Introduction And Importance: Most severe complications of DBS appear in the perioperative period. There are no published case reports of delayed ICH occurring more than three months from electrode implantation. The pathogenesis of delayed ICH remains unclear.
Case Presentation: We present a 64-year-old male with essential tremor who sustained a delayed intracerebral hemorrhage (ICH) 2.5 years after implantation of a deep brain stimulating electrode.
Discussion: The patient sustained a thalamic-midbrain ICH that may have been related to the positioning of the electrode. An analysis was performed to determine the cause and risk factors that may have contributed. Based on these findings, it is possible that the proximity of the cannula or electrode may have mildly injured the wall of the superior thalamic vein during implantation, or perhaps being in contact with the vein over a longer-term having an effect, which in either of these scenarios can subsequently lead to ICH formation on the sudden rise of intracranial pressure.
Conclusion: It emphasizes the importance of proper surgical navigation planning, image- guidance, and the use of image verification.
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http://dx.doi.org/10.1016/j.ijscr.2021.105969 | DOI Listing |
PLOS Glob Public Health
December 2024
The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
The third, stepped-wedge, cluster-randomized, Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT3), has shown that a goal-directed multi-faceted Care Bundle incorporating protocols for the management of physiological variables was safe and effective for improving functional recovery in a broad range of patients with acute intracerebral hemorrhage (ICH). The INTERACT3 Care Bundle included time- and target-based protocols for the management of early intensive lowering of systolic blood pressure (SBP, target <140mmHg), glucose control (target 6.1-7.
View Article and Find Full Text PDFVet Radiol Ultrasound
January 2025
Neurology Department, Animal Referral Centre, Auckland, New Zealand.
An approximately 7-week-old female American Bulldog was presented for head injury and seizures. The dog was obtunded with absent left-sided postural reactions, absent left palpebral reflex, delayed vestibulo-ocular reflex bilaterally, and calvarial hyperesthesia. CT revealed a fragmented, depressed fracture of the right frontal bone, with an associated abscess and evidence of raised intracranial pressure.
View Article and Find Full Text PDFStroke
December 2024
Division of Neurology, Hamilton Health Sciences, McMaster University and Population Health Research Institute, ON, Canada (R.A.J., A.H.K., A.S.).
Recovery trajectories in intracerebral hemorrhage (ICH) are recognized as distinct from those observed in ischemic stroke. This narrative review aims to clarify the pathophysiology underlying ICH recovery patterns, highlighting the unique timeline and nature of functional improvements seen in ICH survivors. Population-based cohort studies tracking functional outcomes in a longitudinal fashion, along with randomized clinical trial data with standardized outcome assessments, have demonstrated that ICH recovery generally has a delayed onset in the first weeks, followed by a steep early subacute stage recovery (typically up to 3 months) continuing in protracted, gradual improvements beyond 3 to 6 months.
View Article and Find Full Text PDFInt J Stroke
December 2024
Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
Rationale: The benefit of tenecteplase in the treatment of large vessel occlusion (LVO) patients presenting within 24 hours of symptom onset remains unclear.
Aim: To assess the effectiveness and safety of tenecteplase, compared to standard of care, in patients presenting within the first 24 hours of symptom onset with a LVO and target mismatch on perfusion CT.
Methods And Design: The "Extending the time window for Tenecteplase by Effective Reperfusion of peNumbrAL tissue in patients with Large Vessel Occlusion" (ETERNAL-LVO) trial is a prospective, randomized, open-label, blinded endpoint, phase 3, parallel-group, superiority trial with covariate-adjusted 1:1 randomization, and adaptive sample size re-estimation.
PeerJ Comput Sci
November 2024
Research Center, Future University in Egypt, New Cairo, Egypt.
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