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Subarachnoid hemorrhage

Hua Liu, Yong Liu, Jinbing Zhao, Hongyi Liu, Shengxue He
BACKGROUND: Inflammatory responses are correlated with secondary brain injury after aneurysmal subarachnoid hemorrhage (aSAH). Galectin-3 (Gal-3) is a novel biomarker reflecting inflammation status, and its elevated circulating levels are associated with poor prognosis of some inflammatory diseases. The aim of this study was to evaluate the relationship between Gal-3 plasma levels and prognosis in a group of aSAH patients. MATERIALS AND METHODS: We assessed plasma Gal-3 levels in 120 patients and 120 healthy individuals...
October 2016: Brain and Behavior
Navneet Singla, Ashish Aggarwal, Sameer Vyas, Ankur Sanghvi, Pravin Salunke, Ravi Garg
BACKGROUND: A sudden onset of neurological symptoms in patients is conventionally thought to be due to vascular phenomenon, with one common differential diagnosis being subarachnoid hemorrhage. Another important differential diagnosis is ischemic stroke. An uncommon cause of such acute symptoms can be hemorrhage in a pre-existing tumor, that is, intratumoral hemorrhage (ITH). PURPOSE: ITH is an important, though uncommon differential diagnosis in cases of sudden onset of neurological deterioration...
October 2016: Annals of Neurosciences
Alexander C Schwed, Monica M Boggs, Drew Watanabe, David S Plurad, Brant A Putnam, Dennis Y Kim
Consensus is lacking for ideal management of mild traumatic brain injury (mTBI) with intracranial hemorrhage (ICH). Patients are often monitored in the intensive care unit (ICU) without additional interventions. We sought to identify admission variables associated with a favorable outcome (ICU admission for 24 hours, no neurosurgical interventions, no complications or mortality) to divert these patients to a non-ICU setting in the future. We reviewed all patients with mTBI [Glasgow Coma Scale (GCS) = 13-15] and concomitant ICH between July 1, 2012, and June 30, 2015...
October 2016: American Surgeon
Hiroshi Yokota, Yuki Ida, Daisuke Wajima, Fumihiko Nishimura, Hiroyuki Nakase
BACKGROUND: A Rathke cleft cyst (RCC) with non-hemorrhagic rupture mimicking pituitary apoplexy has been rarely reported. CASE DESCRIPTION: A 52-year-old woman, previously diagnosed with asymptomatic RCC, came to us with a severe headache, along with visual dysfunction and symptoms of pituitary insufficiency. Fluid-attenuated inversion recovery magnetic resonance imaging demonstrated diffuse hyper-intensity in the cerebral cisterns, while watery clear cerebrospinal fluid was obtained by lumbar puncture...
October 21, 2016: World Neurosurgery
Apar S Patel, Christoph J Griessenauer, Raghav Gupta, Nimer Adeeb, Paul M Foreman, Hussain Shallwani, Justin M Moore, Mark R Harrigan, Adnan H Siddiqui, Christopher S Ogilvy, Ajith J Thomas
INTRODUCTION: Cerebral vasospasm following subarachnoid hemorrhage (SAH) is the single most important cause of neurological decline following successful treatment of the ruptured aneurysm. Here, we report safety and efficacy of non-compliant balloon angioplasty for the treatment of cerebral vasospasm. METHODS: Three major academic institutions in the United States provided data on cerebral vasospasm treated with non-compliant balloon angioplasty between October 2004 and February 2016...
October 21, 2016: World Neurosurgery
Daniel Dubinski, Sae-Yeon Won, Jürgen Konczalla, Jan Mersmann, Christof Geisen, Eva Herrmann, Volker Seifert, Christian Senft
OBJECTIVE: Rupture of an intracranial aneurysm usually presents with an acute onset, requires multidisciplinary intensive care treatment, and the overall death and disability rates are high. The ABO blood type is known to play an important role in hemostasis, thrombosis and vascular NO response. The aspect of ABO blood type in onset, clinical progress and outcome after SAH are to date largely unexplored. We conducted this study to elucidate the association of ABO blood type on the occurrence and outcome of aneurysmal SAH...
