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subarachnoid hemorrhage and vasospasm

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https://www.readbyqxmd.com/read/28634501/subarachnoid-hemorrhage-and-long-term-stroke-risk-after-traumatic-brain-injury
#1
Nicholas A Morris, Joséphine Cool, Alexander E Merkler, Hooman Kamel
BACKGROUND: Recent studies suggest that traumatic brain injury (TBI) is a risk factor for subsequent ischemic stroke, even years after the initial insult. The mechanisms of the association remain unclear. The presence of traumatic subarachnoid hemorrhage (tSAH) may mediate the effect of TBI on long-term stroke risk, as it has previously been linked to short-term vasospasm and delayed cerebral ischemia. METHODS: Using administrative claims data, we conducted a retrospective cohort study of acute care hospitalizations...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28634064/subarachnoid-hemorrhage-in-advanced-age-comparison-of-patients-aged-70-79-years-and-80-years-and-older
#2
N Brawanski, F Kunze, M Bruder, S Tritt, C Senft, J Berkefeld, V Seifert, J Konczalla
OBJECTIVE: Clinical routine shows an increasing admission rate of elderly patients suffering from SAH. We retrospectively compared patients aged 70-79 and over 80 years (80+). Aim of the study was to identify differences in outcome and prognostic factors to better anticipate clinical course and therefore treat this special subgroup better. METHODS: Patients were entered into a prospectively collected database. Between 1999 and 06/2014 191 patients suffered from SAH and aged ≥70 years...
June 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28619499/results-of-early-high-flow-bypass-and-trapping-for-ruptured-blood-blister-like-aneurysms-of-the-internal-carotid-artery
#3
Yuichiro Kikkawa, Toshiki Ikeda, Ririko Takeda, Hiroyuki Nakajima, Takeshi Ogura, Hidetoshi Ooigawa, Hiroki Kurita
OBJECTIVE: The aim of this study is to clarify the efficacy and safety of early surgery using trapping of the affected internal carotid artery (ICA) and high-flow bypass between second portion of the middle cerebral artery and cervical external carotid artery with radial artery graft for ruptured blood blister-like aneurysms (BBAs) arising from anterior wall of the ICA. METHODS: Medical chart of consecutive 16 patients (M:F=7:9, mean 59 years) with subarachnoid hemorrhage (WFNS grade I:2, II:5, III:2, IV:4, V:3) due to ruptured BBA surgically treated between July 2010 and October 2015 were retrospectively reviewed...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28610434/isoflavones-and-gastrointestinal-infection-two-potential-triggers-for-reversible-cerebral-vasoconstriction-syndrome
#4
Björn Machner, Tobias Boppel, Thomas Münte
Background Reversible cerebral vasoconstriction syndrome (RCVS) is an important differential diagnosis of singular or recurrent thunderclap headache. Prognosis is generally good, however complications of the transient segmental vasospasms of cerebral arteries such as stroke, subarachnoidal hemorrhage and brain edema may worsen the clinical outcome. Although the exact pathomechanism is still unclear, various vasoactive substances and conditions (e.g. post partum) have been identified as triggering RCVS. Cases We report on the clinical course and management of two cases of typical RCVS that were associated with two different precipitants previously not described: A gastrointestinal infection and isoflavones, which are phytoestrogens used for menopausal vasomotor symptoms...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28609751/aneurysmal-subarachnoid-hemorrhage-lead-to-systemic-upregulation-of-il-23-il-17-inflammatory-axis
#5
Shafqat Rasul Chaudhry, Erdem Güresir, Hartmut Vatter, Thomas M Kinfe, Dirk Dietrich, Alf Lamprecht, Sajjad Muhammad
IL-23 and IL-17 are pro-inflammatory cytokines. IL-23 is secreted by activated macrophages and dendritic cells, while IL-17 by Th17 cells. Serum IL-23 and IL-17 are known to be elevated in numerous inflammatory diseases including neurodegenerative diseases. The role of serum IL-23 and IL-17 in aneurysmal subarachnoid hemorrhage (aSAH) has still not been investigated. The present work investigates the serum IL-23 and IL-17 levels and their association with post hemorrhagic complications and clinical outcome in patients with aSAH...
