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The contribution of imaging in diagnosis, preoperative assessment, and follow-up of moyamoya disease

A review

Susanna Bacigaluppi, Amir R. Dehdashti, Ronit Agid, Timo Krings, Michael Tymianski, and David J. Mikulis

ability to invoke circle of Willis collateral vessels, which are lost in patients with moyamoya secondary to involvement of these collateral vessels by the disease process. Patients with moyamoya are therefore more dependent on a less effective pial collateral circulation for maintenance of flow. Patients in the infarct TIA group, who showed a marked increase in the OEF, were considered to be at risk for further deterioration. In these patients the MTT (which usually has an inverse relationship with cerebral perfusion pressure), was larger. Evidence of the effectiveness

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Thrombin and hemin as central factors in the mechanisms of intracerebral hemorrhage–induced secondary brain injury and as potential targets for intervention

Ranjith Babu, Jacob H. Bagley, Chunhui Di, Allan H. Friedman, and Cory Adamson

, Shalmon E , Hovda DA , : Increase in extracellular glutamate caused by reduced cerebral perfusion pressure and seizures after human traumatic brain injury: a microdialysis study . J Neurosurg 89 : 971 – 982 , 1998 10.3171/jns.1998.89.6.0971 131 Vespa PM , O'Phelan K , Shah M , Mirabelli J , Starkman S , Kidwell C , : Acute seizures after intracerebral hemorrhage: a factor in progressive midline shift and outcome . Neurology 60 : 1441 – 1446 , 2003 10.1212/01.WNL.0000063316.47591.B4 132 Vu TK , Hung DT , Wheaton VI

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Unraveling the complexities of invasive multimodality neuromonitoring

Saurabh Sinha, Eric Hudgins, James Schuster, and Ramani Balu

framework ( Table 1 ). Pathological processes that increase cerebral metabolic demand may benefit from augmentation of cerebral perfusion pressure (CPP), whereas instances in which supply exceeds demand may require CPP reductions to minimize hemorrhagic complications. TABLE 1. Matching of cerebral metabolic demand to supply Demand > Supply Demand = Supply Demand < Supply Ischemia Normal Functional hyperemia (normal) Seizure Sedation Malignant hypertension Spreading depolarization Anesthesia Luxury perfusion Cerebral edema, vasospasm Cerebral infarct Specific Monitoring

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Management of raised intracranial pressure in aneurysmal subarachnoid hemorrhage: time for a consensus?

Naif M. Alotaibi, Justin Z. Wang, Christopher R. Pasarikovski, Daipayan Guha, Fawaz Al-Mufti, Muhammad Mamdani, Gustavo Saposnik, Tom A. Schweizer, and R. Loch Macdonald

≤ 8 to maintain ICP < 22 mm Hg and cerebral perfusion pressure (CPP) between 60–70 mm Hg. 10 Applying the same management algorithm to aSAH has gained traction without any strong supporting evidence of efficacy. Table 1 presents some of the current Brain Trauma Foundation recommendations for elevated ICP and several theoretical limitations to consider when applying them to aSAH. TABLE 1. Recommendations from the Brain Trauma Foundation for TBI-associated raised ICP and the limitations and implications of applying them to aSAH patients Recommendation * Limitations

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Editorial. Sodium values and the use of hyperosmolar therapy following traumatic brain injury

Gregory W. J. Hawryluk

/CNS Joint Section on Neurotrauma and Critical Care. I have great respect for Claudia Robertson and the impactful contributions that she and her colleagues have made to our discipline. A common theme emanating from this group’s important works has been the repeated demonstration of practitioners taking something assumed to be good too far—in violation of Milton’s “rule of Not too much.” To date, her group has demonstrated that routinely pushing the cerebral perfusion pressure above 70 mm Hg is inadvisable, and that transfusion of blood to a hemoglobin concentration of 10 g

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The role of ICP monitoring in meningitis

Areej Tariq, Pedro Aguilar-Salinas, Ricardo A. Hanel, Neeraj Naval, and Mohamad Chmayssani

infectious meningitis. Pathophysiology Intracranial pressure is maintained in a delicate balance by limiting forces exerted by the bony skull and the opposing forces by intracranial contents, i.e., brain tissue, CSF, and cerebral blood. Normal values of ICP range between 5 and 15 mm Hg. Overall, an increase of the ICP may reduce the cerebral perfusion pressure (CPP = mean arterial pressure − ICP) leading to brain ischemia and infarction if not corrected in a timely manner. Pathogens reach the subarachnoid space (SAS) through the bloodstream or from contiguous sites (spread