October 21, 2016: World Neurosurgery
Zenghui Qian, Xin Feng, Huibin Kang, Xiaolong Wen, Wenjuan Xu, Fei Zhao, Chuhan Jiang, Zhongxue Wu, Youxiang Li, Aihua Liu
BACKGROUND: Recent studies have reported the use of stent-assisted coiling (SAC) for wide-necked aneurysms in patients with acute subarachnoid hemorrhage (SAH). This study attempted to determine whether it is safe and efficient to use SAC for wide-necked aneurysms during post-SAH days 4-10. METHODS: We reviewed 126 consecutive patients with ruptured wide-necked aneurysms who underwent SAC. The patients were classified into the early cohort (SAC was performed within post-SAH days 0-3) and late cohort (SAC was performed within post-SAH days 4-10)...
October 21, 2016: World Neurosurgery
Yuxia Duan, Haoli Xu, Rui Li, Kuikui Zheng, Zilong Hu, Nan Wu, Yunjun Yang, Qichuan Zhuge, Weijian Chen
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a frequent and fearful complication following aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study is to assess the diagnostic accuracy of computed tomography perfusion (CTP) during an admission baseline period for the prediction of DCI. METHODS: Fifty-four aSAH cases were screened by baseline CTP within 3 days after aSAH and were reexamined with CTP 7-17 days after aSAH. Relative cerebral blood volume, relative cerebral blood flow (CBF), and relative mean transit time were measured...
October 21, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Ronald Chang, Lindley E Folkerson, Duncan Sloan, Jeffrey S Tomasek, Ryan S Kitagawa, H Alex Choi, Charles E Wade, John B Holcomb
BACKGROUND: Plasma-based resuscitation improves outcomes in trauma patients with hemorrhagic shock, while large-animal and limited clinical data suggest that it also improves outcomes and is neuroprotective in the setting of combined hemorrhage and traumatic brain injury. However, the choice of initial resuscitation fluid, including the role of plasma, is unclear for patients after isolated traumatic brain injury. METHODS: We reviewed adult trauma patients admitted from January 2011 to July 2015 with isolated traumatic brain injury...
October 13, 2016: Surgery
Sana Iqbal, Erik G Hayman, Caron Hong, Jesse A Stokum, David B Kurland, Volodymyr Gerzanich, J Marc Simard
Aneurysmal subarachnoid hemorrhage (SAH) typically carries a poor prognosis. Growing evidence indicates that overabundant production of nitric oxide (NO) may be responsible for a large part of the secondary injury that follows SAH. Although SAH modulates the activity of all three isoforms of nitric oxide synthase (NOS), the inducible isoform, NOS-2, accounts for a majority of NO-mediated secondary injuries after SAH. Here, we review the indispensable physiological roles of NO that must be preserved, even while attempting to downmodulate the pathophysiologic effects of NO that are induced by SAH...
2016: Brain Circulation
Jason Mackey, Jane C Khoury, Kathleen Alwell, Charles J Moomaw, Brett M Kissela, Matthew L Flaherty, Opeolu Adeoye, Daniel Woo, Simona Ferioli, Felipe De Los Rios La Rosa, Sharyl Martini, Pooja Khatri, Joseph P Broderick, Mario Zuccarello, Dawn Kleindorfer
OBJECTIVE: To characterize temporal trends in subarachnoid hemorrhage (SAH) incidence and outcomes over 5 time periods in a large population-based stroke study in the United States. METHODS: All SAHs among residents of the Greater Cincinnati/Northern Kentucky region at least 20 years of age were identified and verified via study physician review in 5 distinct year-long study periods between 1988 and 2010. We abstracted demographics, care patterns, and outcomes, and we compared incidence and case-fatality rates across the study periods...
October 21, 2016: Neurology
Qiang Tan, Qianwei Chen, Zhou Feng, Xia Shi, Jun Tang, Yihao Tao, Bing Jiang, Liang Tan, Hua Feng, Gang Zhu, Yunfeng Yang, Zhi Chen
Fibrosis in ventricular system has a role in hydrocephalus following intraventricular hemorrhage (IVH). The cannabinoid receptor 2 (CB2) has been reported to participate in alleviating the fibrosis process of many diseases. However, its role in fibrosis after IVH was unclear so far, and we hypothesized that CB2 activation has potential to attenuate hydrocephalus after IVH via restricting fibrosis. So the present study was designed to investigate this hypothesis in a modified rat IVH model. Autologous non-anticoagulative blood injection model was induced to mimic ventricular extension of hemorrhage in adult Sprague-Dawley rats...
