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Subarachnoid hemorrhage

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https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#1
Megan Moyer, Bethany Young, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
February 23, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28229304/early-elevated-levels-of-soluble-triggering-receptor-expressed-on-myeloid-cells-1-in-subarachnoid-hemorrhage-patients
#2
Xin-Gang Sun, Qian Ma, Gang Jing, Li Wang, Xu-Dong Hao, Gai-Qing Wang
Early brain injury (EBI) contributes to poor prognosis of subarachnoid hemorrhage (SAH). This study aimed to clarify whether triggering receptor expressed on myeloid cells-1 (TREM-1) was implicated in the inflammatory mechanisms of EBI. The cerebrospinal fluid (CSF) levels of soluble TREM-1 (sTREM-1), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) as well as plasma levels of white blood cells (WBC) count and C-reactive protein in 17 SAH patients at early stage (within the EBI period) and 9 volunteers were observed...
February 22, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28224318/chemical-angioplasty-with-spasmolytics-for-vasospasm-after-subarachnoid-hemorrhage
#3
Aleš Hejčl, Filip Cihlář, Vojtěch Smolka, Petr Vachata, Robert Bartoš, Jan Procházka, Jiří Cihlář, Martin Sameš
BACKGROUND: Clinically symptomatic vasospasm leading to delayed ischemic neurological deficits occurs in up to 30% of patients with subarachnoid hemorrhage (SAH). Vasospasm can result in a serious decline in clinical conditions of patients with SAH, yet the algorithm for vasospasm treatment and prevention remains unclear. Intra-arterial administration of vasodilators is one of the modalities used for vasospasm therapy. METHODS: Over the last 7 years, we have treated 27 female and 7 male patients with vasospasm using intra-arterial administration of either nimodipine or milrinone; all had suffered aneurysm rupture...
February 21, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28222415/young-adult-patient-with-headache-fever-and-blurred-vision
#4
Stavroula A Paschou, Konstantinos Tzioras, Vasiliki Trianti, Stavroula Lyra, Vasileios-Arsenios Lioutas, Andreas Seretis, Andromachi Vryonidou
BACKGROUND AND IMPORTANCE: This case highlights the fact that acute pituitary apoplexy may be misdiagnosed due to being confused with other entities exhibiting similar symptoms, such as meningitis or subarachnoid hemorrhage. CLINICAL PRESENTATION: A patient in his late 30s presented with sudden and severe frontal headache, fever, blurred vision, nausea, confusion, as well as oculomotor palsy (CN III) with partial ptosis of the left eyelid, dilated left pupil and left eye globe deviation inferiorly and laterally...
October 2016: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28217390/management-of-aneurysmal-subarachnoid-hemorrhage-state-of-the-art-and-future-perspectives
#5
REVIEW
Giovanni Grasso, Concetta Alafaci, R Loch Macdonald
BACKGROUND: Aneurysmal subarachnoid hemorrhage (SAH) accounts for 5% of strokes and carries a poor prognosis. It affects around 6 cases per 100,000 patient years occurring at a relatively young age. METHODS: Common risk factors are the same as for stroke, and only in a minority of the cases, genetic factors can be found. The overall mortality ranges from 32% to 67%, with 10-20% of patients with long-term dependence due to brain damage. An explosive headache is the most common reported symptom, although a wide spectrum of clinical disturbances can be the presenting symptoms...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28217381/concurrent-cervical-dural-and-multiple-perimedullary-arteriovenous-fistulas-presenting-with-subarachnoid-hemorrhage-the-source-of-bleeding-was-invisible-at-initial-angiography
#6
Iku Nambu, Naoyuki Uchiyama, Kouichi Misaki, Masanao Mohri, Mitsutoshi Nakada
BACKGROUND: We report the concurrence of a spinal dural arteriovenous fistula (DAVF) and multiple perimedullary arteriovenous fistulas (PAVFs) presenting with subarachnoid hemorrhage (SAH). Moreover, the bleeding site was detected 1 month after onset. CASE DESCRIPTION: A 56-year-old man was admitted to our hospital with an SAH. A DAVF and two PAVFs were detected at the C2 level by two rounds of digital subtraction angiography. The source of bleeding, an aneurysm on the feeding artery of PAVF, was detected at the second angiogram, which was performed 1 month after the onset of SAH...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28216398/engaging-in-a-keyhole-concept-for-the-management-of-ruptured-and-unruptured-aneurysms
#7
Daniel D Cavalcanti, Roberto C de Paula, Paula L Alvarenga, Paulo José P da Mata, Paulo Niemeyer Filho
OBJECTIVE: Many new endovascular devices have been used under the guidance of the International Subarachnoid Aneurysm Trial (ISAT). Clipping still offers higher occlusion rates, and its technique continues to evolve, resulting in smaller exposures and reduced manipulation to brain tissue. We sought to evaluate the routine use of the minisphenoidal approach to manage intracranial aneurysms in a high-volume institution. METHODS: We retrospectively reviewed our database of aneurysm patients from October 2013 to May 2016...
