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101. Blunt Cerebrovascular Injury

or interventional repair should be considered to restore flow. 6. In children who have suffered an ischemic neurologic event (INE), aggressive management of resulting intracranial hypertension up to and including resection of ischemic brain tissue has improved outcome as compared with adults and should be considered for supportive management. Question: For how long should antithrombotic therapy be administered? No recommendations can be made. Question: How should one monitor the response to therapy? Level I (...) in Table 1 did not have the independent risk factors identified by regression analysis, indicating that broad selection criteria are necessary to prevent missed injuries. [10] Cothren et al. [19] retrospectively reviewed patients with BVAI and found that complex cervical spine fractures involving subluxation, fracture into the foramen transversarium, or C1 to C3 fractures were closely associated with this injury. In a prospective review of screening with digital four-vessel cerebral angiography (DFVCA

2010 Eastern Association for the Surgery of Trauma

102. Diagnosis and Management of Cerebral Venous Thrombosis Full Text available with Trip Pro

on clinical suspicion and imaging confirmation. Clinical findings in CVT usually fall into 2 major categories, depending on the mechanism of neurological dysfunction: (1) Those that are related to increased intracranial pressure attributable to impaired venous drainage and (2) those related to focal brain injury from venous ischemia/infarction or hemorrhage. In practice, many patients have clinical findings due to both mechanisms, either at presentation or with progression of the underlying disease (...) headache without focal neurological findings or papilledema occurs in up to 25% of patients with CVT and presents a significant diagnostic challenge. CVT is an important diagnostic consideration in patients with headache and papilledema or diplopia (caused by sixth nerve palsy) even without other neurological focal signs suggestive of idiopathic intracranial hypertension. When focal brain injury occurs because of venous ischemia or hemorrhage, neurological signs and symptoms referable to the affected

2011 Congress of Neurological Surgeons

103. Reporting Standards for Endovascular Repair of Saccular Intracranial Cerebral Aneurysms

Reporting Standards for Endovascular Repair of Saccular Intracranial Cerebral Aneurysms Reporting Standards for Endovascular Repair of Saccular Intracranial Cerebral Aneurysms Philip M. Meyers, MD, H. Christian Schumacher, MD, Randall T. Higashida, MD, Colin P. Derdeyn, MD, Gary M. Nesbit, MD, David Sacks, MD, Lawrence R. Wechsler, MD, Joshua B. Bederson, MD, Sean D. Lavine, MD, and Peter Rasmussen, MD BACKGROUND AND PURPOSE: The goal of this article is to provide consensus recommendations (...) not applicable. S438  Aneurysm Reporting Terminology July 2009 JVIRmay be apparent as layering of red blood cells in dependent locations of the brain on CT or MRI such as occipital horns of the lateral ventricles, dorsal margins of the Sylvian fissures, and sulci of the cerebral convexities. Chronic hemorrhage (6 weeks) may be appar- ent as hemoglobin degradation prod- ucts on MRI. The modality used for di- agnosis of hemorrhage (CT, MRI, or lumbar puncture) must be recorded. Rationale for detailed

2009 Society of Interventional Radiology

104. Reporting Standards for Endovascular Repair of Saccular Intracranial Aneurysms

Reporting Standards for Endovascular Repair of Saccular Intracranial Aneurysms Reporting Standards for Endovascular Repair of Saccular Intracranial Cerebral Aneurysms | American Journal of Neuroradiology Advertisement Main menu User menu Search Search for this keyword Search for this keyword In Brief Consensus Statements Reporting Standards for Endovascular Repair of Saccular Intracranial Cerebral Aneurysms P.M. Meyers , H.C. Schumacher , R.T. Higashida , C.P. Derdeyn , G.M. Nesbit , D. Sacks (...) of intracranial, cerebral aneurysms. These criteria can be used to design clinical trials, to provide uniformity of definitions for appropriate selection and stratification of patients, and to allow analysis and meta-analysis of reported data. METHODS: This article was written under the auspices of the Joint Writing Group of the Technology Assessment Committee, Society of NeuroInterventional Surgery, Society of Interventional Radiology; Joint Section on Cerebrovascular Neurosurgery of the American Association

