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subarachnoid hemorrhage and vasospasm

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https://www.readbyqxmd.com/read/27900416/-intensive-care-treatment-after-aneurysmal-subarachnoid-hemorrhage
#1
U Jaschinski
Aneurysmal subarachnoid hemorrhage (SAH) is a devastating disease and nearly one third of patients die in the acute phase. Due to the bleeding event, a hyperactive sympathetic nervous system and an uncontrolled inflammatory response have a profound local and systemic impact on other organ functions. Neuroendocrinological disorders and cardiopulmonary morbidity are dominant. Despite a decrease in hospital mortality for high volume centers, a high proportion of survivors suffer from neurological deficits. Knowledge of the pathophysiology of vasospasms in the later stages of the disease has increased...
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27883038/anti-high-mobility-group-box-1-hmgb1-antibody-attenuates-delayed-cerebral-vasospasm-and-brain-injury-after-subarachnoid-hemorrhage-in-rats
#2
Jun Haruma, Kiyoshi Teshigawara, Tomohito Hishikawa, Dengli Wang, Keyue Liu, Hidenori Wake, Shuji Mori, Hideo Kohka Takahashi, Kenji Sugiu, Isao Date, Masahiro Nishibori
Although delayed cerebral vasospasm (DCV) following subarachnoid hemorrhage (SAH) is closely related to the progression of brain damage, little is known about the molecular mechanism underlying its development. High mobility group box-1 (HMGB1) plays an important role as an initial inflammatory mediator in SAH. In this study, an SAH rat model was employed to evaluate the effects of anti-HMGB1 monoclonal antibody (mAb) on DCV after SAH. A vasoconstriction of the basilar artery (BA) associated with a reduction of nuclear HMGB1 and its translocation in vascular smooth muscle cells were observed in SAH rats, and anti-HMGB1 mAb administration significantly suppressed these effects...
November 24, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27867126/coiling-is-not-superior-to-clipping-in-patients-with-high-grade-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#3
REVIEW
Zhi-Wei Xia, Xiao-Ming Liu, Jun-Yu Wang, Hui Cao, Feng-Hua Chen, Jun Huang, Qi-Zhuang Li, Shuang-Shi Fan, Bing Jiang, Zi-Gui Chen, Quan Cheng
BACKGROUND: Outcomes of coiling embolization versus clipping for patients with high-grade aneurysmal subarachnoid hemorrhage (aSAH) have not been previously compared. We reviewed the current evidence regarding the safety and efficacy of clipping versus coiling for high-grade aSAH. METHODS: We conducted a meta-analysis of studies that comparring clipping with coiling in patients with high-grade aSAH published from January 1999-February 2016 in Medline, Embase, and Cochrane databases based on PRISMA inclusion and exclusion criteria...
November 17, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27866915/trends-in-transcranial-doppler-monitoring-in-aneurysmal-subarachnoid-hemorrhage-a-10-year-analysis-of-the-nationwide-inpatient-sample
#4
Gyanendra Kumar, Karen C Albright, John P Donnelly, Angela Hays Shapshak, Mark R Harrigan
BACKGROUND: Transcranial Doppler (TCD) is endorsed by national guidelines for use in aneurysmal subarachnoid hemorrhage (aSAH) for surveillance of cerebral vasospasm (CV). However, nationwide data on utilization of TCD for CV detection and monitoring in aSAH are lacking. METHODS: Analysis of nationwide trends in TCD prevalence was performed using Nationwide Inpatient Sample (NIS) data from 2002 to 2011. Raw counts were converted into weighted counts, which were used to generate national estimates...
November 17, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27827324/dissociation-of-early-and-delayed-cerebral-infarction-after-aneurysmal-subarachnoid-hemorrhage
#5
Oliver G S Ayling, George M Ibrahim, Naif M Alotaibi, Peter A Gooderham, R Loch Macdonald
BACKGROUND AND PURPOSE: Cerebral infarction after aneurysmal subarachnoid hemorrhage is a significant cause of substantial morbidity and mortality. Because early and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage may be mediated by different processes, we evaluated whether aneurysm-securing methods contributed to infarcts and whether long-term outcomes differ between early and delayed infarcts. METHODS: A post hoc analysis of the CONSCIOUS-1 study (Clazosentan to Overcome Neurological Ischemia and Infarction Occurring After Subarachnoid Hemorrhage) was performed...
