Aspirin still unproven as therapy for curbing brain aneurysm growth

Cincinnati — Could an aspirin a day keep an aneurysm at bay? That was the question asked by stroke researchers in the University of Cincinnati Department of Neurosurgery. The researchers reviewed the cases of 186 patients who had unruptured intracranial (brain) aneurysms that were being monitored for growth at Mayfield Brain & Spine. They found a tiny difference between patients who took an aspirin daily and those who did not take any aspirin. Aneurysms in the group that took aspirin grew in 11.9% of patients (3 percent per year) while aneurysms in the non-aspirin group grew in 16.5% (4 percent …

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Questioning the classical flow of CSF

Data has already been adding up which clarifies the classic model of CSF flow that experts rely on, is not correct.  In almost all modern neuroscience literature, since the original work on hydrocephalus by Dr. Dandy, Dr. Blackfin, and Dr. Cushing, CSF is made by the choroid plexus.   Then CSF flows through the lateral ventricles into the foramen of Monroe, into the third ventricle, through the aqueduct of Sylvius, and into the fourth ventricle where it exits the ventricular system through the foramen of Magendie or Lushka into the cerebral subarachnoid space.  Then the CSF bathes the brain or …

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Application of emerging technologies to improve access to ischemic stroke care

Neurosurg Focus. 2017 Apr;42(4):E8. doi: 10.3171/2017.1.FOCUS16520. Application of emerging technologies to improve access to ischemic stroke care. Vuong SM, Carroll CP, Tackla RD, Jeong WJ, Ringer AJ. Abstract During the past 20 years, the traditional supportive treatment for stroke has been radically transformed by advances in catheter technologies and a cohort of prominent randomized controlled trials that unequivocally demonstrated significant improvement in stroke outcomes with timely endovascular intervention. However, substantial limitations to treatment remain, among the most important being timely access to care. Nonetheless, stroke care has continued its evolution by incorporating technological advances from various fields that can further …

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Vascular Diseases of the Spinal Cord: Infarction, Hemorrhage, and Venous Congestive Myelopathy

Abstract Vascular pathologies of the spinal cord are rare and often overlooked. This article presents clinical and imaging approaches to the diagnosis and management of spinal vascular conditions most commonly encountered in clinical practice. Ischemia, infarction, hemorrhage, aneurysms, and vascular malformations of the spine and spinal cord are discussed. Pathophysiologic mechanisms, clinical classification schemes, clinical presentations, imaging findings, and treatment modalities are considered. Recent advances in genetic and syndromic vascular pathologies of the spinal cord are also discussed. Clinically relevant spinal vascular anatomy is reviewed in detail. PMID: 27616317

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Selective Digestive Decontamination (SDD) – The ICU Book

Lately I’ve been reading The ICU Book by Paul L. Marino.  Everyone in crticial care recommmends this book as standard reading for interns and junior residents, and I have to say it has been quite the read so far. One of the articles in Marino’s book that has really stuck out to me has to do with selective digestive decontamination (SDD). Marino explains that in the presence of severe chronic illness, the G.I. tract becomes populated with more pathogenic organisms capable of causing invasive infections. He quotes one study that showed that hospitalized patients are often colonized with pathogenic organisms …

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Trust in the White Coat

Medical culture is a weird yet powerful force that bonds together those who practice medicine.  From the SOB in bed 2 to the frequent-flyer out in the waiting room, the connection that we get by speaking our medical lingo brings out a special bond  of the medical culture.  Its a large, sub-culture, and like many sub-cultures we have our different rules and lingo.  I would even argue that within our large medical sub-culture we have many many different smaller ones inside that.  Nurses, techs, doctors, etc.  And even among the doctors their tends to be this imaginary dividing line between …

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