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subarachnoid hemorrhage and vasospasm

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https://www.readbyqxmd.com/read/28224318/chemical-angioplasty-with-spasmolytics-for-vasospasm-after-subarachnoid-hemorrhage
#1
Aleš Hejčl, Filip Cihlář, Vojtěch Smolka, Petr Vachata, Robert Bartoš, Jan Procházka, Jiří Cihlář, Martin Sameš
BACKGROUND: Clinically symptomatic vasospasm leading to delayed ischemic neurological deficits occurs in up to 30% of patients with subarachnoid hemorrhage (SAH). Vasospasm can result in a serious decline in clinical conditions of patients with SAH, yet the algorithm for vasospasm treatment and prevention remains unclear. Intra-arterial administration of vasodilators is one of the modalities used for vasospasm therapy. METHODS: Over the last 7 years, we have treated 27 female and 7 male patients with vasospasm using intra-arterial administration of either nimodipine or milrinone; all had suffered aneurysm rupture...
February 21, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28217390/management-of-aneurysmal-subarachnoid-hemorrhage-state-of-the-art-and-future-perspectives
#2
REVIEW
Giovanni Grasso, Concetta Alafaci, R Loch Macdonald
BACKGROUND: Aneurysmal subarachnoid hemorrhage (SAH) accounts for 5% of strokes and carries a poor prognosis. It affects around 6 cases per 100,000 patient years occurring at a relatively young age. METHODS: Common risk factors are the same as for stroke, and only in a minority of the cases, genetic factors can be found. The overall mortality ranges from 32% to 67%, with 10-20% of patients with long-term dependence due to brain damage. An explosive headache is the most common reported symptom, although a wide spectrum of clinical disturbances can be the presenting symptoms...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28215029/an-introduction-to-the-pathophysiology-of-aneurysmal-subarachnoid-hemorrhage
#3
REVIEW
Jasper H van Lieshout, Maxine Dibué-Adjei, Jan F Cornelius, Philipp J Slotty, Toni Schneider, Tanja Restin, Hieronymus D Boogaarts, Hans-Jakob Steiger, Athanasios K Petridis, Marcel A Kamp
Pathophysiological processes following subarachnoid hemorrhage (SAH) present survivors of the initial bleeding with a high risk of morbidity and mortality during the course of the disease. As angiographic vasospasm is strongly associated with delayed cerebral ischemia (DCI) and clinical outcome, clinical trials in the last few decades focused on prevention of these angiographic spasms. Despite all efforts, no new pharmacological agents have shown to improve patient outcome. As such, it has become clear that our understanding of the pathophysiology of SAH is incomplete and we need to reevaluate our concepts on the complex pathophysiological process following SAH...
February 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28201539/endovascular-rescue-therapies-for-refractory-vasospasm-after-subarachnoid-hemorrhage-a-prospective-evaluation-study-using-multimodal-continuous-event-neuromonitoring
#4
Walid Albanna, Miriam Weiss, Marguerite Müller, Marc Alexander Brockmann, Annette Rieg, Catharina Conzen, Hans Clusmann, Anke Höllig, Gerrit Alexander Schubert
No abstract text is available yet for this article.
February 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28199398/a-segmentation-based-volumetric-approach-to-localize-and-quantify-cerebral-vasospasm-based-on-tomographic-imaging-data
#5
Axel Neulen, Tobias Pantel, Michael Kosterhon, Stefanie Kirschner, Marc A Brockmann, Sven R Kantelhardt, Alf Giese, Serge C Thal
INTRODUCTION: Quantification of cerebral vasospasm after subarachnoid hemorrhage (SAH) is crucial in animal studies as well as clinical routine. We have developed a method for computer-based volumetric assessment of intracranial blood vessels from cross-sectional imaging data. Here we demonstrate the quantification of vasospasm from micro computed tomography (micro-CT) data in a rodent SAH model and the transferability of the volumetric approach to clinical data. METHODS: We obtained rodent data by performing an ex vivo micro-CT of murine brains after sham surgery or SAH by endovascular filament perforation on day 3 post hemorrhage...
