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subarachnoid hemorrhage and vasospasm

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https://www.readbyqxmd.com/read/29243981/assessment-of-intracranial-venous-blood-flow-after-subarachnoid-hemorrhage-a-new-approach-to-diagnose-vasospasm-with-transcranial-color-coded-duplex-sonography
#1
Florian Connolly, Stephan J Schreiber, Christoph Leithner, Georg Bohner, Peter Vajkoczy, José M Valdueza
OBJECTIVE Transcranial color-coded duplex sonography (TCCS) is a reliable tool that is used to assess vasospasm in the M1 segment of the middle cerebral artery (MCA) after subarachnoid hemorrhage (SAH). A distinct increase in blood flow velocity (BFV) is the principal criterion for vasospasm. The MCA/internal carotid artery (ICA) index (Lindegaard Index) is also widely used to distinguish between vasospasm and cerebral hyperperfusion. However, extracranial ultrasonography assessment of the neck vessels might be difficult in an intensive care unit...
December 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29241271/how-reliable-is-pupillary-evaluation-following-subarachnoid-hemorrhage-effect-of-oculomotor-nerve-degeneration-secondary-to-posterior-communicating-artery-vasospasm-first-experimental-study
#2
Cengiz Ozturk, Nuriye Guzin Ozdemir, Ayhan Kanat, Mehmet Dumlu Aydin, Huseyin Findik, Nazan Aydin, Mehmet Esref Kabalar, Hizir Kazdal, Coskun Yolas, Orhan Baykal, Muhammet Calik
No abstract text is available yet for this article.
December 14, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29204979/treatment-of-spontaneous-subarachnoid-hemorrhage-and-self-reported-neuropsychological-performance-at-6-months-results-of-a-prospective-clinical-pilot-study-on-good-grade-patients
#3
Elisabeth Bründl, Petra Schödel, Sylvia Bele, Martin Proescholdt, Judith Scheitzach, Florian Zeman, Alexander Brawanski, Karl-Michael Schebesch
AIM: Limited focus has been placed on neuropsychological patient profiles after spontaneous subarachnoid hemorrhage (sSAH). We conducted a prospective controlled study in good-grade sSAH patients to evaluate the time course of treatment-specific differences in cognitive processing after sSAH. MATERIAL AND METHODS: 26 consecutive sSAH patients were enrolled (drop out n=5). 9 patients received endovascular aneurysm occlusion (EV), 6 patients were treated microsurgically (MS), and 6 patients with perimesencephalic SAH (pSAH) underwent standardized intensive medical care...
November 1, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29204037/staged-multimodality-treatment-of-a-large-ruptured-fusiform-supraclinoid-internal-carotid-artery-aneurysm-microsurgical-clip-assisted-endovascular-coiling
#4
Dale Ding, Thomas J Buell, Ching-Jen Chen, Daniel M Raper, Kenneth C Liu, Dennis G Vollmer
In the contemporary era of aneurysm management, large fusiform aneurysms presenting with subarachnoid hemorrhage (SAH) remain particularly challenging lesions to successfully manage. We describe a staged, multimodal treatment strategy for a 71-year-old patient who presented with a large ruptured fusiform aneurysm of the supraclinoid internal carotid artery (ICA) and a fetal posterior communicating artery which originated from the inferomedial aspect of the aneurysm. In the first stage, we performed a partial microsurgical clip reconstruction of the fusiform aneurysm and secured its rupture site, which was identified intraoperatively...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29201854/traumatic-intracerebral-and-subarachnoid-hemorrhage-due-to-a-ruptured-pseudoaneurysm-of-middle-meningeal-artery-accompanied-by-a-medial-sphenoid-wing-dural-arteriovenous-fistula
#5
Jae Won Park, Jong Young Lee
Traumatic pseudoaneurysms of middle meningeal artery (MMA) and medial sphenoid wing dural arteriovenous fistula (dAVF) are rare. These lesions usually result from traumatic brain injury, and associated with skull fracture. In this paper, the authors report a case of a patient with a ruptured traumatic pseudoaneurysm of MMA and medial sphenoid wing dAVF presented with an intracerebral hemorrhage in the left temporal region and subarachnoid hemorrhage. These lesions were completely obliterated by endovascular treatment, and the patient was recovered without any neurologic deficit...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29194369/elevated-systemic-il-6-levels-in-patients-with-aneurysmal-subarachnoid-hemorrhage-is-an-unspecific-marker-for-post-sah-complications
#6
Shafqat Rasul Chaudhry, Birgit Stoffel-Wagner, Thomas Mehari Kinfe, Erdem Güresir, Hartmut Vatter, Dirk Dietrich, Alf Lamprecht, Sajjad Muhammad
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is still a fatal and morbid disease, although bleeding aneurysms can be secured in almost all cases. Occurrence of post-SAH complications including cerebral vasospasm, delayed cerebral ischemia, hydrocephalus, epilepsy, and infections are the main determinants of clinical outcome. Hence, it is important to search for early predictors for specific post-SAH complications to treat these complications properly. Both cellular and molecular (cytokines) inflammation play a key role after aSAH during the phase of occurrence of post-SAH complications...
