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Article ; Online: Fatal cerebral air embolism from atrio-oesophageal fistula following cardiac ablation.

Keh, Ryan Yann Shern / du Plessis, Daniel / Potter, Gillian M / Kobylecki, Christopher / Cooper, Paul

2024 Volume 24, Issue 1, Page(s) 37–40

Abstract: A young woman with Rogers syndrome (thiamine-responsive megaloblastic anaemia, diabetes mellitus and sensorineural deafness) presented with headache, recurrent supraventricular tachycardia and features of an upper gastrointestinal bleed, 1 month after ... ...

Abstract	A young woman with Rogers syndrome (thiamine-responsive megaloblastic anaemia, diabetes mellitus and sensorineural deafness) presented with headache, recurrent supraventricular tachycardia and features of an upper gastrointestinal bleed, 1 month after radiofrequency cardiac ablation for supraventricular tachycardia. She deteriorated rapidly after endoscopy and subsequently died. Brain imaging during the acute deterioration showed diffuse intracranial air embolism and hypoxic-ischaemic injury. Postmortem examination showed an atrio-oesophageal fistula, a rare complication of cardiac ablation. Clinicians should suspect this condition in patients with acute neurological deterioration after cardiac ablation who have diffuse air embolism on imaging.
MeSH term(s)	Female ; Humans ; Atrial Fibrillation ; Embolism, Air/etiology ; Esophageal Fistula/complications ; Esophageal Fistula/diagnosis ; Thiamine Deficiency/complications ; Tachycardia, Supraventricular/complications
Language	English
Publishing date	2024-01-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2170881-2
ISSN	1474-7766 ; 1474-7758
ISSN (online)	1474-7766
ISSN	1474-7758
DOI	10.1136/pn-2023-003915
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Article ; Online: Imaging of Petrous Apex Lesions.

Potter, Gillian M / Siripurapu, Rekha

Neuroimaging clinics of North America

2021 Volume 31, Issue 4, Page(s) 523–540

Abstract: The petrous apex may be affected by a range of lesions, commonly encountered as incidental and asymptomatic findings on imaging performed for other clinical reasons. Symptoms associated with petrous apex lesions commonly relate to mass effect and/or ... ...

Abstract	The petrous apex may be affected by a range of lesions, commonly encountered as incidental and asymptomatic findings on imaging performed for other clinical reasons. Symptoms associated with petrous apex lesions commonly relate to mass effect and/or direct involvement of closely adjacent structures. Petrous apex lesions are optimally assessed using a combination of high-resolution CT and MRI of the skull base. Management of petrous apex lesions varies widely, reflecting the range of possible pathologies, with imaging playing a key role, including lesion characterization, surveillance, surgical planning, and oncological contouring.
MeSH term(s)	Humans ; Magnetic Resonance Imaging ; Petrous Bone/diagnostic imaging ; Skull Base ; Tomography, X-Ray Computed
Language	English
Publishing date	2021-07-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1314594-0
ISSN	1557-9867 ; 1052-5149
ISSN (online)	1557-9867
ISSN	1052-5149
DOI	10.1016/j.nic.2021.06.005
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Article ; Online: Idiopathic Fistula in an Unrepaired Submucous Cleft Palate.

Potter, Julie / Rivers, Clare M / Roche, Aidan / Cairns, Gillian / Devlin, Mark / Russell, Craig / Drake, David

The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association

2022 Volume 61, Issue 1, Page(s) 159–165

Abstract: Palatal fistulae are a recognised complication in individuals who have undergone surgical repair of a cleft palate, however, congenital or idiopathic palatal fistulae are rare. This report discusses the presentation and treatment of a 16-year-old female ... ...

