Articles: hematoma.
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Multicenter Study Observational Study
Venous phase of computed tomography angiography increases spot sign detection, but intracerebral hemorrhage expansion is greater in spot signs detected in arterial phase.
Variability in computed tomography angiography (CTA) acquisitions may be one explanation for the modest accuracy of the spot sign for predicting intracerebral hemorrhage expansion detected in the multicenter Predicting Hematoma Growth and Outcome in Intracerebral Hemorrhage Using Contrast Bolus CT (PREDICT) study. This study aimed to determine the frequency of the spot sign in intracerebral hemorrhage and its relationship with hematoma expansion depending on the phase of image acquisition. ⋯ Later image acquisition of CTA improves the frequency of spot sign detection. However, spot signs identified in earlier phases may be associated with greater absolute enlargement. A multiphase CTA including arterial and venous acquisitions could be optimal in patients with intracerebral hemorrhage.
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Multicenter Study
Predicting hematoma expansion after primary intracerebral hemorrhage.
Many clinical trials focus on restricting hematoma expansion following acute intracerebral hemorrhage (ICH), but selecting those patients at highest risk of hematoma expansion is challenging. ⋯ A 9-point prediction score for hematoma expansion was developed and independently validated. The results open a path for individualized treatment and trial design in ICH aimed at patients at highest risk of hematoma expansion with maximum potential for therapeutic benefit.
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Multicenter Study Observational Study
Frequency of hematoma expansion after spontaneous intracerebral hemorrhage in children.
Hematoma expansion is the only modifiable predictor of outcome in adult intracerebral hemorrhage; however, the frequency and clinical significance of hematoma expansion after childhood intracerebral hemorrhage are unknown. ⋯ Hematoma expansion occurs in children with intracerebral hemorrhage and may require urgent treatment. Repeat CT should be considered in children with either large hemorrhage or increased intracranial pressure.
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Multicenter Study
Effects of atorvastatin on chronic subdural hematoma: a preliminary report from three medical centers.
Chronic subdural hematoma (CSDH) is common and more prevalent in the aged population. Surgical intervention is the treatment of choice, but its outcomes may not be satisfactory because of recurrence and physical infirmity associated with aging. Aberrant angiogenesis and localized inflammation contribute to the formation of CSDH. Atorvastatin is active in promoting angiogenesis and modulating inflammation. We hypothesize that atorvastatin is effective in reducing CSDH and have tested the hypothesis in a preliminary prospective study of small cohort of patients. ⋯ Results of this preliminary prospective study show that the oral administration of atorvastatin is safe and effective in treating CSDH, offering a cost-effective alternative to surgery. A prospective randomized clinical trial is required to validate the effect of atorvastatin.
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Bmc Cardiovasc Disor · Jan 2014
Multicenter StudyTreatment patterns and their outcomes of acute aortic intramural hematoma in real world: multicenter registry for aortic intramural hematoma.
Intramural hematoma of the aorta (IMH), a variant of classic aortic dissection, shows very dynamic process in the early phase. The aim of this study is to evaluate clinical outcomes of patients with acute aortic IMH from real world registry data. ⋯ For real world practice in Korea, most of IMH patients were treated medically at presentation and showed favorable outcomes. Thus, even in type A acute IMH, early medical treatment with alternative surgical conversion for selected, complicated cases would be a favorable treatment option.