Abstract:
:Acute coagulopathy is common after traumatic brain injury (TBI), particularly in severe cases of acute subdural hemorrhage (ASDH). Although acute coagulopathy is associated with poor outcomes, the optimal treatment strategy remains unknown. Here, we report the initial results of an empirical cryoprecipitate transfusion strategy that we developed as an early intervention for acute coagulopathy after TBI. We performed chart reviews of adult patients (aged ≥18 years) who received early cryoprecipitate transfusion after admission to our institution with a diagnosis of severe TBI (Glasgow Coma Scale ≤8) and ASDH from March 2013 to December 2016. We compared the outcomes of these patients with those who were treated before the implementation of the cryoprecipitate transfusion strategy (January 2011-February 2013). During the study period, 33 patients received early cryoprecipitate transfusion and no acute transfusion-related adverse event was reported. The rate of coagulopathy development within 24 h after admission was lower in these patients (23%) than in the controls (49%), but the difference was not significant (P = 0.062). The in-hospital mortality rate was 36% in patients receiving early cryoprecipitate transfusion and 52% in controls. After adjusting for confounding factors, the in-hospital mortality rate was significantly lower in the intervention period [adjusted odds ratio: 0.25, 95% confidence interval (CI): 0.08-0.78, P = 0.017]. In summary, we analyzed initial results of a cryoprecipitate transfusion strategy in patients with severe isolated TBI and ASDH. No acute transfusion-related adverse event was observed, and early transfusion of the in-house-produced cryoprecipitate may have reduced rates of coagulopathy development and in-hospital mortality.
journal_name
Neurol Med Chir (Tokyo)journal_title
Neurologia medico-chirurgicaauthors
Shibahashi K,Nishimura S,Sugiyama K,Hoda H,Hamabe Y,Fujita Hdoi
10.2176/nmc.oa.2019-0062subject
Has Abstractpub_date
2019-10-15 00:00:00pages
371-378issue
10eissn
0470-8105issn
1349-8029journal_volume
59pub_type
杂志文章abstract::A 64-year-old male presented with an extremely unusual case of solitary clivus metastasis from gastric cancer manifesting as mild headache and diplopia 10 years after radical excision of the primary tumor. The patient underwent surgical resection using an endoscopic transsphenoidal approach. Histological examination r...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.52.751
更新日期:2012-01-01 00:00:00
abstract::A 60-year-old female presented with a very rare spontaneous dissection in the common carotid artery manifesting as disturbance of consciousness and left dense hemiparesis immediately after swimming. Cerebral angiography showed complete obstruction of the right common carotid artery. Endarterectomy was performed to rem...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.35.373
更新日期:1995-06-01 00:00:00
abstract::A 44-year-old woman and a 55-year-old woman were treated with gamma knife surgery (GKS) for occipital arteriovenous malformation (AVM). Angiography confirmed complete nidus obliterations 2 years after GKS. However, both patients complained of chronic headache and visual symptoms from around 7 years after GKS. Magnetic...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.50.62
更新日期:2010-01-01 00:00:00
abstract::The authors report two rare cases of multiple meningiomas in both the intracranial and spinal regions. A 64-year-old female presented with a right sphenoidal ridge meningioma and a cervical extramedullary meningioma. Tumor histology was transitional and vacuolated types, respectively. The tumors were removed successfu...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.31.720
更新日期:1991-11-01 00:00:00
abstract::A rare case of an epidermoid tumor lying within Meckel's cave is reported. A 27-year-old housewife presented with complaints of right facial hypesthesia for two and a half years. On examination she had partial loss of touch sensation in the right trigeminal nerve distribution. Magnetic resonance imaging revealed a tum...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.40.74
更新日期:2000-01-01 00:00:00
abstract::Parent artery occlusion (PAO) is an alternative to surgical clipping or endovascular endosaccular coil embolization for the management of cerebral aneurysms. Most giant and fusiform aneurysms are not amenable to endosaccular coil embolization due to anatomical considerations, such as a broad-neck. However, majority of...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract::The distribution of exogenous 45Ca in the focal ischemia rat model (middle cerebral artery occlusion) was studied using 45Ca autoradiography. High 45Ca accumulations were observed in the frontal cortex and caudate-putamen corresponding with morphological damage shown by HE staining. Regional 45Ca concentrations were c...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.34.76
