Incidence of spontaneous subdural hematoma in incident cases of pulmonary arterial hypertension: a registry of cases occurring over a five-year period

Prada, Luis; Gavilanes, Francisca; Souza, Rogério

doi:10.1590/s1806-37132015000100014

Cited by 3 publications

(4 citation statements)

References 7 publications

(7 reference statements)

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“…The phase III IMPRES study, which also investigated the effects of imatinib on PAH, has demonstrated improvement in walking distance, reduction of pulmonary resistance, and improvement in cardiac output (Hoeper et al, 2013). Although impressive results have been obtained in experimental models of PH (Schermuly et al, 2005) and in the compassionate treatment (Frost et al, 2015; Ghofrani et al, 2005; Speich et al, 2015), the clinical trials were discontinued due to those safety issues of imatinib (Hoeper et al, 2013; Prada, Gavilanes, & Souza, 2015). Furthermore, imatinib inhibits Abl kinase resulting in increased endoplasmic reticulum stress, leading to mitochondrial dysfunction (Rainbolt, Saunders, & Wiseman, 2014).…”

Section: Growth Factor Receptor Signallingmentioning

confidence: 99%

Kinases as potential targets for treatment of pulmonary hypertension and right ventricular dysfunction

Weiß

Böehm

Egemnazarov

et al. 2020

British J Pharmacology

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Pulmonary hypertension (PH) is a progressive pulmonary vasculopathy that causes chronic right ventricular pressure overload and often leads to right ventricular failure. Various kinase inhibitors have been studied in the setting of PH and either improved or worsened the disease, highlighting the importance of understanding the specific role of the respective kinases in a spatiotemporal cellular context. In this review, we will summarize the knowledge on the role of kinases in PH and focus on druggable targets for which certain criteria are met: (a) deregulation of the kinase in PH; (b) smallmolecule inhibitors are available (e.g. from the oncology field); (c) preclinical studies have shown their efficacy in PH models; and (d) when available, therapeutic exploitation in human PH has been initiated. Along this line, clinical considerations such as personalized medicine approaches to predict therapy response and adverse side events such as cardiotoxicity together with their clinical management are discussed.

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Section: Growth Factor Receptor Signallingmentioning

confidence: 99%

Kinases as potential targets for treatment of pulmonary hypertension and right ventricular dysfunction

Weiß

Böehm

Egemnazarov

et al. 2020

British J Pharmacology

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“…1 ► Venous hypertension that involves the cerebral vasculature can predispose patients to develop intracranial haemorrhages, and, in this case, cause a mottled, haemorrhagic appearance of the brain parenchyma. 2 contributors IFF was responsible for the initial written content and obtaining images. YC was responsible for reviewing and editing the manuscript and providing images for this case.…”

Section: Learning Pointsmentioning

confidence: 99%

Spontaneous subdural haematoma in a paediatric patient on anticoagulant therapy

et al. 2017

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DescriptionA 5-year old girl with congenital mitral and subaortic stenosis on anticoagulant therapy since her mechanical mitral valve replacement, and a remote history of idiopathic intrahepatic cholestasis requiring liver transplantation presented with jaundice and pruritus. She was found to have elevated transaminases, and an echocardiogram revealed significantly increased right ventricular pressures concerning for pulmonary hypertension. Subsequently, the patient needed to be intubated for respiratory insufficiency and poor cardiac output. After several days in the intensive care unit (ICU), she was noted to be bradycardic and have a dilated right pupil. A stat CT of the head demonstrated a large mixed density right-sided subdural haematoma with mass effect, midline shift and early uncal and transtentorial herniation, as well as a small subdural haematoma on the left (figure 1). The mixed density of the haematoma on CT scan was likely a result of multiple haemorrhages over the previous several days and/or hyperacute blood product accumulation in the setting of a coagulopathy.The patient was taken to the operating room for emergent decompressive craniectomy and evacuation of subdural haematoma. Prior to surgery, her coagulopathy was reversed with protamine, decreasing her PTT from 150 to 37 s. The patient was also given mannitol and hyperventilated as temporising measures while the operating room was being prepared. A large right frontotempoparietal craniectomy was performed in standard fashion. Removal of the bone flap revealed impressive swelling and tense dura with a blue tint. The dura was then opened progressively to avoid herniation of brain tissue or hypotension. Extensive mixed density clot was evacuated to reveal markedly swollen brain parenchyma with a mottled appearance, likely due to a combination of cerebral contusions from the mass effect of the haematoma as well as the patient's underlying venous hypertension (figure 1). After a satisfactory and uneventful decompression, an ICP monitor was placed, the bone flap was left off and the skin was closed in routine fashion. The patient was kept intubated and transported back to the ICU for further management. Figure 1 CT of the head showing right-sided subdural haematoma with mass effect, midline shift and a small subdural haematoma on the left and swollen brain parenchyma with mottled appearance after evacuation of subdural haematoma and decompressive craniectomy. Learning points

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“…In the area of vascular diseases, the development of specific medications for the treatment of pulmonary arterial hypertension has had an undeniable impact on the development of knowledge related to that particular clinical situation, not only for its identification, in Brazil and elsewhere, but also for establishing treatment strategies and quantifying risks. 3 - 6 The example of pulmonary arterial hypertension illustrates the fact that this is not an issue related to disease prevalence, because it determines only the “moment” at which the change occurs.…”

mentioning

confidence: 99%

“…Ainda nas doenças vasculares, o desenvolvimento de medicações específicas para o tratamento da hipertensão arterial pulmonar teve impacto inequívoco no desenvolvimento do conhecimento associado a essa situação clínica tão peculiar, tanto para o reconhecimento de sua realidade em nosso meio e no exterior, quanto para estabelecer estratégias de tratamento e seus riscos. 3 - 6 A hipertensão arterial pulmonar evidencia que essa não é uma questão relacionada à prevalência da doença, que determina isoladamente o momento de mudança.…”

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Momentum

Souza

2017

J. bras. pneumol.

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Incidence of spontaneous subdural hematoma in incident cases of pulmonary arterial hypertension: a registry of cases occurring over a five-year period

Cited by 3 publications

References 7 publications

Kinases as potential targets for treatment of pulmonary hypertension and right ventricular dysfunction

Kinases as potential targets for treatment of pulmonary hypertension and right ventricular dysfunction

Spontaneous subdural haematoma in a paediatric patient on anticoagulant therapy

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