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Posterior Cerebral Artery CVA

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1. Posterior Cerebral Artery CVA

Posterior Cerebral Artery CVA Posterior 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 Posterior Cerebral Artery (...) CVA Posterior Cerebral Artery CVA Aka: Posterior Cerebral Artery CVA , Cerebrovascular Accident of Posterior Cerebral Artery , PCA CVA From Related Chapters II. Findings: Peripheral Signs and Symptoms Visual Changes Homonymous hemianopia Cortical blindness Lack of depth perception Failure to see objects not centered in visual field s Memory deficits Dyslexia III. Findings: Central Signs and Symptoms Thalamic or subthalamic nuclei involvement Diffuse sensory loss Mild Cerebral peduncle involvement

2018 FP Notebook

2. Posterior Cerebral Artery CVA

Posterior Cerebral Artery CVA Posterior 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 Posterior Cerebral Artery (...) CVA Posterior Cerebral Artery CVA Aka: Posterior Cerebral Artery CVA , Cerebrovascular Accident of Posterior Cerebral Artery , PCA CVA From Related Chapters II. Findings: Peripheral Signs and Symptoms Visual Changes Homonymous hemianopia Cortical blindness Lack of depth perception Failure to see objects not centered in visual field s Memory deficits Dyslexia III. Findings: Central Signs and Symptoms Thalamic or subthalamic nuclei involvement Diffuse sensory loss Mild Cerebral peduncle involvement

2015 FP Notebook

3. Posterior Circulation

Circulation Aka: Posterior Circulation , Basilar Artery , Vertebral Artery , Basilar Apex , Vertebrobasilar Artery , Vertebrobasilar Junction , Anterior Spinal Artery , Posterior Inferior Cerebellar Artery , Anterior Inferior Cerebellar Artery , Superior Cerebellar Artery , Posterior Cerebral Artery , Posterior Communicating Artery II. Anatomy Posterior Circulation Main Source: Two Vertebral Artery l arteries combine to form Basilar Artery Basilar Artery divides to form posterior cerebral arteries (...) arteries at the posterior border of the pons then diverges at the anterior border forming the two superior and two posterior cerebral arteries. Definition (MSH) The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries. Concepts Body Part, Organ, or Organ Component ( T023 ) MSH SnomedCT 59011009 English Arteries, Basilar , Artery, Basilar , Basilar Arteries , Basilar

2018 FP Notebook

4. "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

5. Posterior Circulation

Circulation Aka: Posterior Circulation , Basilar Artery , Vertebral Artery , Basilar Apex , Vertebrobasilar Artery , Vertebrobasilar Junction , Anterior Spinal Artery , Posterior Inferior Cerebellar Artery , Anterior Inferior Cerebellar Artery , Superior Cerebellar Artery , Posterior Cerebral Artery , Posterior Communicating Artery II. Anatomy Posterior Circulation Main Source: Two Vertebral Artery l arteries combine to form Basilar Artery Basilar Artery divides to form posterior cerebral arteries (...) arteries at the posterior border of the pons then diverges at the anterior border forming the two superior and two posterior cerebral arteries. Definition (MSH) The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries. Concepts Body Part, Organ, or Organ Component ( T023 ) MSH SnomedCT 59011009 English Arteries, Basilar , Artery, Basilar , Basilar Arteries , Basilar

2015 FP Notebook

6. Carotid Artery, Stenosis

cerebral artery, PCA = posterior cerebral artery, PCCA = posterior communicating cerebral artery. Time-of-flight (TOF) magnetic resonance angiography (MRA) is based on the physics of imaging moving blood. TOF MRA is useful for patients who cannot tolerate iodinated contrast agents used in CTA. TOF MRA is subject to motion degredation artifacts. Critical arterial stenosis and near occlusions may be falsely seen as short-segment areas of occlusion in noncontrasted TOF MRA. The principals of cervical (...) stenosis. Axial 3-dimensional maximum intensity magnetic resonance (MR) angiogram in a patient with bilateral carotid artery occlusion. Note the absence of flow in the intracranial internal carotid arteries (yellow arrows). The remaining blood flow to the cerebral hemispheres is the result of collateral branches of the vertebral arteries, including the posterior communicating arteries (white arrows). Carotid duplex imaging is performed most commonly in patients with moderate risk factors

2014 eMedicine Radiology

7. 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

8. 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

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. 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

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

) min minute g grams hr hour kg kilograms J Joules mm millimetres 1% 1 g per 100mL cm centimetres g/L grams per Litre km kilometres mL/hr millilitres per hour Clinical Terminology AAA Abdominal aortic aneurysm CPR Cardiopulmonary resuscitation ABG Arterial blood gas CSF Cerebrospinal fluid ACEI Angiotensin converting enzyme inhibitor CSL Compound sodium lactate ACR Albumin creatinine ratio CT Computerised tomogram ACS Acute coronary syndrome CTG Cardiotochography AF Atrial fibrillation CTPA (...) Computerised tomography pulmonary angiogram AFB Acid fast bacilli CVA Cerebrovascular accident ALS Advanced life support CVC Central venous catheter APH Antipartum haemorrhage CVP Central venous pressure APO Acute pulmonary oedema CXR Chest x-ray ARCBS Australian Red Cross Blood Service DBP Diastolic blood pressure ARDS Adult respiratory distress syndrome DC Direct current ATLS Advanced trauma life support DIC Disseminated intravascular coagulopathy BBB Bundle branch block DKA Diabetic keto-acidosis BP

