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Delayed cerebral ischemia

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https://www.readbyqxmd.com/read/29235296/-effect-of-astragaloside-%C3%A2-combined-with-panax-notoginseng-saponins-on-cerebral-ischemia-reperfusion-injury-and-study-of-pharmacokinetics-in-rats
#1
Jing-Xian Li, Xiao-Qian Yang, Biao Tang, Xiao-Dan Liu, Ying-Hong Tang, Chang-Qing Deng, Xiao-Ping Huang
The aim is to study the effect of astragaloside Ⅳ (AST Ⅳ) combined with Panax notoginseng saponins (PNS) on cerebral ischemia-reperfusion injury, and to probe the synergistic mechanism through the pharmacokinetics of the four major components such as AST Ⅳ, ginsenoside Rg₁ (Rg₁), ginsenoside Rb₁ (Rb₁), notoginsenoside R₁ (R₁) in cerebral ischemia-reperfusion rats. Following the establishment of cerebral ischemia/reperfusion model in rats by modified suture method, neurological function score, cerebral infarction area and pathomorphology were used to evaluate the pharmacological effect that the combination of AST Ⅳ and PNS antagonized cerebral ischemia-reperfusion injury; the contents of AST Ⅳ, Rg₁, Rb₁, R₁ in rat plasma of different time points were determined with ultra performance liquid chromatography tandem massspectrometry (UPLC-MS/MS), pharmacokinetic parameters were calculated and pharmacokinetics changes of the main effective components were analyzed...
October 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29224114/coated-platelet-trends-predict-short-term-clinical-outcomeafter-subarachnoid-hemorrhage
#2
Bappaditya Ray, Vijay M Pandav, Eleanor A Mathews, David M Thompson, Lance Ford, Lori K Yearout, Bradley N Bohnstedt, Shuchi Chaudhary, George L Dale, Calin I Prodan
Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high socio-economic burden. Prothrombotic states of early brain injury (EBI) and delayed cerebral ischemia (DCI) after aSAH determine morbidity and mortality. To understand how activated platelets might contribute to such prothrombotic states, we studied trends in coated-platelets during EBI and DCI periods. Serial blood samples from a prospective cohort of aSAH patients were collected and assayed for coated-platelet levels. Patient's coated-platelet level during post-hospital discharge follow-up served as an estimate of baseline...
December 9, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29207618/neuroprotective-effect-of-a-novel-gastrodin-derivative-against-ischemic-brain-injury-involvement-of-peroxiredoxin-and-tlr4-signaling-inhibition
#3
Xiao-Na Mao, Hong-Jing Zhou, Xiao-Jia Yang, Li-Xue Zhao, Xi Kuang, Chu Chen, Dong-Ling Liu, Jun-Rong Du
The inhibition of extracellular inflammatory peroxiredoxin (Prx) signaling appears to be a potential therapeutic strategy for neuroinflammatory injury after acute ischemic stroke. Gastrodin (Gas) is a phenolic glycoside that is used for the treatment of cerebral ischemia, accompanied by regulation of the autoimmune inflammatory response. The present study investigated the neuroprotective effects of Gas and its derivative, Gas-D, with a focus on the potential mechanism associated with inflammatory Prx-Toll-like receptor 4 (TLR4) signaling...
October 31, 2017: Oncotarget
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
#4
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/29171362/complications-of-endovascular-treatment-for-acute-ischemic-stroke-prevention-and-management
#5
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/29163332/clinical-use-of-cerebral-microdialysis-in-patients-with-aneurysmal-subarachnoid-hemorrhage-state-of-the-art
#6
REVIEW
Raimund Helbok, Mario Kofler, Alois Josef Schiefecker, Maxime Gaasch, Verena Rass, Bettina Pfausler, Ronny Beer, Erich Schmutzhard
Objective: To review the published literature on the clinical application of cerebral microdialysis (CMD) in aneurysmal subarachnoid hemorrhage (SAH) patients and to summarize the evidence relating cerebral metabolism to pathophysiology, secondary brain injury, and outcome. Methods: Study selection: Two reviewers identified all manuscripts reporting on the clinical use of CMD in aneurysmal SAH patients from MEDLINE. All identified studies were grouped according to their focus on brain metabolic changes during the early and subacute phase after SAH, their association with mechanisms of secondary brain injury and outcome...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29158449/induced-hypertension-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage-a-randomized-clinical-trial
#7
Celine S Gathier, Walter M van den Bergh, Mathieu van der Jagt, Bon H Verweij, Jan Willem Dankbaar, Marcella C Müller, Annemarie W Oldenbeuving, Gabriel J E Rinkel, Arjen J C Slooter
BACKGROUND AND PURPOSE: Induced hypertension is widely used to treat delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage, but a literature review shows that its presumed effectiveness is based on uncontrolled case-series only. We here report clinical outcome of aneurysmal subarachnoid hemorrhage patients with DCI included in a randomized trial on the effectiveness of induced hypertension. METHODS: Aneurysmal subarachnoid hemorrhage patients with clinical symptoms of DCI were randomized to induced hypertension or no induced hypertension...
