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Subarachnoid hemorrhage

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https://www.readbyqxmd.com/read/28088803/small-versus-large-ruptured-intracranial-aneurysm-concerns-with-the-site-of-aneurysm
#1
Bum Joon Kim, Hyun Goo Kang, Byeong-Duk Kwun, Jae-Sung Ahn, Jisung Lee, Sung Ho Lee, Dong-Wha Kang, Jong S Kim, Sun U Kwon
BACKGROUND: Although size is one of the strongest predictors, small aneurysms often rupture. We compared the characteristics of small and large ruptured intracranial aneurysms (RIAs) according to their location to find the factors associated with small RIAs in each location. METHODS: Patients with subarachnoid hemorrhage due to saccular RIAs were consecutively enrolled. The sizes were dichotomized as small (<5 mm) or large, and the location was classified as paraclinoid-distal internal carotid artery, sidewalls of anterior or middle cerebral artery (MCA; sidewall), MCA-bifurcation, anterior or posterior communicating artery (Acom or Pcom, respectively), and posterior circulation RIAs...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28087430/ryanodine-receptor-1-polymorphism-is-not-associated-with-aneurysmal-subarachnoid-hemorrhage-or-its-clinical-sequelae
#2
Philipp Hendrix, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
OBJECTIVE: The pathophysiological mechanisms underlying cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remain poorly understand. Ryanodine receptors (RYR) are intracellular calcium channels involved in the regulation of vascular smooth muscle cells and cerebrovascular tone and diameter. Previous work reported an association between a RYR polymorphism and cerebral vasospasm. Here, we sought to assess the impact of that RYR polymorphism on aSAH and its clinical sequelae...
January 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28087184/clinical-characteristics-of-ruptured-distal-middle-cerebral-artery-aneurysms-review-of-the-literature
#3
REVIEW
Keiji Tsutsumi, Tetsuyoshi Horiuchi, Alhusain Nagm, Yasuyuki Toba, Kazuhiro Hongo
Middle cerebral artery (MCA) aneurysms usually arise at the primary MCA bifurcation or trifurcation. Distal MCA aneurysms are rarely considered as sources of aneurysmal subarachnoid hemorrhage (SAH). It has been reported that ruptured distal MCA aneurysms are associated with head trauma, neoplastic emboli, arterial dissection, or bacterial infection. We experienced five cases of ruptured distal MCA aneurysms and evaluated their clinical characteristics. Retrospective analysis of aneurysmal SAH at Kobayashi Neurosurgical Neurological Hospital was performed from January, 2004 to December, 2014...
January 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28079589/in-vogue-ketamine-for-neuroprotection-in-acute-neurologic-injury
#4
Josh D Bell
Neurologic deterioration following acute injury to the central nervous system may be amenable to pharmacologic intervention, although, to date, no such therapy exists. Ketamine is an anesthetic and analgesic emerging as a novel therapy for a number of clinical entities in recent years, including refractory pain, depression, and drug-induced hyperalgesia due to newly discovered mechanisms of action and new application of its known pharmacodynamics. In this focused review, the evidence for ketamine as a neuroprotective agent in stroke, neurotrauma, subarachnoid hemorrhage, and status epilepticus is highlighted, with a focus on its applications for excitotoxicity, neuroinflammation, and neuronal hyperexcitability...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28070645/middle-cerebral-artery-aneurysms-with-intracerebral-hematoma-the-impact-of-side-and-volume-on-final-outcome
#5
Ondrej Navratil, Kamil Duris, Vilem Juran, Eduard Neuman, Karel Svoboda, Martin Smrcka
BACKGROUND: Middle cerebral artery aneurysms (MCA aneurysms) belong to the most frequent type of intracranial aneurysms forming an intracerebral hematoma. The consequences of the hematoma-the laterality, the impact of ICH volume and size of the aneurysm with the final outcome of these patients had not been studied in detail in this location, and we focused on the analysis of these factors. METHODS: Patients with MCA aneurysms and associated intracerebral hematomas with a volume ≥10 ml were studied; these were treated from January 2006 to December 2015...
January 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28070640/erratum-to-thrombectomy-for-ischemic-stroke-meta-analyses-of-recurrent-strokes-vasospasms-and-subarachnoid-hemorrhages
#6
Robert Emprechtinger, Brigitte Piso, Peter A Ringleb
No abstract text is available yet for this article.
