RESUMO
Elevated intracranial pressure in patients with chronic renal failure has several potential causes. Its rare occurrence secondary to the hemodynamic effects of hemodialysis is described and the findings support a multifactorial etiology ("two hits").
Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Cateteres de Demora/efeitos adversos , Hipertensão Intracraniana/complicações , Pressão Intracraniana/fisiologia , Falência Renal Crônica/terapia , Papiledema/etiologia , Diálise Renal/instrumentação , Idoso , Diagnóstico Diferencial , Seguimentos , Humanos , Hipertensão Intracraniana/fisiopatologia , Hipertensão Intracraniana/terapia , Falência Renal Crônica/complicações , Falência Renal Crônica/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Papiledema/diagnóstico , Papiledema/fisiopatologia , Diálise Renal/efeitos adversos , Punção Espinal/métodos , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: Intracranial aneurysms are a public health issue with a potential for rupturing, causing significant morbidity/mortality. The prevalence of unruptured intracranial aneurysms, including those that are asymptomatic, varies widely, as it has been determined through autopsy studies as well as conventional angiography. However, computed tomography angiography, a less invasive procedure, has replaced the use of conventional angiography in the recent decades. The objective of the present study is to determine the prevalence of incidental aneurysms. METHODS: The present study reviews all computed tomography angiography cases within the past decade at a single institution. RESULTS: Of 2195 cases included in the study, 39 (1.8%) were found to have asymptomatic unruptured aneurysms. CONCLUSIONS: The numbers of asymptomatic incidental aneurysms have increased.
Assuntos
Angiografia Cerebral , Achados Incidentais , Aneurisma Intracraniano/epidemiologia , Adulto , Idoso , Aneurisma Roto/diagnóstico por imagem , Angiografia Digital , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
Epistaxis is a common clinical complaint with a spectrum of severity ranging from spontaneous cessation to unrelenting, life threatening hemorrhage requiring surgical treatment. Both otolaryngologic and neurointerventional techniques are discussed to provide a comprehensive paradigm to treat patients with epistaxis. An exhaustive review of the anatomic basis for the two main subtypes of epistaxis is provided as well as a graduated approach to appropriate clinical management.
Assuntos
Epistaxe/diagnóstico , Epistaxe/cirurgia , Procedimentos Neurocirúrgicos/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Ensaios Clínicos como Assunto/métodos , Humanos , Resultado do TratamentoRESUMO
Neurological complications of coronary angiographic procedures are uncommon, varied and can include central nervous toxicity caused by contrast agents (contrast reactions), as well as ischemic and hemorrhagic stroke. These complications are rare; however, more recent data derived from neuroimaging studies suggest that there is a higher incidence of 'silent' ischemic events. The impact of these subclinical events is still uncertain, but a few studies suggest that long term they may lead to cognitive decline, which is usually subtle. The clinical presentation of both contrast reactions and strokes can, at times, be very similar as there is a higher than expected incidence of posterior circulation involvement with both. While the treatment of contrast reactions is usually supportive, treatment of ischemic stroke in patients undergoing catheterization procedures appears, based on limited case report series, to lead to favorable outcomes with immediate neuroangiographic intervention, including local administration of recombinant-type tissue plasminogen activator.
