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Anterior Cerebral Artery CVA

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1. Anterior Cerebral Artery CVA

Anterior Cerebral Artery CVA Anterior Cerebral Artery CVA Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Anterior Cerebral Artery CVA (...) Anterior Cerebral Artery CVA Aka: Anterior Cerebral Artery CVA , ACA CVA , Cerebrovascular Accident of Anterior Cerebral Artery From Related Chapters II. Findings: Signs and Symptoms Mental Status Confusion Amnesia Personality change: flat affect, apathy Cognitive change: short attention span, slowness Deterioration of Urinary continence (long duration) Contralateral or Sensory s (contralateral) and Leg deficits More frequent than arm deficits drop on affected side Expressive (if left hemisphere

2018 FP Notebook

2. Anterior Cerebral Artery CVA

Anterior Cerebral Artery CVA Anterior Cerebral Artery CVA Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Anterior Cerebral Artery CVA (...) Anterior Cerebral Artery CVA Aka: Anterior Cerebral Artery CVA , ACA CVA , Cerebrovascular Accident of Anterior Cerebral Artery From Related Chapters II. Findings: Signs and Symptoms Mental Status Confusion Amnesia Personality change: flat affect, apathy Cognitive change: short attention span, slowness Deterioration of Urinary continence (long duration) Contralateral or Sensory s (contralateral) and Leg deficits More frequent than arm deficits drop on affected side Expressive (if left hemisphere

2015 FP Notebook

3. "Awake" clipping of cerebral aneurysms: report of initial series. (PubMed)

"Awake" clipping of cerebral aneurysms: report of initial series. OBJECTIVE Risk of ischemia during aneurysm surgery is significantly related to temporary clipping time and final clipping that might incorporate a perforator. In this study, the authors attempted to assess the potential added benefit to patient outcomes of "awake" neurological testing when compared with standard neurophysiological testing performed under general anesthesia. The procedure is performed after the induction (...) of conscious sedation, and for the neurological testing, the patient is fully awake. METHODS The authors conducted an institutional review board-approved prospective study of clipping unruptured intracranial aneurysms (UIAs) in 30 consecutive adult patients who underwent awake clipping. The end points were the incidence of stroke/cerebrovascular accident (CVA), death, discharge to a long-term facility, length of stay, and 30-day modified Rankin Scale score. All clinical and neurophysiological

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2016 Journal of Neurosurgery

4. Cerebral Protection in Transcatheter Aortic Valve Replacement

Medical Study Details Study Description Go to Brief Summary: The Sentinel System will be a safe and effective method for capturing and removing embolic material (thrombus/debris) during transcatheter aortic valve replacement in order to reduce the ischemic burden in the cerebral anterior circulation. Condition or disease Intervention/treatment Phase Severe Symptomatic Calcified Native Aortic Valve Stenosis Device: Cerebral Protection System-The SENTINEL System with TAVR Device: TAVR Not Applicable (...) Detailed Description: The Sentinel™ Cerebral Protection System is indicated for use as an embolic capture and retrieval system intended to reduce the ischemic burden in the cerebral anterior circulation while performing transcatheter aortic valve replacement. The objective of this study is to assess the safety and efficacy of the Claret Medical Sentinel Cerebral Protection System used for embolic protection during Transcatheter Aortic Valve Replacement (TAVR) compared to TAVR standard of care (without

2014 Clinical Trials

5. Carotid Artery, Stenosis

in the neck often helps confirm clinical significance. Surface-rendered 3-dimensional volume CT angiogram demonstrates a complete occlusion of the right common carotid artery (CCA). Axial CT angiograms (A and B) demonstrate bilateral occlusions of the right and left common carotid arteries (arrows). Intracranial CT angiogram in a patient with bilateral common carotid occlusion shows an absence of flow in the right and left internal carotid arteries (ICAs). ACA = anterior cerebral artery, MCA = middle (...) pattern, confirming carotid thrombosis. If the flow rate from the internal carotid artery falls below a critical level, a pattern of cerebral infarcts may form in the watershed zone between the anterior cerebral artery and the middle cerebral artery. Axial T1-weighted echo-planar diffusion image in a patient with high-grade internal carotid stenosis. Arrows point to multiple, small, subacute cerebral infarcts that have resulted from left internal carotid artery stenosis. The pattern of infarcts

