Browsing by Author "Mellado, Patricio"
Now showing 1 - 8 of 8
Results Per Page
Sort Options
- ItemCarotid artery dissection: Endovascular treatment. Report of 12 patients(WILEY-LISS, 2008) Fava, Mario; Meneses, Luis; Loyola, Soledad; Tevah, Jose; Bertoni, Hernan; Huetel, Isidro; Mellado, PatricioObjective: The purpose of this article is to report our experience with endovascular treatment of internal carotid artery (ICA) dissection with the use of stents. Background: Carotid Dissection is an important cause of ischemic stroke in young and middle-aged patients. There are some patients in whom invasive management is recommended. Methods: Twelve patients (eight females, four males), mean age of 50 years (range 3580 years) with ICA dissection, were treated with the endovascular approach during a 24-month period. Patients included in this study underwent magnetic resonance (MR) and digital subtraction angiography (DSA) for diagnosis. Over this time period, 162 patients with ICA dissections were seen at our institution. Indications for endovascular treatment were: recurrent ischemic events despite adequate anticoagulant treatment in seven cases, contraindication to anticoagulation in four cases, and one case with significant mismatch between diffusion and perfusion weighted MR. Eleven dissections were spontaneous and one was traumatic. The follow-up was performed clinically with Doppler ultrasound (US) and MR at 6, 12, and 24 months. Results: Stent deployment was successful in all cases. Acute symptoms were resolved in 66.7% of patients. No patients deteriorated their neurological status. There were no new clinical events, stent stenosis or occlusion on 24 months follow-up. Conclusion: Our results showed an excellent clinical outcome of the treated patients. This suggests promising results with the use of endovascular treatment in selected patients. (c) 2008 Wiley-Liss, Inc.
- ItemCircumflex Scapular Artery Pseudoaneurysm as an Unusual Source of Emboli in Recurrent Posterior Circulation Stroke(2022) Marine, Leopoldo; Velasquez, Fernando; Sandoval, Patricio; Mellado, Patricio; Carlos Zamora, Juan; Vergara, Francisco; Pablo Cruz, JuanObjective: To present a rare cause of recurrent posterior embolic strokes originating from a partially thrombosed pseudoaneurysm of a shoulder artery after arthroscopy. Materials and Methods: The clinical history, complementary studies and follow-up were reviewed. Results: The patient was successfully embolized and presented no new ischemic episodes at the 3-month follow-up visit. Conclusions: Shoulder artery pseudoaneurysm should be considered as an unusual source of posterior embolic strokes.
- ItemComplete T2-fogging of pontomedullary infarction in Locked-In Syndrome(2008) Nagel, Simon; Herweh, Christian; Bonaut, Aitziber Aleu; Schellinger, Peter D.; Mellado, PatricioWe report a patient who was treated with intravenous thrombolysis, and subsequently developed a Locked-In Syndrome (LIS). After 2 days, magnetic resonance imaging showed a large bilateral pontomedullary infarction. However, in contrast to the patient's clinical situation, the follow-up T2-weighted MR images up to day 26 did not display the infarction. This phenomenon is known as the so-called fogging effect.
- ItemEndovascular cooling in a patient with neuroleptic malignant syndrome(ELSEVIER SCIENCE BV, 2008) Diedler, Jennifer; Mellado, Patricio; Veltkamp, RolandWe report a case of severe neuroleptic malignant syndrome with hyperthermia, rhabdomyolysis and hepatic failure where we applied endovascular cooling in order to reverse hyperthermia. After rapid normalization of core temperature at 37.5 degrees C, the patient's condition improved and CK levels dropped. However, upon withdrawl of endovascular temperature control there was a relapse. This is the first Case where endovascular cooling was applied successfully in neuroleptic malignant syndrome. (c) 2007 Elsevier B.V. All rights reserved.
