Featured Research

from universities, journals, and other organizations

Foreign-body material identified at site of fatal brain hemorrhage

Date:
December 10, 2013
Source:
American Association of Neurological Surgeons (AANS)
Summary:
Researchers hypothesize about the role that polyvinylpyrrolidone may play in fatal hemorrhages several days after successful cerebral aneurysm treatment.

A paper from neurosurgical researchers discusses a problem that started as a medical mystery and became a cautionary tale. Fatal hemorrhages occurred in the brains of two patients several days after successful cerebral aneurysm treatment with the Pipeline™ Embolization Device (PED). These hemorrhages were located in the same vascular territory as the treated aneurysms but were not close enough to the lesions to be directly linked to the aneurysms or their treatment. Over time, physicians began to suspect that these were not isolated hemorrhages, but in fact, were occurring in approximately four percent of patients treated in this manner.

In the second patient (Case 1 in this paper), embolic non-biological material had been found close to the site of hemorrhage, but the nature of the material and its relationship to the hemorrhage was unclear. When a third patient at a distant institution (Case 2) developed a similar delayed hemorrhage, the treating physicians were advised to check carefully for the presence of embolic foreign material. When the material was confirmed to be present in the third patient (Case 2), preserved tissue from the first patient (Case 3) was re-examined and the embolic material, albeit in lesser amounts, was identified adjacent to the hemorrhagic area. The source of this material became the next question to answer.

Autopsy specimens in all three patients contained collections of non-biological material at the site of brain hemorrhage. Tests showed this material to be polyvinylpyrrolidone (PVP), a water-soluble polymer with various applications such as an adhesive in glue sticks, a binder in pharmaceutical tablets, and a lubricant coating in catheters. Deposits of PVP were found in the hemorrhagic areas, clogging blood vessels and extending into surrounding brain tissue. The only other place in the brain that PVP was found was on the surface of the PED in two of the patients. Since the PED does not contain PVP, the researchers focused on other materials used in the endovascular procedure. They suspect that the PVP sloughed off the Cook Shuttle Guiding Sheath that was used to deliver the PED, and they provide videos showing how this may have occurred. The PVP may then have traveled through the vasculature from the site of aneurysm treatment to the location where hemorrhage later occurred.

The researchers discuss the role PVP could have played in the fatal hemorrhages. However, they note that there is no clear-cut evidence that the presence of PVP was the direct or sole cause of fatal brain hemorrhage in these patients. PVP is a component in numerous supplies used in endovascular procedures, and its presence has not been directly linked with catastrophic events. In addition, there are other factors that could cause brain hemorrhage in patients undergoing aneurysm treatment.

The researchers describe and discuss additional potential causes of hemorrhage as well as the possibility that a combination of two or more factors, including PVP, could lead to this serious event. All are detailed in their paper, "Histopathological assessment of fatal ipsilateral intraparenchymal hemorrhages after the treatment of supraclinoid aneurysms with the Pipeline Embolization Device. Report of 3 cases"


Story Source:

The above story is based on materials provided by American Association of Neurological Surgeons (AANS). Note: Materials may be edited for content and length.


Journal Reference:

  1. Yin C. Hu, Vivek R. Deshmukh, Felipe C. Albuquerque, David Fiorella, Randal R. Nixon, Donald V. Heck, Stanley L. Barnwell, Cameron G. McDougall. Histopathological assessment of fatal ipsilateral intraparenchymal hemorrhages after the treatment of supraclinoid aneurysms with the Pipeline Embolization Device. Journal of Neurosurgery, 2013; 1 DOI: 10.3171/2013.11.JNS131599

Cite This Page:

American Association of Neurological Surgeons (AANS). "Foreign-body material identified at site of fatal brain hemorrhage." ScienceDaily. ScienceDaily, 10 December 2013. <www.sciencedaily.com/releases/2013/12/131210101929.htm>.
American Association of Neurological Surgeons (AANS). (2013, December 10). Foreign-body material identified at site of fatal brain hemorrhage. ScienceDaily. Retrieved April 17, 2014 from www.sciencedaily.com/releases/2013/12/131210101929.htm
American Association of Neurological Surgeons (AANS). "Foreign-body material identified at site of fatal brain hemorrhage." ScienceDaily. www.sciencedaily.com/releases/2013/12/131210101929.htm (accessed April 17, 2014).

Share This



More Health & Medicine News

Thursday, April 17, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Obama: 8 Million Healthcare Signups

Obama: 8 Million Healthcare Signups

AP (Apr. 17, 2014) President Barack Obama gave a briefing Thursday announcing 8 million people have signed up under the Affordable Care Act. He blasted continued Republican efforts to repeal the law. (April 17) Video provided by AP
Powered by NewsLook.com
Is Apathy A Sign Of A Shrinking Brain?

Is Apathy A Sign Of A Shrinking Brain?

Newsy (Apr. 17, 2014) A recent study links apathetic feelings to a smaller brain. Researchers say the results indicate a need for apathy screening for at-risk seniors. Video provided by Newsy
Powered by NewsLook.com
Could Even Casual Marijuana Use Alter Your Brain?

Could Even Casual Marijuana Use Alter Your Brain?

Newsy (Apr. 16, 2014) A new study conducted by researchers at Northwestern and Harvard suggests even casual marijuana use can alter your brain. Video provided by Newsy
Powered by NewsLook.com
Thousands Of Vials Of SARS Virus Go Missing

Thousands Of Vials Of SARS Virus Go Missing

Newsy (Apr. 16, 2014) A research institute in Paris somehow misplaced more than 2,000 vials of the deadly SARS virus. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins