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subarachnoid hemorrhage and vasospasm

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https://www.readbyqxmd.com/read/28812108/ultra-early-detection-of-microcirculatory-injury-as-predictor-of-developing-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#1
Philipp Gölitz, Philip Hoelter, Julie Rösch, Karl Roessler, Frauke Knossalla, Arnd Doerfler
PURPOSE: Delayed cerebral ischemia (DCI) still remains a major complication after subarachnoid hemorrhage (SAH). The aim of our study was to evaluate whether flow analysis of admission digital subtraction angiography (DSA) using parametric color coding (PCC), a postprocessing algorithm, allows ultra-early identification of SAH patients at risk for developing subsequent symptomatic vasospasm. METHODS: In this study 52 patients who suffered SAH from aneurysm rupture, were retrospectively enrolled...
August 15, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28808649/the-effect-of-a-single-dose-dantrolene-in-patients-with-vasospasm-following-aneurysmal-subarachnoid-hemorrhage
#2
Masih Sabouri, Mahmood Momeni, Fariborz Khorvash, Majid Rezvani, Homayon Tabesh
BACKGROUND: Cerebral vasospasm is a prolonged, occasionally severe, but reversible narrowing of the cerebral arteries that begins 3 to 5 days after the hemorrhage becomes maximal at 14 days. This study is designed to evaluate the effect of dantrolene on the reduction of vasospasm following aneurysmal subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: This randomized controlled clinical trial was conducted on 32 patients with proven aneurysms in AL-Zahra hospital during 2011-2013...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28777022/association-of-cystathionine-beta-synthase-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage
#3
Philipp Hendrix, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Mingkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
OBJECTIVE Cystathionine β-synthase (CBS) is involved in homocysteine and hydrogen sulfide (H2S) metabolism. Both products have been implicated in the pathophysiology of cerebrovascular diseases. The impact of CBS polymorphisms on aneurysmal subarachnoid hemorrhage (aSAH) and its clinical sequelae is poorly understood. METHODS Blood samples from all patients enrolled in the CARAS (Cerebral Aneurysm Renin Angiotensin System) study were used for genetic evaluation. The CARAS study prospectively enrolled aSAH patients at 2 academic institutions in the United States from 2012 to 2015...
August 4, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28774294/temperature-variability-in-the-day-night-cycle-is-associated-with-further-intracranial-pressure-during-therapeutic-hypothermia
#4
Adriano Barreto Nogueira, Eva Annen, Oliver Boss, Faraneh Farokhzad, Christopher Sikorski, Emanuela Keller
BACKGROUND: To assess whether circadian patterns of temperature correlate with further values of intracranial pressure (ICP) in severe brain injury treated with hypothermia. METHODS: We retrospectively analyzed temperature values in subarachnoid hemorrhage patients treated with hypothermia by endovascular cooling. The circadian patterns of temperature were correlated with the mean ICP across the following day (ICP24). RESULTS: We analyzed data from 17 days of monitoring of three subarachnoid hemorrhage patients that underwent aneurysm coiling, sedation and hypothermia due to refractory intracranial hypertension and/or cerebral vasospasm...
August 3, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28767031/microsurgical-vascular-manipulation-in-aneurysm-surgery-and-delayed-ischemic-injury
#5
Muhammad Omar Chohan, Andrew P Carlson, Cristina Murray-Krezan, Christopher L Taylor, Howard Yonas
BACKGROUND: The role of aggressive surgical manipulation with clot evacuation, arachnoid dissection, and papaverine-guided adventitial dissection of large vessels during ruptured aneurysm surgery in reducing vasospasm is controversial. Here we describe a single-institution experience in aneurysm surgery outcomes with and without aggressive surgery. METHODS: We performed retrospective analysis of all patients >18 years of age with subarachnoid hemorrhage (SAH) from anterior circulation aneurysms between 2008 and 2013 at the University of New Mexico Hospital...
