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https://www.readbyqxmd.com/read/28195428/blood-brain-barrier-breakdown-in-reversible-cerebral-vasoconstriction-syndrome-implications-for-pathophysiology-and-diagnosis
#1
Mi Ji Lee, Jihoon Cha, Hyun Ah Choi, Sook-Young Woo, Seonwoo Kim, Shuu-Jiun Wang, Chin-Sang Chung
OBJECTIVE: Diagnosis of reversible cerebral vasoconstriction syndrome (RCVS) is currently based on luminographic findings of vasoconstriction. In addition to vasoconstriction, the blood-brain barrier (BBB) breakdown has been postulated as a central mechanism of RCVS. Our aim was to document BBB breakdown in patients with RCVS and its role for the pathophysiology-based diagnosis of RCVS. METHODS: We prospectively recruited 72 consecutive patients with thunderclap headache who did not have aneurysmal subarachnoid hemorrhage from April 2015 to July 2016 at the Samsung Medical Center...
February 13, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28192263/cholesterol-reducing-agents-for-treatment-of-aneurysmal-subarachnoid-haemorrhage-systematic-review-and-meta-analyses-of-randomized-controlled-trials
#2
REVIEW
T Akhigbe, A Zolnourian, D Bulters
BACKGROUND: Aneurysmal haemorrhage induced cerebral vasospasm; DIND, poor neurological outcome and mortality are major causes of mortality and morbidity. The effects of cholesterol lowering agents in these patients remain controversial. This up to date systematic review and meta-analyses aimed to evaluate the efficacy of statin use in patients with aneurysmal subarachnoid haemorrhage METHODS: Systematic review of literature conducted using electronic database searched up to September 2016 included Cochrane Central Register of Controlled trials in the Cochrane library, Medline, Embase and Science Citation Index Expanded database to identify relevant studies...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28190553/cervical-spine-imaging-for-young-children-with-inflicted-trauma-expanding-the-injury-pattern
#3
Joanne Baerg, Arul Thirumoorthi, Rosemary Vannix, Asma Taha, Amy Young, Alexander Zouros
AIM: The purpose of this study was to document the incidence and pattern of cervical spine (c-spine) injuries in children below 36months with inflicted trauma. METHODS: An IRB approved, prospective cohort study was performed between July 2011 and January 2016. Inclusion criteria were: age below 36months, loss of consciousness after inflicted trauma, and one initial head computed tomography finding: a subdural, intraventricular, intraparenchymal, subarachnoid hemorrhage, diffuse axonal injury, hypoxic injury, or cerebral edema...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28154972/convexity-subarachnoid-haemorrhage-has-a-high-risk-of-intracerebral-haemorrhage-in-suspected-cerebral-amyloid-angiopathy
#4
D Wilson, I C Hostettler, G Ambler, G Banerjee, H R Jäger, D J Werring
The risk of future symptomatic intracerebral haemorrhage (sICH) remains uncertain in patients with acute convexity subarachnoid haemorrhage (cSAH) associated with suspected cerebral amyloid angiopathy (CAA). We assessed the risk of future sICH in patients presenting to our comprehensive stroke service with acute non-traumatic cSAH due to suspected CAA, between 2011 and 2016. We conducted a systematic search and pooled analysis including our cohort and other published studies including similar cohorts. Our hospital cohort included 20 patients (mean age 69 years; 60% male); 12 (60%) had probable CAA, and 6 (30%) had possible CAA according to the modified Boston criteria; two did not meet CAA criteria because of age <55 years, but were judged likely to be due to CAA...