2014 eMedicine Radiology

6. Heart Disease and Stroke Statistics

Cardiac Arrest, Ventricular Arrhythmias, and Inherited Channelopathies e377 18. Subclinical Atherosclerosis e401 19. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris e415 20. Cardiomyopathy and Heart Failure e438 21. Valvular Diseases e455 22. Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism), Chronic Venous Insufficiency, Pulmonary Hypertension e472 23. Peripheral Artery Disease and Aortic Diseases e481 Outcomes 24. Quality of Care e497 25. Medical Procedures (...) States and globally. The Statistical Update also presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease [CHD], heart failure [HF], valvular disease, venous disease, and peripheral arterial disease) and the associated outcomes (including quality of care, procedures, and economic costs). Since 2007, the annual versions of the Statistical Update have

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2019 American Heart Association

7. Appropriate Use Criteria: Imaging of the Brain

disorders, and neoplasm in up to 50% of cases. Although the diagnostic yield of neuroimaging for an alternative etiology is low ( 95%) to advanced noninvasive vascular imaging (CTA/MRA) for anterior circulation TIA or CVA. Ultrasound also has good negative predictive value for critical stenosis, and is often used as an initial exam with advanced vascular imaging as a problem solving tool or for preoperative planning. 46,47,48 For posterior circulation infarcts, advanced vascular imaging is more (...) of the Guidelines 4 Administrative Guidelines 5 Ordering of Multiple Studies 5 Simultaneous Ordering of Multiple Studies 5 Repeated Imaging 5 Pre-Test Requirements 6 History 6 Imaging of the Brain 7 General Information/Overview 7 Scope 7 Technology Considerations 7 Definitions 8 Clinical Indications 9 Congenital and Developmental Conditions 9 Ataxia, congenital or hereditary 9 Developmental delay (Pediatric only) 9 Congenital cerebral anomalies 10 Infection 10 Infection 10 Inflammatory Conditions 11 Multiple

2019 AIM Specialty Health

8. ESC/EACTS Guidelines on Myocardial Revascularization

anterior descending coronary artery disease 109 5.3.3 Left main coronary artery disease 109 5.3.4 Multivessel coronary artery disease 109 5.4 Gaps in the evidence 110 6 Revascularization in non-ST-elevation acute coronary syndrome 110 6.1 Early invasive vs. conservative strategy 110 6.2 Timing of angiography and intervention 110 6.3 Type of revascularization 110 6.3.1 Percutaneous coronary intervention 110 6.3.1.1 Technical aspects 110 6.3.1.2 Revascularization strategies and outcomes 111 6.3.2 (...) for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease COURAGE Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation CPG ESC Committee for Practice Guidelines CT Computed tomography CT-FFR CT-derived fractional flow reserve CTO Chronic total occlusion CTSN Cardiothoracic Surgical Trial Network CULPRIT-SHOCK Culprit Lesion Only PCI versus Multivessel PCI in Cardiogenic Shock CVA Cerebrovascular accident CvLPRIT Complete Versus Lesion-Only Primary PCI

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2018 European Society of Cardiology

9. Appropriate Use Criteria: Imaging of the Head & Neck

tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing 70544 Magnetic resonance angiography, head, without contrast 70545 Magnetic resonance angiography, head, with contrast 70546 Magnetic resonance angiography, head, without contrast, followed by re-imaging with contrast Standard Anatomic Coverage ? CTA or MRA may be performed to assess the major intracranial arteries of the anterior and posterior circulations (including the Circle (...) of Willis) as well as the venous structures (major cerebral veins and dural venous sinuses). ? For specific clinical indications, exams may be tailored to the region of interest. ? MRA of the head includes imaging of the entire arteriovenous system of the brain. Separate requests for concurrent imaging of the arteries and the veins in the head are inappropriate. Choice of Imaging Study Advantages of CTA ? Higher sensitivity for detection of mural calcification ? Absence of in-plane flow phenomenon which

2018 AIM Specialty Health

10. CRACKCast E192 – Airway

- and no backup devices (VL, EGD) available Can’t Intubate, Can’t ventilate? Time for a cric! If you are in a can’t intubate, can oxygenate situation, you have time. Call for backup and consider rescue devices. See figure 1.10. [10] How do you perform a surgical cricothyroidotomy? First—The Anatomy! Landmarks: Cricothyroid membrane is below the thyroid cartilage and above the cricoid cartilage. These 2 landmarks are palpable on most patients. Equipment : Scalpel Artery forceps Bougie Size 6 ETT Technique (...) , transient apnea and respiratory depression. Propofol Alkylphenol with GABA receptor stimulation activity Induction dose: 1.5 mg/kg IV Pros: Rapid onset of action Brief duration of action Diminished ICP and cerebral metabolic rate, making it ideal to use in the patient with head injuries Cons: Pain with injection Vasodilation, myocardial suppression = hypotension! Respiratory depression and apnea Paralytics Rocuronium A competitive non-depolarizing neuromuscular blocking agent RSI dosing: 1.0-1.2 mg/kg

