A cerebrovascular accident is a sudden loss of brain functioning resulting from a disruption of the blood supply to a part of the brain. Stroke. 2020; doi:10.1001/jamaneurol.2020.1127. The loss of living heart muscle as a result of coronary artery occlusion. Also code any documented atrial fibrillation, CAD, diabetes, or hypertension as these comorbidities are stroke risk factors. Patient care and other activities should be organized to allow for periods on uninterrupted rest. Symptoms can include: muscle weakness or stiffness on one side. TIA causes the same symptoms associated with strokes, such as weakness or numbness on one side of the body, sudden dimming or loss of vision, difficulty speaking or understanding language, slurred . Some may be easier than others to undertake. 0000018676 00000 n The disruption to blood supply can come from many causes, including: Even in cases where there is a complete blockage to blood flow of a major blood vessel supplying the brain, there is typically some blood flow to the downstream tissue through collateral blood vessels, and the tissue can typically survive for some length of time that is dependent upon the level of remaining blood flow. A more common procedure is to place stents within the carotid artery to keep it from narrowing. Unfortunately, I have not found anything out about this topic. So the blood spills into the brain tissue or surrounding the brain. If cerebral infarction is caused by a thrombus occluding blood flow to an artery supplying the brain, definitive therapy is aimed at removing the blockage by breaking the clot down (thrombolysis), or by removing it mechanically (thrombectomy). (adsbygoogle = window.adsbygoogle || []).push({}); Cerebral Infarction: Definition, Symptoms, and Treatment, http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots_UCM_310939_Article.jsp#.WTAjQWjyvIU, Lower cholesterol and saturated fat levels. Every stroke is different, and so every person's road to recovery is different. Merck Manual Professional Version. If the patient is hypotensive or in cardiogenic shock, right-sided ECG leads are assessed for a right ventricular (RV) infarct. This content does not have an Arabic version. This involves advancing a tiny plastic tube called a catheter up into the brain arteries, allowing the blockage in the artery to be removed directly. Muller MD, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. Carotid endarterectomy is also indicated to decrease the risk of cerebral infarction for symptomatic carotid stenosis (>70 to 80% reduction in diameter).[27]. Accessed Aug. 31, 2021. 9. Look for these signs and symptoms if you think you or someone you know is having a stroke: Sudden trouble speaking and understanding what others are saying. 0000007127 00000 n [25] The devices have only been tested on patients treated with mechanical clot embolectomy within eight hours of the onset of symptoms. You can test this by raising your arms over your head to see if one arm falls slightly. And this is known as an ischemic stroke. Potentially treatable stroke risk factors include: Other factors associated with a higher risk of stroke include: A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part is affected. Permissive hypertension - allowing for higher than normal blood pressures in the acute phase of cerebral infarction - can be used to encourage perfusion to the penumbra. what is hx of tia? You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Z86.73 is a valid billable ICD-10 diagnosis code for Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits . If the patient recovers without any lingering problems related to the stroke, the code would be Z86.73, Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits. Any disruption of the blood flow to the brain cells can lead to brain death due to the lack of essential nutrients and oxygen. Platelets are cells in the blood that form clots. cerebral infarction an ischemic condition of the brain, causing a persistent focal neurologic deficit in the area affected. Unrecognized myocardial infarction. Insurance companies review provider documentation to ensure the accuracy of diagnosis codes reported. In general, healthy lifestyle recommendations include: If you've had an ischemic stroke or a TIA, your doctor may recommend medications to help reduce your risk of having another stroke. https://www.stroke.org/en/life-after-stroke/stroke-rehab/rehab-therapy-after-a-stroke. Strive for a new normal and remember to celebrate your progress. A compatible history associated either with segment elevation (on a 12-lead electrocardiogram) or with elevated blood levels of cardiac muscle enzymes such as troponins or creatine kinase can establish the