February 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28126980/-a-case-of-cervical-internal-carotid-artery-occlusion-presenting-with-subarachnoid-hemorrhage-caused-by-rupture-of-leptomeningeal-anastomosis
#5
Tsuyoshi Tsukada, Toru Masuoka, Hideo Hamada, Shoutarou Itou, Takuya Akai, Hideaki Iizuka
A 71-year-old man was admitted to our hospital with a diagnosis of subarachnoid hemorrhage (SAH). Angiographies revealed neither aneurysms nor vascular anomalies. However, these images elucidated the occlusion of the left cervical internal carotid artery as well as developed leptomeningeal anastomoses through the ipsilateral posterior cerebral artery, which resulted in blood perfusing the ipsilateral middle and anterior cerebral artery territories. Because the localization of SAH coincided with the developed leptomeningeal anastomosis, we speculated that the rupture of the developed leptomeningeal anastomosis in the basal cistern was the cause of SAH...
January 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28097330/electroencephalographic-periodic-discharges-and-frequency-dependent-brain-tissue-hypoxia-in-acute-brain-injury
#6
Jens Witsch, Hans-Peter Frey, J Michael Schmidt, Angela Velazquez, Cristina M Falo, Michael Reznik, David Roh, Sachin Agarwal, Soojin Park, E Sander Connolly, Jan Claassen
Importance: Periodic discharges (PDs) that do not meet seizure criteria, also termed the ictal interictal continuum, are pervasive on electroencephalographic (EEG) recordings after acute brain injury. However, their association with brain homeostasis and the need for clinical intervention remain unknown. Objective: To determine whether distinct PD patterns can be identified that, similar to electrographic seizures, cause brain tissue hypoxia, a measure of ongoing brain injury...
January 9, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28062803/posterior-circulation-perforator-aneurysms-a-proposed-management-algorithm
#7
Thomas J Buell, Dale Ding, Daniel M S Raper, Ching-Jen Chen, Harry R Hixson, R Webster Crowley, Avery J Evans, Mary E Jensen, Kenneth C Liu
INTRODUCTION: Subarachnoid hemorrhage (SAH) from posterior circulation perforator aneurysms (PCPAs) is rare and its natural history is unknown. Diagnosis may be difficult, acute management is poorly defined, and long-term recurrent SAH rates and clinical outcome data are lacking. METHODS: We searched our institution's records for cases of PCPA rupture and analyzed patient demographics, Hunt and Hess (HH) grades, diagnostic imaging, management, and clinical outcomes...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28004163/treatment-of-cerebral-vasospasm-following-aneurysmal-subarachnoid-haemorrhage-a-systematic-review-and-meta-analysis
#8
Grégoire Boulouis, Marc Antoine Labeyrie, Jean Raymond, Christine Rodriguez-Régent, Anne Claire Lukaszewicz, Damien Bresson, Wagih Ben Hassen, Denis Trystram, Jean Francois Meder, Catherine Oppenheim, Olivier Naggara
OBJECTIVES: To examine the clinical outcome of aneurysmal subarachnoid haemorrhage (aSAH) patients exposed to cerebral vasospasm (CVS)-targeted treatments in a meta-analysis and to evaluate the efficacy of intra-arterial (IA) approaches in patients with severe/refractory vasospasm. METHODS: Randomised controlled trials, prospective and retrospective observational studies reporting clinical outcomes of aSAH patients exposed to CVS targeted treatments, published between 2006-2016 were searched using PubMed, EMBASE and the Cochrane Library...
December 21, 2016: European Radiology
https://www.readbyqxmd.com/read/27998455/-optic-nerve-subarachnoid-space-expansion-in-mr-imaging-a-etiology-study
#9
M Li, Q G Xu, J Q Wang, Y R Wang, J Zhao, S H Wei
Objective: To investigate spectrum of causes in optic nerve subarachnoid space (ONSS) expansion by using Magnetic Resonance Imaging (MRI). Methods: A retrospective study. Twenty-six patients (46 eyes) with ONSS expansion and 20 healthy adults (40 eyes) were recruited in Neuro-ophthalmology Department of Chinese PLA General Hospital from January, 2014 to December, 2015. The diameters were measured on the optic nerve (OND) and optic nerve sheath (ONSD) 2.4 mm behind the globe. ONSS was calculated by the formula of (ONSD-OND)/2...