Abstract	Palatal fistulae are a recognised complication in individuals who have undergone surgical repair of a cleft palate, however, congenital or idiopathic palatal fistulae are rare. This report discusses the presentation and treatment of a 16-year-old female with a submucous cleft palate, who presented with a recent onset change in speech and evidence of a new palatal fistula. There was no history of recent infection or known trauma, and the patient had not undergone any previous palatal surgery. This report discusses the clinical presentation, recommended management and relevant literature for this rare phenomenon.
MeSH term(s)	Female ; Humans ; Adolescent ; Cleft Palate/diagnostic imaging ; Cleft Palate/surgery ; Cleft Palate/complications ; Fistula/surgery ; Plastic Surgery Procedures ; Speech
Language	English
Publishing date	2022-11-28
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1069409-2
ISSN	1545-1569 ; 0009-8701 ; 1055-6656
ISSN (online)	1545-1569
ISSN	0009-8701 ; 1055-6656
DOI	10.1177/10556656221138899
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Article ; Online: Cerebral small-vessel disease: what lies beyond the early years?

Potter, Gillian M / Román, Gustavo

Neurology

2011 Volume 76, Issue 8, Page(s) 684–685

MeSH term(s)	Blood Vessels/pathology ; Cerebrovascular Disorders/pathology ; Cerebrovascular Disorders/physiopathology ; Humans
Language	English
Publishing date	2011-02-22
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/WNL.0b013e31820eb127
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Article ; Online: Intraoperative diagnosis of facial schwannomas: a multicenter summation of clinical experience, preoperative avoidance, and intraoperative management protocol.

Journal of neurosurgery

2023 Volume 139, Issue 4, Page(s) 972–983

Abstract: Objective: Preoperative differentiation of facial nerve schwannoma (FNS) from vestibular schwannoma (VS) can be challenging, and failure to differentiate between these two pathologies can result in potentially avoidable facial nerve injury. This study ... ...

Abstract	Objective: Preoperative differentiation of facial nerve schwannoma (FNS) from vestibular schwannoma (VS) can be challenging, and failure to differentiate between these two pathologies can result in potentially avoidable facial nerve injury. This study presents the combined experience of two high-volume centers in the management of intraoperatively diagnosed FNSs. The authors highlight clinical and imaging features that can distinguish FNS from VS and provide an algorithm to help manage intraoperatively diagnosed FNS. Methods: Operative records of 1484 presumed sporadic VS resections between January 2012 and December 2021 were reviewed, and patients with intraoperatively diagnosed FNSs were identified. Clinical data and preoperative imaging were retrospectively reviewed for features suggestive of FNS, and factors associated with good postoperative facial nerve function (House-Brackmann [HB] grade ≤ 2) were identified. A preoperative imaging protocol for suspected VS and recommendations for surgical decision-making following an intraoperative FNS diagnosis were created. Results: Nineteen patients (1.3%) with FNSs were identified. All patients had normal facial motor function preoperatively. In 12 patients (63%), preoperative imaging demonstrated no features suggestive of FNS, with the remainder showing subtle enhancement of the geniculate/labyrinthine facial segment, widening/erosion of the fallopian canal, or multiple tumor nodules in retrospect. Eleven (57.9%) of the 19 patients underwent a retrosigmoid craniotomy, and in the remaining patients, a translabyrinthine (n = 6) or transotic (n = 2) approach was used. Following FNS diagnosis, 6 (32%) of the tumors underwent gross-total resection (GTR) and cable nerve grafting, 6 (32%) underwent subtotal resection (STR) and bony decompression of the meatal facial nerve segment, and 7 (36%) underwent bony decompression only. All patients undergoing subtotal debulking or bony decompression exhibited normal postoperative facial function (HB grade I). At the last clinical follow-up, patients who underwent GTR with a facial nerve graft had HB grade III (3 of 6 patients) or IV facial function. Tumor recurrence/regrowth occurred in 3 patients (16%), all of whom had been treated with either bony decompression or STR. Conclusions: Intraoperative diagnosis of an FNS during a presumed VS resection is rare, but its incidence can be reduced further by maintaining a high index of suspicion and undertaking further imaging in patients with atypical clinical or imaging features. If an intraoperative diagnosis does occur, conservative surgical management with bony decompression of the facial nerve only is recommended, unless there is significant mass effect on surrounding structures.
MeSH term(s)	Humans ; Retrospective Studies ; Neoplasm Recurrence, Local/pathology ; Neurilemmoma/diagnostic imaging ; Neurilemmoma/surgery ; Neuroma, Acoustic/diagnostic imaging ; Neuroma, Acoustic/surgery ; Cranial Nerve Neoplasms/diagnostic imaging ; Cranial Nerve Neoplasms/surgery ; Facial Nerve/diagnostic imaging ; Facial Nerve/surgery ; Facial Nerve/pathology ; Treatment Outcome ; Multicenter Studies as Topic
Language	English
Publishing date	2023-03-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2023.2.JNS222368
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Article ; Online: Cerebral perivascular spaces visible on magnetic resonance imaging: development of a qualitative rating scale and its observer reliability.

