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  • ISSN: 2334-2307
    Early Online
    Volume 4, Issue 1
    Review Article
    Chi Lan Nguyen Vu, Bernard Yan*
    Abstract:
    Since 1996, Intravenous thrombolysis by recombinant tissue plasminogen activator has been increasingly utilized for the treatment of acute ischemic stroke. However, a small proportion of patients develop post thrombolysis intracerebral haemorrhage which negates the beneficial effects of thrombolysis. The incidence of symptomatic intracerebral haemorrhage ranged from 2.2 to 11% and leads to increased mortality up to 47%. Stroke severity and hyperglycaemia are reasonably robust risk factors for post thrombolysis intracerebral haemorrhage. However, with the emergence of advanced neuroimaging techniques, novel imaging markers for intracerebral haemorrhage have been identified. It is the aim of this review article to examine the current understanding of risk factors and risk assessment scores of intracerebral haemorrhage post thrombolysis.
    Case Report
    Yusuf Inanç1 Yilmaz Inanç and Sirma Geyik*
    Abstract:
    Since 1996, Intravenous thrombolysis by recombinant tissue plasminogen activator has been increasingly utilized for the treatment of acute ischemic stroke. However, a small proportion of patients develop post thrombolysis intracerebral haemorrhage which negates the beneficial effects of thrombolysis. The incidence of symptomatic intracerebral haemorrhage ranged from 2.2 to 11% and leads to increased mortality up to 47%. Stroke severity and hyperglycaemia are reasonably robust risk factors for post thrombolysis intracerebral haemorrhage. However, with the emergence of advanced neuroimaging techniques, novel imaging markers for intracerebral haemorrhage have been identified. It is the aim of this review article to examine the current understanding of risk factors and risk assessment scores of intracerebral haemorrhage post thrombolysis.
    Payam Saadat, Alijan Ahmadi Ahangar*, Narges Sotouneh and Shayan Alijanpour
    Abstract:
    Extramedullary hematopoiesis (EMH) occurs in approximately 15% of cases of thalassemia. Paraspinal mass of extramedullary hematopoiesis are a rare compensatory process in intermediate and severe thalassemia. We present a case of a paravertebral extramedullary hematopoiesis (EMH) with a spinal cord compression in a 27-year-old man with beta thalassemia intermediate who complaint of paresis in lower extremities and progression up to umbilical level.
    Paravertebral (EMH) although rare, should always be considered in the differential diagnosis of any upper motor neuron disease condition in patients with thalassemia and therefore appropriate studies should perform to investigate the probable paravertebral ectopic marrow before any surgical intervention.
    Reena Baweja, Arun Mensinkai, Kesava Reddy, Ayse Unsal and Demetrios J. Sahlas*
    Abstract:
    Bilateral fornix infarction presenting with combined retrograde and anterograde amnesia is a recognized, yet rare, clinical entity. We present details of two cases – the first was a spontaneous infarction attributed to small vessel cerebrovascular disease and the second was a post-operative complication following clipping of an anterior communicating artery aneurysm. Both infarcts were initially missed on non contrast CT although later confirmed on MRI. Comprehensive neuropsychological assessment was completed for both patients, including a two year follow-up assessment on our second patient, demonstrating minimal improvement. The anatomy related to the perforators of the anterior communicating artery is reviewed as well as the importance of considering fornix infarction on brain imaging in any patient presenting with acute global amnesia.
    Research Article
    Vivien H. Lee*, James J. Conners, Sayona John, Katharina M. Busl, Sarah Y. Song, Shawna Cutting, Laurel Cherian, Sebastian Pollandt, Torrey Boland, Diana Goodman, George Lopez, Thomas P. Bleck, and Rajeev Garg
    Abstract:
    Background: Bedside ABC/2 methods of measuring intracerebral hemorrhage (ICH) volumes are valuable clinical and research tools. The two most common methods of bedside calculation are the ABC/2 formula and the sABC/2 formula.
    Methods: We retrospectively reviewed 142 consecutive spontaneous ICH patients admitted to our institution from November 1, 2009 to October 1, 2010. ICH volume was calculated using both ABC/2 and sABC/2 methods. Based on the ICH volume calculated by the ABC/2 formula, the patients were divided into 3 groups: small (< 30cc), medium (30-60cc) and large (> 60cc).
    Results: Among 142 patients with ICH, the location was deep in 68 (47.8%), lobar in 52 (36.6%), and infratentorial in 22 (15.4%). The mean volume of ICH using ABC/2 was 17.5 cc (range, 0.19 to 90.3) and using sABC/2 was 30.4 cc (range, 0.26 to 171). The mean difference in volumes between ABC/2 and sABC/2 was 12.8 cc (SD + 17.6). The mean percentage difference in volumes between ABC/2 and sABC/2 was 76.9% (SD + 39.7). The differences between the volume by sABC/2 and ABC/2 increased with larger ICH volumes, with the equation of the regression line as follows: sABC2 = 0.2959659 + 1.7190626 ABC2 (p < 0.0001).
    Conclusion: sABC/2 and ABC2 methods do not correlate, and the differences between the methods increase with larger ICH volumes. Clinicians should be aware of the limitations of bedside ICH volume measurement tools.
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