December 11, 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/27979421/a-comparison-between-evacuation-from-the-scene-and-interhospital-transportation-using-a-helicopter-for-subarachnoid-hemorrhage
#10
Kouhei Ishikawa, Kazuhiko Omori, Ikuto Takeuchi, Kei Jitsuiki, Toshihiko Yoshizawa, Hiromichi Ohsaka, Yasuaki Nakao, Takuji Yamamoto, Youichi Yanagawa
PURPOSE: We investigated the changes in the vital signs and the final outcomes subarachnoid hemorrhage (SAH) patients who were evacuated from the scene using the doctor-helicopter (Dr. Heli) service and those who only underwent interhospital transportation using the doctor-helicopter Dr. Heli service to investigate safety of this system METHODS: We retrospectively investigated all of the patients with non-traumatic SAH who were transported by a Dr. Heli between January 2010 and March 2016...
December 10, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27922256/statins-in-critical-care-to-give-or-not-to-give
#11
Amr S Omar, Samy Hanoura, Haifa M Aljanubi, Ahmed Mahfouz
Owing to statin's immune modulatory, anti-inflammatory, antioxidant, antithrombotic and endothelial function actions, they are widely used in the critical care settings in diverse disease scenarios. We aim to explore the evidence to globalize the utilization of statins in the intensive care practice for different indications. We carried out a search of the PubMed, Cochrane and EMBASE databases up to January 2016. We included review articles, meta-analyses, and original trials on the effects of statin therapy in the intensive care unit (ICU) combining the following MESH terms: 'satins', 'intensive care, 'cardiac surgery', 'sepsis', 'acute respiratory distress syndrome' 'pneumonia', subarachnoid hemorrhage', traumatic brain injury and 'critical illness'...
December 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27916758/-hydrocephalus-mimicking-idiopathic-normal-pressure-hydrocephalus-as-the-first-manifestation-of-neurosarcoidosis
#12
Atsuhiko Sugiyama, Makoto Kobayashi, Kumiko Agatsuma, Takeshi Bo, Toshiaki Shiojiri, Hidetoshi Mochida, Yoshio Suzuki, Takashi Matsunaga, Satoshi Kuwabara
A 61-year-old woman presented with a 10-month history of gait disturbance and a 7-month history of urinary incontinence. The Hasegawa dementia scale-revised score indicated cognitive impairment. Brain magnetic resonance imaging (MRI) indicated hydrocephalus with disproportionately enlarged subarachnoid space. This is usually considered a characteristic finding in idiopathic normal pressure hydrocephalus (iNPH). Ventriculo-peritoneal shunting improved the patient's symptoms. Neurosarcoidosis was suspected as a cause of the hydrocephalus because of the abnormalities in the cerebrospinal fluid and the abnormal enhancement of the cauda equina, the leptomeninges of the brainstem, and the spinal cord, as seen on MRI with gadolinium enhancement...