Potter, Gillian M / Chappell, Francesca M / Morris, Zoe / Wardlaw, Joanna M

Cerebrovascular diseases (Basel, Switzerland)

2015 Volume 39, Issue 3-4, Page(s) 224–231

Abstract: Background: Perivascular spaces (PVS) are an important component of cerebral small vessel disease (SVD), several inflammatory disorders, hypertension and blood-brain barrier breakdown, but are difficult to quantify. A recent international collaboration ... ...

Abstract	Background: Perivascular spaces (PVS) are an important component of cerebral small vessel disease (SVD), several inflammatory disorders, hypertension and blood-brain barrier breakdown, but are difficult to quantify. A recent international collaboration of SVD experts has highlighted the need for a robust, easy-to-use PVS rating scale for the effective investigation of the diagnostic and prognostic significance of PVS. The purpose of the current study was to develop and extend existing PVS scales to provide a more comprehensive scale for the measurement of PVS in the basal ganglia, centrum semiovale and midbrain, and to test its intra- and inter-rater agreement, assessing reasons for discrepancy. Methods: We reviewed previously published PVS scales, including site of PVS assessed, rating method, and size and morphological criteria. Retaining key features, we devised a more comprehensive scale in order to improve the reliability of PVS rating. Two neuroradiologists tested the new scale in MRI brain scans of 60 patients from two studies (stroke, ageing population), chosen to represent a full range of PVS, and demonstrating concomitant features of SVD such as lacunes and white matter hyperintensities. We rated basal ganglia, centrum semiovale, and midbrain PVS. Basal ganglia and centrum semiovale PVS were rated 0 (none), 1 (1-10), 2 (11-20), 3 (21-40) and 4 (>40), and midbrain PVS were rated 0 (none visible) or 1 (visible). We calculated kappa statistics for rating, assessed consistency in use of PVS categories (Bhapkar test) and reviewed sources of discrepancy. Results: Intra- and inter-rater kappa statistics were highest for basal ganglia PVS (range 0.76-0.87 and 0.8-0.9, respectively) than for centrum semiovale PVS (range 0.68-0.75 and 0.61-0.8, respectively) or midbrain PVS (inter-rater range 0.51-0.52). Inter-rater consistency was better for basal ganglia compared to centrum semiovale PVS (Bhapkar statistic 2.49-3.72, compared to 6.79-21.08, respectively). Most inter-rater disagreements were due to very faint PVS, coexisting extensive white matter hyperintensities (WMH) or the presence of lacunes. Conclusions: We developed a more inclusive and robust visual PVS rating scale allowing rating of all grades of PVS severity on structural brain imaging. The revised PVS rating scale has good observer reliability for basal ganglia and centrum semiovale PVS, best for basal ganglia PVS, and moderate reliability for midbrain PVS. Agreement is influenced by PVS severity and the presence of background features of SVD. The current scale can be used in further studies to assess the clinical implications of PVS.
MeSH term(s)	Age Distribution ; Blood-Brain Barrier/pathology ; Brain/pathology ; Cerebral Small Vessel Diseases/pathology ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Reproducibility of Results
Language	English
Publishing date	2015-03-19
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1069462-6
ISSN	1421-9786 ; 1015-9770
ISSN (online)	1421-9786
ISSN	1015-9770
DOI	10.1159/000375153
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Article ; Online: Evaluating Risk Factors for Developing Hypoglycemia During Treatment of Hyperkalemia With Intravenous Regular Insulin.