2014 Clinical Practice Guidelines Portal

14. 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

16. Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

survivors diagnosed in childhood or young adulthood who had received >35 Gy of cardiac radiation. All had evidence of radiation-induced cardiac damage, and 6 had at least 1 coronary artery with severe stenosis. Since these early studies, the incidence and risk factors of cardiovascular disease (CVD) have been studied intensely, as described in the present article. Indeed, cardiac-specific disease is the most common noncancer cause of death among long-term childhood cancer survivors (...) (imatinib/sunitinib)Alkylating agents (cyclophosphamide/ifosfamide)Cisplatin Oxidative stressInhibition of Abl kinase mitochondrial dysfunctionVascular endothelial cell injuryHypomagnesia, coronary artery fibrosis CHF indicates congestive heart failure; and HERG, human ether-a-go-go related. The types of chemotherapy-induced cardiovascular alterations reported primarily, but not exclusively, in adults include the following: Acute cardiac rhythm abnormalities (arrhythmias including QT prolongation

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2013 American Heart Association

17. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate Use Criteria for Coronary Revascularization Focused Update

at healthpermissions@elsevier.com. 3 TABLE OF CONTENTS PREAMBLE 7 1. INTRODUCTION 8 1.1. DOCUMENT DEVELOPMENT PROCESS 8 1.1.1. Writing Committee Organization 8 1.1.2. Document Development and Approval 8 1.2. PURPOSE OF THIS DOCUMENT 8 2. BACKGROUND AND HISTORICAL ASPECTS 9 2.1. PATHOPHYSIOLOGY AND CLINICAL COURSE 9 2.2. DIAGNOSIS 10 2.2.1. Echocardiography Versus Catheterization 10 2.2.2. Stress Testing 10 2.3. SPECIAL CONSIDERATIONS 11 2.3.1. Symptom Status 11 2.3.2. Associated Coronary Artery Disease 11 2.3.3 (...) % stenosis) in major coronary arteries should be treated with concomitant CABG. Options in patients with combined AS and CAD continue to grow with the use of hybrid procedures where PCI is followed by valve surgery. It is possible that such a strategy could be performed in the setting of TAVR (36,37). 2.3.3. Associated Lesions—AR, MR, Pulmonary Hypertension, TR Patients with severe AS often have additional associated significant valvular heart disease. Treatment of these lesions in patients undergoing

2012 Society for Cardiovascular Angiography and Interventions

18. The RhinoChill intranasal cooling system for reducing temperature after cardiac arrest

Cerebrovascular Disorders/ 275909 8 (stroke or strokes or poststroke or poststrokes or cerebrovasc* or cerebro-vasc* or brain vasc* or cerebral vasc* or cva* or apoplexy* or SAH).ti,ab. 196056 9 ((brain* or cerebr* or cerebell* or cortical or vertebrobasilar or hemisphere* or intracran* or intra- cran* or intracerebral or infratentorial or infra-tentorial or supratentorial or supra-tentorial or MCA or anterior circulation or posterior circulation or basal gangli*) adj5 (ischemi* or ischaemi* or infarct (...) or cerebrovasc* or cerebro-vasc* or brain next vasc* or cerebral next vasc* or cva* or apoplex* or SAH) 31807 #9 ((brain* or cerebr* or cerebell* or cortical or vertebrobasilar or hemispher* or intracran* or intra-cran* or intracerebral or infratentorial or infra-tentorial or supratentorial or supra-tentorial or MCA or anterior next circulation or posterior next circulation or basal next gangli*) near/ 5 (ischemi* or ischaemi* or infarct* or thrombo* or emboli* or occlus* or hypox* or vasospasm*)) 5794 #10

2014 National Institute for Health and Clinical Excellence - Advice

19. Family Practice Notebook Updates 2017

with CAD Risk <7.5% (gyn, ) Surgical arsenal includes MRgFUS and IR embolization, as well as the traditional or myomectomy Medical management has changed little (still s, IUD, s) is an interesting option given its other uses ( in ) (lung, peds, ) Supportive care, nasal suctioning and maintain hydration (all other measures e.g. nebs, steroids, are defunct) (ent, vestibular) Distinguish triggered episodic VS spontaneous episodic VS continuous ( ) Critical to consider posterior CVA in (continuous (...) (esp. on the back) (endo, pharm) goals are 140-180 mg/dl may typically be continued while hospitalized (but caution with s, s) In hospital protocols exist for initiating basal, bolus and correctional (gi, liver) is the most common cause of asymptomatic mild s (<5 times normal) Other than , s, , and may also increase s Rare cases include , , (endo, dm, er) Fluid and precede Identify precipitating conditions (e.g. ) caution in overhydration of children (risk of cerebral edema) (cv, pharm, adverse

2018 FP Notebook

20. Ischemic Stroke

, Cerebrovascular Accident , Cerebrovascular Disease , Cerebral Infarction , Ischemic CVA , CVA From Related Chapters II. Risk Factors See III. Epidemiology: Incidence (from most to least common) Overall : More than 795,000 cases in U.S. per year (2012) First Stroke: 610,000 Recurrent Stroke: 185,000 Ischemic Stroke: 85-88% Thrombotic Stroke (most common) Embolic Stroke Lacunar Stroke (least common of Ischemic Strokes) : 9% : 3% IV. Pathophysiology: Types Thrombotic CVA Typically in older patients May also (...) occur over age 40 years old with risks ( , , , abuse, ) Large vessel thrombosis (carotid, l arteries or ) cause fluctuating or recurring deficits developing over days Small vessel thrombosis involve deeper brain tissue (e.g. , , pons, ) Embolic CVA More common in patients under age 50 years old Associated with new onset , valvular heart disease, endocarditis Cardiac or aortic source with often multiple sites affected and maximal deficit at onset Hypoperfusion May present as focal CVA due

2018 FP Notebook

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