Download Hemorrhagic Stroke by Edoardo Boccardi, Marco Cenzato, Francesco Curto, Marco PDF

By Edoardo Boccardi, Marco Cenzato, Francesco Curto, Marco Longoni, Cristina Motto, Valentina Oppo, Valentina Perini, Simone Vidale

ISBN-10: 3319321293

ISBN-13: 9783319321295

ISBN-10: 3319321307

ISBN-13: 9783319321301

This publication offers specific sensible counsel at the administration of hemorrhagic stroke within the scientific settings encountered in day-by-day perform. Real-life instances are used to depict quite a lot of scientific eventualities and to focus on major points of administration of hemorrhagic stroke. moreover, diagnostic and healing protocols are awarded and invaluable decision-making algorithms are only if are particular to the various pros taken with supply of stroke care and to differing kinds of health facility facility. The assurance is finished through the inclusion of updated medical historical past info suitable to prognosis and treatment. all through, the process followed is either functional and multidisciplinary. The ebook might be of worth for all practitioners fascinated with the supply of stroke care, and in addition for scientific students.

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The use of sequences with fluid-­ attenuated inversion recovery (FLAIR) and SWI is particularly sensitive to paramagnetic substances such as haemoglobin degradation products [137]. If CT scan findings are negative and clinical suspicion is high, a lumbar puncture should be performed, taking into account that in only 3 % of patients with negative CT findings within 12 h of onset of symptoms, a lumbar puncture shows haemoglobin metabolites and an angiography confirms the presence of a ruptured aneurysm [132].

The surgical strategy consists in firstly identifying, isolating and closing afferent arteries and secondly isolating the AVM nidus from all afferents coming from the white matter and finally closing, blocking off the veins and removing the malformation. The main risk with surgery is that a residue of the AVM may remain and start bleeding again in the immediate post-­ operative period. For this reason it is indispensable to carry out angiographic control at the end of the operation so as to exclude the presence of any residue, and any that is found must be removed.

It is located within the microcatheter. Once the aneurysm is reached, a platinum metal wire (spiral or coil) can be pushed into the microcatheter. The wire has “winding shape memory” which allows it to return to a three-dimensional ball of the desired size, corresponding to the size of the aneurysm. Several well-compacted spirals are usually needed to completely exclude the aneurysm sac, but if the aneurysms are very small one spiral is enough. The ultimate goal of the procedure is to completely exclude the aneurysm from the circulation (to prevent further ruptures) and to maintain ­ perfect patency of all the arteries in the region.

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