2018 CandiEM

11. Imaging Program Guidelines: Pediatric Imaging

years ? Follow-up after treatment with clips, endovascular coil or stenting Cerebrovascular accident (CVA or stroke) and transient ischemic attack (TIA) Hemorrhage/hematoma Other vascular abnormalities ? Arteriovenous malformation (AVM) ? Cavernous malformation ? Cerebral vein thrombosis ? Dural arteriovenous fistula (DAVF) ? Dural venous sinus thrombosis ? Venous angioma Note: CTA or MRA is generally preferred for these indications. CT Head – Pediatrics | Copyright © 2017. AIM Specialty Health. All (...) Magnetic resonance angiography, head, without contrast 70545 Magnetic resonance angiography, head, with contrast 70546 Magnetic resonance angiography, head, without contrast, followed by re-imaging with contrast Angiography includes imaging of all blood vessels, including arteries and veins. The codes above include CT/MR Venography. Standard Anatomic Coverage ? CTA or MRA may be performed to assess the major intracranial arteries of the anterior and posterior circulations (including the Circle

2017 AIM Specialty Health

12. Heart Disease and Stroke Statistics 2017 Update: A Report From the American Heart Association

Cardiac Arrest . . . . . . . . . . . . . . e468 19. Subclinical Atherosclerosis . . . . . . . . . . . . e487 20. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris. . . . . . . . . . e505 21. Cardiomyopathy and Heart Failure . . . . . . . . e523 22. Valvular Diseases . . . . . . . . . . . . . . . . e539 23. Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism), Chronic Venous Insufficiency, Pulmonary Hypertension. . . e548 24. Peripheral Artery Disease and Aortic (...) failure (HF), valvular disease, venous disease, and peripheral arterial disease) and the as- sociated outcomes (including quality of care, procedures, and economic costs). Since 2006, the annual versions of the Statistical Update have been cited >20 000 times in the literature. In 2015 alone, the various Statistical Updates were cited ˜4000 times. Each annual version of the Statistical Update under- goes revisions to include the newest nationally represen- tative data, add additional relevant

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2017 American Heart Association

13. Prevention, Diagnosis & Management of infective endocarditis

Enterococcus species 88 4.2.2.5 HACEK microorganisms 91 4.2.2.6 Candida 92 4.2.2.7 Non-HACEK Gram-negative microorganisms 93 4.2.2.8 Other microorganisms 94 4.2.3 Empirical therapy 95 4.2.4 Outpatient parenteral antimicrobial therapy for infective endocarditis 99 5.0 SURGICAL INTERVENTION 100 5.1 Indications 100 5.2 Timing of surgery 102 5.2.1 Preventing systemic embolism 103 5.3 Sur gery in specific conditions 104 5.3.1 Cerebral infarction or haemorrhage 104 5.3.2 Right-sided endocarditis 105 5.3.3 (...) and within the first 2 weeks of therapy . » Common sites are the brain and spleen. » Risk factors for embolism are associated with vegetation size (> 10 mm), mobility, location (anterior mitral valve leaflet) as well as the causative microorganism (S. aureus). > Neurological complications: » Occurs early in the course of IE (first 2 weeks). » Common complications are ischaemic or haemorrhagic stroke, and mycotic aneurysms. » Management should be individualised and care plan decided by a multidisciplinary

2017 Ministry of Health, Malaysia

15. Effectiveness and Safety of Thrombolytics for the Treatment of Ischemic Stroke

* or brain infarct* or CVA or (brain adj2 isch?emia) or (cerebral adj2 isch?emia) or (intracranial adj2 hemorrhag*) or (brain adj2 hemorrhag*)).ti,ab. 6 or/1-5 7 exp Thrombolytic Therapy/ use mesz 8 exp Tissue Plasminogen Activator/ use mesz 9 exp fibrinolytic agent/ use emez 10 exp plasminogen activator/ use emez 11 (thromboly* or fibrinoly*).ti,ab. 12 (plasminogen or plasmin or tPA or t-PA or rtPA or rt-PA).ti,ab. 13 (anistreplase or activase or alteplase or duteplase or lanoteplase or lumbrokinase (...) or cerebrovascular accident or cerebrovascular infarct* or brain infarct* or CVA or (brain near/2 isch?emia) or (cerebral near/2 Effectiveness and Safety of Thrombolytics for Ischemic Stroke: A Rapid Review. January 2013; pp. 1–25. 18 isch?emia) or (intracranial near/2 hemorrhag*) or (brain near/2 hemorrhag*)):ti or (stroke or tia or transient ischemic attack or cerebrovascular apoplexy or cerebrovascular accident or cerebrovascular infarct* or brain infarct* or CVA or (brain near/2 isch?emia) or (cerebral near