July 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28762878/long-acting-statin-for-aneurysmal-subarachnoid-hemorrhage-a-randomized-double-blind-placebo-controlled-trial
#6
Masato Naraoka, Naoya Matsuda, Norihito Shimamura, Kenichiro Asano, Kenichi Akasaka, Atsuhito Takemura, Seiko Hasegawa, Hiroki Ohkuma
Statins have pleiotropic effects that are considered beneficial in preventing cerebral vasospasm and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage (aSAH). Many studies using statins have been performed but failed to show remarkable effects. We hypothesized that a long-acting statin would be more effective, due to a longer half-life and stronger pleiotropic effects. Patients with aSAH were randomly assigned to a pitavastatin group (4 mg daily; n = 54) and a placebo group ( n = 54) after repair of a ruptured aneurysm...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28756589/crosstalk-between-the-angiotensin-and-endothelin-system-in-the-cerebrovasculature-after-experimental-induced-subarachnoid-hemorrhage
#7
Stefan Wanderer, Jan Mrosek, Hartmut Vatter, Volker Seifert, Juergen Konczalla
Under physiologic conditions, losartan showed a dose-dependent antagonistic effect to the endothelin-1 (ET-1)-mediated vasoconstriction. This reduced vasoconstriction was abolished after preincubation with an endothelin B1 receptor (ET(B1)-receptor) antagonist. Also, an increased ET(B1)-receptor-dependent relaxation to sarafotoxin S6c (S6c; an ET(B1)-receptor agonist) was detected by preincubation with losartan. Investigations after experimental induced subarachnoid hemorrhage (SAH) are still missing. Therefore, we analyzed losartan in a further pathological setup...
July 29, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28755916/early-emerging-markers-of-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage-a-literature-review
#8
REVIEW
Fawaz Al-Mufti, Krishna Amuluru, Brendan Smith, Nitesh Damodara, Mohammad El-Ghanem, Inder P Singh, Neha Dangayach, Chirag D Gandhi
BACKGROUND: Delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage is characterized by a highly complex pathophysiology and results in neurological deterioration after the inciting bleed. Despite its significant consequences, prompt diagnosis can be elusive and treatment is often administered too late. Early brain injury, which occurs within the first 72 hours post-ictus, may be an important factor for delayed cerebral ischemia and poor overall outcome. Here we explore the purported clinical and pathological manifestations of early brain injury to identify biomarkers that could have prognostic value...
July 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28750945/high-prevalence-of-rare-ryanodine-receptor-type-1-variants-in-patients-suffering-from-aneurysmatic-subarachnoid-hemorrhage-a-pilot-study
#9
Jan Coburger, Thomas Kapapa, Cristian Rainer Wirtz, Karin Jurkat-Rott, Werner Klingler
Subarachnoid hemorrhage (SAH) remains a challenging neurosurgical disease. The ryanodine receptor type 1 Ca2+ channel (RyR1) plays a crucial role in vasoconstriction and hemostasis. Mutations of the encoding gene, RYR1, are known to cause susceptibility to malignant hyperthermia (MH). Recently, a RYR1 mutation was found to be associated with abnormal bleeding times. Therefore, an assessment of the RYR1 gene might be of high relevance in patients with aneurysmatic SAH. In the presented pilot study, we screened 10 patients suffering from SAH for RYR1 variants and, for the first time in SAH, performed an assessment of pathogenicity of these variants using protein prediction software...
July 24, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28747460/carbon-monoxide-preserves-circadian-rhythm-to-reduce-the-severity-of-subarachnoid-hemorrhage-in-mice
#10
Nils Schallner, Judith-Lisa Lieberum, David Gallo, Robert H LeBlanc, Patrick M Fuller, Khalid A Hanafy, Leo E Otterbein
BACKGROUND AND PURPOSE: Subarachnoid hemorrhage (SAH) is associated with a temporal pattern of stroke incidence. We hypothesized that natural oscillations in gene expression controlling circadian rhythm affect the severity of neuronal injury. We moreover predict that heme oxygenase-1 (HO-1/Hmox1) and its product carbon monoxide (CO) contribute to the restoration of rhythm and neuroprotection. METHODS: Murine SAH model was used where blood was injected at various time points of the circadian cycle...
