Brain Aneurysm Coiling : Endovascular Coiling of Intracranial Aneurysms in Mumbai
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Brain Aneurysm is a ballooning of the artery in the brain. This was traditionally treated by open surgery. Endovascular Coiling is the new accepted method for treatment of aneurysms. This is a safer treatment with a faster recovery period. All done through a small needle prick in the thigh. A true advancement of modern medicine
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Sah
This document discusses subarachnoid hemorrhage (SAH), which occurs when there is bleeding into the space between the brain and the thin tissues that cover the brain. The most common cause of SAH is the rupture of an intracranial aneurysm, which affects around 25,000-30,000 people in the US each year. The initial mortality rate is around 45% and over half of survivors are left with major neurological deficits. Diagnosis involves CT scans, lumbar puncture, and angiography. Treatment focuses on surgical clipping or coiling of the aneurysm as well as managing complications like vasospasm, hydrocephalus, and rebleeding through medical therapy.
Cerebral aneurysm
This document discusses subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms. Key points include: SAH occurs in 1-6% of the population and is most common in those aged 40-60 years. The majority of SAH cases are caused by ruptured aneurysms. Factors that increase aneurysm risk include smoking, hypertension, family history, and connective tissue disorders. Clinical presentation ranges from headache to loss of consciousness. Outcomes depend on factors like age, grade of SAH, time to treatment, and development of complications like vasospasm. Endovascular coiling or surgical clipping are used to treat ruptured aneurysms. Oral nimodipine
Aneurysm
This document discusses cerebral aneurysms and subarachnoid hemorrhage. It notes that ruptured cerebral aneurysms account for 75% of subarachnoid hemorrhages, which affect 27,000 Americans per year. The majority of cerebral aneurysms occur at specific locations on major cerebral vessels. Ruptured aneurysms have high rates of morbidity and mortality, while unruptured aneurysms have lower risks if left untreated. The document discusses risks factors, classifications, complications including vasospasm, and approaches to treatment and anesthesia management for patients with cerebral aneurysms and subarachnoid hemorrhage.
Neuroprotection during cerebral aneurysm surgery
This document discusses neuroprotection during cerebral aneurysm surgery. It describes two main types of aneurysm surgery - open craniotomy where surgical clips are used, and endovascular surgery where coils are used. The main mechanisms of neuronal injury during aneurysm surgery are ischemia, excessive glutamate release, and excitotoxicity. Various neuroprotective strategies are discussed, including maintaining normal blood pressure, partial pressure of carbon dioxide, blood glucose, and temperature. Intravenous and inhalation anesthetic agents that reduce cerebral blood flow and metabolism are recommended. The "triple-H" therapy of mild induced hypertension, hemodilution, and hypervolemia can also increase cerebral blood flow and oxygenation during surgery.
Concerns and challenges during anesthetic management of aneurysmal
Anesthetic management of patients with aneurysmal subarachnoid hemorrhage is challenging due to the emergency presentation, complex pathology, varied intracranial and systemic manifestations, and special management requirements. Successful outcomes rely on understanding the pathophysiology, associated complications, preoperative optimization, definitive therapy choice, vigilant monitoring, and optimal postoperative care. Key concerns include effects of the ruptured aneurysm, maintaining a relaxed brain during surgery, monitoring for ischemia during temporary vessel occlusion, and detecting postoperative complications.
subarachnoid hemorrhage
A 35-year-old male presented to the emergency room with a sudden severe headache and neck stiffness after pruning flowers in his garden. A CT scan confirmed that he had experienced a subarachnoid hemorrhage (SAH), which is a type of stroke caused by bleeding into the space between the brain and the thin tissues that cover the brain. The bleeding is often due to the rupture of an aneurysm or arteriovenous malformation in the brain. Treatment involves bed rest, controlling hypertension, steroids or diuretics to reduce brain swelling, calcium channel blockers to reduce mortality, and potentially clipping or coiling the aneurysm to prevent rebleeding if it is the cause.
Management of SAH
Vipul Gupta describes his approach to managing subarachnoid hemorrhage (SAH) at his hospital in India. He works closely with neurosurgery as part of an integrated team. For aneurysmal SAH, patients undergo angiography within 24 hours to identify any aneurysms. Aneurysms are often coiled in the same session. Techniques like balloon-assisted coiling are used for complex aneurysms. Flow diverters are used for giant or fusiform aneurysms that cannot be coiled. Aggressive prevention and treatment of vasospasm is emphasized, including continuous intra-arterial nimodipine and milrinone. Overall, this integrated approach aims for good outcomes with over 85
Subarachnoid hemorrhage
Subarachnoid hemorrhage occurs when blood leaks into the subarachnoid space surrounding the brain. The most common causes are aneurysmal rupture or trauma. Clinical features include a sudden, severe "thunderclap" headache and may include neck stiffness, nausea, vomiting, and loss of consciousness. Diagnosis is made through lumbar puncture and brain imaging. Untreated, SAH has high mortality with 50% dying within 30 days. Survivors often have neurological deficits. Treatment focuses on securing the ruptured aneurysm to prevent rebleeding.
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Sah
This document discusses subarachnoid hemorrhage (SAH), which occurs when there is bleeding into the space between the brain and the thin tissues that cover the brain. The most common cause of SAH is the rupture of an intracranial aneurysm, which affects around 25,000-30,000 people in the US each year. The initial mortality rate is around 45% and over half of survivors are left with major neurological deficits. Diagnosis involves CT scans, lumbar puncture, and angiography. Treatment focuses on surgical clipping or coiling of the aneurysm as well as managing complications like vasospasm, hydrocephalus, and rebleeding through medical therapy.
Cerebral aneurysm
This document discusses subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms. Key points include: SAH occurs in 1-6% of the population and is most common in those aged 40-60 years. The majority of SAH cases are caused by ruptured aneurysms. Factors that increase aneurysm risk include smoking, hypertension, family history, and connective tissue disorders. Clinical presentation ranges from headache to loss of consciousness. Outcomes depend on factors like age, grade of SAH, time to treatment, and development of complications like vasospasm. Endovascular coiling or surgical clipping are used to treat ruptured aneurysms. Oral nimodipine
Aneurysm
This document discusses cerebral aneurysms and subarachnoid hemorrhage. It notes that ruptured cerebral aneurysms account for 75% of subarachnoid hemorrhages, which affect 27,000 Americans per year. The majority of cerebral aneurysms occur at specific locations on major cerebral vessels. Ruptured aneurysms have high rates of morbidity and mortality, while unruptured aneurysms have lower risks if left untreated. The document discusses risks factors, classifications, complications including vasospasm, and approaches to treatment and anesthesia management for patients with cerebral aneurysms and subarachnoid hemorrhage.