Beard, Meghan M / McKenzie, Jeffrey J / Potter, Terry G / Varney Gill, Kimberly

Journal of pharmacy practice

2024 , Page(s) 8971900231223025

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2024-01-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	1027474-1
ISSN	1531-1937 ; 0897-1900
ISSN (online)	1531-1937
ISSN	0897-1900
DOI	10.1177/08971900231223025
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Article ; Online: Enzyme replacement therapy and white matter hyperintensity progression in Fabry disease.

Stefaniak, James D / Parkes, Laura M / Parry-Jones, Adrian R / Potter, Gillian M / Vail, Andy / Jovanovic, Ana / Smith, Craig J

Neurology

2018 Volume 91, Issue 15, Page(s) e1413–e1422

Abstract: Objective: To explore the association between enzyme replacement therapy (ERT), clinical characteristics, and the rate of progression of white matter hyperintensities (WMH) in patients with Fabry disease (FD).: Methods: Patients with a confirmed ... ...

Abstract	Objective: To explore the association between enzyme replacement therapy (ERT), clinical characteristics, and the rate of progression of white matter hyperintensities (WMH) in patients with Fabry disease (FD). Methods: Patients with a confirmed diagnosis of FD, aged 18 years or older, participating in an existing FD observational study (NCT00196742), with at least 2 serial MRI brain scans at least 2 years apart for the period between December 2006 and August 2016 were included in this cohort study. Total WMH volume was estimated for each image using a semiautomated procedure. We performed linear regression to calculate the primary outcome measure of WMH change rate for each participant. Associations between ERT, clinical characteristics, and the primary outcome were explored using multiple linear regression. Results: Eight hundred sixty-three MRI time points were analyzed for the 149 included participants. Age ( Conclusion: In a large cohort of patients with FD, we did not find an association between ERT and WMH progression, while higher total cholesterol was associated with slower WMH progression. Further research is needed into the pathogenesis and treatment of cerebrovascular disease in this rare condition.
MeSH term(s)	Adult ; Age Factors ; Brain/diagnostic imaging ; Brain/drug effects ; Cholesterol/blood ; Cohort Studies ; Disease Progression ; Enzyme Replacement Therapy ; Fabry Disease/blood ; Fabry Disease/diagnostic imaging ; Fabry Disease/drug therapy ; Female ; Humans ; Image Interpretation, Computer-Assisted/methods ; Magnetic Resonance Imaging/methods ; Male ; Pattern Recognition, Automated/methods ; Treatment Outcome ; White Matter/diagnostic imaging ; White Matter/drug effects
Chemical Substances	Cholesterol (97C5T2UQ7J)
Language	English
Publishing date	2018-09-12
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/WNL.0000000000006316
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Article ; Online: Wide variation in definition, detection, and description of lacunar lesions on imaging.

Potter, Gillian M / Marlborough, Fergal J / Wardlaw, Joanna M

Stroke

2011 Volume 42, Issue 2, Page(s) 359–366

Abstract: Background and purpose: Variation in the definition of lacunar lesions on imaging and difficulties in their detection may be hampering lacunar stroke research. We assessed literature definitions of imaging lacunar lesions and the definitions and ... ...

