Abstract:
:An anecdotal series of nine patients (three men and six women with an average age of 57 years) presented with progressive neurologic deterioration while on medical therapy for large right hemispheric cerebral infarction. Clinical signs of uncal herniation (anisocoria or fixed and dilated pupils, and/or left hemiplegia with right decerebrate posturing) were present in seven of these nine patients. Computerized tomography of the head confirmed mass effect from cerebral edema. It was the clinical judgment of the treating neurologists and neurosurgeons that each of these nine patients would perish unless surgical decompression of the infarcted brain was performed. Accordingly, each was treated with right hemicraniectomy and dural augmentation. Six patients demonstrated neurologic improvement on the first postoperative day. One patient, with a postoperative diagnosis of lung cancer, died 1 month after surgery. The remaining eight patients are currently living with their families with a follow-up period ranging from 5 to 25 months. Patient outcome as evaluated by the Barthel Index indicates that three individuals are functioning with minimal assistance and that the remaining six patients are functionally dependent. After rehabilitative therapy, four patients returned for elective cranioplasty. These results suggest that hemicraniectomy can be an effective lifesaving procedure for malignant cerebral edema after large hemispheric infarction.
journal_name
Strokejournal_title
Strokeauthors
Delashaw JB,Broaddus WC,Kassell NF,Haley EC,Pendleton GA,Vollmer DG,Maggio WW,Grady MSdoi
10.1161/01.str.21.6.874subject
Has Abstractpub_date
1990-06-01 00:00:00pages
874-81issue
6eissn
0039-2499issn
1524-4628journal_volume
21pub_type
杂志文章相关文献
STROKE文献大全abstract:BACKGROUND AND PURPOSE:Delayed cerebral ischemia and infarction due to reduced CBF remains the leading cause of poor outcome after aneurysmal subarachnoid hemorrhage. Hypertonic saline (HS) is associated with an increase in CBF. This study explores whether CBF enhancement with HS in patients with poor-grade subarachnoi...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.109.560698
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Evidence now exists for a pathogenic role for neutrophils in acute cerebral ischemia. We have studied the patterns and temporal profile of cerebral neutrophil recruitment to areas of acute ischemic stroke (IS) and have attempted to correlate this with neurological status and outcome. METHODS:Pat...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000130592.71028.92
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Depression after stroke is often described as underdiagnosed and undertreated. However, there are few data on self-reported depression and use of antidepressants in stroke patients at large. MATERIALS AND METHODS:In the Swedish national quality assessment register, Riks-Stroke, 15 747 stroke sur...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000121643.86762.9a
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:A ruptured intracranial aneurysm (IA) is the leading cause of a subarachnoid hemorrhage. This study seeks to define a specific gene whose mutation leads to disease. METHODS:More than 500 IA probands and 100 affected families were enrolled and clinically characterized. Whole exome sequencing was ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.116.014161
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hyperglycemia enhances the deleterious effect of global cerebral ischemia. One possible explanation is that increased anaerobic glycolysis leads to exaggeration of intracellular acidosis and increased postischemic edema. To examine the importance of this edema on postischemic cerebral perfusion d...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.27.8.1405
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The applicability of a novel differentiation technique in embolus detection based on the coincidence principle and using a multigate probe was evaluated in this study. METHODS:According to the coincidence method, high-intensity transients should only be classified as microembolic signals if they...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.27.4.683
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The efficacy and safety of different antiplatelet regimes for prevention of stroke in patients at high risk were investigated in a systematic review and meta-analysis. METHODS:We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Web of Science. Twenty-two studies comprisi...
journal_title:Stroke
pub_type: 杂志文章,meta分析,评审
doi:10.1161/STROKEAHA.113.002590
更新日期:2014-02-01 00:00:00
abstract::Background and Purpose- The optimal antithrombotic strategy to balance thromboembolic and bleeding events, especially acute stroke, for patients with atrial fibrillation following coronary stenting remains a matter of debate. We conducted a network meta-analysis to identify the antithrombotic regimen associated with t...