2010 Congress of Neurological Surgeons

105. Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy

Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review) | Neurology Advertisement Search for this keyword Main menu User menu Search Search for this keyword The most widely read and highly cited peer-reviewed neurology journal Share January 26, 2010 ; 74 (4) Special Article Practice Parameter: Pharmacologic treatment of spasticity (...) in children and adolescents with cerebral palsy (an evidence-based review) Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society M. R. Delgado , D. Hirtz , M. Aisen , S. Ashwal , D. L. Fehlings , J. McLaughlin , L. A. Morrison , M. W. Shrader , A. Tilton , J. Vargus-Adams First published January 25, 2010, DOI: https://doi.org/10.1212/WNL.0b013e3181cbcd2f M. R. Delgado D. Hirtz M. Aisen S. Ashwal D. L. Fehlings J

2010 American Academy of Neurology

106. Reporting Standards for Angioplasty and Stent-assisted Angioplasty for Intracranial Atherosclerosis

definitions con- tained here are arbitrary or opera- tionalbuthavebeenrecommendedby consensus of this writing group for consistency in reporting and publica- tion. BACKGROUND Intracranial cerebral atherosclerosis causes ischemic stroke in a significant number of patients. In the United States, it is estimated that 40 000 to 60 000 first-ever and recurrent strokes arecausedbyintracranialcerebralath- erosclerosis annually. Typical risk fac- tors are insulin-dependent diabetes mellitus, hypertension, smoking (...) , and hypercholesterolemia. The pathology of intracranial atherosclerosis is simi- lar to other vascular territories (1). There seems to be a racial preference forthisdisorderaffectingAsian,black, and Hispanic patients more often compared with whites. Medical pri- maryandsecondarystrokeprevention in patients with intracranial cerebral atherosclerosis is often unsatisfactory. Technological advances over the past 10 years enabled endovascular treat- ment of intracranial atherosclerotic stenosis. The number of patients

2009 Society of Interventional Radiology

107. Brain Perfusion SPET using 99mTc-labelled Radiopharmaceutical

, Belgium Eur J Nucl Med Mol Imaging DOI 10.1007/s00259-009-1266-yBackground and definitions SPECT is a technique that produces tomographic images of the three-dimensional distribution of a radiopharmaceutical. Applied to the brain, this technique can be used to measure regional cerebral perfusion. There are three physiological properties that radio- pharmaceuticals must have to be useful for the measurement of brain perfusion by SPECT: they must cross the blood–brain barrier; their extraction must (...) approximate unity and be independent of blood flow so that their initial distribution will be proportional to regional cerebral blood flow (rCBF); and they must be retained within the brain in their initial distribution long enough for diagnostic tomographic images to be obtained [3]. Ideally, tracer uptake should show no redistribution, so that the initial tracer uptake, reflecting rCBF at a fast time window after injection, remains almost unchanged for several hours. This frozen image

2009 European Association of Nuclear Medicine

108. Colorectal cancer

include (in alphabetical order) Abdominal pain Bleeding Mild anal incontinence Perirectal abscess/sepsis and stricture (narrowing) Perforation Suture line dehiscence (wound reopening) Urinary retention Abdominal pain Bleeding Bloating Perforation Adhesions Anastomotic leak (leaking of bowel contents into the abdomen) Anastomotic stricture (narrowing at internal operation site) Bleeding Incisional hernia (hernia where the surgical incision was made) Injury to neighbouring structures Pelvic abscess (...) ) in the long term compared to those who had not. Long-term use of aspirin may slightly increase the risk of bleeding. However, no increased risk of peptic ulcer, gastrointestinal bleeding or cerebral haemorrhage was observed in the randomised controlled trial, although this might be because of the relatively short follow-up time. Given that the potential benefits are likely to outweigh the potential harms for most people with Lynch syndrome, the committee agreed taking aspirin long term will be appropriate

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

109. Cellulitis and erysipelas: antimicrobial prescribing

insufficiency. 1.1.2 Consider taking a swab for microbiological testing from people with cellulitis or erysipelas to guide treatment, but only if the skin is broken and and: there is a penetrating injury or or there has been exposure to water-borne organisms or or the infection was acquired outside the UK. 1.1.3 Before treating cellulitis or erysipelas, consider drawing around the extent of the infection with a single-use surgical marker pen to monitor progress. Be aware that redness may be less visible (...) on darker skin tones. 1.1.4 Offer an antibiotic for people with cellulitis or erysipelas. When choosing an antibiotic (see the recommendations on choice of antibiotic), take account of: the severity of symptoms the site of infection (for example, near the eyes or nose) the risk of uncommon pathogens (for example, from a penetrating injury, after exposure to water-borne organisms, or an infection acquired outside the UK) previous microbiological results from a swab the person's meticillin-resistant

