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BACKGROUND AND PURPOSE Elevated blood pressure (BP) is commonly observed in acute ischemic stroke and is known to be associated with hemorrhagic transformation (HT). However, the effect of BP variability on the development of HT is not known well. METHODS A consecutive series of patients with acute ischemic stroke, who were hospitalized within 24 hours of(More)
CONTEXT Although embolism and low-flow phenomenon are the 2 main mechanisms of stroke in internal carotid artery (ICA) occlusive disease, the mechanism of border-zone infarction remains controversial. Diffusion-weighted imaging (DWI) can more easily detect small or multiple ischemic lesions than conventional imaging. OBJECTIVES To investigate the ischemic(More)
OBJECTIVE To report changes of cerebral blood flow and metabolism associated with status epilepticus after cardiac arrest. DESIGN Case report. SETTING Neurological intensive care unit in a university hospital. PATIENT An 85-year-old man resuscitated from out-of-hospital cardiac arrest underwent brain multimodality monitoring and treatment with(More)
BACKGROUND AND PURPOSE To identify a minimally acceptable cerebral perfusion pressure threshold above which the risks of brain tissue hypoxia (BTH) and oxidative metabolic crisis are reduced for patients with subarachnoid hemorrhage (SAH). METHODS We studied 30 poor-grade SAH patients who underwent brain multimodality monitoring (3042 hours).(More)
The Long-Evans Cinnamon (LEC) rat, which accumulates excess copper (Cu) in its liver, is an animal model of Wilson's disease. We evaluated and compared the distributions of Cu, ferrous (Fe2+), and ferric (Fe3+) iron in four-brain regions, namely, in the cerebral cortex, cerebellum, substantia nigra (SN), and striatum of LEC and Long-Evans Agouti rats at 30(More)
BACKGROUND As the practice of aggressive temperature control has become more commonplace, new clinical problems are arising, of which shivering is the most common. Treatment for shivering while avoiding the negative consequences of many anti-shivering therapies is often difficult. We have developed a stepwise protocol that emphasizes use of the least(More)
BACKGROUND Silent infarction is common in poor-grade subarachnoid hemorrhage (SAH) patients and associated with poor outcome. Invasive neuromonitoring devices may detect changes in cerebral metabolism and oxygenation. METHODS From a consecutive series of 32 poor-grade SAH patients we identified all CT-scans obtained during multimodal neuromonitoring and(More)
OBJECTIVE Although brain swelling is an important cause of neurological deterioration, real time measurement of brain edema does not currently exist. Because thermal conductivity is proportional to percentage water content, we used the thermal conductivity constant to estimate brain water content (BWC). METHODS Between June 2008 and November 2010, 36(More)
INTRODUCTION We sought to determine the effect of nutritional support and insulin infusion therapy on serum and brain glucose levels and cerebral metabolic crisis after aneurysmal subarachnoid hemorrhage (SAH). METHODS We used a retrospective observational cohort study of 50 mechanically ventilated poor-grade (Hunt-Hess 4 or 5) aneurysmal SAH patients who(More)
BACKGROUND AND PURPOSE Limited data exist to recommend specific cerebral perfusion pressure (CPP) targets in patients with intracerebral hemorrhage. We sought to determine the feasibility of brain multimodality monitoring for optimizing CPP and potentially reducing secondary brain injury after intracerebral hemorrhage. METHODS We retrospectively analyzed(More)