A 60-year-old male presented to the emergency department with acute change in mental status while recovering from a recent hemicraniectomy. During evaluation by the emergency physician, a point-of-care ultrasound (POCUS) was performed using the patient's existing craniectomy site as a sonographic window. Multiple areas of intracranial hemorrhage were visualized on POCUS and head computed tomography scan ultimately requiring urgent neurosurgical intervention. Our case report demonstrates an innovative application of POCUS in the emergency department- setting that has potential to expedite diagnosis and management of life-threatening neurosurgical etiologies, such as hemorrhage and midline shift, in a unique patient population.
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http://dx.doi.org/10.1002/emp2.12419 | DOI Listing |
J Neurosurg Pediatr
January 2025
4Department of Neurosurgery, Children's Hospital Colorado Anschutz Medical Campus, Aurora; and.
Objective: Pediatric traumatic brain injury (TBI) represents a significant public health concern and source of resource utilization. The aim of this study was to establish the ability of the previously published pediatric Brain Injury Guidelines (pBIG) to identify patients with traumatic intracranial hemorrhage (ICH) who might not require routine repeat neuroimaging, neurosurgical consultation, or hospital admission in a large level I and level II trauma cohort.
Methods: Pediatric patients who presented with traumatic ICH between 2018 and 2022 at the included institutions were retrospectively reviewed and sorted into pBIG categories using clinical and radiographic criteria.
Alzheimers Dement
December 2024
Indiana University School of Medicine, Stark Neurosciences Research Institute, Department of Neurology, Indianapolis, IN, USA.
Anti-amyloid immunotherapy holds great promise for our patients and their families as the first disease-modifying therapy for the treatment of Alzheimer's disease (AD) to be approved. Positive clinical trials for lecanamab and donanemab showed significant and rapid lowering of brain amyloid burden and a significant slowing of cognitive decline. Amyloid-related imaging abnormalities (ARIA) in the form of vasogenic edema (ARIA-E) and micro - and macro- hemorrhages (ARIA-H) remain the major obstacle to broad use of these agents.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
The George Institute for Global Health, Newtown, NSW, Australia.
Background: Intracerebral hemorrhage (ICH) is the most severe and disabling stroke, accounting for up to 50% of the cases in low-to-middle-income countries. High rates of cognitive decline and dementia follow acute ICH, due to the common underlying vasculopathy of cerebral small vessel disease (CSVD). The international clinical trial, TRIDENT (Triple therapy prevention of Recurrent Intracerebral Disease EveNts Trial), aims to determine the effectiveness of the fixed low-dose Triple Pill combination of blood pressure-lowering agents (telmisartan 20 mg, indapamide 1.
View Article and Find Full Text PDFNeurol Res
January 2025
Department of Neurology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Background: It has been suggested that smokers have higher recanalization rate, lower risk of cerebral hemorrhage and better prognosis than non-smokers (smoking paradox) after reperfusion therapy in patients with acute ischemic stroke (IS). This study aimed to assess the effects of smoking on recanalization, intracranial hemorrhage, and clinical outcomes in patients with acute IS following reperfusion therapy.
Methods: Patients were categorized into smokers and non-smokers, with data collected on types of reperfusion therapy, demographics, medication use, comorbidities, stroke etiology, mRS and NIHSS scores, TICI and ECASS classifications.
Ann Med
December 2025
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background: With the refinement of catheter technology, distal medium vessel occlusions (DMVOs) are now viewed as amenable to endovascular treatment (EVT) but its efficacy and safety remains unclear in AIS patients with DMVO.
Methods: We conducted a systematic search of PubMed, Embase databases and Cochrane Library up to December 2023 using keywords to identify studies comparing EVT versus BMT in AIS with DMVOs. The assessed clinical outcomes were excellent functional outcome, good functional outcome, 90-day mortality, symptomatic intracranial hemorrhage (sICH), and early neurological improvement (ENI) after treatment.
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