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Stroke: Introduction and Types01:29

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
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Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Dementia l: Introduction01:22

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Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...

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Chronic subdural hematoma: What precisely are we treating?

Yang Qiao1,2,3, Sáfa Alkarawi1, Vincent E Provasek4

  • 1Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, Houston, TX, USA.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
|July 21, 2024
PubMed
Summary

Subdural hematoma (SDH) is blood between the dura and arachnoid membranes. This review focuses on chronic SDH, exploring its mass-like growth and evolving endovascular treatment strategies.

Keywords:
Neo-angiogenesischronic subdural hematomamiddle meningeal artery embolization

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Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Subdural hematoma (SDH) is a collection of blood between the dura mater and arachnoid membrane.
  • SDH subtypes are categorized by imaging, cause, and symptom onset, impacting prognosis and treatment.
  • Acute SDH from traumatic brain injury evolves into sub-acute and chronic forms over weeks.

Purpose of the Study:

  • To review the anatomical features of end-stage chronic SDH (cSDH).
  • To reconceptualize cSDH based on its mass-like growth patterns.
  • To highlight the shift towards endovascular treatment for cSDH.

Main Methods:

  • Literature review of anatomical features and imaging characteristics of SDH.
  • Analysis of the evolution of SDH from acute to chronic stages.
  • Examination of neo-membranization and neo-angiogenesis in cSDH.

Main Results:

  • Chronic SDH exhibits neo-membranization and neo-angiogenesis, leading to mass-like growth.
  • Imaging reveals distinct characteristics for acute, sub-acute, and chronic SDH.
  • Understanding cSDH evolution informs treatment strategies.

Conclusions:

  • Chronic SDH presents complex anatomical features and mass-like growth.
  • Reconceptualizing cSDH supports a shift towards endovascular interventions.
  • Further research into endovascular techniques for cSDH is warranted.