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Subarachnoid bleed

Isaac Ng, Nikolay Bugaev, Ron Riesenburger, Aaron C Shpiner, Janis L Breeze, Sandra S Arabian, Reuven Rabinovici
Infratentorial traumatic intracranial bleeds (ICBs) are rare and the distribution of subtypes is unknown. To characterize this distribution the National Trauma Data Bank (NTDB) 2014 was queried for adults with single type infratentorial ICB, n = 1,821: subdural hemorrhage (SDH), subarachnoid hemorrhage (SAH), epidural hemorrhage (EDH), and intraparenchymal hemorrhage (IPH). Comparisons were made between the groups with statistical significance determined using chi squared and t-tests. SDH occurred in 29% of patients, mostly in elderly on anti-coagulants (13%) after a fall (77%), 42% of them underwent craniotomy, their mortality was the lowest (4%)...
October 17, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Murtaza Cakir, Ali Ahiskalioglu, Erdem Karadeniz, Mehmet Dumlu Aydin, Umit Ali Malcok, Celaleddin Soyalp, Cagatay Calikoglu, Goksin Sengul, Sare Sipal, Ahmet Murat Yayik
Stress ulcers is a trouble complication of subarachnoid hemorrhage (SAH). Although gastrointestinal ulcerations may be attributed to increased HCL secretion in SAH; the exact mechanism of that complication has not been investigated definitively. We studied if vagal network degeneration may cause intestinal atrophy following SAH. Study was conducted on 25 rabbits, with 5 control group (Group-A), 5 SHAM group (Group-B), and 15 SAH group via injection of autologue blood to cisterna magna. Seven animals followed for seven days (Early Decapitated-Group-C) and eight animals followed 21 days (Late Decapitated-Group-D)...
October 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jianfeng Zheng, Rui Xu, Guojing Liu, Zongduo Guo, Xiaochuan Sun
OBJECTIVE: Hypertension is common in patients with aneurysmal subarachnoid hemorrhage (SAH). However, it is still unclear whether premorbid antihypertensive therapy can help to reduce the risk of severe aneurysmal bleeding. Therefore, this study aims to assess the effect of premorbid hypertension control on outcome of patients with aneurysmal SAH. METHODS: We retrospectively reviewed the clinical data of patients with intracranial aneurysms admitted to our institution from February 2012 to December 2017...
October 12, 2018: Acta Neurochirurgica
Mat Goebel, Christopher Tainter, Christopher Kahn, James V Dunford, John Serra, Jodie Pierce, J Joelle Donofrio
BACKGROUND: Left ventricular assist devices (LVADs) are used with increasing frequency and left in place for longer periods of time. Prior publications have focused on the mechanics of troubleshooting the device itself. We aim to describe the epidemiology of LVAD patient presentations to emergency medical services (EMS), prehospital assessments and interventions, and hospital outcomes. METHODS: This is a retrospective chart review of known LVAD patients belonging to a single academic center's heart failure program who activated the 9-1-1 system and were transported by an urban EMS system to one of the center's two emergency departments between January 2012 and December 2015...
October 4, 2018: Prehospital Emergency Care
Marco Zenteno, Angel Lee, Luis Rafael Moscote-Salazar
Persistent primitive trigeminal artery (PPTA), a fetal carotid-basilar anastomosis, is the most common embryological vascular remnant persisting into adult age. However, reported cases associated with cerebral aneurysms are rare. A 33-year-old female presented with an extremely rare PPTA-basilar artery (PPTA-BA) aneurysm manifesting as subarachnoid hemorrhage. Computed tomography revealed subarachnoid bleeding in the prepontine cistern, and cerebral angiography disclosed a PPTA-BA aneurysm. The aneurysm was managed with stent-assisted coiling technique to achieve complete obliteration...
July 2018: Asian Journal of Neurosurgery
Hansen Deng, John K Yue, Beata Durcanova, Javid Sadjadi
Alcohol intoxication is a common risk factor of traumatic brain injury (TBI) and carries a significant health-care burden on underserved patients. Patients with chronic alcohol use may suffer a spectrum of bleeding diatheses from hepatic dysfunction not well studied in the context of TBI. A feared sequela of TBI is the development of coagulopathy resulting in worsened intracranial bleeding. We report the clinical course of an intoxicated patient found down with blunt head trauma and concurrent alcoholic cirrhosis who was awake and responsive in the field...
October 2018: Journal of Neurosciences in Rural Practice
Si Un Lee, Yoonjin Kwak, Chang Wan Oh, O-Ki Kwon, Seung Pil Ban, Tackeun Kim, Hyoung Soo Byoun, Gheeyoung Choe, Young Deok Kim, Jae Seung Bang
Blood blister-like aneurysms (BBAs) are an important cause of subarachnoid hemorrhage (SAH), but proper treatment is uncertain due to the poor prognosis of these aneurysms. The pathogenesis of BBAs remains unclear and few studies have reported on histological examinations of BBAs because it is difficult to obtain a specimen due to a high risk of intraoperative bleeding. In this report, BBAs were histopathologically examined in two patients who presented with SAH due to rupture of a BBA that was treated with surgical trapping and bypass surgery...
