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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)
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)
BACKGROUND The objective of this study was to investigate the relationship between cardiac index (CI) response to a fluid challenge and changes in brain tissue oxygen pressure (PbtO(2)) in patients with subarachnoid hemorrhage (SAH). METHODS Prospective observational study was conducted in a neurological intensive care unit of a university hospital.(More)
BACKGROUND Nimodipine is the only medication shown to improve outcomes after aneurysmal subarachnoid hemorrhage (SAH). Preliminary theories regarding the mechanism by which it prevents vasospasm have been challenged. The acute physiologic and metabolic effects of oral Nimodipine have not been examined in patients with poor-grade SAH. METHODS This is an(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 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)
The usefulness of 64-multidetector row computed tomography (MDCT) for the evaluation of aortic atherosclerotic disease (AAD), a potential source of cerebral emboli, has recently been suggested. We aimed to assess the significance of AAD by using MDCT in patients who are suspected to have had embolic stroke clinically or radiologically but without evident(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)
BACKGROUND AND PURPOSE Delayed cerebral ischemia (DCI) is an important complication after subarachnoid hemorrhage and appears to be associated with clot burden on CT. Quantification of hemorrhage on digitized images may be a more accurate method for predicting DCI than qualitative scales. METHODS Quantitative analysis of clot burden on CT was performed in(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)