Neuroprotection during cerebral aneurysm surgery
This document discusses neuroprotection during cerebral aneurysm surgery. It describes two main types of aneurysm surgery - open craniotomy where surgical clips are used, and endovascular surgery where coils are used. The main mechanisms of neuronal injury during aneurysm surgery are ischemia, excessive glutamate release, and excitotoxicity. Various neuroprotective strategies are discussed, including maintaining normal blood pressure, partial pressure of carbon dioxide, blood glucose, and temperature. Intravenous and inhalation anesthetic agents that reduce cerebral blood flow and metabolism are recommended. The "triple-H" therapy of mild induced hypertension, hemodilution, and hypervolemia can also increase cerebral blood flow and oxygenation during surgery.
Concerns and challenges during anesthetic management of aneurysmal
Anesthetic management of patients with aneurysmal subarachnoid hemorrhage is challenging due to the emergency presentation, complex pathology, varied intracranial and systemic manifestations, and special management requirements. Successful outcomes rely on understanding the pathophysiology, associated complications, preoperative optimization, definitive therapy choice, vigilant monitoring, and optimal postoperative care. Key concerns include effects of the ruptured aneurysm, maintaining a relaxed brain during surgery, monitoring for ischemia during temporary vessel occlusion, and detecting postoperative complications.
subarachnoid hemorrhage
A 35-year-old male presented to the emergency room with a sudden severe headache and neck stiffness after pruning flowers in his garden. A CT scan confirmed that he had experienced a subarachnoid hemorrhage (SAH), which is a type of stroke caused by bleeding into the space between the brain and the thin tissues that cover the brain. The bleeding is often due to the rupture of an aneurysm or arteriovenous malformation in the brain. Treatment involves bed rest, controlling hypertension, steroids or diuretics to reduce brain swelling, calcium channel blockers to reduce mortality, and potentially clipping or coiling the aneurysm to prevent rebleeding if it is the cause.
Management of SAH
Vipul Gupta describes his approach to managing subarachnoid hemorrhage (SAH) at his hospital in India. He works closely with neurosurgery as part of an integrated team. For aneurysmal SAH, patients undergo angiography within 24 hours to identify any aneurysms. Aneurysms are often coiled in the same session. Techniques like balloon-assisted coiling are used for complex aneurysms. Flow diverters are used for giant or fusiform aneurysms that cannot be coiled. Aggressive prevention and treatment of vasospasm is emphasized, including continuous intra-arterial nimodipine and milrinone. Overall, this integrated approach aims for good outcomes with over 85
Subarachnoid hemorrhage
Subarachnoid hemorrhage occurs when blood leaks into the subarachnoid space surrounding the brain. The most common causes are aneurysmal rupture or trauma. Clinical features include a sudden, severe "thunderclap" headache and may include neck stiffness, nausea, vomiting, and loss of consciousness. Diagnosis is made through lumbar puncture and brain imaging. Untreated, SAH has high mortality with 50% dying within 30 days. Survivors often have neurological deficits. Treatment focuses on securing the ruptured aneurysm to prevent rebleeding.
Subarachnoid Hemorrhage
Subarachnoid Hemorrhage is Extravasation of blood into the subarachnoid space. It occur mainly due to Ruptured aneurysm (75%).
Pharmacotherapy of Stroke
This document discusses the pharmacotherapy of stroke. It begins by defining stroke and classifying it as either ischemic or hemorrhagic. Risk factors and pathophysiology are described. Clinical presentations include weakness, speech problems, or vision loss. Diagnosis involves imaging like CT or MRI to distinguish ischemic from hemorrhagic stroke. Treatment goals are to reduce injury, prevent complications and recurrence. For ischemic stroke, IV tissue plasminogen activator within 3 hours or aspirin within 48 hours are recommended. Secondary prevention includes managing conditions like atrial fibrillation, hypertension, and diabetes to prevent future strokes.
Sub arachanoid heamorrhage
A 60-year-old male presented to the emergency department with the worst headache of his life along with nausea and vomiting. Subarachnoid hemorrhage (SAH) occurs when blood enters the subarachnoid space surrounding the brain. The most common cause is a ruptured brain aneurysm. Initial management included a CT scan, which has high sensitivity in detecting SAH, control of blood pressure to reduce risk of rebleeding, administration of nimodipine to prevent vasospasm, and neurosurgical consultation. The patient was admitted to the ICU for monitoring and treatment of potential complications of SAH such as rebleeding, vasospasm, hydrocephalus, and seizures.
Sub-Arachnoid Hemorrhage
Subarachnoid hemorrhage is caused most commonly by the rupture of a saccular aneurysm. The rupture causes blood to fill the subarachnoid space, which can lead to neurological deficits or death. Treatment involves securing the aneurysm through surgical clipping or endovascular coiling to prevent rebleeding, as well as managing complications like vasospasm, hydrocephalus, and seizures. Outcomes depend on the grade and location of the initial bleed and development of delayed cerebral ischemia.
Subarachnoid hemorrhage imaging
CT scanning is the preferred initial imaging study for diagnosing subarachnoid hemorrhage (SAH). CT scans can detect blood in the subarachnoid spaces around the brain and have a sensitivity of 93-100% within 24 hours. The amount of blood seen on CT scans correlates with risk of developing vasospasm and can help prognosticate. While CT is very accurate for diagnosing acute SAH, its sensitivity decreases after 5-7 days. If CT is negative but clinical suspicion remains, lumbar puncture should be performed.
Sah
This document summarizes imaging findings related to subarachnoid hemorrhage (SAH). It describes that SAH appears as hyperdense linear structures on CT and hyperintense on FLAIR MRI. The location of blood can localize the source of bleeding such as anterior communicating artery aneurysms presenting with blood in the interhemispheric fissure. Complications include vasospasm, hydrocephalus, and superficial siderosis. Reversible cerebral vasoconstriction syndrome is also discussed, appearing as multifocal "string of beads" narrowing on angiography that resolves within 12 weeks.
Ruptured brain aneurysm
I am a Neurosurgeon with advanced training in Interventional vascular Neurosurgery(FINR) from Zurich, Switzerland, and FMINS-Fellowship in minimally invasive and Endoscopic Neurosurgery from Germany.
I am presently working in Columbia asia hospitals, Bangalore.
My areas of interest are Vascular Neurosurgery, Stroke specialist, interventional neuroradiology.
Subarachnoid haemorrhage assessment and investigation
1) The document summarizes a presentation on the assessment and investigation of subarachnoid haemorrhage (SAH).
2) It finds that modern CT scans have high accuracy in detecting SAH within 6 hours, but lumbar puncture remains important for cases presenting later.
3) The risk of serious side effects from lumbar puncture often outweigh its benefits, except for patients with pre-test probabilities of SAH between 2-7% based on their history and exam findings.
