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subarachnoid hemorrhage and vasospasm

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https://www.readbyqxmd.com/read/29908380/the-impact-of-extubation-failure-in-patients-with-good-grade-subarachnoid-hemorrhage
#1
Jann F Wojak, Claudia Ditz, Abdulkareem Abusamha, Emma Smith, Jan Gliemroth, Volker Tronnier, Jan Küchler
OBJECTIVE: The aim of this study was to analyze the clinical impact of extubation failure (EF) in with good grade subarachnoid hemorrhage (SAH), in which a good clinical course is usually expected. PATIENTS AND METHODS: We reviewed the clinical data from 141 patients with SAH and i. initial Hunt & Hess grade 1-3 ii. induction of general anesthesia for intervention and iii. the presence of data about the functional outcome. Patients were divided into three groups: 1...
June 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29902601/study-of-correlation-between-hp-%C3%AE-1-expression-of-haptoglobin2-1-and-clinical-course-in-aneurysmal-subarachnoid-hemorrhage
#2
Bong Jun Kim, Youngmi Kim, Sung-Eun Kim, Jin Pyeong Jeon
OBJECTIVE: Haptoglobin (Hp) comprising two light (α) and two heavy (β) chains has an anti-oxidant effect following free hemoglobin binding. Among three phenotypes including Hp1-1 (two α1), Hp2-1 (α1 and α2), and Hp2-2 (two α2), a higher protective effect for toxic-free hemoglobin was reported for Hp2-2 than Hp1-1. However, few studies have focused on Hp2-1 in outcome. This study examined the α1 and α2 expression, and evaluated the correlation of Hp2-1 with subarachnoid hemorrhage (SAH) outcome...
June 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29882700/clinical-prediction-of-delayed-cerebral-ischemia-in-aneurysmal-subarachnoid-hemorrhage
#3
Hubert Lee, Jeffrey J Perry, Shane W English, Fahad Alkherayf, Joanne Joseph, Steven Nobile, Linghong Linda Zhou, Howard Lesiuk, Richard Moulton, Charles Agbi, John Sinclair, Dar Dowlatshahi
OBJECTIVE The aim of this study was to derive a clinically applicable decision rule using clinical, radiological, and laboratory data to predict the development of delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH) patients. METHODS Patients presenting over a consecutive 9-year period with subarachnoid hemorrhage (SAH) and at least 1 angiographically evident aneurysm were included. Variables significantly associated with DCI in univariate analysis underwent multivariable logistic regression...
June 8, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29875113/aneurysmal-subarachnoid-hemorrhage-and-vasospasm
#4
Shannon K Burns, Kacie J Brewer, Courtney Jenkins, Sally Miller
Aneurysmal subarachnoid hemorrhage is potentially fatal and is associated with poor outcomes in many patients. Advances in neurosurgical and medical management of ruptured aneurysms have improved mortality rates in patients with aneurysmal subarachnoid hemorrhage. Surgical and endovascular interventions, such as external ventricular drain placement, aneurysm clipping, and endovascular coiling, have been developed over the past few decades. Patients with aneurysmal subarachnoid hemorrhage are also at risk for cerebral vasospasm and delayed cerebral ischemia...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29863100/-reversible-cerebral-vasoconstriction-syndrome-a-clinical-study-of-11-cases
#5
Makoto Takemaru, Shinichi Takeshima, Naoyuki Hara, Takahiro Himeno, Yuji Shiga, Jun Takeshita, Kazuhiro Takamatsu, Eiichi Nomura, Yutaka Shimoe, Masaru Kuriyama
This study reports eleven cases of reversible cerebral vasospasm syndrome (RCVS). Of the 11 patients, two were males and nine were females, with the average age of 47.9 ± 14.1 years. Many of these patients were young. The rates of severe, intractable and pulsative headache, generalized convulsions, and motor hemiparesis were 64%, 27%, and 36%, respectively. As complications of intracerebral lesions in the early stage of disease onset, convexal subarachnoid hemorrhage, lobar intracerebral hemorrhage, and posterior reversible encephalopathy syndrome were observed in 63%, 9%, and 45% of cases, respectively...