November 8, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27812447/continuous-intra-arterial-nimodipine-infusion-in-refractory-symptomatic-vasospasm-after-subarachnoid-hemorrhage
#6
Raimund Helbok, Alexandra Zangerle, Andreas Chemelli, Ronny Beer, Thomas Benke, Rainer Ehling, Marlene Fischer, Martin Sojer, Bettina Pfausler, Claudius Thome, Erich Schmutzhard
INTRODUCTION: Vasospasm still is a major cause of morbidity after aneurysmal subarachnoid hemorrhage. The purpose of this report is to describe the successful management of severe refractory vasospasm with continuous intra-arterial nimodipine (IAN) treatment. CASE DESCRIPTION: A 72-year old right handed woman was admitted with non-traumatic SAH WFNS grade 1. Cerebral computed tomography demonstrated thick blood filling of the basal cisterns, and intraventricular hemorrhage...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27811177/efficacy-of-endovascular-treatment-and-feasibility-of-stent-assisted-coiling-in-the-presence-of-severe-and-symptomatic-vasospasm
#7
Cagatay Andic, Ozgur Kardes, Emre Durdag, Murat Gedikoglu, Sule Akin
BACKGROUND AND PURPOSE: In patients with aneurysmal subarachnoid hemorrhage, deciding the optimal treatment strategy is challenging in the presence of severe and symptomatic vasospasm and the existing literature is limited. The purpose of this study was to evaluate the safety and effectiveness of endovascular treatment of intracranial aneurysms and the feasibility of stent-assisted coiling during severe and symptomatic vasospasm. MATERIALS AND METHODS: Fifteen consecutive patients with 18 aneurysms who underwent endovascular treatment during severe and symptomatic vasospasm were included in the study...
November 3, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27789791/safety-and-outcomes-of-simultaneous-vasospasm-and-endovascular-aneurysm-treatment-svat-in-subarachnoid-hemorrhage
#8
REVIEW
Doniel Drazin, Vernard S Fennell, Edward Gifford, Carlito Lagman, Kunakorn Atchaneeyasakul, Randall C Edgell, Mahmoud Rayes, Andrew Xavier, Muhammad S Hussain, Rishi Gupta, Junaid S Kalia, Osama O Zaidat, Italo Linfante, Raul G Nogueira, Thanh Nguyen, Jamary Oliveira-Filho, Alexandre D M Barros, Alan Boulos, Michael J Alexander, Dileep R Yavagal
BACKGROUND: Simultaneous vasospasm and endovascular aneurysm treatment (SVAT) has been shown to be effective with good clinical outcomes in small series, but these studies have not examined predictive factors for clinical outcome after treatment. OBJECTIVE: To identify the safety and efficacy of SVAT in a large multicenter patient cohort and evaluate prognostic markers of clinical outcome following SVAT. METHODS: This study retrospectively enrolled 50 consecutive patients undergoing SVAT at 11 different centers...
October 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27784210/the-updated-role-of-oxidative-stress-in-subarachnoid-hemorrhage
#9
Yang Yang, Sheng Chen, Jianmin Zhang
Subarachnoid hemorrhage (SAH) is a ruinous disease with high morbidity and mortality. Two areas are becoming research hotspots of this disease: early brain injury (EBI) and delayed vasospasm. There is substantial evidence suggesting that oxidative stress plays a key role in the development of EBI and delayed cerebral vasospasm after SAH. Previous studies show several sources for the excessive generation of free radicals after SAH, such as disrupted mitochondrial respiration, upregulated enzymatic pathways and extracellular hemoglobin degradation...
October 25, 2016: Current Drug Delivery
https://www.readbyqxmd.com/read/27777162/safety-and-efficacy-of-non-compliant-balloon-angioplasty-for-the-treatment-of-subarachnoid-hemorrhage-induced-vasospasm-a-multicenter-study
#10
Apar S Patel, Christoph J Griessenauer, Raghav Gupta, Nimer Adeeb, Paul M Foreman, Hussain Shallwani, Justin M Moore, Mark R Harrigan, Adnan H Siddiqui, Christopher S Ogilvy, Ajith J Thomas
INTRODUCTION: Cerebral vasospasm following subarachnoid hemorrhage (SAH) is the single most important cause of neurological decline following successful treatment of the ruptured aneurysm. Here, we report safety and efficacy of non-compliant balloon angioplasty for the treatment of cerebral vasospasm. METHODS: Three major academic institutions in the United States provided data on cerebral vasospasm treated with non-compliant balloon angioplasty between October 2004 and February 2016...