Subarachnoid hemorrage –eso guidelines for management
1. Intracranial aneurysms have an incidence of 9 per 100,000 people, with a mortality rate of 60% within 6 months if left untreated.
2. Clinical grading scales like Hunt-Hess, WFNS, and PAASH are used to assess patients presenting with subarachnoid hemorrhage, with PAASH showing slightly better correlation with outcome.
3. Risk factors for poor outcomes from aneurysmal subarachnoid hemorrhage include older age, hypertension, aneurysm size and location, rebleeding, delayed cerebral ischemia, and hydrocephalus.
Subarachnoid hemorrhage
The document summarizes subarachnoid hemorrhage (SAH). The most common cause is a ruptured cerebral aneurysm. Clinical presentation includes sudden, severe headache and loss of consciousness. Diagnosis is made using non-contrast CT or lumbar puncture. Treatment involves securing the aneurysm with coiling or clipping, managing rebleeding risk with blood pressure control, and treating complications like hydrocephalus. Outcomes depend on factors like disease severity, treatment at high-volume centers, and management of neurological complications including rebleeding, hydrocephalus, and seizures.
Sub-arachnoid hemorrhage
Subarachnoid hemorrhage is a neurological emergency caused by sudden bleeding into the subarachnoid space, often presenting with a thunderclap headache. It is usually caused by the rupture of an intracranial aneurysm. The case fatality rate of aneurysmal SAH is 30-70% on average. Survivors often have major disability, with 60% never regaining their pre-hemorrhage quality of life. Diagnosis involves CT, LP, CTA and conventional angiography to detect the source of bleeding. Complications include rebleeding, hydrocephalus, vasospasm and hyponatremia. Aggressive treatment is aimed at securing the aneurysm to prevent re
Stroke presentation By Saba Arif
A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food.
Within minutes, brain cells begin to die.
Stroke can be either ischemic or hemorrhagic.
CT in CVA
The document discusses cerebral vascular accidents (CVA or stroke). It describes the main types of ischemic stroke including those caused by cerebral atherothrombosis, cardiogenic embolism, penetrating artery disease, and other rare causes. It discusses risk factors and the clinical presentation of ischemic stroke. It then covers the pathophysiology of ischemia including the penumbra model and thresholds for irreversible tissue damage. Diagnostic imaging findings on non-contrast CT are summarized for acute, subacute and chronic stages. CT perfusion is also discussed for assessing infarct core and penumbra size to guide treatment decisions.
Subarachnoid haemorrhage
The document provides information on subarachnoid haemorrhage (SAH), including:
- SAH is a neurological emergency caused by bleeding in the subarachnoid space, usually due to a ruptured saccular aneurysm.
- Clinical manifestations include the sudden onset of the worst headache of one's life, neck stiffness, vomiting, focal neurological deficits, and loss of consciousness.
- Investigations include non-contrast CT scan, which identifies the location and extent of subarachnoid blood in 95% of cases within 72 hours, and cerebral angiography to locate the aneurysm.
Subarachnoid Haemorrhage Management
This document provides information about subarachnoid hemorrhage (SAH):
- SAH is bleeding into the subarachnoid space, which occurs in 5% of strokes and is usually caused by a ruptured aneurysm.
- Presenting symptoms include a sudden, severe headache and signs of meningeal irritation. Investigations include CT, LP, CTA/MRA to identify the source of bleeding.
- Treatment focuses on stabilizing the patient, securing the aneurysm via coiling or clipping, and preventing/treating complications like rebleeding, hydrocephalus, seizures, and delayed cerebral ischemia.
- Complications are managed through measures like strict blood
Intracranial hemorrhage
This document discusses intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). ICH can be caused by hypertension, cerebral amyloid angiopathy, aneurysms, or bleeding disorders. Common symptoms include sudden headache, weakness on one side of the body, and altered mental status. Treatment focuses on controlling blood pressure, reducing pressure in the brain, and potentially surgically evacuating large bleeds. SAH most often results from aneurysms and presents with a sudden, severe headache. Angiography is used to locate the source of bleeding, and aneurysms are often clipped surgically to prevent rebleeding.
SAH for Neurology Residents
This document discusses aneurysmal subarachnoid hemorrhage (SAH), including its causes, diagnosis, treatment, and complications. The most common cause is rupture of a cerebral aneurysm, which accounts for 80-85% of cases. Diagnosis involves CT scan and lumbar puncture to detect blood. Angiography is used to identify the aneurysm's location. Early securing of the aneurysm via coiling or clipping can prevent rebleeding and improve outcomes, which are also impacted by age, neurological grade, amount of bleeding, vasospasm severity and other factors. Complications include rebleeding, vasospasm, hydrocephalus, seizures, and medical issues.
Hemorrhagic strokes ,Subarachnoid and Intrracerebral
CT and MRI are useful in detecting subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH). CT can detect SAH within 72 hours and locate the aneurysm. MRI is sensitive to subarachnoid blood within 12 hours. Fundus examination may reveal sub-hyaloid hemorrhage in 11-33% of SAH cases. ECG changes in SAH include prolonged QRS and T waves similar to cardiac ischemia. ICH causes include hypertension, anticoagulation, and vascular abnormalities. CT and MRI are used to diagnose ICH. Treatment depends on size and location but may include surgery or medical management.
subarachnoid hemorrhage
A group of nursing students presented a case study on subarachnoid hemorrhage. The presentation covered: an introduction to subarachnoid hemorrhage including causes and risk factors; a specific patient case including demographics, medical history, physical assessment findings and diagnostic test results; anatomy and physiology of the central nervous system; medical management including medications, interventions and treatment; nursing care and interventions; and a conclusion with recommendations. The presentation was outlined and included references.
Subarachnoid haemorrhage
Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space between the brain's outermost layers. It is often caused by the rupture of an aneurysm, which is a bulge or weakening in the wall of a brain artery. Symptoms include a sudden and severe headache, decreased consciousness, vomiting, and neck stiffness. Diagnosis involves CT scan and lumbar puncture to detect blood. Treatment focuses on preventing rebleeding through aneurysm coiling or clipping, and managing complications like hydrocephalus, vasospasm, seizures, and hyponatremia. Prognosis depends on the severity of the initial bleed and development of complications.
Cerebral aneurysm
This document discusses cerebral aneurysms, which are bulges or ballooning in the walls of blood vessels in the brain. It defines aneurysms, lists their causes such as hypertension and smoking, and describes their signs and symptoms like severe headache and alterations in consciousness. The document outlines how aneurysms are diagnosed using CT scans, MRIs, lumbar puncture, and angiography. It then discusses treatment options for aneurysms like surgical clipping or coiling to repair the damaged blood vessel, as well as medical management using medications. Finally, it lists nursing care for patients with aneurysms such as monitoring vital signs, positioning, and preparing for potential emergency surgery.