2017: PloS One
https://www.readbyqxmd.com/read/28182715/mr-angiography-allows-defining-severity-grades-of-cerebral-vasospasm-in-an-experimental-double-blood-injection-subarachnoid-hemorrhage-model-in-rats
#6
Vesna Malinova, Marios N Psychogios, Ioannis Tsogkas, Birte Koennecke, Kim Bleuel, Bogdan Iliev, Veit Rohde, Dorothee Mielke
OBJECTIVE: Magnetic resonance (MR) imaging has been used for the detection of cerebral vasospasm (VSP) related infarction in experimental subarachnoid hemorrhage (eSAH) in rats. Conventional angiography is generally used to visualize VSP, which is an invasive technique with a possible increase in morbidity and mortality. In this study we evaluated the validity of MR-angiography (MRA) in detecting VSP and its feasibility to define VSP severity grades after eSAH in rats. METHODS: SAH was induced using the double-hemorrhage model in 12 rats...
2017: PloS One
https://www.readbyqxmd.com/read/28178356/correction-incidence-and-predictors-of-angiographic-vasospasm-symptomatic-vasospasm-and-cerebral-infarction-in-chinese-patients-with-aneurysmal-subarachnoid-hemorrhage
#7
(no author information available yet)
[This corrects the article DOI: 10.1371/journal.pone.0168657.].
2017: PloS One
https://www.readbyqxmd.com/read/28169856/postinterventional-critical-care-management-of-aneurysmal-subarachnoid-hemorrhage
#8
Sudhir Datar, Alejandro A Rabinstein
PURPOSE OF REVIEW: Subarachnoid hemorrhage from a ruptured aneurysm (aSAH) is a complex disorder with the potential to have devastating effects on the brain as well as other organ systems. After more than 3 decades of research, the underlying pathophysiologic mechanisms remain incompletely understood and important questions remain regarding the evaluation and management of these patients. The purpose of this review is to analyze the recent literature and improve our understanding of certain key clinical aspects...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28156162/contribution-of-both-olfactory-and-systemic-pathways-for-brain-targeting-of-nimodipine-loaded-lipo-pluronics-micelles-in-vitro-characterization-and-in-vivo-biodistribution-study-after-intranasal-and-intravenous-delivery
#9
COMPARATIVE STUDY
Hassan M Rashed, Rehab N Shamma, Emad B Basalious
Nimodipine (NM) is the only FDA-approved drug for treating subarachnoid hemorrhage induced vasospasm. NM has poor oral bioavailability (5-13%) due to its low aqueous solubility, and extensive first pass metabolism. The objective of this study is to develop radiolabeled NM-loaded LPM and to test its ability prolong its circulation time, reduce its frequency of administration and eventually target it to the brain tissue. NM was radiolabeled with (99m)Tc by direct labeling method using sodium dithionite. Different reaction conditions that affect the radiolabeling yield were studied...
November 2016: Drug Delivery
https://www.readbyqxmd.com/read/28153852/effect-of-heparin-on-secondary-brain-injury-in-patients-with-subarachnoid-hemorrhage-an-additional-h-therapy-in-vasospasm-treatment
#10
REVIEW
Markus Bruder, Sae-Yeon Won, Sepide Kashefiolasl, Marlies Wagner, Nina Brawanski, Nazife Dinc, Volker Seifert, Juergen Konczalla
OBJECTIVE: Secondary brain injury leads to high morbidity and mortality rates in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, evidence-based treatment strategies are sparse. Since heparin has various effects on neuroinflammation, microthromboembolism and vasomotor function, our objective was to determine whether heparin can be used as a multitarget prophylactic agent to ameliorate morbidity in SAH. METHODS: Between June 1999 and December 2014, 718 patients received endovascular treatment after rupture of an intracranial aneurysm at our institution; 197 of them were treated with continuous unfractionated heparin in therapeutic dosages after the endovascular procedure...