September 27, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Mohamad Syafeeq Faeez Md Noh, Anna Misyail Abdul Rashid
BACKGROUND: The computed tomography (CT) finding of a pseudo-subarachnoid hemorrhage (SAH) may lead the treating physician into a diagnostic dilemma. We present a case of a pseudo-SAH in a patient with post-resuscitative encephalopathy, secondary to a newly diagnosed bleeding pulmonary arterio-venous malformation (AVM). CASE PRESENTATION: A 19-year-old female presented acutely with massive hemoptysis. Cardiopulmonary resuscitation (CPR) followed, and the patient was subsequently intubated for airway protection with intensive care unit (ICU) admission...
September 28, 2018: BMC Neurology
Teresa A Allison, Pei Jen Lin, Jennifer A Gass, Kenneth Chong, Samuel J Prater, Miguel A Escobar, Heather D Hartman
OBJECTIVE: This study investigated the percentage of patients who achieved hemostasis with 4-factor prothrombin complex concentrate (4-factor PCC) 35 U/kg. The primary end point was to determine the effect of 4-factor PCC 35 U/kg on bleeding progression, assessed using computed tomography. METHODS: This was a retrospective, observational, single-center study conducted in patients with a major bleed admitted to a level 1 trauma center from May 1, 2013, to June 15, 2015, who received 4-factor PCC 35 U/kg for reversal of a direct factor Xa inhibitor taken prior to admission...
September 24, 2018: Journal of Intensive Care Medicine
Helen Wong, Luke Hodgson, Jillian Banfield, Jai J S Shankar
BACKGROUND: In patients with subarachnoid haemorrhage (SAH) and a negative finding on CT angiography (CTA), further imaging with digital subtraction angiography (DSA) is commonly performed to identify the source of bleeding. The purpose of this study was to investigate whether negative findings on CTA can reliably exclude aneurysms in patients with acute SAH. METHODS: This retrospective study identified all DSAs performed between August 2010 and July 2014 within our institution...
September 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Satoru Hayashi, Koji Hosoda, Yo Nishimoto, Motonobu Nonaka, Shinya Higuchi, Toshifumi Miki, Masatoshi Negishi
Background: Segmental arterial mediolysis (SAM) is an uncommon vascular disease, which manifests as catastrophic intraabdominal hemorrhage caused by rupture of visceral dissecting aneurysms in most cases. The etiology of SAM is still unclear, but SAM may be a vasospastic disorder and the responsible pressor agent is norepinephrine. Recently, abdominal SAM coexisting with intracranial dissecting aneurysms has been reported, but the relationship between intraabdominal and intracranial aneurysms in SAM remains unclear, as no cases of concomitant abdominal SAM and ruptured intracranial saccular aneurysm have been reported...
2018: Surgical Neurology International
Christer Sawaya, Raja Sawaya
BACKGROUND A lumbar puncture is a procedure performed to uncover the state of the central nervous system by analysis of the cerebrospinal fluid. It is done also to infuse medications in the subdural space. A lumbar puncture should not cause central nervous system bleeding, but this complication is still occurring in certain cases. CASE REPORT We present 2 cases where a lumbar puncture was performed in the emergency department. The first patient had severe inflammatory lower back pain and received epidural steroids through a lumbar puncture and the second case presented with the clinical picture of meningitis and a lumbar puncture was performed for diagnostic purposes...
September 17, 2018: American Journal of Case Reports
Elisabeth Bründl, Martin Proescholdt, Petra Schödel, Sylvia Bele, Julius Höhne, Florian Zeman, Eva-Maria Stoerr, Alexander Brawanski, Karl-Michael Schebesch
OBJECTIVES: Neuropsychological dysfunction after treatment of spontaneous subarachnoid haemorrhage (sSAH) is common but underreported. The vasoconstrictor neuropeptide Y (NPY) is excessively released after sSAH and in psychiatric disorders. We prospectively analysed the treatment-specific differences in the secretion of endogenous cerebrospinal fluid (CSF) NPY during the acute stage after sSAH and its impact on cognitive processing. METHODS: A total of 26 consecutive patients (f:m = 13:8; mean age 50...