December 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/27896904/contrast-induced-encephalopathy-following-cardiac-catheterization
#13
Roberto Spina, Neil Simon, Romesh Markus, David Wm Muller, Krishna Kathir
OBJECTIVES: To describe the epidemiology, pathophysiology, clinical presentation, and management of contrast-induced encephalopathy (CIE) following cardiac catheterization. BACKGROUND: CIE is an acute, reversible neurological disturbance directly attributable to the intra-arterial administration of iodinated contrast medium. METHODS: The PubMed database was searched and all cases in the literature were retrieved and reviewed. RESULTS: 52 reports of CIE following cardiac catheterization were found...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27890758/surgical-outcome-of-patients-with-very-small-intracranial-aneurysms-a-single-center-experience-from-southern-iran
#14
Abdolkarim Rahmanian, Fariborz Ghaffarpasand, Nima Derakhshan
OBJECTIVES: To report the surgical outcome of very small intracranial aneurysms (VSIAs; ≤3mm) in a large referral neurovascular center in Southern Iran. METHODS: This cross-sectional study was conducted in Southern Iran during a6-year period between 2010 and 2016. We included all the patients with VSIAs (≤3mm) who underwent surgery in our center. All the patients were operated by a single neurosurgeon. Pre- and postoperative CT angiography, intraoperative imaging with indo-cyanine green video angiography was performed in all the cases...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27890750/the-use-of-social-media-communications-in-brain-aneurysms-and-subarachnoid-hemorrhage-a-mixed-method-analysis
#15
Naif M Alotaibi, Nardin Samuel, Justin Wang, Christopher S Ahuja, Daipayan Guha, George M Ibrahim, Tom A Schweizer, Gustavo Saposnik, R Loch Macdonald
BACKGROUND: The diagnosis of a ruptured or unruptured brain aneurysm has a significant impact on patients' quality of life and their psychosocial wellbeing. As a result, patients and caregivers may resort to social media platforms for support and education. The aim of this report is to evaluate the current use of social media and the online communications regarding brain aneurysms. METHODS: Three social media platforms (Facebook, Twitter and YouTube) were assessed for public content pertaining to brain aneurysms in March 2016...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27881167/differing-association-of-alcohol-consumption-with-different-stroke-types-a-systematic-review-and-meta-analysis
#16
Susanna C Larsson, Alice Wallin, Alicja Wolk, Hugh S Markus
BACKGROUND: Whether light-to-moderate alcohol consumption is protective against stroke, and whether any association differs by stroke type, is controversial. We conducted a meta-analysis to summarize the evidence from prospective studies on alcohol drinking and stroke types. METHODS: Studies were identified by searching PubMed to September 1, 2016, and reference lists of retrieved articles. Additional data from 73,587 Swedish adults in two prospective studies were included...
November 24, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27881133/alcohol-and-stroke-the-splitters-win-again
#17
EDITORIAL
Arthur L Klatsky, H Nicole Tran
Study of the relationships of alcohol drinking and risk of stroke can readily become mired in the labyrinthine interactions of drinking categorizations, non-linear associations, disparate cardiovascular conditions, and the heterogeneous types of stroke. This Commentary discusses the recent article by Larsson et al. (BMC Medicine 14:178, 2016). The authors split their material into separate meta-analyses of subarachnoid hemorrhage, intracerebral hemorrhage, and ischemic stroke, finding disparate alcohol-stroke relationships...
November 24, 2016: BMC Medicine
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
#18
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/27831835/imaging-of-neurologic-conditions-in-pregnant-patients
#19
Sangam Kanekar, Shante Bennett
A number of physiologic, hormonal, immunologic, and hemodynamic changes take place in the maternal body during pregnancy. The majority of these changes are essential for maintaining the normal course of pregnancy. However, these changes may also cause acute or chronic conditions that affect various biologic systems in the mother. In addition, conditions of the central and peripheral nervous systems can cause a variety of neurologic symptoms and complications. Neurologic signs and symptoms in pregnant and postpartum women may be due to the exacerbation of a preexisting medical condition, the initial manifestation of a primary central nervous system-related problem, or a neurologic problem unique to pregnancy and the postpartum period...
November 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27793767/ruptured-distal-posterior-inferior-cerebellar-artery-pica-aneurysms-associated-with-cerebellar-arterial-venous-malformations-avms-a-case-series-and-review-of-the-literature-demonstrating-the-need-for-angiographic-evaluation-and-feasibility-of-endovascular-treatment
#20
David Case, David Kumpe, Luis Cava, Robert Neumann, Andrew White, Christopher Roark, Joshua Seinfeld
OBJECTIVE: The characteristics, diagnosis, and preferred management strategies for distal posterior inferior cerebellar artery (PICA) aneurysms associated with cerebellar arteriovenous malformation (AVMs) are poorly understood. We present a case series with attention to aneurysm angioarchitecture, diagnostic imaging, treatment approaches, and a thorough review of the literature. With this information, we demonstrate a specific anatomical pattern for these aneurysms, an underreported need for conventional digital subtraction angiography (DSA) during evaluation, along with the utility of endovascular treatment with liquid embolic agents...
January 2017: World Neurosurgery
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