June 1, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29845232/upregulation-of-microrna%C3%A2-24-causes-vasospasm-following-subarachnoid-hemorrhage-by-suppressing-the-expression-of-endothelial-nitric-oxide-synthase
#6
Huan-Ting Li, Jing Wang, Shi-Fang Li, Lei Cheng, Wan-Zhong Tang, Yu-Gong Feng
MicroRNA (miR)‑24 has been reported to associate with various diseases by acting on different signaling pathways. The present study aimed to elucidate the association between miR‑24 expression levels and vasospasm following subarachnoid hemorrhage (SAH), and its underlying mechanism. An miR online database was searched, identifying endothelial nitric oxide synthase (NOS3) as a potential target gene of miR‑24. A luciferase reporter assay performed to investigate the regulatory association between miR‑24 and NOS3 revealed that miR‑24 bound to the NOS3 3' untranslated region and inhibited NOS3 expression...
May 22, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29805825/ct-perfusion-to-guide-placement-of-invasive-cerebral-perfusion-monitor-in-subarachnoid-hemorrhage-induced-vasospasm
#7
Hosam Al-Jehani, Judith Marcoux, Kawthar Hadhiah, Faisal Alabbas, Mark Angle, Jeanne Teitelbaum
Background: Vasospasm is a challenging component of the subarachnoid hemorrhage "syndrome" that is unpredictable and very difficult to monitor using noninvasive or invasive monitoring technologies in neurocritical units. Methods: We describe the novel use of computerized tomography perfusion (CTP) imaging to choose proper targets for invasive cerebral blood flow monitors. Results: A total of 3 patients are included in this report...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29804416/-effect-and-significance-of-mild-hypothermia-on-cerebral-blood-flow-velocity-and-cerebral-extraction-rate-of-oxygen-in-patients-with-severe-subarachnoid-hemorrhage
#8
T Shui, Z Y Guo, G Z Zhang, Q Chen, B Li
Objective: Through studying the variations of cerebral blood flow velocity and cerebral extraction rate of oxygen to investigate the effect and mechanism of mild hypothermia therapy on early brain injury (EBI) and cerebral vasospasm (CVS) induced by sever subarachnoid hemorrhage (SAH). Methods: A total of 62 adult patients admitted in the Department of Neurosurgery of Tianjin TEDA Hospital from January 2014 to December 2016 with severe SAH without contraindications of hypothermia therapy were randomly divided into mild hypothermia (MH) group of 30 cases and routine treatment (RT) group of 32 cases...
May 22, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29804157/the-evolution-of-invasive-cerebral-vasospasm-treatment-in-patients-with-spontaneous-subarachnoid-hemorrhage-and-delayed-cerebral-ischemia-continuous-selective-intracarotid-nimodipine-therapy-in-awake-patients-without-sedation
#9
Andrej Paľa, Max Schneider, Christine Brand, Maria Teresa Pedro, Yigit Özpeynirci, Bernd Schmitz, Christian Rainer Wirtz, Thomas Kapapa, Ralph König, Michael Braun
Cerebral vasospasm (CV) and delayed cerebral ischemia (DCI) are major factors that limit good outcome in patients with spontaneous subarachnoid hemorrhage (SAH). Continuous therapy with intra-arterial calcium channel blockers has been introduced as a new step in the invasive treatment cascade of CV and DCI. Sedation is routinely necessary for this procedure. We report about the feasibility to apply this therapy in awake compliant patients without intubation and sedation. Out of 67 patients with invasive endovascular treatment of cerebral vasospasm due to spontaneous SAH, 5 patients underwent continuous superselective intracarotid nimodipine therapy without intubation and sedation...
May 26, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29801906/novel-management-strategies-for-medically-refractory-vasospasm-following-aneurysmal-subarachnoid-hemorrhage
#10
REVIEW
Fawaz Al-Mufti, Krishna Amuluru, Nitesh Damodara, Mohammad El-Ghanem, Rolla Nuoman, Naveed Kamal, Sarmad Al-Marsoummi, Nicholas A Morris, Neha S Dangayach, Stephan A Mayer
Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) is an important cause of further morbidity and mortality after an already devastating condition. Though traditionally attributed to vasospasm of large capacitance arteries and the resulting down-stream disruption of cerebral blood flow, the pathogenesis of DCI has proven to be more complex with early brain injury, blood-brain barrier disruption, microthrombosis, cortical spreading depolarizations, and the failure of cerebral autoregulation as newly elucidated factors...