July 26, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28729919/toward-understanding-non-coding-rna-roles-in-intracranial-aneurysms-and-subarachnoid-hemorrhage
#11
Fengzhen Huang, Jiping Yi, Tieqiao Zhou, Xiaoxiang Gong, Hong Jiang, Xiaoxi Yao
Subarachnoid hemorrhage (SAH) is a common and frequently life-threatening cerebrovascular disease, which is mostly related with a ruptured intracranial aneurysm. Its complications include rebleeding, early brain injury, cerebral vasospasm, delayed cerebral ischemia, chronic hydrocephalus, and also non neurological problems. Non-coding RNAs (ncRNAs), comprising of microRNAs (miRNAs), small interfering RNAs (siRNAs) and long non-coding RNAs (lncRNAs), play an important role in intracranial aneurysms and SAH. Here, we review the non-coding RNAs expression profile and their related mechanisms in intracranial aneurysms and SAH...
2017: Translational Neuroscience
https://www.readbyqxmd.com/read/28711533/cvs-dependent-and-cvs-independent-cerebral-infarctions-predict-outcome-after-non-aneurysmal-subarachnoid-hemorrhage-a-single-center-series-with-250-patients
#12
Juergen Konczalla, Sepide Kashefiolasl, Nina Brawanski, Markus Bruder, Florian Gessler, Christian Senft, Joachim Berkefeld, Volker Seifert, Stephanie Tritt
OBJECTIVE: The number of patients with non-aneurysmal subarachnoid hemorrhage (naSAH) has increased over the last decade. Data regarding infarctions in naSAH are still limited. Aim of the study was to identify the rate of cerebral vasospasm (CVS)-dependent and CVS-independent infarctions and their influence on clinical outcomes. METHODS: Between 1999 and 2015, 250 patients suffering from naSAH were analyzed retrospectively. A delayed infarction was analyzed whether it was associated with CVS (CVS-dependent infarction) or not (CVS-independent)...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710044/treatment-strategies-of-subarachnoid-hemorrhage-from-bilateral-vertebral-artery-dissection-a-case-report-and-literature-review-focusing-on-availability-of-stent-placement
#13
Yasuo Murai, Fumihiro Matano, Shoji Yokobori, Hidetaka Onda, Hiroyuki Yokota, Akio Morita
BACKGROUND: Bilateral vertebral artery dissection (VAD) may result in subarachnoid hemorrhage (SAH). However, a variety of factors contribute to the difficulties with treating SAH. We report a case of bilateral VAD with SAH, as well as a literature review. CASE DESCRIPTION: A 32-year-old woman developed headache. Computed tomography (CT) demonstrated diffuse SAH, and 3-dimensional CT indicated bilateral VAD. Her left vertebral artery was severely stenosed and the basilar artery was retrogradely flowed via the posterior communicating artery...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28691981/use-of-23-4-saline-in-symptomatic-vasospasm-and-cushing-s-triad-to-prevent-herniation-and-death-a-case-report
#14
Lauren M Poe, Allison M Janda, Christina F Burger, Joseph J Schlesinger
A 53-year-old woman with migraines presented with Hunt-Hess grade 5 and Fisher grade 4 subarachnoid hemorrhage with intraventricular hemorrhage. She experienced severe vasospasm requiring intra-arterial medications. Continued vasospasm and edema resulted in Cushing's triad with profound tachypnea. Three percentage saline was administered twice without improvement. Despite the general practice to wait until complete neurologic deterioration before administering 23.4% saline, it was administered on 2 separate occasions, once after the failure of the 2 boluses of 3% saline and once on the reappearance of Cushing's triad 24 hours later, and on each occasion produced overall clinical improvement...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#15
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28684727/plasmid-plxsn-mediated-adrenomedullin-gene-therapy-for-cerebral-vasospasm-following-subarachnoid-hemorrhage-in-rats
#16
Xin Li, Xiaoshuang Xia, Xin Li
BACKGROUND The aim of this study was to investigate the protective effect of ADM gene mediated by plasmid pVAX1 on cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH). MATERIAL AND METHODS The recombinant plasmid pVAX-ADM was successfully established, and 40 SD rats were randomly divided into normal saline, pVAX1, pVAX1-ADM low-dose, pVAX1-ADM mid-dose, and pVAX1-ADM high-dose groups. The circumference and diameter of basilar artery, diameter of middle cerebral artery and internal carotid artery, and thickness of basilar artery wall were observed...