更新日期:1994-02-01 00:00:00
abstract::An infant presented with a rare cervical (non-terminal) myelocystocele as a congenital skin-covered mass located in the midline of the posterior aspect of her neck. Magnetic resonance (MR) imaging and computed tomography showed a cystic mass filled with cerebrospinal fluid in the midline of the posterior aspect of the...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.50.174
更新日期:2010-01-01 00:00:00
abstract::Patients with cervical spondylotic myelopathy sometimes complain of cognitive dysfunction, which may be coincidence. However, cognitive dysfunction may be related to disorders of the cervical spine and/or spinal cord. This study investigated cognitive dysfunction in patients with cervical spinal disorders. A total of ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.50.554
更新日期:2010-01-01 00:00:00
abstract::A rare diaphragma sellae meningioma presenting only with signs of hypopituitarism occurred in a 54-year-old male. Preoperative magnetic resonance (MR) imaging clearly demonstrated a small lesion in the supradiaphragmatic area immediately beneath the optic chiasm, displacing the pituitary stalk laterally. Intraoperativ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.32.765
更新日期:1992-09-01 00:00:00
abstract::A 61-year-old man presented with a large cerebellopontine angle meningioma manifesting as a 1-year history of deafness on the right side, in whom hearing was restored from the deaf state immediately after tumor resection. Neuroimaging demonstrated a large mass in the right cerebellopontine angle, originating at the re...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.41.352
更新日期:2001-07-01 00:00:00
abstract::Superficial siderosis is a rare condition caused by hemosiderin deposits in the central nervous system (CNS) due to prolonged or recurrent low-grade bleeding into the cerebrospinal fluid (CSF). CNS tumor could be one of the sources of bleeding, both pre- and postoperatively. We report an extremely rare case of superfi...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.cr.2012-0362
更新日期:2015-01-01 00:00:00
abstract::Hemangioblastoma in the suprasellar region is rare. We present a case of a suprasellar hemangioblastoma that underwent surgical resection using an extended endoscopic transsphenoidal approach. A 64-year-old female patient presented with headache and decreased visual acuity for the last four years, computed tomography ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.cr2011-0016
更新日期:2013-01-01 00:00:00
abstract::The efficacy of endovascular interventions based on magnetic resonance (MR) imaging for acute ischemic stroke caused by embolic carotid T occlusion was assessed. Endovascular intervention was performed in 10 of 751 consecutive acute ischemic stroke patients admitted to our institution between April 2001 and July 2003....
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.51.282
更新日期:2011-01-01 00:00:00
abstract::Transforaminal full-endoscopic lumbar discectomy (TELD) can be performed under local anesthesia. However, there have been no reports on risk factors for a change in vital signs or the need for additional medications to maintain adequate analgesia during this procedure. The purpose of this study was to identify risk fa...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.oa.2020-0275
更新日期:2021-01-28 00:00:00
abstract::An 88-year-old woman presented with a supratentorial primitive neuroectodermal tumor (PNET) manifesting as disturbance of consciousness and left hemiplegia. Magnetic resonance imaging showed a large mass lesion in the right frontotemporal region. She underwent biopsy of the lesion that confirmed the diagnosis of PNET....
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.45.530
更新日期:2005-10-01 00:00:00
abstract::The severe combined immunodeficiency (SCID) mouse was investigated as a model system to study the growth and immunogenicity of human gliomas. Human glioma cell lines U-251MG, KNS-42, SF-188, A-172, and T-98G were injected subcutaneously into SCID mice. The cell lines U-251MG and KNS-42 grew as large, subcutaneous mass...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.36.286
更新日期:1996-05-01 00:00:00
abstract::The protective effect of nilvadipine, a Ca2+ antagonist, on cerebral ischemia was investigated in spontaneously hypertensive rats. The 12-week-old animals were treated for 7 days with either nilvadipine or vehicle using osmotic pumps implanted subcutaneously. Group 1 animals (n = 10) received the vehicle, and Group 2 ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.36.151
更新日期:1996-03-01 00:00:00
abstract::Twenty-eight patients with spontaneous carotid-cavernous sinus fistulas (CCFs) were treated using a variety of techniques. Three of four patients with direct CCFs underwent intravascular embolization with a detachable balloon. Embolization with polyvinyl alcohol particles through an external carotid endoarterial route...