Brain aneurysm
The document discusses brain aneurysms, which are bulging, weak areas in arteries supplying blood to the brain. A brain aneurysm can rupture, causing bleeding in the skull and potentially brain damage or death. While they affect about 1% of the population overall, brain aneurysms are more common in women than men. The most common location for brain aneurysms is at the base of the brain. Risk factors include family history, previous aneurysms, gender, race, high blood pressure, and smoking. Potential symptoms include sudden, severe headaches and neck pain. Diagnosis involves CT, CTA, MRA, or cerebral angiogram scans. Treatment options are surgical clipping or endovascular coiling to prevent blood flow into the aneurys
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Subarachnoid Hemorrhage
Subarachnoid Hemorrhage is Extravasation of blood into the subarachnoid space. It occur mainly due to Ruptured aneurysm (75%).
Pharmacotherapy of Stroke
This document discusses the pharmacotherapy of stroke. It begins by defining stroke and classifying it as either ischemic or hemorrhagic. Risk factors and pathophysiology are described. Clinical presentations include weakness, speech problems, or vision loss. Diagnosis involves imaging like CT or MRI to distinguish ischemic from hemorrhagic stroke. Treatment goals are to reduce injury, prevent complications and recurrence. For ischemic stroke, IV tissue plasminogen activator within 3 hours or aspirin within 48 hours are recommended. Secondary prevention includes managing conditions like atrial fibrillation, hypertension, and diabetes to prevent future strokes.
Sub arachanoid heamorrhage
A 60-year-old male presented to the emergency department with the worst headache of his life along with nausea and vomiting. Subarachnoid hemorrhage (SAH) occurs when blood enters the subarachnoid space surrounding the brain. The most common cause is a ruptured brain aneurysm. Initial management included a CT scan, which has high sensitivity in detecting SAH, control of blood pressure to reduce risk of rebleeding, administration of nimodipine to prevent vasospasm, and neurosurgical consultation. The patient was admitted to the ICU for monitoring and treatment of potential complications of SAH such as rebleeding, vasospasm, hydrocephalus, and seizures.
Sub-Arachnoid Hemorrhage
Subarachnoid hemorrhage is caused most commonly by the rupture of a saccular aneurysm. The rupture causes blood to fill the subarachnoid space, which can lead to neurological deficits or death. Treatment involves securing the aneurysm through surgical clipping or endovascular coiling to prevent rebleeding, as well as managing complications like vasospasm, hydrocephalus, and seizures. Outcomes depend on the grade and location of the initial bleed and development of delayed cerebral ischemia.
Subarachnoid hemorrhage imaging
CT scanning is the preferred initial imaging study for diagnosing subarachnoid hemorrhage (SAH). CT scans can detect blood in the subarachnoid spaces around the brain and have a sensitivity of 93-100% within 24 hours. The amount of blood seen on CT scans correlates with risk of developing vasospasm and can help prognosticate. While CT is very accurate for diagnosing acute SAH, its sensitivity decreases after 5-7 days. If CT is negative but clinical suspicion remains, lumbar puncture should be performed.
Sah
This document summarizes imaging findings related to subarachnoid hemorrhage (SAH). It describes that SAH appears as hyperdense linear structures on CT and hyperintense on FLAIR MRI. The location of blood can localize the source of bleeding such as anterior communicating artery aneurysms presenting with blood in the interhemispheric fissure. Complications include vasospasm, hydrocephalus, and superficial siderosis. Reversible cerebral vasoconstriction syndrome is also discussed, appearing as multifocal "string of beads" narrowing on angiography that resolves within 12 weeks.
Ruptured brain aneurysm
I am a Neurosurgeon with advanced training in Interventional vascular Neurosurgery(FINR) from Zurich, Switzerland, and FMINS-Fellowship in minimally invasive and Endoscopic Neurosurgery from Germany.
I am presently working in Columbia asia hospitals, Bangalore.
My areas of interest are Vascular Neurosurgery, Stroke specialist, interventional neuroradiology.
Subarachnoid haemorrhage assessment and investigation
1) The document summarizes a presentation on the assessment and investigation of subarachnoid haemorrhage (SAH).
2) It finds that modern CT scans have high accuracy in detecting SAH within 6 hours, but lumbar puncture remains important for cases presenting later.
3) The risk of serious side effects from lumbar puncture often outweigh its benefits, except for patients with pre-test probabilities of SAH between 2-7% based on their history and exam findings.
Subarachnoid hemorrage –eso guidelines for management
1. Intracranial aneurysms have an incidence of 9 per 100,000 people, with a mortality rate of 60% within 6 months if left untreated.
2. Clinical grading scales like Hunt-Hess, WFNS, and PAASH are used to assess patients presenting with subarachnoid hemorrhage, with PAASH showing slightly better correlation with outcome.
3. Risk factors for poor outcomes from aneurysmal subarachnoid hemorrhage include older age, hypertension, aneurysm size and location, rebleeding, delayed cerebral ischemia, and hydrocephalus.
Subarachnoid hemorrhage
The document summarizes subarachnoid hemorrhage (SAH). The most common cause is a ruptured cerebral aneurysm. Clinical presentation includes sudden, severe headache and loss of consciousness. Diagnosis is made using non-contrast CT or lumbar puncture. Treatment involves securing the aneurysm with coiling or clipping, managing rebleeding risk with blood pressure control, and treating complications like hydrocephalus. Outcomes depend on factors like disease severity, treatment at high-volume centers, and management of neurological complications including rebleeding, hydrocephalus, and seizures.
Sub-arachnoid hemorrhage
Subarachnoid hemorrhage is a neurological emergency caused by sudden bleeding into the subarachnoid space, often presenting with a thunderclap headache. It is usually caused by the rupture of an intracranial aneurysm. The case fatality rate of aneurysmal SAH is 30-70% on average. Survivors often have major disability, with 60% never regaining their pre-hemorrhage quality of life. Diagnosis involves CT, LP, CTA and conventional angiography to detect the source of bleeding. Complications include rebleeding, hydrocephalus, vasospasm and hyponatremia. Aggressive treatment is aimed at securing the aneurysm to prevent re
Stroke presentation By Saba Arif
A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food.
Within minutes, brain cells begin to die.
Stroke can be either ischemic or hemorrhagic.
CT in CVA
The document discusses cerebral vascular accidents (CVA or stroke). It describes the main types of ischemic stroke including those caused by cerebral atherothrombosis, cardiogenic embolism, penetrating artery disease, and other rare causes. It discusses risk factors and the clinical presentation of ischemic stroke. It then covers the pathophysiology of ischemia including the penumbra model and thresholds for irreversible tissue damage. Diagnostic imaging findings on non-contrast CT are summarized for acute, subacute and chronic stages. CT perfusion is also discussed for assessing infarct core and penumbra size to guide treatment decisions.
