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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Decrease in cortical vein opacification predicts outcome after aneurysmal subarachnoid hemorrhage.

William S Dodd1, Orrin Dayton2, Brandon Lucke-Wold3

  • 1College of Medicine, University of Florida, Gainesville, Florida, USA.

Journal of Neurointerventional Surgery
|December 1, 2022
PubMed
Summary
This summary is machine-generated.

Reduced venous filling after aneurysmal subarachnoid hemorrhage (aSAH) is linked to poor outcomes. This finding highlights the role of cerebral venous hemodynamics in brain injury following aSAH.

Keywords:
CT AngiographyHemorrhageStrokeVein

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Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • The exact causes of brain injury following aneurysmal subarachnoid hemorrhage (aSAH) are not fully understood.
  • Cerebral venous flow patterns may indicate hemodynamic changes after aneurysm rupture.
  • This study investigated the link between venous filling and patient outcomes after aSAH.

Purpose of the Study:

  • To determine if cortical venous opacification score (COVES) decreases after aSAH.
  • To assess if decreased COVES correlates with hydrocephalus, vasospasm, delayed cerebral ischemia (DCI), and poor functional outcomes.

Main Methods:

  • Retrospective observational cohort study of 22 aSAH patients (2016-2018).
  • Measured COVES at admission and subsequent CT angiography (CTA).
  • Compared outcomes (hydrocephalus, vasospasm, DCI, discharge status) between patients with decreased COVES and stable COVES.

Main Results:

  • COVES decreased in 50% of patients (average 1.1 points, P=0.01).
  • Decreased COVES was associated with higher rates of DCI (58% vs 0%, P=0.03) and poor discharge outcomes (100% vs 55%, P=0.03).
  • No significant association found between COVES changes and hydrocephalus or vasospasm.

Conclusions:

  • Reduced venous filling, indicated by decreased COVES on CTA, is associated with poor outcomes in aSAH patients.
  • Venous hemodynamics may play a role in the pathophysiology of brain injury post-aSAH.
  • Further prospective studies are needed to confirm these findings.