journal_title:Neurologia medico-chirurgica
pub_type: 临床试验,杂志文章
doi:10.2176/nmc.34.597
更新日期:1994-09-01 00:00:00
abstract::The correlation between various clinical parameters and MIB-1 (Ki-67) staining indices was evaluated in 58 acoustic neurinomas. The index ranged from 0.37% to 6.61% (mean 1.70%), and did not correlate with age, sex, or initial tumor volume. Sixteen of the 18 tumors removed subtotally or partially showed regrowth, and ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.36.698
更新日期:1996-10-01 00:00:00
abstract::Cancers of the paranasal sinuses and nasal cavity are the most common malignant tumors of the anterior and anterolateral skull base. The treatment of these tumors affecting the skull base is complex due to the significant anatomical features. We examined 25 patients, 17 males and 8 females with mean age 61 +/- 2 years...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.50.20
更新日期:2010-01-01 00:00:00
abstract::Vertebral arteriovenous fistula (VAVF), which can cause subarachnoid hemorrhage (SAH) when having a perimedurally drainage, has been reported as a rare vascular abnormality in patients with neurofibromatosis type 1 (NF-1). In addition, extracranial vertebral aneurysm (EVAn) coexisting with VAVF and NF-1 is considered ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.cr.2017-0241
更新日期:2018-04-15 00:00:00
abstract::Dynamic computed tomographic (DCT) scans with iodine contrast enhancement were compared with simultaneously obtained xenon CT studies of cerebral blood flow (CBF) in 15 patients with subacute or chronic cerebrovascular ischemic disease. Specifically, the width and corrected first moment (cMT1), as demonstrated by DCT,...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.29.20
更新日期:1989-01-01 00:00:00
abstract::Pituitary cysts are fairly often found incidentally in anatomical studies, but symptomatic cysts are relatively uncommon. In this study, the histological characteristics of 42 asymptomatic and three symptomatic Rathke's cleft cysts were examined and compared. The 42 cysts found incidentally at autopsy were classified ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.29.88
更新日期:1989-02-01 00:00:00
abstract::A 68-year-old woman presented with an extremely rare intracranial metastasis from a gastrointestinal stromal tumor (GIST) manifesting as left hemiparesis 2 years after resection of a sacral tumor adjacent to the coccygeal bone. Magnetic resonance imaging revealed an intracranial tumor in the right parietal lobe. Crani...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.46.254
更新日期:2006-05-01 00:00:00
abstract::Coagulation factors were studied in 30 fluids aspirated from 25 patients with chronic subdural hematoma. Compared with the normal range for plasma, the hematoma fluids demonstrated a marked reduction in factors II, V, VII, VIII, and X, moderate reduction of factors IX and XI, and slight reduction of XII. Factor VII an...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.31.32
更新日期:1991-01-01 00:00:00
abstract::The rise in the incidence of tuberculosis is generally related to human immunodeficiency virus infection. However, intracranial tuberculoma, a complication of tuberculosis considered to be a critical disease, can develop even in the absence of immunosuppressive state. Here, we describe 2 cases of intracranial tubercul...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.53.259
更新日期:2013-01-01 00:00:00
abstract::A 21-year-old woman with severe mitral valve regurgitation due to infectious endocarditis was transferred to our institute in a deep coma with intracerebral hemorrhage and acute subdural hematoma. She had no history of head injury. Brain computed tomography revealed left frontoparietal intracerebral hematoma and adjac...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.43.541
更新日期:2003-11-01 00:00:00
abstract::A 41-year-old female suffered transient ischemic attack. Cerebral angiography revealed occlusion of the left internal carotid artery at the cervical portion and collateral pathways consisting of transpial anastomosis and parenchymal anastomosis from the posterior circulation. Five years later, the second angiography w...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.31.957
更新日期:1991-12-01 00:00:00
abstract::Dynamic biologic modeling was used to calculate the transfer rate constant for gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) and capillary permeability in the outer membrane of chronic subdural hematomas and effusions. Following intravenous Gd-DTPA injection, Gd concentrations in the subdural fluid and in t...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.38.697
更新日期:1998-11-01 00:00:00