October 21, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27777156/the-role-of-abo-blood-group-in-cerebral-vasospasm-associated-intracranial-hemorrhage-and-delayed-cerebral-ischemia-in-470-patients-with-subarachnoid-hemorrhage
#11
Daniel Dubinski, Sae-Yeon Won, Jürgen Konczalla, Jan Mersmann, Christof Geisen, Eva Herrmann, Volker Seifert, Christian Senft
OBJECTIVE: Rupture of an intracranial aneurysm usually presents with an acute onset, requires multidisciplinary intensive care treatment, and the overall death and disability rates are high. The ABO blood type is known to play an important role in hemostasis, thrombosis and vascular NO response. The aspect of ABO blood type in onset, clinical progress and outcome after SAH are to date largely unexplored. We conducted this study to elucidate the association of ABO blood type on the occurrence and outcome of aneurysmal SAH...
October 21, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27777149/ruptured-wide-necked-aneurysms-is-stent-assisted-coiling-during-post-hemorrhage-days-4-10-safe-and-efficient
#12
Zenghui Qian, Xin Feng, Huibin Kang, Xiaolong Wen, Wenjuan Xu, Fei Zhao, Chuhan Jiang, Zhongxue Wu, Youxiang Li, Aihua Liu
BACKGROUND: Recent studies have reported the use of stent-assisted coiling (SAC) for wide-necked aneurysms in patients with acute subarachnoid hemorrhage (SAH). This study attempted to determine whether it is safe and efficient to use SAC for wide-necked aneurysms during post-SAH days 4-10. METHODS: We reviewed 126 consecutive patients with ruptured wide-necked aneurysms who underwent SAC. The patients were classified into the early cohort (SAC was performed within post-SAH days 0-3) and late cohort (SAC was performed within post-SAH days 4-10)...
October 21, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27759738/the-relationship-between-il-6-et-1-and-cerebral-vasospasm-in-experimental-rabbit-subarachnoid-hemorrhage
#13
Davide Croci, Edin Nevzati, Hiroki Danura, Salome Schöpf, Javier Fandino, Serge Marbacher, Carl Muroi
BACKGROUND: In subarachnoid hemorrhage (SAH), occurrence of cerebral vasospasm (CVS) mediated by endothelin (ET)-1 might be a result of a compartmental inflammatory response with interleukin (IL)-6 release. We aim to investigate the relationship between ET-1 and IL-6 in association of CVS. METHODS: A total of 24 New Zealand white rabbits where randomly allocated into 3 groups: SAH (n=10), IL-6 (n=10), and sham (n=4). SAH was induced by a closed cranium extracranial-intracranial shunt model...
October 19, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27756669/vitamin-d-deficiency-is-not-associated-with-outcomes-in-aneurysmal-subarachnoid-hemorrhage-patients-a-case-control-study
#14
Yarelis Alvarado Reyes, Alexandra Perez, Gloria Rodriguez-Vega
OBJECTIVE: Vitamin D deficiency has been associated with increased risk and adverse outcomes in many clinical settings including cardiovascular disease, stroke, and critically ill patients. Therefore we aimed to determine whether vitamin D deficiency had any effect in aneurysmal subarachnoid hemorrhage (aSAH) clinical outcomes. METHODS: A retrospective record review was conducted in a tertiary community hospital in Puerto Rico. Adult patients admitted to the neurosurgical intensive care unit (NICU) with a diagnosis of aSAH from January 2013 to July 2014, who had a 25-hydroxyvitamin-D level drawn, were included...