journal_title:Stroke
pub_type: 杂志文章,meta分析
doi:10.1161/STROKEAHA.119.026078
更新日期:2019-08-01 00:00:00
abstract::The morphologic description and measurements of endarterectomy specimens are usually believed to be accurate and are used as the gold standard against which the findings of diagnostic procedures are judged. Pathology data on 289 endarterectomy specimens from five participating centers and the corresponding angiography...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.19.3.289
更新日期:1988-03-01 00:00:00
abstract::We have investigated the effects of a reduced regional or a reduced body temperature, on pial arteriolar response to a variety of vasoactive stimuli. This has been done by studying the effects of these stimuli on groups of mice with different body temperatures, or with different temperatures of the artificial cerebros...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.9.6.580
更新日期:1978-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Tacrolimus, an immunosuppressant agent, has been shown to reduce tissue injury and leukocyte accumulation after transient ischemia. This study was designed to evaluate quantitatively the inhibitory effects of tacrolimus on leukocyte rolling and on subsequent leukocyte accumulation in vivo after t...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.29.7.1431
更新日期:1998-07-01 00:00:00
abstract::Non-invasive vascular testing has proven to be an effective means of identifying patients with significant extracranial carotid artery disease. Such tests can yield valuable physiologic data in patients with TIAs and can identify patients with soft signs who may have significant carotid artery disease and who may be c...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.11.4.325
更新日期:1980-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We earlier reported that risk factors for stroke prepare brain stem tissue for a modified Shwartzman reaction, including the development of ischemia and hemorrhage and the production of tumor necrosis factor-alpha, after a provocative dose of lipopolysaccharide. In the present study, we sought to...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.24.6.880
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We have developed a minimally invasive model of photothrombotic occlusion of the distal middle cerebral artery in rats and have evaluated the patterns and features of the resulting histopathologic injury in two normotensive strains. METHODS:Food-deprived male Sprague-Dawley (n = 14) and Wistar (...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.24.2.286
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:There is little data regarding the cost of pediatric stroke care or the elements that contribute to these costs. We examined costs for poststroke care during the first year after diagnosis and compared these costs with the volume of the cerebral infarct and the level of neurological and functiona...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.107.497420
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The purpose of this study was to evaluate the impact of new treatments by examining the changes between 1990 to 1991 and 2000 to 2001 in in-hospital mortality rates and hospital charges in adult patients with stroke. METHODS:From the Nationwide Inpatient Survey, the largest all-payer inpatient c...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.106.467506
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Thick cisternal clot on CT is a well-recognized risk factor for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH). Whether intraventricular hemorrhage (IVH) or intracerebral hemorrhage (ICH) predisposes to DCI is unclear. The Fisher CT grading scale identifies thick SAH but does...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/hs0901.095677
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The primary purpose of intracranial aneurysm treatment is to prevent rupture. Risk factors for rupture after aneurysm treatment have not been clearly established, and the need to completely occlude aneurysms is debated. METHODS:The Cerebral Aneurysm Rerupture After Treatment (CARAT) study is an ...
journal_title:Stroke
pub_type: 杂志文章,多中心研究
doi:10.1161/STROKEAHA.107.495747
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We aimed to investigate the relationship between early NT-proBNP (N-terminal probrain natriuretic peptide) and all-cause death in patients receiving reperfusion therapy, including intravenous thrombolysis and endovascular thrombectomy (EVT). METHODS:This study included 1039 acute ischemic stroke...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.120.029593
更新日期:2021-01-01 00:00:00
abstract::A new technique is described for the autoradiographic determination of regional brain glucose metabolism employing 14C labeled glucose as substrate and measurement principles previously described for whole brain. Regional glucose values correlate closely with those reported for the 14C-deoxyglucose technique. The meth...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.10.6.690
更新日期:1979-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Ageing is associated with a decline in cerebral blood flow. Animal studies have shown that cholesterol-lowering therapy with statins might preserve cerebral blood flow (CBF). We examined the effect of 40 mg pravastatin on the decline in CBF and brain volume in a subset of elderly subjects partici...
journal_title:Stroke
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.STR.0000173162.88600.29
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Carotid plaque composition is a major determinant of cerebrovascular events. In the present analysis, we evaluated the relationship between intraplaque hemorrhage (IPH) and a thin/ruptured fibrous cap (TRFC) in moderately stenosed carotid arteries and cerebral infarcts on MRI in the ipsilateral h...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.114.008121
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The relation between symptomatic lacunar infarction, silent stroke, and arterial hypertension is controversial. METHODS:From 500 patients with ischemic or hemorrhagic stroke admitted to the Downtown Barcelona Stroke Registry between July 1992 and December 1994, we evaluated prospectively the pre...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.27.3.388
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Postischemic cerebral inflammation may contribute to ischemic cell damage. Intercellular adhesion molecule-1 (ICAM-1) is a glycoprotein expressed on endothelial cells that facilitates leukocyte adhesion. We investigated the effect of administration of an anti-ICAM-1 antibody (1A29) on ischemic ce...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.26.8.1438
更新日期:1995-08-01 00:00:00
abstract::We reviewed demographic data on patients having 2,256 carotid endarterectomies in eight large hospitals in North Carolina to determine the frequency of blacks among these patients. Blacks comprised only 4.6% of the patients having carotid endarterectomy even though they comprised 26% of all patients discharged and 22%...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.20.1.22
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Endovascular therapy has increasingly become the most common treatment for unruptured cerebral aneurysms in the United States. We evaluated a national, multi-hospital database to examine recent utilization trends and compare periprocedural outcomes between clipping and coiling treatments of unrup...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.111.000196
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Several prognostic scores have been developed to predict the risk of symptomatic intracranial hemorrhage (sICH) after ischemic stroke thrombolysis. We compared the performance of these scores in a multicenter cohort. METHODS:We merged prospectively collected data of patients with consecutive isc...
journal_title:Stroke
pub_type: 杂志文章,多中心研究
doi:10.1161/STROKEAHA.113.003806
更新日期:2014-03-01 00:00:00
abstract::The influence of chronic arterial hypertension upon the permeability to albumin of the cerebral capillaries, i.e. the blood-brain barrier, was studied in normotensive Wistar and spontaneously hypertensive Wistar rats with experimental subarachnoid hemorrhage. The blood-brain barrier permeability to albumin was assesse...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.17.3.498
更新日期:1986-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The Emergency Medical Services field triage to stroke centers has gained considerable complexity with the recent demonstration of clinical benefit of endovascular treatment for acute ischemic stroke. We sought to describe a new smartphone freeware application designed to assist Emergency Medical ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.116.016026
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Persons with early stages of chronic kidney disease, defined by a decreased glomerular filtration rate (GFR), have an increased risk of cardiovascular disease. It is unclear whether decreased GFR is a risk factor for stroke. We assessed the association between GFR and stroke in a prospective popu...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.107.489807
更新日期:2007-12-01 00:00:00