December 1, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29172058/rapid-and-simplified-synthesis-of-18-f-fluoromisonidazole-and-its-use-in-pet-imaging-in-an-experimental-model-of-subarachnoid-hemorrhage
#7
Laura Fernandez-Maza, Juan Jose Egea-Guerrero, Marcin Balcerzyk, Gemma Civantos-Jubera, Elena Gordillo-Escobar, Angel Vilches-Arenas, Isabel Fernandez-Gomez, Angel Parrado-Gallego, Francisco Murillo-Cabezas
Cerebral damage secondary to the vasospasm due to subarachnoid hemorrhage (SAH) is an important cause of morbid-mortality. We propose the use of the PET tracer [(18)F]Fluoromisonidazole to visualize the hypoxia due to the vasospasm. On the other hand [(18)F]Fluoromisonidazole synthesis process was optimized, avoiding HPLC purification using SPE cartridges instead, and reducing some synthesis steps. [(18)F]Fluoromisonidazole in vitro stability was tested for ten hours, and in vivo PET/CT images showed higher cerebral uptake in hemorrhagic animals than in control rats...
October 3, 2017: Applied Radiation and Isotopes
https://www.readbyqxmd.com/read/29171362/complications-of-endovascular-treatment-for-acute-ischemic-stroke-prevention-and-management
#8
Joyce S Balami, Philip M White, Peter J McMeekin, Gary A Ford, Alastair M Buchan
Endovascular mechanical thrombectomy (MT) for the treatment of acute stroke due to large vessel occlusion has evolved significantly with the publication of multiple positive thrombectomy trials. MT is now a recommended treatment for acute ischemic stroke. Mechanical thrombectomy is associated with a number of intra-procedural or post-operative complications, which need to be minimized and effectively managed to maximize the benefits of thrombectomy. Procedural complications include: access-site problems (vessel/nerve injury, access-site hematoma and groin infection); device-related complications (vasospasm, arterial perforation and dissection, device detachment/misplacement); symptomatic intracerebral hemorrhage; subarachnoid hemorrhage; embolization to new or target vessel territory...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29169788/stellate-ganglion-block-as-rescue-therapy-in-refractory-vasospasm-after-subarachnoid-hemorrhage
#9
J Sánchez Arguiano, M A Hernández-Hernández, R A Jáuregui Solórzano, S Maldonado-Vega, A González Mandly, J Burón Mediavilla
No abstract text is available yet for this article.
November 20, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29159148/endovascular-treatment-of-symptomatic-vasospasm-after-aneurysmal-subarachnoid-hemorrhage-a-three-year-experience
#10
Eun-Sung Park, Dae-Won Kim, Sung-Don Kang
Objective: The cause of severe clinical vasospasm after aneurysmal subarachnoid hemorrhage remains unknown, despite extensive research over the past 30 years. However, the intra-arterial administration of vasodilating agents and balloon angioplasty have been successfully used in severe refractory cerebral vasospasm. Materials and Methods: We retrospectively analyzed the data of 233 patients admitted to our institute with aneurysmal subarachnoid hemorrhage (SAH) over the past 3 years...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29157018/progressive-dna-and-rna-damage-from-oxidation-after-aneurysmal-subarachnoid-hemorrhage-in-humans
#11
A Jorgensen, J M Staalsoe, A H Simonsen, S G Hasselbalch, P Høgh, A Weimann, Poulsen He, N V Olsen
Free radical toxicity is considered a key mechanism in the neuronal damage occurring after aneurysmal subarachnoid hemorrhage (SAH). We measured markers of DNA and RNA damage from oxidation in cerebrospinal fluid from 45 patients with SAH on day 1-14 after ictus and 45 age-matched healthy control subjects. At baseline, both markers were significantly increased in patients compared to controls (p-values < 0.001), and exhibited a progressive further increase (to > 20-fold above control levels) from day 5-14...