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The occipitofrontal circumference: reliable prediction of the intracranial volume in children with syndromic and complex craniosynostosis

Bianca Francisca Maria Rijken, Bianca Kelly den Ottelander, Marie-Lise Charlotte van Veelen, Maarten Hans Lequin, and Irene Margreet Jacqueline Mathijssen

14 Hayward R : Venous hypertension and craniosynostosis . Childs Nerv Syst 21 : 880 – 888 , 2005 10.1007/s00381-004-1114-0 15 Hayward R , Gonsalez S : How low can you go? Intracranial pressure, cerebral perfusion pressure, and respiratory obstruction in children with complex craniosynostosis . J Neurosurg 102 : 1 Suppl 16 – 22 , 2005 16 Hill CA , Vaddi S , Moffitt A , Kane AA , Marsh JL , Panchal J , : Intracranial volume and whole brain volume in infants with unicoronal craniosynostosis . Cleft Palate Craniofac J 48 : 394

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Hydrocephalus treatment in patients with craniosynostosis: an analysis from the Hydrocephalus Clinical Research Network prospective registry

Christopher M. Bonfield, Chevis N. Shannon, Ron W. Reeder, Samuel Browd, James Drake, Jason S. Hauptman, Abhaya V. Kulkarni, David D. Limbrick Jr., Patrick J. McDonald, Robert Naftel, Ian F. Pollack, Jay Riva-Cambrin, Curtis Rozzelle, Mandeep S. Tamber, William E. Whitehead, John R. W. Kestle, John C. Wellons III, and for the Hydrocephalus Clinical Research Network (HCRN)

of hydrocephalus associated with faciocraniosynostosis . J Neurosurg Pediatr . 2010 ; 6 ( 1 ): 17 – 22 . 20593982 10.3171/2010.3.PEDS09484 6 Blaser SI , Padfield N , Chitayat D , Forrest CR . Skull base development and craniosynostosis . Pediatr Radiol . 2015 ; 45 ( suppl 3 ): S485 – S496 . 26346154 10.1007/s00247-015-3320-1 7 Hayward R , Gonsalez S . How low can you go? Intracranial pressure, cerebral perfusion pressure, and respiratory obstruction in children with complex craniosynostosis . J Neurosurg . 2005 ; 102 (1)(suppl

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Cardiac arrest in spontaneous subarachnoid hemorrhage and associated outcomes

Eric Feldstein, Jose F. Dominguez, Gurkamal Kaur, Smit D. Patel, Alis J. Dicpinigaitis, Rosa Semaan, Leanne E. Fuentes, Jonathan Ogulnick, Christina Ng, Cameron Rawanduzy, Haris Kamal, Jared Pisapia, Simon Hanft, Krishna Amuluru, Srihari S. Naidu, Howard A. Cooper, Kartik Prabhakaran, Stephan A. Mayer, Chirag D. Gandhi, and Fawaz Al-Mufti

CA in the prehospital phase. 8 , 9 Cases of SAH associated with out-of-hospital CA are known to have a dismal prognosis, with studies finding that 0% to 9.1% of such patients survive to hospital discharge. 8 , 10 , 11 SAH is well recognized as a cause of cardiac arrhythmia and neurogenic myocardial injury, which can manifest as sudden circulatory collapse. 12 A massive surge in intracranial pressure (ICP), a resultant reduction cerebral perfusion pressure (CPP), and primary injury to the hypothalamus and brainstem vasomotor centers are thought to trigger the

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More pronounced hemodynamic alterations in patients with brain arteriovenous malformation–associated epilepsy

Martina Sebök, Menno Robbert Germans, Christiaan Hendrik Bas van Niftrik, Zsolt Kulcsár, Luca Regli, and Jorn Fierstra

–33 Arteriolar exhaustion resulting from a shunt-induced, chronically reduced cerebral perfusion pressure was thought to be the underlying cause of reduced vascular reserve capacity in xenon CT studies after acetazolamide challenges. 34 One previous study reported on the utility of advanced novel BOLD-CVR imaging, showing perinidal impairment of the cerebrovascular autoregulatory reserve in patients with seizure-prone bAVM and highlighting a strong association with venous congestion in all seizure-prone patients. 11 In our study, a clear association of venous congestion with