June 10, 2017: Cytokine
https://www.readbyqxmd.com/read/28597450/effect-of-visible-light-on-vasospasticity-of-post-subarachnoid-hemorrhage-cerebrospinal-fluid
#6
Pulat Akin Sabanci, Bulent Omay, Yavuz Aras, Aydın Aydoseli, Achmet Ali, Tulin Erdem, Altay Sencer, Talat Kiris
Background and Objective Cerebral vasospasm (CV) is a serious complication of subarachnoid hemorrhage (SAH) with high morbidity and mortality rates. The mechanism of CV has not been determined. There are many theories related to this unsolved issue, one of which supports CV as a two-stage phenomenon from a pathophysiologic perspective. The first stage consists of inhibition of neuronal nitric oxide synthase by oxyhemoglobin, which results in a decrease of nitric oxide (NO) production. The second stage consists of an increase in the levels of asymmetric dimethylarginine through bilirubin oxidation products (BOXes), which are oxidized by-products of hemoglobin metabolism...
June 8, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28582545/stereotactic-catheter-ventriculocisternostomy-for-clearance-of-subarachnoid-hemorrhage-in-patients-with-coiled-aneurysms
#7
Roland Roelz, Christian Scheiwe, Horst Urbach, Volker A Coenen, Peter Reinacher
BACKGROUND: Cerebral vasospasm leading to delayed cerebral infarction (DCI) is a central source of poor outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). Current treatments of cerebral vasospasm are insufficient. Cisternal blood clearance is a promising treatment option. However, a generally applicable, safe, and effective method to access the cisterns of the brain is lacking. OBJECTIVE: To report on stereotactic catheter ventriculocisternostomy (STX-VCS) as a method to access the cisterns of the brain for clearance of subarachnoid hemorrhage in patients with aSAH and coiled aneurysms...
June 3, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28575305/functional-outcomes-and-delayed-cerebral-ischemia-following-nonperimesencephalic-angiogram-negative-subarachnoid-hemorrhage-similar-to-aneurysmal-subarachnoid-hemorrhage
#8
Fawaz Al-Mufti, Alexander E Merkler, Amelia K Boehme, Elie Dancour, Theresa May, J Michael Schmidt, Soojin Park, E Sander Connolly, Sean D Lavine, Philip M Meyers, Jan Claassen, Sachin Agarwal
BACKGROUND: The angiogram-negative subarachnoid hemorrhage (SAH) literature includes patients with perimesencephalic hemorrhage, which is recognized to have a much better outcome than aneurysmal SAH. OBJECTIVE: To evaluate the clinical outcomes of Nonperimesencephalic Angiogram-Negative SAH (NPAN-SAH). METHODS: A prospective, spontaneous SAH database of 1311 patients that accrued between April 2006 and December 2014 was screened. All patients with NPAN-SAH and 2 consecutive negative cerebral angiograms were included...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28549643/hypertonic-saline-for-raised-intracranial-pressure-following-aneurysmal-subarachnoid-hemorrhage-a-systematic-review
#9
REVIEW
Christopher R Pasarikovski, Naif M Alotaibi, Fawaz Al-Mufti, R Loch Macdonald
BACKGROUND: The use of hyperosmolar agents such as mannitol or hypertonic saline (HTS) to control high intracranial pressure (ICP) in traumatic brain injury patients has been well studied. However, the role of HTS in the management of aneurysmal subarachnoid hemorrhage (aSAH)-associated raised ICP is still unclear. METHODS: We performed a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome of this review is to quantify ICP reduction produced by HTS and its effect on clinical outcomes defined by any standardized functional score...