February 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28216394/the-pconus-device-for-treatment-of-complex-wide-neck-anterior-communicating-artery-aneurysms
#8
Paul Emile Labeyrie, Benjamin Gory, Marta Aguilar-Perez, Elisa Pomero, Alessandra Biondi, Roberto Riva, Francis Turjman, Hans Henkes
BACKGROUND: and Purpose: Anterior communicating artery (AcomA) aneurysms with a wide neck are often not feasible for endovascular coiling. Emerging devices for neck protection, as the pCONus stent, are promising for endovascular treatment of challenging intracranial aneurysms. We report the preliminary results with pCONus in the treatment of wide-neck AcomA aneurysms. MATERIALS AND METHODS: All consecutive patients harboring AcomA aneurysms treated with pCONus in 3 European centers were retrospectively reviewed...
February 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28216212/-sentinel-seizure-as-a-warning-sign-preceding-fatal-rupture-of-a-giant-middle-cerebral-artery-aneurysm
#9
Lukas Andereggen, Robert H Andres
BACKGROUND: Sentinel headache is a well-known warning sign preceding subarachnoid hemorrhage (SAH) due to rupture of an intracranial aneurysm. New-onset seizure or "sentinel seizure" preceding aneurysmal SAH, however, is uncommon. CASE DESCRIPTION: We report on a 51-year-old man who presented with a new-onset seizure. Diagnostic work-up revealed a giant middle cerebral artery aneurysm without evidence of subarachnoid or intracerebral hemorrhage. Anti-epileptic therapy was initiated, elective diagnostic angiography and subsequent treatment was scheduled and the patient discharged home...
February 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28216208/a-rare-case-of-pediatric-lumbar-spinal-ependymoma-mimicking-meningitis
#10
Ezeali Mike Ekuma, Kiyoshi Ito, Akihiro Chiba, Yosuke Hara, Kohei Kanaya, Tetsuyoshi Horiuchi, Samuel Ohaegbulam, Kazuhiro Hongo
Spontaneous acute subarachnoid hemorrhage (SAH) from lumbar ependymoma in children is rare. We report a case of a14-year-old boy who developed sudden radicular low back pain while playing baseball. He was initially managed conservatively in a local hospital for suspected lumbar disc herniation, but later developed meningeal symptoms and fever before being referred to our hospital. There he underwent a diagnostic lumbar puncture in the emergency room; his cerebrospinal fluid suggested an SAH. Physical examination showed meningeal signs and cauda equina features...
February 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28215029/an-introduction-to-the-pathophysiology-of-aneurysmal-subarachnoid-hemorrhage
#11
REVIEW
Jasper H van Lieshout, Maxine Dibué-Adjei, Jan F Cornelius, Philipp J Slotty, Toni Schneider, Tanja Restin, Hieronymus D Boogaarts, Hans-Jakob Steiger, Athanasios K Petridis, Marcel A Kamp
Pathophysiological processes following subarachnoid hemorrhage (SAH) present survivors of the initial bleeding with a high risk of morbidity and mortality during the course of the disease. As angiographic vasospasm is strongly associated with delayed cerebral ischemia (DCI) and clinical outcome, clinical trials in the last few decades focused on prevention of these angiographic spasms. Despite all efforts, no new pharmacological agents have shown to improve patient outcome. As such, it has become clear that our understanding of the pathophysiology of SAH is incomplete and we need to reevaluate our concepts on the complex pathophysiological process following SAH...