October 15, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27742373/scutellarin-attenuates-vasospasm-through-the-erk5-klf2-enos-pathway-after-subarachnoid-hemorrhage-in-rats
#15
Qiang Li, Yujie Chen, Xuan Zhang, Shilun Zuo, Hongfei Ge, Yanyan Chen, Xin Liu, John H Zhang, Huaizhen Ruan, Hua Feng
Angiographic vasospasm, especially in the early phases (<72h) of subarachnoid hemorrhage (SAH), is one of the major complications after an aneurysm rupture and is often the cause of delayed neurological deterioration. Scutellarin (SCU), a flavonoid extracted from the traditional Chinese herb Erigeron breviscapus, has been widely accepted as an antioxidant, but the effect of SCU on vasospasm after SAH remains elusive. Endovascular perforation was conducted to induce SAH in Sprague-Dawley rats. Then, the underlying mechanism of the anti-vasospasm effect of SCU was investigated using a modified Garcia scale, India ink angiography, cross-sectional area analysis, immunohistochemistry staining and western blot...
October 11, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27741143/effect-of-the-drainage-of-cerebrospinal-fluid-in-patients-with-aneurismal-subarachnoid-hemorrhage-a-meta-analysis
#16
Cong Qian, Xiaobo Yu, Jingyin Chen, Chi Gu, Lin Wang, Gao Chen, Yuying Dai
BACKGROUND AND OBJECTIVES: Vasospasm-related injury such as delayed ischemic neurological defect (DIND) or cerebral infarction is an important prognostic factor for aneurismal subarachnoid hemorrhage (SAH). Whether cerebrospinal fluid (CSF) drainage can achieve a better outcome in aneurismal SAH patients after coiling or clipping remains the subject of debate. Here, we report a meta-analysis of the related available literature to assess the effect of continuous CSF drainage on clinical outcomes in patients with aneurismal SAH...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27740993/ultrasound-in-neurology
#17
Georgios Tsivgoulis, Andrei V Alexandrov
PURPOSE OF REVIEW: Low cost, avoidance of irradiation, and high temporal resolution are inherent advantages of ultrasound imaging that translate into multiple clinical uses in many domains of neurology. This article presents clinical uses of ultrasound examination in cerebrovascular, neurodegenerative, and peripheral nervous system diseases. RECENT FINDINGS: Modern treatment and prevention of ischemic stroke rely on prompt diagnosis. Ultrasonography has found a place as a noninvasive screening test and bedside technique that provides estimates of the degree of stenosis as well as hemodynamic and structural information about intracranial and extracranial vessels in real time...
October 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27738873/effects-of-toll-like-receptor-4-antagonists-against-cerebral-vasospasm-after-experimental-subarachnoid-hemorrhage-in-mice
#18
Fumihiro Kawakita, Masashi Fujimoto, Lei Liu, Fumi Nakano, Yoshinari Nakatsuka, Hidenori Suzuki
Toll-like receptor 4 (TLR4) signaling may play a crucial role in the occurrence of cerebral vasospasm after subarachnoid hemorrhage (SAH). The main purpose of this study was to assess if selective blockage of TLR4 on cerebral arteries prevents cerebral vasospasm development and neurological impairments after SAH in mice. One hundred fourteen mice underwent endovascular perforation SAH or sham operation and were randomly divided into the following 6 groups: sham+vehicle, sham+LPS-RS ultrapure 8 μg, sham+LPS-RS ultrapure 40 μg, SAH+vehicle, SAH+LPS-RS ultrapure 8 μg, and SAH+LPS-RS ultrapure 40 μg...
October 13, 2016: Molecular Neurobiology
https://www.readbyqxmd.com/read/27737684/management-of-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#19
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27734336/ficolin-1-levels-in-patients-developing-vasospasm-and-cerebral-ischemia-after-spontaneous-subarachnoid-hemorrhage
#20
Laura Llull, Steffen Thiel, Sergio Amaro, Álvaro Cervera, Anna M Planas, Ángel Chamorro
Activation of the inflammatory generating complement system might play a pathogenic role in spontaneous subarachnoid hemorrhage (SAH). We studied whether plasma and cerebrospinal fluid (CSF) levels of complement proteins were associated with angiographic vasospasm and cerebral ischemic lesions after SAH. Ficolin-1 (M-ficolin), ficolin-3 (H-ficolin), mannose-binding lectin (MBL), MBL-associated serine protease 2 (MASP-2), MASP-3, and MAp44 were analyzed in plasma of 45 SAH patients at 24 h after bleeding. Additionally, ficolin-1 levels were measured in cerebrospinal fluid (CSF) samples obtained 24 h after bleeding in 19 patients with external ventricular drainage placement...
October 12, 2016: Molecular Neurobiology
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