- ItemHemorrhagic complications after off-label thrombolysis for ischemic stroke(LIPPINCOTT WILLIAMS & WILKINS, 2007) Aleu, Aitziber; Mellado, Patricio; Lichy, Christoph; Koehrmann, Martin; Schellinger, Peter D.Background and Purpose-Only 2% to 4% of patients with acute ischemic stroke receive thrombolytic therapy resulting from the current strict inclusion criteria among other issues. Safety of intravenous and intraarterial thrombolysis in off-label situations is controversially discussed. We sought to review the reports on such patients regarding intra- and extracranial hemorrhage. Summary of Review-A MEDLINE search for off-label uses of thrombolysis revealed reports on 273 patients treated with intraarterial or intravenous thrombolysis for ischemic stroke. Symptomatic intracranial hemorrhage occurred in 19 of 273 patients (6.95%) and extracranial hemorrhage in 17 of 273 (6.22%). Conclusions-These data suggest that the overall bleeding risk in off-label thrombolysis may not be as high as presumed. However, the small number of patients in each group and the likely underreporting of worse outcomes preclude drawing any conclusion as to specific treatment recommendations. Selected patients might benefit, however, from thrombolysis in situations not currently considered in the inclusion criteria. To obtain a meaningful database, a registry for off-label thrombolysis should be created. (Stroke. 2007;38:417-422.)
- ItemHipotermia intravascular prolongada en un paciente con hipertensión endocraneana refractaria(SOC MEDICA SANTIAGO, 2012) Rovegno, Maximiliano; Luis Valenzuela, Jose; Mellado, Patricio; Andresen, MaxThe use of hypothermia after cardiac arrest caused by ventricular fibrillation is a standard clinical practice, however its use for neuroprotection has been extended to other conditions. We report a 23-year-old male with intracranial hypertension secondary to a parenchymal hematoma associated to acute hydrocephalus. An arterial malformation was found and embolized. Due to persistent intracranial hypertension, moderate hypothermia with a target temperature of 33 degrees C was started. After 12 hours of hypothermia, intracranial pressure was controlled. After 13 days of hypothermia a definitive control of intracranial pressure was achieved. The patient was discharged 40 days after admission, remains with a mild hemiparesia and is reassuming his university studies. (Rev Med Chile 2012; 140: 219-224).
- ItemQuantitative EEG Correlates of Low Cerebral Perfusion in Severe Stroke(2009) Diedler, Jennifer; Sykora, Marek; Bast, Thomas; Poli, Sven; Veltkamp, Roland; Mellado, Patricio; Steiner, Thorsten; Rupp, AndreContinuous EEG provides the unique possibility to monitor neuronal function non-invasively. In our pilot study, we evaluated EEG spectral power during spontaneous drops in cerebral perfusion pressure (CPP) in deeply sedated and mechanically ventilated patients with severe stroke. We aimed to identify parameters that may be used for continuous monitoring even in patients with a burst-suppression baseline EEG pattern.
- ItemSARCOID-LIKE GRANULOMATOUS MYOSITIS-ASSOCIATED HYPERCALCEMIA. AN INFREQUENT CASE TO CONSIDER(2021) Uslar, Thomas; Olmos, Roberto; Godoy-Santin, Jaime; Mellado, Patricio; Gonzalez, GilbertoPTH-independent hypercalcemia due to granulomatous disease is well-documented and sarcoidosis is the most characteristic disease, although there are others. We describe a case of sarcoid-like granulomatous myositis. An 87-year-old man was referred with tetraparesis and hypercalcemia (albumin-corrected calcium of 13.4 mg/dl) following a trip to the Caribbean. The evaluation showed a suppressed PTH, 25-hydroxy vitamin D of 7.5 ng/ml, F-18-FDG PET/CT showed markedly increased uptake in intercostal, back, shoulder, buttock and thigh muscles and a deltoid biopsy confirmed extensive granulomatous myositis. He was prescribed glucocorticoids which resulted in normalized plasma calcium levels and complete recovery from tetraparesis. Sarcoid-like granulomatous myositis should be incorporated into the differential diagnosis of PTH-independent hypercalcemia, especially in the absence of clinical features of sarcoidosis and with special emphasis on the use of F-18-FDG PET/CT to ensure a correct approach.