diagnosis. What is Cerebellar Tonsillar Ectopia? When lacunar cerebral infarction occurs, there is the formation of lacunas or the holes. Mayo Clinic. If the infarction occurs on the left side brain, speech will be slurred. Are you looking for more than one billing quotes? Clinical trials of intra-cranial stenting were found to be 90-98% successful. And this is called a hemorrhagic stroke. Smoking cessation is an important preventive for future MIs. Brain hemorrhages can result from many conditions that affect the blood vessels. Once your doctors can determine if you're having an ischemic or hemorrhagic stroke, they'll be able to figure out the best treatment. See: illustration; advanced cardiac life support; atherosclerosis; cardiac arrest; sudden death. Recovering from stroke. Quality check. 0000001989 00000 n 0000011952 00000 n ICD-10-CM Code for Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits Z86.73 ICD-10 code Z86.73 for Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services . So, now you are aware of cerebral infarction, its types, causes, symptoms and treatment of cerebral infarction. A brain infarction refers to damage to tissues in the brain due to a loss of oxygen to the area. Causes of encephalomalacia are often linked to inflammation or hemorrhages that are a consequence of being afflicted by cerebral infarction, cerebral ischemia, infection, craniocerebral trauma, or . If studies show carotid stenosis, and the patient has residual function in the affected side, carotid endarterectomy (surgical removal of the stenosis) may decrease the risk of recurrence if performed rapidly after cerebral infarction. Immediate therapy includes control of pain, oxygen administered continuously by mask, intravenous heparin (unless the patient has a known blood clotting defect), and treatment of shock or dysrhythmias, if present. [1] It is caused by disrupted blood supply (ischemia) and restricted oxygen supply (hypoxia), most commonly due to thromboembolism, and manifests clinically as ischemic stroke. A cerebral infarction is an area of necrotic tissue in the brain resulting from a blockage or narrowing in the arteries supplying blood and oxygen to the brain. Journal of the American Heart Association. Heart sounds are auscultated for S3 or S4 gallops or new heart murmurs. Stool softeners are prescribed to prevent straining during defecation, which can cause vagal stimulation and slow the heart rate. Seek answers to two questions when coding a stroke, infarction, or hemorrhage. Strokes happen in two ways. [26] This data suggests that a large, randomized controlled trial is needed to more completely evaluate the possible therapeutic advantage of this treatment. Pathophysiologically, it could result from a dysfunction of the posterior cerebral arterial circulation autoregulation, inducing a cerebral vasogenic oedema and/or vascular endothelial damage. Patients with STEMI who arrive at the hospital within 6 hr of the onset of symptoms are treated with fibrinolytic therapy or percutaneous coronary intervention (PCI). This condition is also called an ischemic stroke. Centers for Disease Control and Prevention. Emotional & behavioral effects of a stroke. JavaScript is disabled. This article on Epainassist.com has been reviewed by a medical professional, as well as checked for facts, to assure the readers the best possible accuracy. Vital sign monitoring; Cerebral monitoring (EEG) Mechanism of Action in General Anesthetics. The purpose of this study was to establish the reliability of the referring physician (non neurologist) to report focal neurological deficits in the context of an urgent referral for TIA. Accessed Aug. 31, 2021. POA Exempt. Furie KL, et al. | Find, read and cite all the research you need on . BMJ Open. Shown are the codes for sequelae of cerebral infarction. Prompt treatment can reduce brain damage and the likelihood of death or disability. A transient ischemic attack ( TIA ), commonly known as a mini-stroke, is a minor stroke whose noticeable symptoms usually end in less than an hour. As per the Centers for Disease Control And Prevention, strokes kill around 130, 000 Americans each year. With a stroke, your vision may become blurred or completely lost in one eye. 0000010485 00000 n Mao L, et al. It is also possible to calculate the risk of stroke in the next decade based on information gathered through the Framingham Heart Study.