November 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29150648/shedding-light-on-the-neonatal-brain-probing-cerebral-hemodynamics-by-diffuse-optical-spectroscopic-methods
#8
Parisa Farzam, Erin M Buckley, Pei-Yi Lin, Katherine Hagan, P Ellen Grant, Terrie Eleanor Inder, Stefan A Carp, Maria Angela Franceschini
Investigating the cerebral physiology of healthy term newborns' brains is important for better understanding perinatal brain injuries, of which the most common etiologies are hypoxia and ischemia. Hence, cerebral blood flow and cerebral oxygenation are important biomarkers of brain health. In this study, we employed a hybrid diffuse optical system consisting of diffuse correlation spectroscopy (DCS) and frequency-domain near infrared spectroscopy (FDNIRS) to measure hemoglobin concentration, oxygen saturation, and indices of cerebral blood flow and metabolism...
November 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29119370/vasoconstriction-and-impairment-of-neurovascular-coupling-after-subarachnoid-hemorrhage-a-descriptive-analysis-of-retinal-changes
#9
Catharina Conzen, Walid Albanna, Miriam Weiss, David Kürten, Walthard Vilser, Konstantin Kotliar, Charlotte Zäske, Hans Clusmann, Gerrit Alexander Schubert
Impaired cerebral autoregulation and neurovascular coupling (NVC) contribute to delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Retinal vessel analysis (RVA) allows non-invasive assessment of vessel dimension and NVC hereby demonstrating a predictive value in the context of various neurovascular diseases. Using RVA as a translational approach, we aimed to assess the retinal vessels in patients with SAH. RVA was performed prospectively in 24 patients with acute SAH (group A: day 5-14), in 11 patients 3 months after ictus (group B: day 90 ± 35), and in 35 age-matched healthy controls (group C)...
November 8, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29118800/septoplasty-scepter-balloon-angioplasty-for-vasospasm-after-aneurysmal-subarachnoid-hemorrhage
#10
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/29115698/grading-scales-in-subarachnoid-hemorrhage-many-options-but-do-we-have-a-winner
#11
EDITORIAL
Venkatakrishna Rajajee
Grading the severity of Aneurysmal Subarachnoid Hemorrhage (aSAH) is essential, for several reasons- to provide a reliable prognosis, establish comparability across groups in research studies and quality assessments, follow the progress of an individual patient, and guide decisions on management. The Hunt-Hess and World Federation of Neurological Surgeons (WFNS) scales are clinical scales, with a focus on symptoms and signs thought to reflect the extent of primary brain injury and, therefore, functional outcome...
November 8, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29109695/the-role-of-thromboinflammation-in-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#12
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
https://www.readbyqxmd.com/read/29104730/haptoglobin-genotype-and-outcome-after-subarachnoid-haemorrhage-new-insights-from-a-meta-analysis
#13
Ben Gaastra, James Glazier, Diederik Bulters, Ian Galea
Haptoglobin (Hp) is a plasma protein involved in clearing extracellular haemoglobin and regulating inflammation; it exists as two genetic variants (Hp1 and Hp2). In a meta-analysis of six published studies, we confirm that Hp genotype affects short-term outcome (cerebral vasospasm and/or delayed cerebral ischemia) after subarachnoid haemorrhage (SAH) but not long-term outcome (Glasgow Outcome Score and modified Rankin Scale between one and three months). A closer examination of the heterozygous group revealed that the short-term outcome of Hp2-1 individuals clustered with that of Hp1-1 and not Hp2-2, suggesting that the presence of one Hp1 allele was sufficient to confer protection...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29101862/elevated-glycated-hemoglobin-level-and-hyperglycemia-after-aneurysmal-subarachnoid-hemorrhage
#14
Kerim Beseoglu, Hans-Jakob Steiger
OBJECTIVES: Elevated blood glucose is frequently detected early after aneurysmal subarachnoid hemorrhage (aSAH) and is considered a risk factor for poor neurological outcome. However it remains unclear whether hyperglycemia is caused by the SAH ictus or reflects a pre-existing hyperglycemic metabolism. In a prospective register we analysed glycated haemoglobin levels (HbA1c) in patients with aSAH and its influence on outcome. PATIENTS AND METHODS: Between July 2012 and July 2014, 87 patients with confirmed aSAH were included (NCT02081820)...