May 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28548598/associations-between-endothelin-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage-clinical-vasospasm-delayed-cerebral-ischemia-and-functional-outcome
#10
Christoph J Griessenauer, Robert M Starke, Paul M Foreman, Philipp Hendrix, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Mingkuan Lin, Beverly C Walters, Jean-Francois Pittet, Mali Mathru
OBJECTIVE Endothelin-1, a potent vasoconstrictor, and its receptors may be involved in the pathogenesis of aneurysmal subarachnoid hemorrhage (aSAH), clinical vasospasm, delayed cerebral ischemia (DCI), and functional outcome following aSAH. In the present study, common endothelin single nucleotide polymorphisms (SNPs) and their relation to aSAH were evaluated. METHODS Blood samples from all patients enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study were used for genetic evaluation. The CARAS study prospectively enrolled patients with aSAH at 2 academic institutions in the US from 2012 to 2015...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28515610/hyperemia-causing-delayed-recovery-in-traumatic-brain-injury
#11
Shalini Nair, Ramanan Rajagopal
Subarachnoid hemorrhage is a common manifestation of traumatic brain injury. A clinical deterioration in Glasgow Coma Scale score without an accompanying radiological worsening is suggestive of vasospasm. However, hyperemia could be another possibility which can easily be considered with corroborating transcranial Doppler (TCD) features. This case report reiterates the value of TCD in such instances.
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28503488/treatment-of-cerebral-vasospasm-in-an-infant-using-a-modified-dotter-technique
#12
Brian M Snelling, Samir Sur, Sumedh S Shah, Eric C Peterson
An 8-month old female presented with spontaneous subarachnoid hemorrhage and was treated successfully with endovascular coil embolization of the ruptured aneurysm. Transcranial Doppler ultrasound performed four days later demonstrated middle cerebral artery (MCA) velocities greater than 350 cm/sec on the right and greater than 200 cm/sec on the left, despite medical management. The patient demonstrated no focal neurological deficits, though examination was limited by our patient's sedation and intubation. Angiography revealed severe vasospasm of the supraclinoid internal carotid and MCA territories, bilaterally...
March 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28499220/effects-of-preadmission-beta-blockers-on-neurogenic-stunned-myocardium-after-aneurysmal-subarachnoid-hemorrhage-a-meta-analysis
#13
Hai Luo, Wei-Xin Song, Jin-Wen Jiang, Jian-Lan Zhao, Wei-Lin Rong, Mei-Hua Li
OBJECTIVE: Spontaneous subarachnoid hemorrhage is mostly caused by the rupture of an aneurysm. Neurogenic stunned myocardium (NSM) is one of the most frequent complications caused by aneurysmal subarachnoid hemorrhage (aSAH). The possible pathogenesis of NSM may be that the catecholamine peak resulting from aSAH leads to subendocardial ischemia or coronary artery spasm. We designed this meta-analysis to find out whether beta-blockers (BB) can significantly reduce the incidence of NSM and improve the outcomes of aSAH...
July 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28484291/follow-up-of-vasospasm-by-transcranial-doppler-sonography-tcd-in-subarachnoid-hemorrhage-sah
#14
Jasminka Djelilovic-Vranic, Vanja Basic-Kes, Merita Tiric-Campara, Edina Djozic, Jasmin Kulenovic
INTRODUCTION: Subarachnoid hemorrhage (SAH)represents hemorrhage in the space between arachnoidea and pia mater, due to aneurysm burst, spontaneously or as a consequence of trauma. It is condition that occurs more common in women than men, and its most common complications are rebleeding and vazospasm. As a result of vasospasm, develops ischemia in the portion of brain tissue that can cause additional neurological deficit. Transcranial Doppler Sonography (TCD) is a noninvasive ultrasound diagnostic method that allows monitoring of the state of intracerebral hemodynamics...
March 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28481394/the-effect-of-intravenous-l-carnitine-on-vasospasm-process-in-the-experimental-subarachnoid-hemorrhage-model
#15
Ahmet Soyer, Murat Gokten, Kamil Oge, Figen Soylemezoglu
AIM: Cerebral vasospasm after subarachnoid hemorrhage (SAH) is an important cause of morbidity and mortality. In this study we examined the effects of L-carnitine on cerebral vasospasm process. MATERIAL AND METHODS: Twenty male New Zealand white rabbits were randomly divided into 4 groups. Group 1 served as control; group 2 were not subjected to SAH and received intravenous L-carnitine 3 times; group 3 were subjected to SAH and group 4 were subjected to SAH and treated with 100 mg/kg intravenous L-carnitine at 0 24 and 48 hours after SAH...