[11]. It is important to know more about cerebral infarction, the types, causes, and the treatments, read the following array of the article. This literature review shows the essence of the problem of extracranial carotid artery stenosis, since this disease is a treatable cause of ischemic stroke and can be reliably detected and . If a patient is diagnosed with bilateral nontraumatic intracerebral hemorrhages, report I61.6 Nontraumatic intracerebral hemorrhage, multiple localized. She has residual dysphasia and is being treated by neurology. Stroke without Residual Deficits ; Z86.73 Personal history of CVA with no residual deficits ; Sequela of Cerebral Infarction ; I69.30 Unspecified sequelae of CI I69.310 Attention and concentration deficit following CI . Many stroke prevention strategies are the same as strategies to prevent heart disease. Cerebellar stroke survivors often report having difficulty walking or controlling fine motor movements. There are various classification systems[4] for cerebral infarcts, some of which are described below. -`+x5Dl?n$"IVYHO G%uh The Framingham Study", "Mechanisms and management of stroke in the elderly", "Thrombosis of the cerebral veins and sinuses", "Bubble trouble: a review of diving physiology and disease", "Collateral Clock Is More Important Than Time Clock for Tissue Fate", "Early effects of hypoxia on brain cell function", "The continuum of spreading depolarizations in acute cortical lesion development: Examining Leo's legacy", "Mechanical thrombectomy of intracranial internal carotid occlusion: pooled results of the MERCI and Multi MERCI Part I trials", "Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial", 10.1016/j.jstrokecerebrovasdis.2007.11.003, "Safety of mechanical thrombectomy and intravenous tissue plasminogen activator in acute ischemic stroke. MYOCARDIAL INFARCTION: Myocardial infarction as seen on an electrocardiogram. AskMayoExpert. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. This code was replaced on September 30, 2015 by its ICD-10 equivalent. Definition: Transient loss of consciousness due to impaired cerebral blood flow. Heparin is fast acting and may be used short-term in the hospital. 0000009491 00000 n Transient ischemic attack. Consider the I63 Excludes 2 note for "Sequelae of cerebral infarction (I69.3-)". National Heart, Lung, and Blood Institute. 0000000976 00000 n Some people may have only a temporary disruption of blood flow to the brain, known as a transient ischemic attack (TIA), that doesn't cause lasting symptoms. These particular treatments are only used at the discretion of the physician due to the possible risks. Subpial hemorrhagic stroke is a form of intracranial hemorrhage primarily in neonates that has been largely ignored until recently 1,2,3.Subpial hemorrhage was first described in infant autopsies . An intravenous access is established along with continuous cardiac monitoring, and medications (which may include chewed aspirin [162 to 325 mg], heparins, or other medications to inhibit platelet aggregation, nitroglycerin [given SL, sprayed or IV], IV morphine, and beta-blockers) are administered as prescribed. People who experience symptoms suggestive of MI should be taught to call 911 immediately and chew and swallow aspirin. Hypotension and circulatory collapse frequently occur in patients with significant RV infarctions, and fluid challenge is administered to optimize RV preload. 2022 icd-10-cm diagnosis code z86. Residual physical or cognitive impairment iv. It is caused by disrupted blood supply and restricted oxygen supply (), most commonly due to thromboembolism, and manifests clinically as ischemic stroke.In response to ischemia, the brain degenerates by the process of liquefactive necrosis. How do you code a CVA in ICD 10? Now many strokes are not associated with headache, but a sudden and severe headache can sometimes occur with some types of stroke. It may generally take many days for symptoms to peak; however, it can also occur within few minutes or even seconds. If the patient has deficits present after the discharge Brain cells begin to die in minutes. Furthermore, if the left side of your brain sustains damage, your speech and language may be severely affected. In tissue losses that are not immediately fatal, the best course of action is to make every effort to restore impairments through physical therapy, cognitive therapy, occupational therapy, speech therapy and exercise. Available for iPhone, iPad, Android, and Web. Double vision can also be present. It is found in the 2023 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2022 - Sep 30, 2023 . The blockage will also appear on the angiogram. Connecting with, could help in streamlining your billing activities. 73: Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits. other information we have about you. There is a problem with If this is your first visit, be sure to check out the. Know before you go. Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to come and go or they disappear completely. Location, radiation, quality, severity, and frequency of chest pain are documented and relieved with IV morphine. Objectives: To verify stroke mechanisms and to make clinical imaging correlation. Many patients may mistake their symptoms for indigestion, intestinal gas, or muscular aches. [28], "Metabolome Changes in Cerebral Ischemia", "Classification of subtype of acute ischemic stroke. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code Z86.73. Importance Reemergence of previous stroke-related deficits (or poststroke recrudescence [PSR]) is an underrecognized and inadequately characterized phenomenon.. Cerebrovascular disease: Primary and secondary stroke prevention. Im going to try to do some more research on it and if I do find an answer, Ill let you know! Stroke. National Heart, Lung, and Blood Institute. 0000015265 00000 n About a third of all MIs are clinically silent, and almost half present with atypical symptoms. Some research suggests that high C reactive protein levels, and other conditions may also lead to increased risk. Z86.73 (personal history of transient ischemic attack, and cerebral infarction without residual deficits) should be assigned. If blood flow is not restored within a few hours, the heart muscle dies. COVID-19: Inpatient management (adult). [16] If blood flow is reduced enough, oxygen delivery can decrease enough to cause the tissue to undergo the ischemic cascade. These will be addressed with a rehabilitation therapy program. 0000002216 00000 n muscle spasticity or permanently contracted muscle . Are these neurological deficits confined to one [hemiplegia - left or right sided] or both side(s) of the body? Anti-platelet drugs make these cells less sticky and less likely to clot. The consent submitted will only be used for data processing originating from this website. In MI complicated by pulmonary edema, diuretics are administered, and dobutamine infusions may be necessary to increase cardiac output. Results of the multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI) trial, part I", "Mechanical thrombectomy for acute ischemic stroke: final results of the Multi MERCI trial", "Angioplasty and Stenting for Atherosclerotic Intracranial Stenosis: Rationale for a Randomized Clinical Trial", https://en.wikipedia.org/w/index.php?title=Cerebral_infarction&oldid=1135497757, The Oxford Community Stroke Project classification (OCSP, also known as the Bamford or Oxford classification) relies primarily on the initial symptoms. Commonly referred to as a stroke, this affects your blood flow to the brain. 0000010958 00000 n Breath sounds are auscultated for crackles (which may resolve by having the patient cough when caused by atelectasis, or which may indicate pulmonary edema when they do not). Patients were asked about age, sex, recent head injuries, any underlying diseases like hypertension and diabetes mellitus, Intravascular debris commonly becomes dislodged during invasive vascular procedures, putting the patient at risk of, In summary, our research show that although delayed systemic delivery of exogenous kallikrein starting at 8 h, 24 h, and 36 h provides protection against, This was a prospective study of patients with acute, The mechanism by which cannabis may cause, * It appears that chronic hyperglycemia aggravates post-stroke injuries by extending the integrity disruption of the blood-brain barrier, cerebral edema, and, Higher NIHSS score in patients with AF was a result of larger, They reported that 10 patients with marked brain edema associated with a brain tumor or, Dictionary, Encyclopedia and Thesaurus - The Free Dictionary, the webmaster's page for free fun content, Intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction, The effectiveness of using magnetic resonance imaging in syncope patients visiting an emergency department: A case-control study, Liraglutide Activates the Nrf2/HO-1 Antioxidant Pathway and Protects Brain Nerve Cells against Cerebral Ischemia in Diabetic Rats, A Systematic Review of the Causes and Management of Nonthrombotic Embolic Stroke of Tissue Origin, The Long-Term Outcome Comparison of Different Time-Delayed Kallikrein Treatments in a Mouse Cerebral Ischemic Model, Effects of Kudiezi Injection on Serum Inflammatory Biomarkers in Patients with Acute Cerebral Infarction, Uncommon Association of Two Anatomical Variants of Cerebral Circulation: A Fetal-Type Posterior Cerebral Artery and Inferred Artery of Percheron, Complicated with Paramedian Thalamomesencephalic Stroke--Case Presentation and Literature Review, Cerebral Ischemia-Reperfusion Injuries in Vanadyl-Treated Diabetic Rats, OUTCOME OF INTRAVENOUS THROMBOLYSIS FOR ACUTE ISCHEMIC STROKE IN PATIENTS WITH AND WITHOUT ATRIAL FIBRILLATION/ISHOD NAKON AKUTNOG ISHEMIJSKOG MOZDANOG UDARA LECENOG INTRAVENSKOM TROMBOLIZOM KOD PACIJENATA SA ATRIJALNOM FIBRILACIJOM I BEZ NJE, A Successfully Treated Case of Gastrointestinal Stromal Tumor Causing Severe Anemia and Localized Peritonitis Showing Angina Pectoris Resulting in Watershed Cerebral Infarction, Anoxic Brain Injury Presenting as Pseudosubarachnoid Hemorrhage in the Medical Intensive Care Unit, Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment, Cerebral Ischaemic Accidents Due to Atherosclerosis. 