Subarachnoid haemorrhage
The document provides information on subarachnoid haemorrhage (SAH), including:
- SAH is a neurological emergency caused by bleeding in the subarachnoid space, usually due to a ruptured saccular aneurysm.
- Clinical manifestations include the sudden onset of the worst headache of one's life, neck stiffness, vomiting, focal neurological deficits, and loss of consciousness.
- Investigations include non-contrast CT scan, which identifies the location and extent of subarachnoid blood in 95% of cases within 72 hours, and cerebral angiography to locate the aneurysm.
Subarachnoid Haemorrhage Management
This document provides information about subarachnoid hemorrhage (SAH):
- SAH is bleeding into the subarachnoid space, which occurs in 5% of strokes and is usually caused by a ruptured aneurysm.
- Presenting symptoms include a sudden, severe headache and signs of meningeal irritation. Investigations include CT, LP, CTA/MRA to identify the source of bleeding.
- Treatment focuses on stabilizing the patient, securing the aneurysm via coiling or clipping, and preventing/treating complications like rebleeding, hydrocephalus, seizures, and delayed cerebral ischemia.
- Complications are managed through measures like strict blood
Intracranial hemorrhage
This document discusses intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). ICH can be caused by hypertension, cerebral amyloid angiopathy, aneurysms, or bleeding disorders. Common symptoms include sudden headache, weakness on one side of the body, and altered mental status. Treatment focuses on controlling blood pressure, reducing pressure in the brain, and potentially surgically evacuating large bleeds. SAH most often results from aneurysms and presents with a sudden, severe headache. Angiography is used to locate the source of bleeding, and aneurysms are often clipped surgically to prevent rebleeding.
SAH for Neurology Residents
This document discusses aneurysmal subarachnoid hemorrhage (SAH), including its causes, diagnosis, treatment, and complications. The most common cause is rupture of a cerebral aneurysm, which accounts for 80-85% of cases. Diagnosis involves CT scan and lumbar puncture to detect blood. Angiography is used to identify the aneurysm's location. Early securing of the aneurysm via coiling or clipping can prevent rebleeding and improve outcomes, which are also impacted by age, neurological grade, amount of bleeding, vasospasm severity and other factors. Complications include rebleeding, vasospasm, hydrocephalus, seizures, and medical issues.
Hemorrhagic strokes ,Subarachnoid and Intrracerebral
CT and MRI are useful in detecting subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH). CT can detect SAH within 72 hours and locate the aneurysm. MRI is sensitive to subarachnoid blood within 12 hours. Fundus examination may reveal sub-hyaloid hemorrhage in 11-33% of SAH cases. ECG changes in SAH include prolonged QRS and T waves similar to cardiac ischemia. ICH causes include hypertension, anticoagulation, and vascular abnormalities. CT and MRI are used to diagnose ICH. Treatment depends on size and location but may include surgery or medical management.
subarachnoid hemorrhage
A group of nursing students presented a case study on subarachnoid hemorrhage. The presentation covered: an introduction to subarachnoid hemorrhage including causes and risk factors; a specific patient case including demographics, medical history, physical assessment findings and diagnostic test results; anatomy and physiology of the central nervous system; medical management including medications, interventions and treatment; nursing care and interventions; and a conclusion with recommendations. The presentation was outlined and included references.
Subarachnoid haemorrhage
Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space between the brain's outermost layers. It is often caused by the rupture of an aneurysm, which is a bulge or weakening in the wall of a brain artery. Symptoms include a sudden and severe headache, decreased consciousness, vomiting, and neck stiffness. Diagnosis involves CT scan and lumbar puncture to detect blood. Treatment focuses on preventing rebleeding through aneurysm coiling or clipping, and managing complications like hydrocephalus, vasospasm, seizures, and hyponatremia. Prognosis depends on the severity of the initial bleed and development of complications.
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Cerebral aneurysm
This document discusses cerebral aneurysms, which are bulges or ballooning in the walls of blood vessels in the brain. It defines aneurysms, lists their causes such as hypertension and smoking, and describes their signs and symptoms like severe headache and alterations in consciousness. The document outlines how aneurysms are diagnosed using CT scans, MRIs, lumbar puncture, and angiography. It then discusses treatment options for aneurysms like surgical clipping or coiling to repair the damaged blood vessel, as well as medical management using medications. Finally, it lists nursing care for patients with aneurysms such as monitoring vital signs, positioning, and preparing for potential emergency surgery.
Brain aneurysm
The document discusses brain aneurysms, which are bulging, weak areas in arteries supplying blood to the brain. A brain aneurysm can rupture, causing bleeding in the skull and potentially brain damage or death. While they affect about 1% of the population overall, brain aneurysms are more common in women than men. The most common location for brain aneurysms is at the base of the brain. Risk factors include family history, previous aneurysms, gender, race, high blood pressure, and smoking. Potential symptoms include sudden, severe headaches and neck pain. Diagnosis involves CT, CTA, MRA, or cerebral angiogram scans. Treatment options are surgical clipping or endovascular coiling to prevent blood flow into the aneurys
Diagnostic Imaging of Intracranial Aneurysms
1) The document discusses various types of intracranial aneurysms including their presentation, incidence, diagnosis, and radiographic features.
2) Saccular aneurysms are the most common type and can cause subarachnoid hemorrhage from rupture. They are often detected on CT/CTA or catheter angiography.
3) Other aneurysm types discussed include fusiform, dissecting, mycotic, oncotic, and traumatic pseudoaneurysms. These have different etiologies and features on imaging.
Medicine 5th year, 3rd lecture (Dr. Mohammed Tahir)
This document discusses intracranial hemorrhage (ICH), including its epidemiology, etiologies, diagnosis, and treatment strategies. The most common causes of ICH are hypertension and cerebral amyloid angiopathy. Diagnosis is made using CT scan. Treatment focuses on controlling blood pressure, intracranial pressure, and cerebral perfusion pressure. Surgical intervention may be indicated for large hemorrhages or those causing brain compression. New therapies are being tested to improve outcomes for this condition.
Endovascular treatment of cerebral aneurysms
1) Endovascular treatment of cerebral aneurysms has evolved from early techniques using balloons and detachable coils to modern techniques using bioactive coils, flow diverters, and liquid embolic agents.
2) Placement of coils aims to occlude the aneurysm but often results in incomplete occlusion, with recanalization rates of over 30%. Newer bioactive coils and flow diverters better induce thrombosis.
3) Flow diverters like the Pipeline device promote parent vessel reconstruction and improved aneurysm occlusion compared to traditional coiling or stenting. One-year follow up shows successful aneurysm treatment with this emerging technology.
MRA-Development-160405
The document outlines the development of the Mutual Recognition Arrangement (MRA) on Tourism Professionals in ASEAN. Key points:
1. The MRA aims to facilitate the mobility of tourism professionals within ASEAN by recognizing their competency qualifications across countries.