February 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28153625/ruptured-mycotic-aneurysm-and-cerebral-vasospasm-in-the-setting-of-endocarditis-and-heart-failure-requiring-cardiothoracic-surgery-case-report-and-review
#11
Chih-Ta Lin, Bruce Tranmer, Susan Durham, David Johnson, Mark Hamlin, R Morton Bolman
BACKGROUND: Ruptured mycotic aneurysm in the setting of cardiac failure and cerebral vasospasm presents unique management challenges. CASE DESCRIPTION: The authors describe a case of a ruptured mycotic aneurysm with subarachnoid hemorrhage (SAH), cerebral vasospasm, and endocarditis with heart failure who successfully underwent craniotomy, neuro-endovascular treatments, and cardiopulmonary bypass for mitral valve replacement while in cerebral vasospasm. This case highlights the clinical management strategies of a patient with a ruptured mycotic aneurysm, SAH, cerebral vasospasm, endocarditis, and heart failure...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28137545/delayed-normalization-of-electrocardiograms-in-patients-with-takotsubo-cardiomyopathy-due-to-aneurysmal-subarachnoid-hemorrhage
#12
Keisuke Kadooka, Hiromu Hadeishi, Kosuke Kadooka
BACKGROUND: Takotsubo cardiomyopathy (TCM) is caused by excessive physical and mental stress, and sometimes causes potentially fatal arrhythmias such as torsades de pointes. This study characterized the features of TCM due to aneurysmal subarachnoid hemorrhage (SAH), particularly the delayed normalization of electrocardiograms compared to that of transthoracic echocardiograms. METHODS: Ten patients with TCM were selected from the 450 SAH patients treated in our hospital between January 2007 and November 2015...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089197/long-term-follow-up-analysis-of-microsurgical-clip-ligation-and-endovascular-coil-embolization-for-dorsal-wall-blister-aneurysms-of-the-internal-carotid-artery
#13
Mason A Brown, Cristian F Guandique, Jonathan Parish, Aubrey C McMillan, Stephen Lehnert, Nassir Mansour, Michael Tu, Bradley N Bohnstedt, Troy D Payner, Thomas J Leipzig, Andrew J DeNardo, John A Scott, Aaron A Cohen-Gadol
: Blister aneurysms at non-branching sites of the dorsal internal carotid artery (dICA) are fragile, rare, and often difficult to treat. The purpose of this study is to address the demographics, treatment modalities, and long-term outcome of patients treated for dICA blister aneurysms. A retrospective review of medical records identified all consecutive patients who presented with a blister aneurysm from 2002 to 2011 at our institution. Eighteen patients (M=7, F=11; mean age: 48.4±15...
January 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28087430/ryanodine-receptor-1-polymorphism-is-not-associated-with-aneurysmal-subarachnoid-hemorrhage-or-its-clinical-sequelae
#14
Philipp Hendrix, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
OBJECTIVE: The pathophysiological mechanisms underlying cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remain poorly understand. Ryanodine receptors (RYR) are intracellular calcium channels involved in the regulation of vascular smooth muscle cells and cerebrovascular tone and diameter. Previous work reported an association between a RYR polymorphism and cerebral vasospasm. Here, we sought to assess the impact of that RYR polymorphism on aSAH and its clinical sequelae...
January 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28070640/erratum-to-thrombectomy-for-ischemic-stroke-meta-analyses-of-recurrent-strokes-vasospasms-and-subarachnoid-hemorrhages
#15
Robert Emprechtinger, Brigitte Piso, Peter A Ringleb
No abstract text is available yet for this article.