January 9, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28069456/neurocardiac-protection-with-milrinone-for-restoring-acute-cerebral-hypoperfusion-and-delayed-ischemic-injury-after-experimental-subarachnoid-hemorrhage
#7
Tomoko Mutoh, Tatsushi Mutoh, Kazumasu Sasaki, Kazuhiro Nakamura, Yasuko Tatewaki, Tatsuya Ishikawa, Yasuyuki Taki
BACKGROUND AND PURPOSE: Acute cerebral hypoperfusion following subarachnoid hemorrhage (SAH) is highly related to the pathogenesis of delayed cerebral ischemia (DCI), but the therapeutic option is poorly available. This study aimed to clarify the effect of milrinone (MIL) on cerebral blood flow (CBF) and related outcomes after experimental SAH. METHODS: Twenty-seven male C57BL/6 mice were assigned to either sham surgery (SAH-sham; n=6), SAH induced by endovascular perforation (control; n=10), or SAH followed by cardiac support with intravenous MIL (n=11) performed 1...
January 6, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28064344/diffuse-18-f-fdg-accumulation-in-the-subarachnoid-space-detected-by-pet-ct-in-a-patient-with-subarachnoid-hemorrhage-and-hyperglycemia
#8
Zhanli Fu, Jin Zhang, Meng Liu, Ziao Li, Qian Li
No abstract text is available yet for this article.
January 7, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28062803/posterior-circulation-perforator-aneurysms-a-proposed-management-algorithm
#9
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/28059660/effects-of-decompressive-craniectomy-on-functional-outcomes-and-death-in-poor-grade-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#10
Naif M Alotaibi, Ghassan Awad Elkarim, Nardin Samuel, Oliver G S Ayling, Daipayan Guha, Aria Fallah, Abdulrahman Aldakkan, Blessing N R Jaja, Airton Leonardo de Oliveira Manoel, George M Ibrahim, R Loch Macdonald
OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to assess the impact of DC on functional outcome and death in patients after poor-grade aSAH. METHODS A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059659/antiplatelet-therapy-for-the-prevention-of-peri-coiling-thromboembolism-in-high-risk-patients-with-ruptured-intracranial-aneurysms
#11
Nancy J Edwards, Wesley H Jones, Aditya Sanzgiri, Juan Corona, Mark Dannenbaum, Peng Roc Chen
OBJECTIVE The most frequent procedural complication of the endovascular treatment of intracranial aneurysms is a thromboembolic event (TEE); in a subset of patients, such events will cause permanent neurological disability. In patients with unruptured aneurysms, increasing evidence supports the use of periprocedural antiplatelet therapy to prevent TEEs. The object of this study was to evaluate whether patients with ruptured aneurysms and subarachnoid hemorrhage would also benefit from periprocedural antiplatelet therapy...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059632/pseudoaneurysm-formation-due-to-rupture-of-intracranial-aneurysms-case-series-and-literature-review
#12
Motohiro Nomura, Kentaro Mori, Akira Tamase, Tomoya Kamide, Syunsuke Seki, Yu Iida, Tatsu Nakano, Yuichi Kawabata, Taro Kitabatake, Teruyuki Nakajima, Kiyoyuki Yasutake, Kei Egami, Tatsunori Takahashi, Mitsuyuki Takahashi, Kunio Yanagimoto
Background Intracranial pseudoaneurysm formation due to a ruptured non-traumatic aneurysm is extremely rare. We describe the radiological findings and management of pseudoaneurysms due to ruptured cerebral aneurysms in our case series and previously reported cases. Patients and methods Four additional and 20 reported patients presenting with subarachnoid hemorrhage (SAH) are included. Radiological findings and clinical features of these patients were reviewed. Results In our series, three-dimensional computed tomographic angiography (3D-CTA) and/or angiography showed an irregular- or snowman-shaped cavity extending from the parent artery...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28056515/race-ethnicity-as-a-predictor-for-location-of-death-in-patients-with-acute-neurovascular-events
#13
Say Salomon, Elizabeth Chuang, Deepa Bhupali, Daniel Labovitz
BACKGROUND: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. METHODS: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28054290/treatment-of-hyponatremia-in-patients-with-acute-neurological-injury
#14
Theresa Human, Aaron M Cook, Brian Anger, Kathleen Bledsoe, Amber Castle, David Deen, Haley Gibbs, Christine Lesch, Norah Liang, Karen McAllen, Christopher Morrison, Dennis Parker, A Shaun Rowe, Denise Rhoney, Kiranpal Sangha, Elena Santayana, Scott Taylor, Eljim Tesoro, Gretchen Brophy
BACKGROUND: Little data exist regarding the practice of sodium management in acute neurologically injured patients. This study describes the practice variations, thresholds for treatment, and effectiveness of treatment in this population. METHODS: This retrospective, multicenter, observational study identified 400 ICU patients, from 17 centers, admitted for ≥48 h with subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), intraparenchymal hemorrhage, or intracranial tumors between January 1, 2011 and July 31, 2012...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28054289/procalcitonin-is-a-poor-predictor-of-non-infectious-fever-in-the-neurocritical-care-unit
#15
Karin Halvorson, Sameer Shah, Corey Fehnel, Bradford Thompson, N Stevenson Potter, Mitchell Levy, Linda Wendell
BACKGROUND: Fever is a common occurrence in the Neurocritical Care Unit (NCCU). It is reported that up to 50 % of these fevers are associated with a non-infectious source. As this is a diagnosis of exclusion, a complete fever evaluation must be done to rule out infection. Procalcitonin (PCT) has been identified as a possible biomarker to distinguish infectious from non-infectious etiologies of fever. We hypothesized that PCT could be used as a predictor of infectious fever in febrile patients with intracranial hemorrhage admitted to the NCCU...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28048972/astaxanthin-improves-cognitive-performance-in-mice-following-mild-traumatic-brain-injury
#16
Xinran Ji, Dayong Peng, Yiling Zhang, Jun Zhang, Yuning Wang, Yuan Gao, Ning Lu, Peifu Tang
[BACKGROUND]: Traumatic brain injury (TBI) produces lasting neurological deficits that plague patients and physicians. To date, there is no effective method to combat the source of this problem. Here, we utilized a mild, closed head TBI model to determine the modulatory effects of a natural dietary compound, astaxanthin (AST). AST is centrally active following oral administration and is neuroprotective in experimental brain ischemia/stroke and subarachnoid hemorrhage (SAH) models. We examined the effects of oral AST on the long-term neurological functional recovery and histological outcomes following moderate TBI in a mice model...