July 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29792042/imaging-predictors-of-outcome-in-acute-spontaneous-subarachnoid-hemorrhage-a-review-of-the-literature
#11
Isabel Fragata, Patrícia Canhão
Spontaneous subarachnoid hemorrhage (SAH) accounts for about 5% of strokes, but has a very high morbidity and mortality. Many survivors are left with important cognitive impairment and are severely incapacitated. Prediction of complications such as vasospasm and delayed cerebral ischemia, and of clinical outcome after SAH, is challenging. Imaging studies are essential in the initial evaluation of SAH patients and are increasingly relevant in assessing for complications and prognosis. In this article, we reviewed the role of imaging studies in evaluating early brain injury and predicting complications as well as clinical and neuropsychological prognosis after acute SAH...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29785667/cerebral-autoregulation-in-stroke
#12
REVIEW
Pedro Castro, Elsa Azevedo, Farzaneh Sorond
PURPOSE OF REVIEW: Cerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29775770/treatment-of-ruptured-vertebral-artery-dissection-and-abdominal-hemorrhage-associated-with-segmental-arterial-mediolysis-using-endovascular-coil-embolization-va-dissection-associated-with-sam
#13
Taiki Isaji, Tomotaka Ohshima, Sigeru Miyachi, Naoki Matsuo, Reo Kawaguchi, Masakazu Takayasu
BACKGROUND: Segmental arterial mediolysis is a rare disease characterized by idiopathic noninflammatory vasculopathy involving small to medium arteries. Here, we report a case of ruptured cerebral and abdominal aneurysms, which were successfully treated using emergency endovascular coil embolization. CASE DESCRIPTION: A 45-year-old male suffered subarachnoid hemorrhage caused by the rupture of the right vertebral artery dissecting aneurysm, which was treated using emergency endovascular coiling...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29770118/neuroinflammation-as-a-target-for-intervention-in-subarachnoid-hemorrhage
#14
REVIEW
Airton Leonardo de Oliveira Manoel, R Loch Macdonald
Aneurysmal subarachnoid hemorrhage (SAH) is a sub-type of hemorrhagic stroke associated with the highest rates of mortality and long-term neurological disabilities. Despite the improvement in the management of SAH patients and the reduction in case fatality in the last decades, disability and mortality remain high in this population. Brain injury can occur immediately and in the first days after SAH. This early brain injury can be due to physical effects on the brain such as increased intracranial pressure, herniations, intracerebral, intraventricular hemorrhage, and hydrocephalus...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29760928/aneurysmal-subarachnoid-hemorrhage-intensive-care-for-improving-neurological-outcome
#15
REVIEW
Tomoya Okazaki, Yasuhiro Kuroda
Background: Aneurysmal subarachnoid hemorrhage is a life-threatening disease requiring neurocritical care. Delayed cerebral ischemia is a well-known complication that contributes to unfavorable neurological outcomes. Cerebral vasospasm has been thought to be the main cause of delayed cerebral ischemia, and although several studies were able to decrease cerebral vasospasm, none showed improved neurological outcomes. Our target is not cerebral vasospasm but improving neurological outcomes...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29760013/severity-of-cerebral-vasospasm-associated-with-development-of-collaterals-following-aneurysmal-subarachnoid-hemorrhage
#16
Fawaz Al-Mufti, Jens Witsch, Nathan Manning, Michael Crimmins, Krishna Amuluru, Sachin Agarwal, Soojin Park, Joshua Z Willey, Hooman Kamel, E Sander Connolly, Philip M Meyers, Jan Claassen
INTRODUCTION: Cerebral collateral circulation has been studied extensively in ischemic stroke where it has been shown to be a predictor of reperfusion, final infarct size, and outcome. Little is known about the significance of the collaterals in the setting of aneurysmal subarachnoid hemorrhage (aSAH). We sought to evaluate the effect of cerebral vasospasm on the development of cerebral collaterals following aneurysmal subarachnoid hemorrhage and the effects of the latter on delayed cerebral ischemia (DCI)...