September 14, 2018: Neurological Research
Arati Suvatha, M K Sibin, Dhananjaya I Bhat, K V L Narasingarao, Vikas Vazhayil, G K Chetan
BACKGROUND: The rupture of a brain aneurysm causes bleeding in the subarachnoid space and is known as aneurysmal subarachnoid haemorrhage (aSAH). In our study, we evaluated the association of factor XIII polymorphism and the risk of Aneurysmal subarachnoid haemorrhage (aSAH) in South Indian population. METHODS: The study was performed in 200 subjects with aSAH and 205 healthy control subjects. Genotyping of rs5985(c.103G > T (p.Val35Leu)) and rs5982(c.1694C > T (p...
September 5, 2018: BMC Medical Genetics
Michael Hugelshofer, Christopher M Sikorski, Martin Seule, Jeremy Deuel, Carl I Muroi, Martina Seboek, Kevin Akeret, Raphael Buzzi, Luca Regli, Dominik J Schaer, Emanuela Keller
BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is often complicated by the occurrence of delayed ischemic neurologic deficits (DIND), which impairs the clinical outcome of patients. The release of oxyhemoglobin (oxyHb) from lysing erythrocytes into cerebrospinal fluid (CSF) may critically contribute to the development of DIND. METHODS: Ventricular CSF of 18 high-grade (Fisher 3 and 4) aSAH patients was sampled daily from external ventricular drains between days 0 and 14 after bleeding...
August 27, 2018: World Neurosurgery
Peyton L Nisson, Ali Tayebi Meybodi, Adam Roussas, Whitney James, Garrett K Berger, Arnau Benet, Michael T Lawton
BACKGROUND: Occasionally, previously coiled aneurysms will require secondary treatment with surgical clipping, representing a more complicated aneurysm to treat than the naïve aneurysm. Patients who initially presented with a ruptured aneurysm may pose an even riskier group to treat than those with unruptured previously coiled aneurysms, given their potentially higher risk for rerupture. The objective of this study was to assess the clinical outcomes of patients who undergo microsurgical clipping of ruptured previously coiled cerebral aneurysms...
August 23, 2018: World Neurosurgery
Gert-Jan Allemeersch, Caroline Muylaert, Koenraad Nieboer
We report the case of a 41-year-old male with traumatic coronary artery dissection after a high-speed motor vehicle collision. Computed tomography imaging revealed multiple intracranial subdural and subarachnoid bleedings, a skull base fracture and multiple bilateral rib fractures. There was no pericardial hemorrhage, haemothorax or pneumothorax. No intra-abdominal lesions were found. A 12-lead electrocardiogram on arrival showed an acute myocardial infarction. Emergency angiography showed complete dissection of the right coronary artery without reflow after placement of 6 coronary stents...
January 4, 2018: Journal of the Belgian Society of Radiology
Axel Neulen, Michael Kosterhon, Tobias Pantel, Stefanie Kirschner, Hermann Goetz, Marc A Brockmann, Sven R Kantelhardt, Serge C Thal
Subarachnoid hemorrhage (SAH) is a subtype of hemorrhagic stroke. Cerebral vasospasm that occurs in the aftermath of the bleeding is an important factor determining patient outcome and is therefore frequently taken as a study endpoint. However, in small animal studies on SAH, quantification of cerebral vasospasm is a major challenge. Here, an ex vivo method is presented that allows quantification of volumes of entire vessel segments, which can be used as an objective measure to quantify cerebral vasospasm. In a first step, endovascular casting of the cerebral vasculature is performed using a radiopaque casting agent...
July 28, 2018: Journal of Visualized Experiments: JoVE
Suliana Teoh, Monika Hofer, Richard Kerr, Nicola Warner, Wilhelm Kueker, Peter M Rothwell, Giovanna Zamboni
This article describes an unusual presentation of disseminated oligodendroglial-like leptomeningeal tumour. A previously healthy 23-year-old Caucasian woman presented with headache, photophobia and recurrent seizures. Initial investigations were suggestive of subarachnoid haemorrhage. Her symptoms deteriorated rapidly and within weeks she developed complete blindness and diffuse sensory ataxia. The aim of this article is to increase awareness of this rare disease, especially in patients who present with acute, rapidly progressive neurological symptoms with signs of acute or chronic central nervous system bleeding...
August 9, 2018: Neuroradiology Journal
Hirotaka Inoue, Makiko Miyahara, Yumi Funato, Shota Ozaki, Kensuke Kato, Ryuichi Noda, Shoji Yamaguchi, Yuta Tamai, Masato Inoue, Koichiro Okamoto, Tetsuo Hara
BACKGROUND AND PURPOSE: Gastrointestinal bleeding is an important complication in the acute phase of hemorrhagic stroke. In this study, we aimed to identify the risk factors for gastrointestinal bleeding in patients with hemorrhagic stroke despite the administration of antiulcer drugs. METHODS: We conducted a retrospective cohort study of our hemorrhagic stroke cases. We analyzed the background factors associated with gastrointestinal bleeding in the study population and their outcomes...
August 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
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