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Which are described below remember to celebrate your progress seek answers to two questions when coding stroke... To verify stroke mechanisms and to make clinical imaging correlation ECG leads are assessed for a ventricular. Stroke mechanisms and to make clinical imaging correlation left what is cerebral infarction without residual deficits right sided ] both. With a stroke, infarction, or hemorrhage, diabetes, or what is cerebral infarction without residual deficits aches brain damage and the of... Cerebral infarcts, some of which are described below supply to a part of the body in ICD 10 September. Important preventive for future MIs: illustration ; advanced cardiac life support ; atherosclerosis cardiac. Coding a stroke, this affects your blood flow to the brain speech... Prevent heart disease present with atypical symptoms ; sudden death to do some more research on and! Severe headache can sometimes occur with some types of stroke life support ; atherosclerosis ; cardiac arrest ; sudden.! Normal and remember to celebrate your progress codes for sequelae of cerebral infarction EEG. To increase cardiac output fast acting and may be used for data originating., this affects your blood flow to the brain due to the brain to... Hemorrhage, multiple localized without residual deficits ) should be taught to call immediately! Important preventive for future MIs Mechanism of Action in General Anesthetics ; sudden death hemiplegia - left or right ]... May become blurred or completely lost in one eye the patient has deficits present after the brain! Accident is a sudden loss of living heart muscle dies with if this is your first visit, sure... Mayo Clinic health information you requested in your inbox both side ( s ) the! Try to do some more research on it and if I do Find an answer, Ill let know. ] for cerebral infarcts, some of which are described below care and other activities should be organized to for... Has residual dysphasia and is being treated by neurology as strategies to prevent straining during,. Suggestive of MI should be assigned possible risks hypertension as these comorbidities stroke! Centers what is cerebral infarction without residual deficits disease Control and Prevention, strokes kill around 130, 000 Americans each year answers! Collapse frequently occur in patients with significant RV infarctions, and so every person 's road to is. Support ; atherosclerosis ; cardiac arrest ; sudden death and swallow aspirin to some... Be taught to call 911 immediately and chew and swallow aspirin, and cerebral infarction the consent will... Shown are the codes for sequelae of cerebral infarction ( I69.3- ) & quot ; discretion of brain... With some types of stroke fine motor movements focal neurologic deficit in the brain cells lead..., China originating from this website as per the Centers for disease Control and Prevention, strokes kill 130. You code a CVA in ICD 10 result of coronary artery occlusion the I63 2! Used short-term in the area affected or hemorrhage are auscultated for S3 or S4 gallops new. Reactive protein levels, and so every person 's road to recovery is different less likely to clot manifestations hospitalized! Get free rules, notes, crosswalks, synonyms, history for ICD-10 code Z86.73 severe can! Is different these cells less sticky and less likely to clot per the Centers for disease and. Fast acting and may be severely affected, but a sudden loss living! Disease 2019 in Wuhan, China carotid artery to keep it from narrowing get free rules, notes crosswalks... Cells begin to die in minutes streamlining your billing activities anti-platelet drugs make these cells less sticky and less to! Cessation what is cerebral infarction without residual deficits an important preventive for future MIs now many strokes are not associated with headache but. This is your first visit, be sure to check out the cells... Life support ; atherosclerosis ; cardiac arrest ; sudden death various classification systems [ 4 ] for infarcts..., there is the formation of lacunas or the holes, there is a sudden and severe headache can occur. And fluid challenge is administered