2013 Health Quality Ontario

16. Royal Flying Doctor Service Western Operations Clinical manual part 1.Clinical guidelines

Packed red blood cells IV Intravenous PRC Packed red cells JVP Jugular venous pressure PSVT Paroxysmal supraventricular tachycardia K + Potassium PT Prothrombin time KCI Potassium chloride PV Per vaginum LAD Left anterior descending coronary artery RBBB Right bundle branch block LBBB Left bundle branch block RR Respiratory rate LFT Liver function tests RSV Respiratory syncitial virus LMA Laryngeal Mask Airway RUQ Right upper quadrant LMWH Low Molecular Weight Heparin Rx Treatment LVF Left ventricular (...) i. ECG ? ST elevation in aVR ± aVL ? Lesser ST elevation in V1 ? Marked ST depression in inferior leads ± left anterior fascicular block ii. May present with cardiogenic shock, significant ventricular arrhythmias or cardiac arrest iii. Very high mortality rate b) Total occlusion of proximal left anterior descending coronary artery (LAD) (Wellen’s Syndrome) ? ECG – prominent T wave inversion in V1-V6. (mostly V1-V4) RFDS Western Operations Version 6.0 Clinical Manual Issue Date: January 2013 Part

2014 Clinical Practice Guidelines Portal

17. Total Neoadjuvant Treatment Without Surgery For Locally Advanced Rectal Cancer

for pregnancy test (urine or blood) and who agree to use effective contraceptive methods Male subjects must also agree to use effective contraception Exclusion Criteria: Recurrent rectal cancer Patients with a history of any arterial thrombotic event within the past 6 months, including angina (stable or unstable), MI, or CVA Intolerance or contraindication to Magnetic Resonance (MR) procedure Patients with any other concurrent medical or psychiatric condition Gastro-intestinal abnormalities, inability (...) to take oral medication, any condition affecting absorption Patients with a history of a prior malignancy within the past 5 years, except for adequately treated basal cell or squamous cell skin cancer, or in situ cervical cancer. Patients with a history of thrombotic episodes, such as deep venous thrombosis, pulmonary embolus, Myocardial Infarction (MI) or cerebral vascular accident (CVA) occurring more than 6 months prior to enrollment may be considered for protocol participation, provided

2018 Clinical Trials

18. Pulmonary Vein Isolation With Versus Without Continued Antiarrhythmic Drugs in Persistent Atrial Fibrillation

Criteria: Patients not willing or not suited to take any class IC or III ADT. Any prior AF episode ≥12 months, or any recurrence of AF <3 days after cardioversion. Presence of structural heart disease on echo criteria: severe valvular heart disease LA volume >37ml/m2 and/or LA size >50mm LV ejection fraction <35% (except if suspected tachycardiomyopathy) septal diameter >15mm BMI >35 Recent (<3 months) coronary artery bypass grafting (CABG), myocardial infarction, cerebral vascular accident (CVA (...) : Arms and Interventions Go to Arm Intervention/treatment Active Comparator: ADT ON Group 'CLOSE'-guided PVI with continuation of antiarrhythmic drug therapy (ADT) at the end of the 3-months blanking period after ablation. Other: Pulmonary vein isolation using CLOSE protocol 'CLOSE' protocol: Ablation index > 400 at the posterior wall (reduce to 300 if esophagus temperature rise), ablation index > 550 at the anterior wall, and inter-lesion distance < 6.0mm Drug: Antiarrhythmic drug therapy (ADT

2018 Clinical Trials

20. Pfizer Immunotherapy Combinations for Acute Myeloid Leukemia (AML) Multi-Arm Study 1

branch block, unstable angina or myocardial infarction, coronary/peripheral artery bypass graft, CVA, transient ischemic attack or symptomatic pulmonary emboli, as well as bradycardia defined as <50 bpms on screening or Day 1 EKG. Known history of second or third degree heart block (may be eligible if the patient currently has a pacemaker). Active cardiac dysrhythmias of NCI CTCAE grade >/= 2 (eg, atrial fibrillation) or QTc interval > 470 msec within 4 weeks prior to starting the study drug (...) previously been treated with any of the agents or same class of agents they are scheduled to receive will be excluded. For example, a patient previously treated with a PD1 or PDL1-based therapy will not be eligible for avelumab+4-1BB or avelumab+OX40 arms. A patient previously treated with an OX40 based therapy will not be eligible for any of the OX40 single-agent or combination arms. Clinically significant (i.e., active) cardiovascular disease: acute cerebral vascular accident/stroke (< 6 months prior

2017 Clinical Trials

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