July 7, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28682429/study-on-the-expression-and-mechanism-of-inflammatory-factors-in-the-brain-of-rats-with-cerebral-vasospasm
#17
Q Huang, G Wang, Y-L Hu, J-X Liu, J Yang, S Wang, H-B Zhang
OBJECTIVE: We investigated the significance of IL-1 and ICAM-1 in rat's subarachnoid hemorrhage (SAH) cerebral vasospasm (CVS) model. MATERIALS AND METHODS: A total of 30 Sprague-Dawley (SD) rats were randomly divided into the SAH group and the Sham group. Cisterna magna auto blood injection was used to prepare the CVS models. We studied and compared changes in the basilar arteries diameters before and after SAH. We measured the cerebrovascular inner diameter before and after SAH modeling using the ultrasound...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28678308/evaluation-function-of-transcranial-two-dimensional-and-color-doppler-ultrasonography-tccs-for-patients-with-different-degrees-of-cerebral-vasospasm-before-and-after-the-nimodipine-treatment
#18
J-L Wang, X-N Li, Y-H Zhang, X Li, Y-L Yang
OBJECTIVE: To evaluate the changes in cerebral hemodynamics of patients with different degrees of cerebral vasospasm before and after the nimodipine treatment using transcranial two-dimensional and color Doppler ultrasonography (TCCS). PATIENTS AND METHODS: A total of 77 patients with subarachnoid hemorrhage was collected; and the maximum peak systolic velocity (Vs), end diastolic velocity (Vd), time averaged maximum velocity (Vm), pulsatility index (PI) and resistance index (RI) of middle cerebral artery (MCA) were measured by spectral Doppler technique...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28671243/time-dependent-and-lesion-dependent-hmgb1-selective-localization-in-brains-of-patients-with-cerebrovascular-diseases
#19
Takahiko Umahara, Toshiki Uchihara, Katsuiku Hirokawa, Kentaro Hirao, Soichiro Shimizu, Takao Hashimoto, Hiroo Terasi, Haruo Hanyu
High mobility group box 1 protein (HMGB1) has multiple functions, including the maintenance of nucleosomes and the regulation of gene transcription. HMGB1 is released from activated macrophages, resulting in the induction of inflammatory cytokines. Recently, much research about the role of HMGB1 in cerebrovascular disease (CVD) has been reported. In an animal model, HMGB1 neutralization ameliorates brain infarction, there is an early release of HMGB1 from neurons, and HMGB1 antibody attenuates delayed cerebral vasospasm in experimental subarachnoid hemorrhage...
July 3, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/28665071/feasibility-and-safety-of-mild-therapeutic-hypothermia-in-poor-grade-subarachnoid-hemorrhage-prospective-pilot-study
#20
Wookjin Choi, Soon Chan Kwon, Won Joo Lee, Young Cheol Weon, Byungho Choi, Hyeji Lee, Eun Suk Park, Ryeok Ahn
Therapeutic hypothermia (TH) improves the neurological outcome in patients after cardiac arrest and neonatal hypoxic brain injury. We studied the safety and feasibility of mild TH in patients with poor-grade subarachnoid hemorrhage (SAH) after successful treatment. Patients were allocated randomly to either the TH group (34.5°C) or control group after successful clipping or coil embolization. Eleven patients received TH for 48 hours followed by 48 hours of slow rewarming. Vasospasm, delayed cerebral ischemia (DCI), functional outcome, mortality, and safety profiles were compared between groups...
August 2017: Journal of Korean Medical Science
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