2. It establishes common competency standards, curriculum frameworks and certification procedures to standardize tourism education and skills recognition.
3. The MRA infrastructure includes bodies like the National Tourism Professional Boards, Tourism Professional Certification Boards, and ASEAN Tourism Professional Registration System to assess, certify and register professionals.
Mra Main Presentation 08 25 11 Ppshow Final Tw
Miami Research Associates (MRA) is the largest physician-owned clinical research center in the US, established in 1996. MRA's mission is to partner with the pharmaceutical industry to discover and develop innovative medicines through clinical research. MRA operates multiple research centers across therapeutic areas and has successfully conducted over 1,000 clinical trials. MRA prides itself on its dedicated staff and state-of-the-art 11,000 square foot Phase I facility capable of conducting complex clinical trials.
MRA General Capabilities
Experiential mobile marketing uses customized mobile tours to directly engage with customers and build brand loyalty. MRA is an expert in mobile experiential marketing, providing end-to-end services including custom vehicle design and build, staffing, tour logistics management, and marketing support. Their nationwide service network works to ensure tours are well-maintained to reliably share brand messages with millions of impressions on the road.
MRA Wikispaces Presentation
This document discusses how to use Wikispaces for blended learning. It defines wikis and Wikispaces, explaining that Wikispaces is a free and user-friendly wiki program for educators. Wikis allow for collaboration and active learning. The document provides examples of how teachers can use Wikispaces for classroom organization, hosting class content, projects, discussions, and portfolios. Specific resources and exemplary Wikispaces pages are shared. Setup of Wikispaces is demonstrated. Teachers are then instructed to begin creating unit pages on their own Wikispaces to organize and link classroom resources.
Summer Leadership Tech Session
1. The document provides an overview of various Web 2.0 tools and technologies for educational use, including social networking, sharing, and collaboration tools like blogs, wikis, podcasts, and Google Docs.
2. Examples of specific tools mentioned include Ning, Skype, YouTube, TeacherTube, SurveyMonkey, Photopeach, Flip Video, Delicious, and Google Calendar.
3. The document encourages teachers to incorporate these technologies to engage students in more meaningful learning activities and exploration of topics that interest them.
Complete Information on Cerebral Aneurysm or Brain Aneurysm
A cerebral aneurysm is a bulging, weak spot on a blood vessel in the brain that can fill with blood and put pressure on surrounding tissues. It may also leak or rupture, spilling blood into the brain. Cerebral aneurysms most often occur along arteries at the base of the skull. They can be present from birth or develop later due to injury. Symptoms may include headaches, double vision, or eye pain if the aneurysm pushes on brain structures. Tests like CT scans, MRIs, eye exams, and angiograms can diagnose cerebral aneurysms and detect any bleeding in the brain.
Classic sign crbral aneurysm pbl
This document classifies cerebral aneurysms into three cases: ruptured, leaking, and unruptured. [1] A ruptured aneurysm causes a sudden, extremely severe headache described as the "worst headache ever" along with nausea, vomiting, neck stiffness, vision changes, sensitivity to light, seizures, drooping eyelid, loss of consciousness, or confusion. [2] A leaking aneurysm may cause a mild headache and will likely rupture fully. [3] An unruptured aneurysm may be asymptomatic, but a large one could press on brain tissue and cause eye or facial pain, vision changes, numbness, or weakness. The defining symptom of an aneurysm is the extreme rapid onset of
Brain Aneurysms & AV Malformations
The document discusses brain aneurysms and arteriovenous malformations (AVMs). It defines aneurysms as dilations of arteries and describes the most common types. It lists risk factors and potential signs/symptoms. Treatment options for aneurysms include surgery to clip them or endovascular coiling. The document also defines AVMs as abnormal connections between arteries and veins, bypassing capillaries. It discusses their presentation, complications like hemorrhaging, and diagnostic tools. Treatment may involve surgery, radiosurgery, or embolization. The risks and management of complications like hydrocephalus and vasospasm are also outlined.
55 DAVID SUTTON PICTURES VASCULAR IMAGING IN NEURORADIOLOGY
This document contains 55 figures with captions describing various angiographic images of the brain and neck vasculature. The figures show normal anatomy as well as various pathological findings including aneurysms, arterial stenosis, arterial variations and anomalies. Each figure is accompanied by a brief caption labeling the structures in the image and highlighting any abnormalities.
15 DAVID SUTTON PICTURES Arteriography and Intervewntional Radiology
The document contains descriptions and images of various vascular conditions. There are over 60 figures showing ultrasound images, CT scans, MRAs, DSAs and other imaging modalities depicting abdominal aortic aneurysms, aortic dissections, arterial occlusions, aneurysms in different locations, arteriovenous malformations and fistulas. The images illustrate normal and pathological findings and are intended to demonstrate different vascular diseases and abnormalities.
Cerebral Vascular Disease
This document discusses cerebral vascular diseases such as intracranial aneurysms and arteriovenous malformations. It defines arteriovenous malformations as a congenital mal-development of blood vessels where arterial blood flows directly into draining veins without passing through capillaries first. The document also lists different types of intracranial vascular malformations including arteriovenous malformations, cavernous angioma, telangiectasia, and venous malformations. Finally, it notes some potential etiologies of intracranial aneurysms such as being idiopathic, traumatic, infectious, or radiation-induced.
Cerebral Hemorrhage By Arlyn M. Valencia, M.D. Associate Professor, Universit...
The document discusses different types of hemorrhagic stroke including primary intracerebral hemorrhage, subarachnoid hemorrhage, and hemorrhage from cerebral amyloid angiopathy. Risk factors for hemorrhagic stroke include hypertension, aging, cigarette smoking, and alcoholism. Management of hemorrhagic stroke focuses on controlling bleeding, removing blood from the brain, managing increased intracranial pressure, and treating any underlying correctable causes.
Intracranial vascular disease
This document discusses various pathologies of intracranial vascular disease including aneurysms, arteriovenous malformations (AVMs), cavernomas, and venous anomalies. It provides details on the presentation, diagnosis, and treatment of each condition. Key points include that aneurysms can cause subarachnoid hemorrhage and have risks of rupture related to size, location, and other factors. AVMs are abnormal connections between arteries and veins without an intervening capillary bed that can cause hemorrhage. Cavernomas are venous malformations that can cause seizures or hemorrhage. Venous anomalies are the most common type and appear as thickened veins on imaging.
Imaging of the traumatic brain injury by Rathachai Kaewlai, MD
This document provides an overview of imaging for traumatic brain injury (TBI). It discusses the goals of imaging in TBI, including rapid diagnosis of life-threatening injuries. Computed tomography (CT) is emphasized as the initial important imaging modality due to its availability, speed, and sensitivity for injuries requiring surgery. CT findings of various primary and secondary brain lesions are reviewed in detail. The document also discusses indications for additional imaging with skull X-rays and magnetic resonance imaging (MRI) in certain clinical scenarios.