December 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29099296/dual-antiplatelet-therapy-in-aneurysmal-subarachnoid-hemorrhage-association-with-reduced-risk-of-clinical-vasospasm-and-delayed-cerebral-ischemia
#15
Yasunori Nagahama, Lauren Allan, Daichi Nakagawa, Mario Zanaty, Robert M Starke, Nohra Chalouhi, Pascal Jabbour, Robert D Brown, Colin P Derdeyn, Enrique C Leira, Joseph Broderick, Marc Chimowitz, James C Torner, David Hasan
OBJECTIVE Clinical vasospasm and delayed cerebral ischemia (DCI) are devastating complications of aneurysmal subarachnoid hemorrhage (aSAH). Several theories involving platelet activation have been postulated as potential explanations of the development of clinical vasospasm and DCI. However, the effects of dual antiplatelet therapy (DAPT; aspirin and clopidogrel) on clinical vasospasm and DCI have not been previously investigated. The objective of this study was to evaluate the effects of DAPT on clinical vasospasm and DCI in aSAH patients...
November 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29089437/transient-hypoxemia-chronically-disrupts-maturation-of-preterm-fetal-ovine-subplate-neuron-arborization-and-activity
#16
Evelyn McClendon, Daniel C Shaver, Kiera Degener-O'Brien, Xi Gong, Thuan Nguyen, Anna Hoerder-Suabedissen, Zoltán Molnár, Claudia Mohr, Ben D Richardson, David J Rossi, Stephen A Back
Preterm infants are at risk for a broad spectrum of neurobehavioral disabilities associated with diffuse disturbances in cortical growth and development. During brain development, subplate neurons (SPNs) are a largely transient population that serves a critical role to establish functional cortical circuits. By dynamically integrating into developing cortical circuits they assist in consolidation of intra and extracortical circuits. Although SPNs reside in close proximity to cerebral white matter, which is particularly vulnerable to oxidative stress, the susceptibility of SPNs remains controversial...
October 31, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29088959/traumatic-brain-injury-and-intracranial-hemorrhage-induced-cerebral-vasospasm-a-systematic-review
#17
Fawaz Al-Mufti, Krishna Amuluru, Abhinav Changa, Megan Lander, Neil Patel, Ethan Wajswol, Sarmad Al-Marsoummi, Basim Alzubaidi, I Paul Singh, Rolla Nuoman, Chirag Gandhi
OBJECTIVE Little is known regarding the natural history of posttraumatic vasospasm. The authors review the pathophysiology of posttraumatic vasospasm (PTV), its associated risk factors, the efficacy of the technologies used to detect PTV, and the management/treatment options available today. METHODS The authors performed a systematic review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the following databases: PubMed, Google Scholar, and CENTRAL (the Cochrane Central Register of Controlled Trials)...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29077161/expression-and-significance-of-vwf-gmp-140-and-adamts13-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#18
W-H Li, C-J Hui, H Ju
OBJECTIVE: The aim of this study was to investigate the role of the von Willebrand factor (vWF) in patients with aneurysmal subarachnoid hemorrhage (aSAH), platelet membrane glycoprotein-140 (GMP-140). The aim is also to discover the expression and clinical significance of von Willebrand factor (vWF) cleaving protease (ADAMTS13). PATIENTS AND METHODS: 83 patients with aSAH were selected from January 2014 to December 2016. The patients were divided into cerebral vasospasm group (CVS group) (n = 37) and no convulsion group (non-CVS group) (n = 46); delayed cerebral ischemia group (DCI group) (n = 31) and non-delayed cerebral ischemia group (non-DCI group) (n = 52)...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29066230/intraoperative-neurophysiologic-monitoring-ionm-changes-associated-with-a-case-of-delayed-thalamic-infarct-implications-for-postoperative-management
#19
Forough Ghavami, Omar Choudhri, Michael Marks, Jaime R López
Treatment of cerebral aneurysms poses a risk of cerebral hemorrhage and/or ischemia; these potential sequelae are usually associated with changes in intraoperative neurophysiologic monitoring (IONM) modalities. Our case demonstrates a patient with significant changes in IONM during the treatment of a right posterior cerebral artery aneurysm who did not develop neurologic deficits until three days postoperatively. IONM changes can represent a guide in postoperative patient management and may pose grounds for closer monitoring of patients with IONM changes that do not develop immediate postoperative deficits...
October 21, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29063300/delayed-cerebral-ischemia-after-subarachnoid-hemorrhage-beyond-vasospasm-and-towards-a-multifactorial-pathophysiology
#20
REVIEW
Joseph R Geraghty, Fernando D Testai
PURPOSE OF REVIEW: Delayed cerebral ischemia (DCI) is common after subarachnoid hemorrhage (SAH) and represents a significant cause of poor functional outcome. DCI was mainly thought to be caused by cerebral vasospasm; however, recent clinical trials have been unable to confirm this hypothesis. Studies in humans and animal models have since supported the notion of a multifactorial pathophysiology of DCI. This review summarizes some of the main mechanisms under investigation including cerebral vascular dysregulation, microthrombosis, cortical spreading depolarizations, and neuroinflammation...
October 23, 2017: Current Atherosclerosis Reports
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