December 31, 2016: Brain Research
https://www.readbyqxmd.com/read/28043115/angiopoietin-1-and-angiopoietin-2-expression-imbalance-influence-in-early-period-after-subarachnoid-hemorrhage
#17
Hua Gu, Zhen-Hai Fei, Yi-Qi Wang, Jian-Guo Yang, Chao-Hui Zhao, Yong Cai, Xing-Ming Zhong
PURPOSE: Microvascular endothelial integrity is important for maintaining the blood-brain barrier (BBB). However, subarachnoid hemorrhage (SAH) disrupts this integrity, making the BBB dysfunctional-an important pathophysiological change after SAH. Angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) regulate microvascular permeability by balancing each other's expression. METHODS: This study investigated the dynamics of Ang-1 and Ang-2 expression after SAH and the protective effect of Ang-1 on BBB functioning using an endovascular puncture model of rat SAH...
December 2016: International Neurourology Journal
https://www.readbyqxmd.com/read/28039044/preclinical-efficacy-of-human-albumin-in-subarachnoid-hemorrhage
#18
Liumin Wang, Meiying Li, Yi Xie, Lili Xu, Ruidong Ye, Xinfeng Liu
Human Albumin is a unique pleiotropic protein with multiple properties. Previous clinical and laboratory studies have indicated a possible beneficial effect of Albumin in subarachnoid hemorrhage (SAH). The present study aimed to further define the preclinical characteristics of Albumin. SAH was induced by endovascular perforation in Sprague-Dawley rats. In the dose-escalation study, Albumin ranging from 0.02g/kg to 1.0g/kg was intravenously infused immediately after SAH. In the therapeutic window study, 1.0g/kg Albumin was administered at 0h, 2h, 4h or 8h after SAH...
December 28, 2016: Neuroscience
https://www.readbyqxmd.com/read/28035993/brain-monitoring-in-critically-neurologically-impaired-patients
#19
REVIEW
Salazar Jones, Gary Schwartzbauer, Xiaofeng Jia
Assessment of neurologic injury and the evolution of severe neurologic injury is limited in comatose or critically ill patients that lack a reliable neurologic examination. For common yet severe pathologies such as the comatose state after cardiac arrest, aneurysmal subarachnoid hemorrhage (aSAH), and severe traumatic brain injury (TBI), critical medical decisions are made on the basis of the neurologic injury. Decisions regarding active intensive care management, need for neurosurgical intervention, and withdrawal of care, depend on a reliable, high-quality assessment of the true state of neurologic injury, and have traditionally relied on limited assessments such as intracranial pressure monitoring and electroencephalogram...
December 27, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28034814/outcome-prognostic-factors-and-follow-up-results-after-subarachnoid-hemorrhage-from-pericallosal-artery-aneurysms
#20
Nazife Dinc, Stephanie Lescher, Johanna Quick-Weller, Joachim Berkefeld, Johannes Platz, Christian Senft, Volker Seifert, Juergen Konczalla
OBJECTIVE: Pericallosal artery aneurysms (PAA) are usually rare (2-5%) and treatment is challenging for both modalities, surgical and endovascular. The authors performed this analysis to determine the outcome and prognostic factors after subarachnoidal hemorrhage due to ruptured pericallosal artery aneurysms. MATERIALS AND METHODS: A total of 32 patients with ruptured PAA were admitted to our hospital between 1999 and 2014, added to our prospective database and analyzed retrospectively...
December 26, 2016: World Neurosurgery
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