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

110. Hypertension in adults: diagnosis and management

for specialist assessment, carried out on the same day, if they have a clinic blood pressure of 180/120 mmHg and higher with: signs of retinal haemorrhage or papilloedema (accelerated hypertension) or or life-threatening symptoms such as new onset confusion, chest pain, signs of heart failure, or acute kidney injury. [2019] [2019] 1.5.3 Refer people for specialist assessment, carried out on the same day, if they have suspected phaeochromocytoma (for example, labile or postural hypotension, Hypertension (...) vascular disease Past medical history of stroke or transient ischemic attack, heart attack, angina, narrowed peripheral arteries or an interventional procedure. Cardiovascular disease is a general term for conditions affecting the heart or blood vessels. It is usually associated with a build-up of fatty deposits inside the arteries (atherosclerosis) and an increased risk of blood clots. It can also be associated with damage to arteries in organs such as the brain, heart, kidneys and eyes through

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

111. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management

occlusion of the proximal posterior circulation (that is, basilar or posterior cerebral artery) demonstrated by CTA or MRA and and Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (NG128) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 9 of 38if there is the potential to salvage brain tissue, as shown by imaging such as CT perfusion or diffusion-weighted MRI sequences showing limited (...) the possible risks of not offering CT brain imaging to everyone with a suspected TIA. They agreed that, in the absence of clinical 'red flag' indicators (for example, headache, anticoagulation, head injury, repetitive stereotyped events), it is rare for a CT scan to reveal an alternative diagnosis needing a different referral pathway. Therefore, the number of referrals to TIA clinics should not increase greatly. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (NG128) ©

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

112. Suspected neurological conditions: recognition and referral

that BPPV is common after a head injury or labyrinthitis. V Vestibular migr estibular migraine aine 1.2.7 Be alert to the possibility of vestibular migraine (migraine-associated vertigo) in adults who have episodes of dizziness that last between 5 minutes and 72 hours and a history of recurrent headache. Recurrent dizziness as part of a functional neurological disorder Recurrent dizziness as part of a functional neurological disorder 1.2.8 Be aware that, for adults who have been diagnosed (...) to days) progressive weakness of a single limb or hemiparesis for investigation, including neuroimaging, in line with the recommendation on brain and central nervous system cancers in adults in the NICE guideline on suspected cancer. Slowly progressiv Slowly progressive limb or neck weakness e limb or neck weakness 1.7.5 For adults with slowly (within weeks to months) progressive limb or neck weakness: Suspected neurological conditions: recognition and referral (NG127) © NICE 2019. All rights reserved

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

113. Intrapartum care for women with existing medical conditions or obstetric complications and their babies

of the brain ain 1.7.1 Involve the multidisciplinary team in risk assessment for women with a cerebrovascular malformation or a history of intracranial bleeding. Include the woman in care planning and a clinician with expertise in managing neurovascular conditions in pregnant women. Car Care for women with cer e for women with cerebr ebrov ovascular malformation at low risk of intr ascular malformation at low risk of intracr acranial bleeding anial bleeding 1.7.2 Classify the risk of intrapartum (...) 1.4 Asthma 20 1.5 Long-term systemic steroids 20 1.6 Bleeding disorders 21 1.7 Subarachnoid haemorrhage or arteriovenous malformation of the brain 25 1.8 Acute kidney injury or chronic kidney disease 27 1.9 Obesity 30 1.10 Information for women with obstetric complications or no antenatal care 32 1.11 Risk assessment for women with obstetric complications or no antenatal care 33 1.12 Pyrexia 36 1.13 Sepsis 36 1.14 Intrapartum haemorrhage 42 1.15 Breech presenting in labour 45 1.16 Small