May 14, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29753899/co-adjuvant-treatment-of-vasospasm-in-ruptured-unsecured-cerebral-aneurysms-with-aggressive-angioplasty-intra-arterial-nimodipine-and-aneurysm-embolization
#17
Ching-Chang Chen, Alvin Yi-Chou Wang, Chun-Ting Chen, Po-Chuan Hsieh
BACKGROUND: Vasospasm is a major cause of morbidity and mortality in patients following aneurysmal subarachnoid hemorrhage (SAH). Although early treatment of ruptured aneurysms is advocated, delayed intervention complicates the treatment strategy and leading to significant vasospasm and a poor prognosis. We report our experience of endovascular protocol for occlusion of the unsecured aneurysm and angioplasty for vasospasm in a single session. METHODS: A total of 24 cases with significant vasospasm and unsecured ruptured cerebral aneurysm were reviewed among 660 aneurysmal SAH patients between January 2011 and May 2017...
May 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29749915/continuous-infusion-of-low-dose-unfractionated-heparin-after-aneurysmal-subarachnoid-hemorrhage-a-preliminary-study-of-cognitive-outcomes
#18
Robert F James, Nicolas K Khattar, Zaid S Aljuboori, Paul S Page, Elaine Y Shao, Lacey M Carter, Kimberly S Meyer, Michael W Daniels, John Craycroft, John R Gaughen, M Imran Chaudry, Shesh N Rai, D Erik Everhart, J Marc Simard
OBJECTIVE Cognitive dysfunction occurs in up to 70% of aneurysmal subarachnoid hemorrhage (aSAH) survivors. Low-dose intravenous heparin (LDIVH) infusion using the Maryland protocol was recently shown to reduce clinical vasospasm and vasospasm-related infarction. In this study, the Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive changes in aSAH patients treated with the Maryland LDIVH protocol compared with controls. METHODS A retrospective analysis of all patients treated for aSAH between July 2009 and April 2014 was conducted...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29735721/relation-of-rhoa-in-peripheral-blood-mononuclear-cells-with-severity-of-aneurysmal-subarachnoid-hemorrhage-and-vasospasm
#19
María Del Carmen González-Montelongo, Juan José Egea-Guerrero, Francisco Murillo-Cabezas, Rafaela González-Montelongo, Zaida Ruiz de Azúa-López, Ana Rodríguez-Rodríguez, Angel Vilches-Arenas, Antonio Castellano, Juan Ureña
BACKGROUND AND PURPOSE: Rho-kinase, an effector of RhoA, is associated with various cardiovascular diseases in circulating blood cells. However, the role of RhoA/Rho-kinase in peripheral blood mononuclear cells from patients with spontaneous aneurysmal subarachnoid hemorrhage (aSAH) has not yet been studied in relation to the severity of this disease. Therefore, we analyzed the expression and activity of RhoA as a possible biomarker in aSAH. METHODS: Twenty-four patients with aSAH and 15 healthy subjects were examined...
June 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29733918/complication-rate-of-intraarterial-treatment-of-severe-cerebral-vasospasm-after-subarachnoid-hemorrhage-with-nimodipine-and-percutaneous-transluminal-balloon-angioplasty-worth-the-risk
#20
Daniela Adami, Joachim Berkefeld, Johannes Platz, Jürgen Konczalla, Waltraud Pfeilschifter, Stefan Weidauer, Marlies Wagner
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a complication of aneurysmal subarachnoid hemorrhage (SAH). Arterial cerebral vasospasm (CVS) is discussed as the main pathomechanism for DCI. Due to positive effects of per os nimodipine, intraarterial nimodipine application is used in patients with DCI. Further, percutaneous transluminal balloon angioplasty (PTA) is applied in focal high-grade spasm of intracranial arteries. However, clinical benefits of those techniques are unconfirmed in randomized trials so far, and complications might occur...
May 4, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
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