stroke | STROKE MANUAL

Aortic arch atherosclerosis

ISCHEMIC STROKE / ETIOPATHOGENESIS Aortic arch atherosclerosis David Goldemund M.D.Updated on 06/11/2023, published on 16/04/2023 [toc] Anatomy the aorta is the main and largest artery in the human body it originates from the left ventricle and extends down to the abdomen, where it branches into the common iliac arteries and a small median sacral artery ... Read more

Complications of endovascular procedures

NEUROIMAGING Complications of endovascular procedures David Goldemund M.D.Updated on 21/03/2024, published on 14/04/2023 [toc] endovascular procedures are a cornerstone in the minimally invasive treatment of vascular disorders, encompassing a broad spectrum of interventions from diagnostic angiography to therapeutic endovascular aneurysm repair, stent placement, or thrombectomy while these techniques offer significant benefits, they are not without ... Read more

Neurological complications during extracorporeal circulation

Multiple emboli on DWI after surgery in ECC

ISCHEMIC STROKE / ETIOPATOGENESIS AND CLASSIFICATION Neurological complications during extracorporeal circulation David Goldemund M.D.Updated on 11/01/2024, published on 14/04/2023 [toc] neurological complications of cardiac surgery are serious, increasing mortality, length of hospital stay, and costs fatal cerebral infarction and severe diffuse encephalopathy with dementia represent the extremes in the spectrum of disabilities that can result ... Read more

Cerebral amyloid angiopathy (CAA)

Cerebral amyloid angiopathy with repeated lobar hematomas

CEREBRAL HEMORRHAGE Cerebral amyloid angiopathy (CAA) David Goldemund M.D.Updated on 05/05/2024, published on 13/04/2023 [toc] Cerebral Amyloid Angiopathy (CAA) is a heterogeneous group of sporadic or familial disorders characterized by deposition of amyloid beta-peptide (Aβ) in the walls of small to medium-sized cerebral and leptomeningeal vessels in the absence of systemic amyloidosis; this accumulation can ... Read more

Brainstem reflexes

ADD-ONS Brainstem reflexes David Goldemund M.D.Updated on 10/03/2024, published on 11/04/2023 brainstem (brain stem) reflexes are involuntary motor responses originating in the brainstem these reflexes are mediated by neural circuits that bypass higher cortical centers, enabling rapid, automatic responses clinically, they are used to: assess the integrity of the brainstem and cranial nerves evaluate the ... Read more

Apnea test for brain death diagnosis

ADD-ONS Apnea test for brain death diagnosis David Goldemund M.D.Updated on 02/02/2024, published on 11/04/2023 [toc] Why the apnea test is performed brain death (BD) is defined as the irreversible cessation of all brain functions (including those of the brainstem) the apnea test is a mandatory examination for determining brain death, serving as an essential ... Read more

Brain death diagnosis

ADD-ONS Brain death diagnosis David Goldemund M.D.Updated on 25/04/2024, published on 10/04/2023 [toc] Brain death definition brain death (BD) is defined as the irreversible loss of all brain functions (including the brainstem), regardless of the continued function of the cardiovascular system and other organs Etiology traumatic brain injury (TBI) stroke global cerebral hypoxia/anoxia (post-CPR conditions) ... Read more

Management of subarachnoid hemorrhage

Aneurysm clipping, artifact from the clip on CT scan

SUBARACHNOID HEMORRHAGE Management of subarachnoid hemorrhage David Goldemund M.D.Updated on 29/04/2024, published on 01/04/2023 [toc] Standard management of SAH focuses on: general care of acutely ill patients (incl. strict blood pressure control and maintenance of normovolemia) prevention and treatment of vasospasms detection and elimination of the aneurysm from the circulation prevention and management of complications (intra- ... Read more

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Management in the subacute phase of cerebral venous thrombosis

Hyperdense sign on NCCT (left), CT venography with defective contrast filling of the right transverse and sigmoid sinuses

CEREBRAL VENOUS SINUS THROMBOSIS Management in the subacute phase of cerebral venous thrombosis David Goldemund M.D.Updated on 21/03/2024, published on 08/03/2023 [toc] Anticoagulant therapy Drug choice acute parenteral therapy (usually using LMWH) is switched to oral anticoagulant therapy after 5-15 days (AHA guidelines, 2024) WARFARIN with a target INR 2-3 → see here DOACs seem ... Read more