2025
Faculty of Health Sciences, Comparative Anatomy and Experimental Histopathology and Surgery, Université des Montagnes, Bangangté, West Cameroon, Cameroon.
Penetrating head trauma is the most fatal form of head injury. Although many cases of penetrating head trauma have been reported in the literature, its management remains complex, requiring a multidisciplinary team, which makes it a challenge in district hospitals where human resources and technical equipment are limited. We aim to present a successful initial management of a case of penetrating head trauma in a rural district hospital before a transfer to a first category hospital.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Hengyang Key Laboratory of Hemorrhagic Cerebrovascular Disease, Department of Neurosurgery, the Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421000, Hunan, China.
Patients with intracranial aneurysms (IA) undergoing endovascular treatment face varying risks and benefits when tirofiban is used for thromboprophylaxis during surgery. Currently, there is a lack of high-level evidence summarizing this information. This study aims to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of tirofiban during endovascular treatment of IA.
View Article and Find Full Text PDFNeurology
February 2025
Department of Neurology, Department of Stroke, University Hospital Cleveland Medical Center, Case Western Reserve University, Cleveland, OH.
Background And Objectives: Although previous trials have established the efficacy and safety of endovascular thrombectomy (EVT) in large ischemic core strokes, most of them excluded patients with extracranial internal carotid artery (e-ICA) occlusion. We aimed to compare outcomes in patients with e-ICA occlusion and large ischemic core infarcts treated with EVT vs medical management (MM).
Methods: This was a secondary analysis of the SELECT2 trial, a randomized controlled trial conducted at 31 international sites.
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