Abstract	Background and purpose: Variation in the definition of lacunar lesions on imaging and difficulties in their detection may be hampering lacunar stroke research. We assessed literature definitions of imaging lacunar lesions and the definitions and detection of lacunar lesions among small-vessel disease researchers. Methods: We assessed definitions of imaging lacunar lesion in 50 randomly selected articles from 3 stroke-related journals and an online survey of small-vessel disease researchers. In the literature review, we assessed clinical/imaging definitions of lacunar stroke. In the survey, we assessed lacunar lesion detection, effects of lesion appearance, background white matter lesions, and provision of relevant data. Results: Among 50 articles, imaging definitions were varied and often limited; size was stated in 21 of 43 (49%) studies of acute and in 9 of 20 (45%) studies of old lesions and site in 18 (42%) and 4 (20%), respectively. Clinical definitions also varied, and images were read mostly by nonradiologists. Among 56 survey respondents, multiple descriptions were used for recent and old, symptomatic and asymptomatic, lesions on imaging. Most agreed on definitions for site (98%) and "old lacunar infarct" (61%) size. Cavitated (vs noncavitated) lesions were usually identified as lacunar lesions; with increasing white matter lesions, however, noncavitated lesions were very unlikely to be identified, even with prior imaging available (7.8%). Conclusions: Imaging definitions of lacunar lesions vary widely, in part due to variation in lesion detection and classification. A consensus for imaging definitions of small-vessel disease features would be helpful.
MeSH term(s)	Brain Infarction/classification ; Brain Infarction/diagnosis ; Diagnostic Imaging/methods ; Diagnostic Imaging/standards ; Humans ; Magnetic Resonance Imaging/methods ; Magnetic Resonance Imaging/standards ; Random Allocation
Language	English
Publishing date	2011-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.110.594754
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Article ; Online: Hyperdense artery sign, symptomatic infarct swelling and effect of alteplase in acute ischaemic stroke.

Wu, Simiao / Mair, Grant / Cohen, Geoff / Morris, Zoe / von Heijne, Anders / Bradey, Nick / Cala, Lesley / Peeters, Andre / Farrall, Andrew J / Adami, Alessandro / Potter, Gillian / Liu, Ming / Lindley, Richard I / Sandercock, Peter A G / Wardlaw, Joanna M

Stroke and vascular neurology

2020 Volume 6, Issue 2, Page(s) 238–243

Abstract: Background: Alteplase improves functional outcomes of patients with acute ischaemic stroke, but its effects on symptomatic infarct swelling, an adverse complication of stroke and the influence of CT hyperdense artery sign (HAS) are unclear. This ... ...

Abstract	Background: Alteplase improves functional outcomes of patients with acute ischaemic stroke, but its effects on symptomatic infarct swelling, an adverse complication of stroke and the influence of CT hyperdense artery sign (HAS) are unclear. This substudy of the Third International Stroke Trial aimed to investigate the association between HAS and symptomatic infarct swelling and effect of intravenous alteplase on this association. Methods: We included stroke patients whose prerandomisation scan was non-contrast CT. Raters, masked to clinical information, assessed baseline (prerandomisation) and follow-up (24-48 hours postrandomisation) CT scans for HAS, defined as an intracranial artery appearing denser than contralateral arteries. Symptomatic infarct swelling was defined as clinically significant neurological deterioration ≤7 days after stroke with radiological evidence of midline shift, effacement of basal cisterns or uncal herniation. Results: Among 2961 patients, HAS presence at baseline was associated with higher risk of symptomatic infarct swelling (OR 2.21; 95% CI 1.42 to 3.44). Alteplase increased the risk of swelling (OR 1.69; 95% CI 1.11 to 2.57), with no difference between patients with and those without baseline HAS (p=0.49). In patients with baseline HAS, alteplase reduced the proportion with HAS at follow-up (OR 0.67; 95% CI 0.50 to 0.91), where HAS disappearance was associated with reduced risk of swelling (OR 0.25, 95% CI 0.14 to 0.47). Conclusion: Although alteplase was associated with increased risk of symptomatic infarct swelling in patients with or without baseline HAS, it was also associated with accelerated clearance of HAS, which in return reduced swelling, providing further mechanistic insights to underpin the benefits of alteplase.
MeSH term(s)	Arteries ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/drug therapy ; Fibrinolytic Agents/adverse effects ; Humans ; Infarction/chemically induced ; Infarction/complications ; Infarction/drug therapy ; Ischemic Stroke/diagnostic imaging ; Ischemic Stroke/drug therapy ; Stroke/diagnostic imaging ; Stroke/drug therapy ; Tissue Plasminogen Activator/adverse effects
Chemical Substances	Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
Language	English
Publishing date	2020-11-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2059-8696
ISSN (online)	2059-8696
DOI	10.1136/svn-2020-000569
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