Anatomy and intervention in cerebral vasculature
1. The cerebral vasculature includes the internal carotid and vertebral arteries which supply blood to the brain. Venous drainage occurs through dural sinuses and cerebral veins.
2. The Circle of Willis is a major vascular structure that connects the arteries of the brain. It includes components like the anterior and posterior cerebral arteries.
3. Imaging techniques used to evaluate the cerebral vasculature include conventional angiography, CT angiography, MR angiography, ultrasound and digital subtraction angiography. Each has advantages and disadvantages for assessing the anatomy and identifying abnormalities.
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Medicine 5th year, 3rd lecture (Dr. Mohammed Tahir)
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Complete Information on Cerebral Aneurysm or Brain Aneurysm
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55 DAVID SUTTON PICTURES VASCULAR IMAGING IN NEURORADIOLOGY
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15 DAVID SUTTON PICTURES Arteriography and Intervewntional Radiology
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Cerebral Hemorrhage By Arlyn M. Valencia, M.D. Associate Professor, Universit...
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Acute thrombolysis in Stroke PPT Dr Jankar copy.
This document discusses protocols for treating acute ischemic stroke with intravenous thrombolysis (IV tPA). It emphasizes that reducing time from hospital arrival to tPA treatment (door-to-needle time) is critical, as earlier treatment leads to better patient outcomes. The National Institutes of Health Stroke Scale (NIHSS) is used to quantify stroke severity and monitor for deterioration, and online certification is available. Intravenous tPA should be administered as a 10% bolus followed by a 60 minute infusion at 0.9 mg/kg, with blood pressure and neurological monitoring during and after treatment.
Stroke power point presentation copy.pptx
1) Acute ischemic stroke is the most common type of stroke and time is critical for treatment. The earlier treatment can begin, the better the outcomes.
2) Thrombolysis using rtPA is the standard treatment for acute ischemic stroke but it is still underused. Reducing the door-to-needle time to under 60 minutes is the most important factor for improving patient outcomes.
3) RtPA works by disrupting blood clots. It is administered as a 10% bolus followed by a 90% infusion over 60 minutes. Close monitoring of blood pressure and neurological status is required during and after treatment due to risk of hemorrhage.
Epidural abcess a case presentation
This document presents a case study of a 68-year-old female patient who presented to the emergency department with worsening lower back pain, lower limb weakness, loss of sensation, urinary retention, and fever. Imaging revealed an extensive precontrast T1 hyperintense thoracolumbar spinal canal extramedullary collection consistent with a spinal epidural abscess. The patient was treated with hemodialysis, IV antibiotics, and a neurosurgery consultation was obtained. The document reviews spinal epidural abscesses, including risk factors, pathogenesis, diagnosis, differential diagnosis, management, and key points.
Epidural abcess a case presentation
This document presents a case study of a 68-year-old female patient who presented to the emergency department with worsening lower back pain, lower limb weakness, loss of sensation, urinary retention, and fever. Imaging revealed an extensive precontrast T1 hyperintense thoracolumbar spinal canal extramedullary collection consistent with a spinal epidural abscess. The patient was treated with hemodialysis, IV antibiotics, and a neurosurgery consultation was obtained. The document reviews spinal epidural abscesses, including risk factors, pathogenesis, diagnosis, differential diagnosis, management, and key points.
Acute Stroke management
This document discusses acute ischemic stroke interventions. It provides details on:
- The typical size and duration of untreated ischemic strokes
- How many neurons and synapses are lost each hour and minute of untreated stroke
- Guidelines for emergency evaluation, diagnosis, and imaging of acute ischemic strokes
- Details on different imaging techniques like CT, MRI, CTA, and perfusion imaging
- Guidelines and recommendations for intravenous thrombolysis with rtPA within 3-4.5 hours of stroke onset.
Anesthesia for cerebral aneurysm repair
The document discusses the anesthetic management of patients undergoing treatment for cerebral aneurysms, including definitions, epidemiology, presentation, diagnosis, management of vasospasm, intracranial pressure, pre-operative assessment and testing, and radiological procedures such as coiling of aneurysms. Precise management of hemodynamics, fluid balance, and respiratory status is important due to the risks of re-bleeding, cerebral ischemia, and impaired autoregulation in these patients.
stroke management
1. The document discusses the diagnosis and management of stroke. It defines stroke, reviews the etiology and types of stroke, and describes tools to assess stroke severity such as the NIHSS score.
2. Acute management of stroke is discussed for both ischemic and hemorrhagic stroke. Treatment options for ischemic stroke include tPA administration and mechanical thrombectomy. Surgery may be considered for hemorrhagic stroke depending on location and size of bleeding.
3. Supportive care measures are also outlined, such as blood pressure and glucose management, antiepileptic drugs, and treating fever, to improve stroke outcomes. The document emphasizes the importance of specialized stroke units for patient care.
SUBARACHNOID HEMORRHAGE
1. A 50-year-old female smoker with hypertension presented with sudden severe headache and brief loss of consciousness at work. She was found to have subarachnoid hemorrhage.
2. Subarachnoid hemorrhage is a neurological emergency caused by bleeding into the subarachnoid space, usually from a ruptured berry aneurysm. It requires rapid diagnosis and treatment to prevent rebleeding, vasospasm, and other complications.
3. Diagnostic tests included a non-contrast CT, which was positive, as well as a CTA and lumbar puncture to confirm the diagnosis and identify the source of bleeding. The patient was treated supportively in the ICU to control
Case report: atypical Rathkes cleft cyst
An 11-year-old female presented with transient headaches for 3 months. MRI revealed a cystic mass in her sella and suprasellar region. Differential diagnoses included Rathke's cleft cyst, epidermoid cyst, and craniopharyngioma. A Rathke's cleft cyst was considered more likely given the imaging findings of a cyst with hyperintense T1 signal and the presence of an intracystic nodule. Treatment for symptomatic cases typically involves drainage or resection of the cyst.
Case report demo 1
An 11-year-old female presented with transient headaches for 3 months. MRI revealed a cystic mass in her sella and suprasellar region. Differential diagnoses included Rathke's cleft cyst, epidermoid cyst, and craniopharyngioma. A Rathke's cleft cyst was considered more likely given the presence of an intracystic nodule on MRI. Treatment would involve aspiration or excision if symptoms worsen, as Rathke's cleft cysts often remain stable without intervention.
Stroke Imaging
This document provides an overview of stroke neuroimaging essentials. It begins with an introduction to stroke basics, including definitions of ischemic and hemorrhagic strokes. It then covers typical stroke presentations based on the affected territory. The document outlines the imaging approach to acute stroke, including the role of non-contrast CT, CTA, and MRA. It reviews common early signs on non-contrast CT such as the hyperdense vessel sign. Later signs like hypoattenuation and mass effect are also discussed. The document concludes with an example case walking through the imaging and management of an acute stroke patient.