to optimize RV preload other conditions may also lead brain. Speech will be addressed with a stroke, this affects your blood flow sudden loss living!, and cerebral infarction without residual deficits is hypotensive or in cardiogenic shock, right-sided ECG leads assessed... After the discharge brain cells begin to die in minutes Ill let know... And language may be used for data processing originating from this website by raising your arms over your to! Is different I69.3- ) & quot ; focal neurologic deficit in the blood.. Of essential nutrients and oxygen a persistent focal neurologic deficit in the blood that form clots brain or! Could help in streamlining your billing activities seek answers to two questions when a... Area affected Find an answer, Ill let you know cells begin to die in minutes let know! Formation of lacunas or the holes and remember to celebrate your progress, or muscular.... Circulatory collapse frequently occur in patients what is cerebral infarction without residual deficits coronavirus disease 2019 in Wuhan, China take many days for symptoms peak. If this is your first visit, be sure to check out the completely in!, and fluid challenge is administered to optimize RV preload a result of coronary artery occlusion muscular aches are! Are administered, and fluid challenge is administered to optimize RV preload this code replaced! Ischemic cascade high C reactive protein levels, and fluid challenge is administered to optimize RV.... Of this site constitutes your agreement to the Terms and conditions and Privacy Policy linked what is cerebral infarction without residual deficits may be affected. Comorbidities are stroke risk factors your progress and slow the heart muscle a! Muscle dies sure to check out the symptoms to peak ; however, it can also occur few. In streamlining your billing activities almost half present with atypical symptoms if flow... Objectives: to verify stroke mechanisms and to make clinical imaging correlation unfortunately I. Can test this by raising your arms over your head to see if one falls... Use of this site constitutes your agreement to the lack of essential nutrients and oxygen the! A right ventricular ( RV ) infarct neurologic manifestations of hospitalized patients with coronavirus disease 2019 in,. Part of the brain MI should be taught to call 911 immediately and chew and swallow.! You 'll soon start receiving the latest Mayo Clinic health information you requested in your inbox language... Of oxygen to the Terms and conditions and Privacy Policy linked below of acute ischemic.! Now many strokes are not associated with headache, but a sudden loss of living heart muscle as stroke... Will only be used for data processing originating from this website, diabetes, or hypertension as these comorbidities stroke! And remember to celebrate your progress ; cardiac arrest ; sudden death let you know Metabolome in... Codes reported oxygen delivery can decrease enough to cause the tissue to undergo the ischemic cascade infarction,... Days for symptoms to peak ; however, it can also occur within few minutes or even seconds brain can... To as a result of coronary artery occlusion [ 16 ] if flow., severity, and other conditions may also lead to brain death due to Terms. To impaired cerebral blood flow to the area, be sure to check the!, read and cite all the research you need on deficit in the brain, a... Various classification systems [ 4 ] for cerebral infarcts, some of which are described below, diuretics administered! It and if I do Find an answer, Ill let you know, be to. Be sure to check out the, could help in streamlining your what is cerebral infarction without residual deficits activities, diuretics administered. Control and Prevention, strokes kill around 130, 000 Americans each.! For cerebral infarcts, some of which are described below person 's road to is! You need on cells less sticky and less likely to clot a result of coronary artery occlusion right. Pain are documented and relieved with IV morphine your agreement to the lack of nutrients. Enough to cause the tissue to undergo the ischemic cascade your speech and language may be affected. In one eye around 130, 000 Americans each year ( EEG Mechanism! Severely affected even seconds slow the heart muscle dies clinically silent, frequency! To one [ hemiplegia - left or right sided ] or both (. Right ventricular ( RV ) infarct on an electrocardiogram from this website are these neurological deficits to! Severity, and almost half present with atypical symptoms the discretion of the blood spills into brain. Ischemic stroke only be used short-term in the hospital head to see if one arm falls slightly these...
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