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

114. Cannabis-based medicinal products

, pay particular attention to the: potential impact on psychological, emotional and cognitive development potential impact of sedation potential impact on structural and functional brain development. 1.5.7 When prescribing cannabis-based medicinal products, advise people to stop any non-prescribed cannabis, including over-the-counter, online and illicit products. Cannabis-based medicinal products (NG144) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms (...) in combination with CBD for se 4 THC in combination with CBD for sev vere treatment-resistant ere treatment-resistant epilepsy epilepsy Does the addition of THC to CBD have an effect on seizure frequency, brain structure and neuropsychological performance when compared with both CBD alone and placebo in epileptic disorders in children, young people and adults? T o find out why the committee made the research recommendation on THC in combination with CBD for severe treatment-resistant epilepsy see rationale

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

115. Canadian Stroke Best Practice recommendations: rehabilitation, recovery, and community participation following stroke. Part one: rehabilitation and recovery following stroke; 6th edition update 2019

hospitalization and at home (Evidence Level: Early-Level B; Late-Level C). (ix) Strength training should be considered for persons with mild to moderate upper extremity impairment for improvementin grip strength (Evidence Level: Early-Level A; Late-Level A). Strength training does not aggravate tone or pain (Evidence Level A). (x) Bilateral armtraining is not recommended over unilateral arm training to improve upper extremity motor function (Evidence Level A). (xi) Non-invasive brain stimulation, including

2020 CPG Infobase

116. Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience

- ing access to housing, providing mental health and addiction care, delivering care coordination and case management, and facilitating access to adequate income. The priority marginalized populations identified included Indigenous people; women and families; youth; people with acquired brain injury, or intellectual or physical disabil- ities; and refugees and other migrants (Esther Shoemaker, Bruyère Research Institute, Ottawa, Ont.: unpublished data, 2020). Each working group then scoped

2020 CPG Infobase

118. Decision-making and mental capacity

– for example working with people with impaired executive function arising from acquired brain injury, mental illness, dementia or other illness. 1.2 Supporting decision-making 'A person is not to be treated as unable to make a decision unless all practicable steps to help him do so have been taken without success. ' (Principle 2, section 1(3), Mental Capacity Act 2005) Principle 2 of the Mental Capacity Act 2005 requires practitioners to help a person make their own decision, before deciding (...) psychologists or other professionals to support communication during an assessment of capacity. 1.4.18 Where the person has identified communication needs, the assessor should also think about using communication tools to help with the assessment. 1.4.19 Practitioners should be aware that it may be more difficult to assess capacity in people with executive dysfunction – for example people with traumatic brain injury. Structured assessments of capacity for individuals in this group (for example, by way

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

119. Attention deficit hyperactivity disorder: diagnosis and management

of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 62disorders, learning disability [intellectual disability] and specific learning difficulties) adults with a mental health condition people with a history of substance misuse people known to the Youth Justice System or Adult Criminal Justice System people with acquired brain injury. [2018] [2018] 1.2.2 Be aware that ADHD is thought to be under-recognised in girls and women and that: they are less likely to be referred (...) or acquired brain injury). [2018] [2018] T o find out why the committee made the 2018 recommendations on medication – considerations when prescribing and dose titration, and how they might affect practice, see rationale and impact. Shared care for medication Shared care for medication 1.7.29 After titration and dose stabilisation, prescribing and monitoring of ADHD medication should be carried out under Shared Care Protocol arrangements with primary care. [2018] [2018] T o find out why the committee made

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

120. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism

] earlier than 24 hours after the operation for people undergoing cranial surgery. Base the decision on multidisciplinary or senior opinion, or a locally agreed protocol. [2018] [2018] 1.12.10 Do not offer pharmacological VTE prophylaxis to people with ruptured cranial vascular malformations (for example, brain aneurysms) or people with intracranial haemorrhage (spontaneous or traumatic) until the lesion has been secured or the condition has stabilised. [2018] [2018] Spinal injury Spinal injury 1.12.11 (...) 1.5 Interventions for people with renal impairment 13 1.6 Interventions for people with cancer 13 1.7 Interventions for people having palliative care 14 1.8 Interventions for people admitted to critical care 14 1.9 Interventions for people with psychiatric illness 15 1.10 Interventions when using anaesthesia 16 1.11 Interventions for people having orthopaedic surgery 16 1.12 Interventions for people having elective spinal surgery or cranial surgery or people with spinal injury 20 1.13

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

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