Management of acute ischemic stroke including tia [autosaved]
acute ischemic stroke, classification, risk factors,investigations,management according to latest aha/asa guidelines 2018
Identifying and managing acute stroke
This document discusses identifying and managing acute stroke. It begins by outlining stroke, including defining ischemic stroke and transient ischemic attack. It then discusses the classification, epidemiology and data from Malaysia on stroke. Risk factors like hyperhomocysteinemia and depression post-stroke are mentioned. The management of acute ischemic stroke is summarized, including thrombolysis guidelines. General investigations and imaging for acute stroke are provided. The document concludes by discussing secondary prevention strategies post-stroke.
C.08a-Diagnosis-and-Treatment-of-Acute-Ischemic-Stroke-Presentation-ppt.pptx
1. The document discusses the diagnosis and treatment of acute ischemic stroke. It outlines the time windows for treatment with intravenous thrombolysis, which is most effective within 4.5 hours of symptom onset.
2. Early diagnosis is critical in stroke care due to the concept of "time is brain". Delays in treatment can lead to further neuronal damage and worse outcomes. The goals are to perform a CT scan within 20 minutes of arrival and initiate thrombolysis within 60 minutes.
3. Post-thrombolytic management focuses on monitoring for hemorrhagic complications and providing supportive care to reduce disability from the stroke.
Brief review in cerebellar stroke -diagnosis
Cerebellar strokes can present with non-specific symptoms like dizziness, nausea, and gait instability. Neurological exams can reveal signs of ataxia, nystagmus, and limb or trunk tremors. MRI is the preferred brain imaging method for diagnosis due to its high sensitivity, while CT scans have lower sensitivity for posterior fossa strokes. Larger lesion sizes (>20cm3) and hemorrhagic strokes are associated with poorer outcomes. Management includes monitoring for cerebellar edema and surgical interventions if herniation or brainstem compression occurs.
Vasculitis for undergraduates
Full academic & clinical informations needed from undergraduates & GP to help in diagnosis & management of cases with Vasculitis
MRI Brain
This document outlines an MRI brain protocol. It begins with an introduction to MRI brain imaging and its advantages over CT, such as lack of radiation exposure and greater soft tissue contrast. Common indications for MRI brain are then listed. The document describes patient preparation, contrast usage, coil positioning, imaging sequences including T1, T2, FLAIR, DWI, and advanced techniques like MRS and fMRI. Specific protocols are provided for conditions like MS, trauma, pituitary imaging, and CSF flow studies.
Thunder
This document summarizes a neurosciences academic meeting that discussed a case of a 25-year-old female who presented with sudden onset of her worst headache ever. Differential diagnoses for thunderclap headache were discussed. Imaging revealed a subarachnoid hemorrhage from an aneurysm. The meeting discussed CT and MR angiography as diagnostic tools compared to catheter angiography, and yields of CSF analysis for diagnosing aneurysmal subarachnoid hemorrhage. Causes of subarachnoid hemorrhage without an identified aneurysm were also reviewed, as well as a new clinical decision tool to exclude subarachnoid hemorrhage.
Cerebral venous sinus thrombosis
This document describes a case of cerebral venous thrombosis (CVT) in a 20-year-old female patient who presented with worsening headache, nausea, dizziness, and blurred vision. It provides details on her medical history, physical exam findings, lab and imaging results. CVT is an uncommon type of stroke more common in young individuals. Risk factors include genetic thrombophilias, acquired conditions like pregnancy/puerperium and cancer. Clinical symptoms vary depending on increased intracranial pressure or focal brain injury. Management involves anticoagulation to stop thrombotic process along with supportive care. Outcomes range from full recovery in 80% of patients to mortality in 6-20% depending on severity of presentation
109890management_stroke.ppt
This document provides information on the management of stroke. It defines stroke and transient ischemic attack (TIA). It describes the different types of stroke and outlines the rationale for developing a stroke acute care pathway. The pathway includes components for TIA management, administration of thrombolysis for ischemic stroke patients within 3 hours of onset, organized inpatient care in a stroke unit, neurointervention, and stroke surgery. It provides details on each component, including evidence-based guidelines and levels of evidence. The goal is to establish an efficient system to rapidly diagnose and treat stroke patients according to best practices to improve outcomes.
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Brain Aneurysm Coiling : Endovascular Coiling of Intracranial Aneurysms in Mumbai
- 1. BRAIN ANEURYSM COILING Dr.Saurabh Joshi, MD, FNVIR www.VeinCenter.in
- 2. • 26 yr old male presented with sudden onset severe headache.
- 4. CLINICAL GRADING SCALES FOR SAH Grade Description Hunt and Hess Scale 1 Asymptomatic or minimal headache and slight nuchal rigidity 2 Moderate to severe headache, nuchal rigidity, no neurological deficit other than cranial nerve palsy 3 Drowsiness, confusion, or mild focal deficit 4 Stupor, moderate to severe hemiparesis, possible early decerebrate rigidity and vegetative disturbances 5 Deep coma, decerebrate rigidity, moribund appearance
- 5. CLINICAL GRADING SCALES FOR SAH Grade Description World Federation of Neurological Surgeons Scale 1 GCS 15, no motor deficit 2 GCS 13 to 14, no motor deficit 3 GCS 13 to 14, with motor deficit 4 GCS 7 to 12, with or without motor deficit 5 GCS 3 to 6, with or without motor deficit
- 6. THE FISHER GRADING OF SAH AS DEMONSTRATED BY CT SCAN Grade 1 2 3 4 Description No blood detected A diffuse deposition or thin layer with all vertical layers of blood (interhemispheric fissure, insular cistern, ambient cistern) less than 1 mm thick) Localized clots and/or vertical layers of blood 1 mm or greater in thickness Diffuse or no subarachnoid blood, but with intracerebral or intraventricular clots
- 7. • Next investigation ??
- 8. • MRA / CTA / DSA ? • CT angiography and MR angiography have limited sensitivity in the detection of small aneurysms. • The accepted reference standard for identification of intracranial aneurysms is intra arterial digital subtraction angiography
- 15. • Elective ventilation for 12 hrs. • Extubated coming morning / HHH protocol. • Uneventful recovery • F/u CT after 3 days significant resolution of the SAH. • Discharged Day 8 after coiling.
- 16. • Dr.Saurabh Joshi is a Neuro and Vascular Interventional Radiologist practicing in a tertiary care hospital in Mumbai. • For Appointments : +919967368256 ( Mon – Sat 9 :00 to 19:00 India Standard Time ) • drsaurabhjoshi1@gmail.com