November 20, 2017: Free Radical Research
https://www.readbyqxmd.com/read/29154725/non-aneurysmal-subarachnoid-hemorrhage-when-is-a-second-angiography-indicated
#12
Asma Bashir, Ronni Mikkelsen, Leif Sørensen, Niels Sunde
Purpose Repeat imaging in patients with non-aneurysmal subarachnoid hemorrhage (NASAH) remains controversial. We aim to report our experience with NASAH with different hemorrhage patterns, and to investigate the need for further diagnostic workup to determine the underlying cause of hemorrhage. Method We conducted a retrospective analysis of all spontaneous SAH with an initial negative computed tomography (CT) with angiography (CTA) and/or digital subtraction angiography (DSA) from October 2011 through May 2017...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/29152941/the-histopathological-and-stereological-assessment-of-the-effect-of-topically-administered-leptin-on-cerebral-vasospasm-in-an-experimental-subarachnoid-hemorrhage-model
#13
Cem Demirel, Cengiz Çokluk, Abdurrahman Aksoy, Kerameddin Aydın, Mehmet Emin Önger, Enis Kuruoğlu, Abdullah Hilmi Marangoz, Ömür Gülsüm Deniz, Süleyman Kaplan
Background/aim: Cerebral vasospasm is a term that refers to prolonged, slowly progressing but reversible pathological narrowing of cerebral arteries occurring several days after subarachnoid hemorrhage (SAH), usually accompanied by a decrease in perfusion distal to the affected artery. Leptin is an endogenous polypeptide hormone that can be carried freely and bound to protein in the blood. Materials and methods: We investigated the superiority of topical application of leptin that may make a contribution to the development of new treatment modalities for unconscious patients in brain injury intensive care units and its preventive effect, which is considered to have multifactorial pathogenesis on cerebral vasospasm occurring after SAH via stereological studies of the basilar artery...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29148905/serum-glucose-potassium-ratio-as-a-clinical-risk-factor-for-aneurysmal-subarachnoid-hemorrhage
#14
Yu Fujiki, Fumihiro Matano, Takayuki Mizunari, Yasuo Murai, Kojiro Tateyama, Kenta Koketsu, Asami Kubota, Shiro Kobayashi, Hiroyuki Yokota, Akio Morita
OBJECTIVE Aneurysmal subarachnoid hemorrhage (SAH) can result in poor outcomes, and biomarkers for predicting poor prognosis have not yet been established. The aim of this study was to clarify the significance of the serum glucose/potassium ratio for predicting the prognosis of aneurysmal SAH. METHODS The authors retrospectively reviewed the records of 565 patients with aneurysmal SAH between 2006 and 2016. The patient group comprised 208 men and 357 women (mean age 61.5 years, range 10-95 years). A statistical analysis was conducted of the clinical and laboratory risk factors of poor outcome, including the serum glucose/potassium ratio...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29136224/reliable-identification-of-benign-clinical-course-in-aneurysmal-subarachnoid-hemorrhage-a-simple-and-qualitative-algorithm
#15
Yifei Duan, James Wright, Christina Wright, Berje Shammassian, Curtis Tatsuoka, Nicholas Bambakidis
BACKGROUND: A reliable method to specifically identify low vasospasm risk in aneurysmal subarachnoid hemorrhage (aSAH) patients has not been previously proposed. OBJECTIVE: To develop a clinical algorithm using admission aSAH clinical severity and subarachnoid blood distribution to identify patients at low risk of clinical vasospasm. METHODS: Clinical severities, admission noncontrasted head computerized tomography (CT) scan, and incidences of vasospasm among 291 aSAH patients treated at our institution were evaluated...