January 9, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28033279/the-effect-of-fenestration-of-the-lamina-terminalis-on-the-incidence-of-shunt-dependent-hydrocephalus-after-aneurysmal-subarachnoid-hemorrhage-fish-study-protocol-for-a-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Chuanyuan Tao, Chaofeng Fan, Xin Hu, Junpeng Ma, Lu Ma, Hao Li, Yi Liu, Hong Sun, Min He, Chao You
BACKGROUND: Shunt-dependent hydrocephalus (SDH) is a well-known sequela following aneurysmal hemorrhage, adversely affecting the outcome after securing ruptured aneurysm. Fenestration of lamina terminalis (FLT) creates an anterior ventriculostomy, facilitates cerebrospinal fluid circulation and clot clearance in the basal cistern. However, controversy exists over whether microsurgical FLT during aneurysm repair can decrease the incidence of SDH. AIMS: The study is designed to determine the efficacy of lamina terminalis fenestration on the reduction of SDH after aneurysm clipping...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28004212/application-of-actuator-driven-pulsed-water-jet-in-aneurysmal-subarachnoid-hemorrhage-surgery-its-effectiveness-for-dissection-around-ruptured-aneurysmal-walls-and-subarachnoid-clot-removal
#17
Hidenori Endo, Toshiki Endo, Atsuhiro Nakagawa, Miki Fujimura, Teiji Tominaga
In clipping surgery for aneurysmal subarachnoid hemorrhage (aSAH), critical steps include clot removal and dissection of aneurysms without premature rupture or brain injuries. To pursue this goal, a piezo actuator-driven pulsed water jet (ADPJ) system was introduced in this study. This study included 42 patients, who suffered aSAH and underwent clipping surgery. Eleven patients underwent surgery with the assistance of the ADPJ system (ADPJ group). In the other 31 patients, surgery was performed without the ADPJ system (Control group)...
December 22, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/28004163/treatment-of-cerebral-vasospasm-following-aneurysmal-subarachnoid-haemorrhage-a-systematic-review-and-meta-analysis
#18
Grégoire Boulouis, Marc Antoine Labeyrie, Jean Raymond, Christine Rodriguez-Régent, Anne Claire Lukaszewicz, Damien Bresson, Wagih Ben Hassen, Denis Trystram, Jean Francois Meder, Catherine Oppenheim, Olivier Naggara
OBJECTIVES: To examine the clinical outcome of aneurysmal subarachnoid haemorrhage (aSAH) patients exposed to cerebral vasospasm (CVS)-targeted treatments in a meta-analysis and to evaluate the efficacy of intra-arterial (IA) approaches in patients with severe/refractory vasospasm. METHODS: Randomised controlled trials, prospective and retrospective observational studies reporting clinical outcomes of aSAH patients exposed to CVS targeted treatments, published between 2006-2016 were searched using PubMed, EMBASE and the Cochrane Library...
December 21, 2016: European Radiology
https://www.readbyqxmd.com/read/28000132/biomarkers-of-glycocalyx-injury-are-associated-with-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage-a-case-series-supporting-a-new-hypothesis
#19
Josh D Bell, Shawn G Rhind, Alex P Di Battista, R Loch Macdonald, Andrew J Baker
BACKGROUND: Delayed cerebral ischemia (DCI) contributes to morbidity following aneurysmal subarachnoid hemorrhage; however, its etiology remains poorly understood. DCI is not only a consequence of angiographic vasospasm, but also involves microthrombosis and neuroinflammation, two events with unexplained phenomenology. The vascular endothelial glycocalyx mediates platelet aggregation and endothelial cell-leukocyte interactions and may play an important role in DCI pathogenesis. METHODS: We present a case series in which we conducted multiplex and singlet enzyme-linked immunosorbent assays of endothelial, glycocalyx, inflammatory, and neuroinjury proteins in both CSF and plasma in three patients during active DCI following SAH...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27997923/the-role-of-hmgb1-in-pial-arteriole-dilating-reactivity-following-subarachnoid-hemorrhage-in-rats
#20
Haoliang Xu, Benjarat Changyaleket, Tibor Valyi-Nagy, Randal O Dull, Dale A Pelligrino, David E Schwartz, Zhao Zhong Chong
High-mobility group box 1 protein (HMGB1) has been implicated in inflammatory responses, and is also associated with cerebral vasospasm after subarachnoid hemorrhage (SAH). However, there are no direct evident links between HMGB1 and cerebral vasospasm. We therefore investigated the effects of HMGB1 on pial arteriole reactivity following SAH in rats. We initially found that SAH induced a significant decrease in pial arteriole dilating responses to sciatic nerve stimulation (SNS), hypercapnia (CO2), and the topical suffusion of acetylcholine (ACh), adenosine (ADO), and s-nitroso-N-acetylpenicillamine (SNAP) over a 7-day period after SAH...
2016: Journal of Vascular Research
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