March 25, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28468328/heparin-and-heparin-derivatives-in-post-subarachnoid-hemorrhage-brain-injury-a-multimodal-therapy-for-a-multimodal-disease
#16
REVIEW
Erik G Hayman, Akil P Patel, Robert F James, J Marc Simard
Pharmacologic efforts to improve outcomes following aneurysmal subarachnoid hemorrhage (aSAH) remain disappointing, likely owing to the complex nature of post-hemorrhage brain injury. Previous work suggests that heparin, due to the multimodal nature of its actions, reduces the incidence of clinical vasospasm and delayed cerebral ischemia that accompany the disease. This narrative review examines how heparin may mitigate the non-vasospastic pathological aspects of aSAH, particularly those related to neuroinflammation...
May 2, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28463833/preventive-effect-of-clazosentan-against-cerebral-vasospasm-after-clipping-surgery-for-aneurysmal-subarachnoid-hemorrhage-in-japanese-and-korean-patients
#17
Miki Fujimura, Jin-Yang Joo, Jong-Soo Kim, Motonori Hatta, Yoshinari Yokoyama, Teiji Tominaga
BACKGROUND: Clazosentan has been explored worldwide for the prophylaxis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH). In a dose-finding trial (CONSCIOUS-1) conducted in Israel, Europe, and North America, clazosentan (1, 5, and 15 mg/h) significantly reduced the incidence of cerebral vasospasm, but its efficacy in Japanese and Korean patients was unknown. We conducted a double-blind comparative study to evaluate the occurrence of cerebral vasospasm in Japanese and Korean patients with aSAH...
May 3, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28455691/long-lasting-cerebral-vasospasm-microthrombosis-apoptosis-and-paravascular-alterations-associated-with-neurological-deficits-in-a-mouse-model-of-subarachnoid-hemorrhage
#18
Mohamad El Amki, Martine Dubois, Antoine Lefevre-Scelles, Nicolas Magne, Mélanie Roussel, Thomas Clavier, Pierre-Olivier Guichet, Emmanuel Gérardin, Vincent Compère, Hélène Castel
Subarachnoid hemorrhage (SAH) is a devastating disease with high mortality and morbidity. Long-term cognitive and sensorimotor deficits are serious complications following SAH but still not well explained and described in mouse preclinical models. The aim of our study is to characterize a well-mastered SAH murine model and to establish developing pathological mechanisms leading to cognitive and motor deficits, allowing identification of specific targets involved in these long-term troubles. We hereby demonstrate that the double blood injection model of SAH induced long-lasting large cerebral artery vasospasm (CVS), microthrombosis formation and cerebral brain damage including defect in potential paravascular diffusion...
April 28, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28431602/a-comprehensive-analysis-of-the-relationship-between-aca-velocities-and-aca-infarction-following-aneurysmal-subarachnoid-hemorrhage
#19
Michael Moussouttas, Jocelyn Cheng, Joseph Antonakakis, Ameesh Patel, Maria Iuanow
PURPOSE: To evaluate the relationship between anterior cerebral artery (ACA) velocities (and ancillary parameters) and ACA infarction following aneurysmal subarachnoid hemorrhage (aSAH), and to examine the factors that influence velocities. METHODS: Retrospective investigation of 500 consecutive aSAH patients. ACA mean velocities (Vm) were evaluated by daily transcranial ultrasound during the early (days 1-4) and late (days 5-20) periods posthemorrhage. Presence and timing of acute ACA infarctions were identified by serial retrospective review of cerebral computerized tomography (CT) scans...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28416786/basilar-artery-vasospasm-after-pretuncal-non-aneurysmal-subarachnoid-hemorrhage-responding-to-milrinone
#20
Abdulrahman Y Alturki, Abdullah S Alamri, Mohamed M Badawy, Benjamin W Lo
Pretruncal (perimesencephalic) non-aneurysmal subarachnoid hemorrhage (PNSAH) is uniformly associated with an excellent outcome. Although cerebral vasospasm remains a common complication of SAH and constitutes an important predictor of outcome, in the setting of PNSAH, it is extremely rare. Preturnal non-aneurysmal subarac refers to a subset of SAH patients with a characteristic pattern of localized blood on CT of the head, normal cerebral angiography, and benign course when compared to the aneurysmal SAH population...
April 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
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