November 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29118801/trends-in-endovascular-treatment-of-aneurysmal-subarachnoid-hemorrhages
#16
Tapan Mehta, Neil Datta, Smit Patel, Kathan Mehta, Mohammed Hussain, Inaam Kureshi, Martin Ollenschleger, Amre Nouh
Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) accounts for 5% of all strokes; 30-day mortality is as high as 40%. We sought to evaluate outcomes of aSAH patients treated 2004-2014 by endovascular therapy (EVT), to demonstrate associated trends, and to evaluate angioplasty use for aSAH-related cerebral vasospasm. Methods: The Nationwide Inpatient Sample (NIS) database 2004-2014 was used to derive a study cohort using ICD-9 codes. Survey procedures were used to adjust for stratified cluster design of NIS...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118800/septoplasty-scepter-balloon-angioplasty-for-vasospasm-after-aneurysmal-subarachnoid-hemorrhage
#17
Bradley A Gross, Daniel A Tonetti, Gregory M Weiner, David M Panczykowski, William J Ares, Cynthia L Kenmuir, Ashutosh P Jadhav, Tudor G Jovin, Brian T Jankowitz
Introduction: Balloon angioplasty can be a requisite approach for the treatment of symptomatic and/or severe vasospasm. Dual-lumen microcatheter balloons have multiple potential advantages for this indication including accommodating a 0.014-inch wire and the potential to deliver superselective vasodilators directly via the microcatheter prior to angioplasty. Methods: The authors reviewed a 3-year institutional experience with the Scepter XC balloon (Microvention, Tustin, CA, USA) in the treatment of postaneurysmal subarachnoid hemorrhage vasospasm, focusing on treatment methods, angiographic, and clinical results...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118793/feasibility-of-real-time-angiographic-perfusion-imaging-in-the-treatment-of-cerebral-vasospasm
#18
Christopher Donaldson, Anthea H O'Neill, Lee-Anne Slater, Winston Chong, Leon T Lai, Ronil V Chandra
Background: Objective assessment and quantification of the severity of cerebral vasospasm following aneurysmal subarachnoid hemorrhage is not routinely utilized. We investigated the feasibility of angiographic perfusion imaging derived from digital subtraction angiography (DSA) following endovascular vasospasm treatment procedures. Methodology: Real-time blood flow analysis was performed using parametric color coding on pre- and postintervention DSA. Semiquantitative parenchymal perfusion parameters (arrival time [AT] of contrast, time to peak [TTP] opacification, and mean transit time [MTT] of contrast) were calculated across 3 vascular territories (anterior cerebral artery [ACA], middle cerebral artery [MCA], and lenticulostriate arteries) using standard 2-D angiographic perfusion software...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29117032/a-preliminary-observational-study-of-anovulatory-uterine-bleeding-after-aneurysmal-subarachnoid-hemorrhage
#19
Suzanne M Brown, Susan W Fifield, Michael A Pizzi, David Alejos, Alexa N Richie, Tri A Dinh, William P Cheshire, Shon E Meek, William D Freeman
INTRODUCTION: It was observed that women with aneurysmal subarachnoid hemorrhage (aSAH) tended to have earlier menses than a typical 21- to 28-day cycle. The goal was to determine whether there is an association between aSAH and early onset of menses. METHODS: All cases of aSAH in women aged 18 to 55 years who were admitted to our facility's neuroscience intensive care unit from June 1, 2011, to June 30, 2012, were reviewed. The electronic healthcare record for each of these patients was examined for documentation of menses onset, computed tomography of the head, brain aneurysm characteristics, modified Fisher score and Glasgow Coma Scale on admission, presence/absence of vasospasm, medical/surgical history, and use of medications that affect the menstrual cycle...
December 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29109695/the-role-of-thromboinflammation-in-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#20
REVIEW
Devin W McBride, Spiros L Blackburn, Kumar T Peeyush, Kanako Matsumura, John H Zhang
Delayed cerebral ischemia (DCI) is a major determinant of patient outcome following aneurysmal subarachnoid hemorrhage. Although the exact mechanisms leading to DCI are not fully known, inflammation, cerebral vasospasm, and microthrombi may all function together to mediate the onset of DCI. Indeed, inflammation is tightly linked with activation of coagulation and microthrombi formation. Thromboinflammation is the intersection at which inflammation and thrombosis regulate one another in a feedforward manner, potentiating the formation of thrombi and pro-inflammatory signaling...
2017: Frontiers in Neurology
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