October 18, 2016: Brain Research
Ivan R Da Silva, Joao A Gomes, Ari Wachsman, Gabriel Rodriguez de Freitas, Jose Javier Provencio
BACKGROUND: It is not well understood whether age impacts transcranial Doppler (TCD) mean flow velocities (MFVs) in patients with aneurysmal subarachnoid hemorrhage (SAH) with or without delayed cerebral ischemia (DCI). The aim of our study was to analyze the behavior of TCD MFV during the first 7 days after SAH in patients of different ages and correlate them with the occurrence of DCI. METHODS: This study is a databank analysis of patients with SAH admitted between 2010 and 2012 in a single center...
October 21, 2016: European Neurology
Isao Horiuchi, Yuko Fukatsu, Junko Ushijima, Eishin Nakamura, Koki Samajima, Kanako Kadowaki, Kenjiro Takagi
Little is known about the influence of pregnancy on pyogenic sterile arthritis, pyoderma gangrenosum, acne (PAPA) syndrome. We experienced a rare case of pregnancy complicated with PAPA syndrome. The patient had various histories of skin and joint disorders and experienced subarachnoid hemorrhage during pregnancy; however, her skin lesion was unaffected.
October 2016: Clinical Case Reports
Zhao Chenhui, Wei Yi
BACKGROUND: Despite great advances in treatment of Aneurysmal subarachnoid hemorrhage (aSAH), yet, a consensus as to the most optimal timing of surgery has not been reached. MATERIALS AND METHODS: PubMed and the Cochrane Library were searched for English-language studies published up to May 2015. Before conducting the meta-analysis, the studies were evaluated for publication bias and heterogeneity. Fixed and random effect models were used to estimate relative risks (RR) and the corresponding 95% confidence intervals (CIs)...
December 7, 2015: Turkish Neurosurgery
Davide Croci, Edin Nevzati, Hiroki Danura, Salome Schöpf, Javier Fandino, Serge Marbacher, Carl Muroi
BACKGROUND: In subarachnoid hemorrhage (SAH), occurrence of cerebral vasospasm (CVS) mediated by endothelin (ET)-1 might be a result of a compartmental inflammatory response with interleukin (IL)-6 release. We aim to investigate the relationship between ET-1 and IL-6 in association of CVS. METHODS: A total of 24 New Zealand white rabbits where randomly allocated into 3 groups: SAH (n=10), IL-6 (n=10), and sham (n=4). SAH was induced by a closed cranium extracranial-intracranial shunt model...
October 19, 2016: Journal of Neurosurgical Sciences
Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
BACKGROUND AND IMPORTANCE: As the use of flow-diverting stents (FDSs) for intracranial aneurysms expands, a small number of case reports have described the successful treatment of blister aneurysms of the internal carotid artery with flow diversion. Blister aneurysms are uncommon and fragile lesions that historically have high rates of morbidity and mortality despite multiple treatment strategies. We report a case of rebleeding after treatment of a ruptured blister aneurysm with deployment of a single FDS...
November 2016: Neurosurgery
Yarelis Alvarado Reyes, Alexandra Perez, Gloria Rodriguez-Vega
OBJECTIVE: Vitamin D deficiency has been associated with increased risk and adverse outcomes in many clinical settings including cardiovascular disease, stroke, and critically ill patients. Therefore we aimed to determine whether vitamin D deficiency had any effect in aneurysmal subarachnoid hemorrhage (aSAH) clinical outcomes. METHODS: A retrospective record review was conducted in a tertiary community hospital in Puerto Rico. Adult patients admitted to the neurosurgical intensive care unit (NICU) with a diagnosis of aSAH from January 2013 to July 2014, who had a 25-hydroxyvitamin-D level drawn, were included...
October 15, 2016: World Neurosurgery
Michitaka Funayama, Motoichiro Kato, Masaru Mimura
BACKGROUND: Although post-stroke depression is a well-characterized disorder, there is less understanding of how pre-existence of depression is affected by a stroke. CASE PRESENTATION: We describe a patient with treatment-resistant major depression, which had been ongoing for 14 years but disappeared shortly after onset of a subarachnoid hemorrhage. Her cognitive function and functional status were mostly unaffected by the stroke. However, she no longer excessively regretted past events...
October 19, 2016: BMC Neurology
Syuichi Tetsuka, Eiji Matsumoto
BACKGROUND: Japan is currently an aging society, with a huge proportion of elderly citizens. Consequently, the incidence and severity of subarachnoid hemorrhage (SAH) is predicted to increase in the future. Computed tomography (CT) is very important in the initial diagnosis of SAH. The proportion of hospitals owning CT systems in Japan is around four times greater than the mean number of systems owned by hospitals in other countries belonging to the Organisation for Economic Co-operation and Development...
October 18, 2016: BMC Neurology
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