February 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28213195/blunt-traumatic-brain-injury-patients-a-role-for-ct-angiography-of-the-head-to-evaluate-non-traumatic-etiologies
#12
REVIEW
Ha Nguyen, Ninh Doan, Michael Gelsomino, Saman Shabani
BACKGROUND: In the setting of trauma, the etiology of intracranial hemorrhage (ICH) is frequently attributed to the physical, traumatic event. Caution should still be directed towards non-traumatic (or spontaneous) etiologies responsible for the trauma, such as hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformation, and hemorrhagic infarcts. The role for immediate CT angiography (CTA) remains controversial to evaluate for non-traumatic etiologies. METHODS: A systematic review of the available literature in Medline PubMed database...
February 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28210988/real-life-experience-with-the-specific-reversal-agent-idarucizumab-for-the-management-of-emergency-situations-in-dabigatran-treated-patients-a-series-of-11-cases
#13
Milan R Vosko, Christof Bocksrucker, Rafał Drwiła, Petr Dulíček, Tomas Hauer, Johannes Mutzenbach, Christoph J Schlimp, David Špinler, Thomas Wolf, Daša Zugwitz
Non-vitamin K antagonist oral anticoagulants (NOACs) have a favorable benefit-risk profile compared with vitamin K antagonists. However, the lack of specific reversal agents has made the management of some patients receiving long-term treatment with NOACs problematic in emergency situations such as major bleeding events or urgent procedures. Idarucizumab, a fully humanized Fab antibody fragment that binds specifically and with high affinity to dabigatran, was recently approved for use in adult patients treated with dabigatran when rapid reversal of its anticoagulant effect is required...
February 16, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28210956/mdivi-1-alleviates-early-brain-injury-after-experimental-subarachnoid-hemorrhage-in-rats-possibly-via-inhibition-of-drp1-activated-mitochondrial-fission-and-oxidative-stress
#14
Pei Wu, Yuchen Li, Shiyi Zhu, Chunlei Wang, Jiaxing Dai, Guang Zhang, Bingjie Zheng, Shancai Xu, Ligang Wang, Tongyu Zhang, PeiQuan Zhou, John H Zhang, Huaizhang Shi
Mdivi-1 is a selective inhibitor of mitochondrial fission protein, Drp1, and can penetrate the blood-brain barrier. Previous studies have shown that Mdivi-1 improves neurological outcomes after ischemia, seizures and trauma but it remains unclear whether Mdivi-1 can attenuate early brain injury after subarachnoid hemorrhage (SAH). We thus investigated the therapeutic effect of Mdivi-1 on early brain injury following SAH. Rats were randomly divided into four groups: sham; SAH; SAH + vehicle; and SAH + Mdivi-1...
February 16, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28209579/patterns-of-brain-injury-in-newborns-treated-with-extracorporeal-membrane-oxygenation
#15
M A Wien, M T Whitehead, D Bulas, M Ridore, L Melbourne, G Oldenburg, B L Short, A N Massaro
BACKGROUND AND PURPOSE: Neonates treated with extracorporeal membrane oxygenation are at risk for brain injury and subsequent neurodevelopmental compromise. Advances in MR imaging and improved accessibility have led to the increased use of routine MR imaging after extracorporeal membrane oxygenation. Our objective was to describe the frequency and patterns of extracorporeal membrane oxygenation-related brain injury based on MR imaging findings in a large contemporary cohort of neonates treated with extracorporeal membrane oxygenation...
February 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28207524/in-stent-stenosis-in-the-patient-with-internal-carotid-aneurysm-after-treated-by-the-willis-covered-stent-two-case-reports-and-literature-review
#16
Lun-Xin Liu, Meng-Yuan Song, Xiao-Dong Xie
: In-stent stenosis after treated by Willis covered stent-case reports. BACKGROUND: Advancements in minimally invasive technology have allowed endovascular reconstruction of internal carotid aneurysm. However, in-stent stenosis is an important and well-characterized complication of stenting after the treatment of internal carotid aneurysm. CASE DESCRIPTION: We would present 2 patients who were diagnosed with in-stent stenosis after the treatment of Willis covered stent...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28202831/-development-of-intracerebral-hemorrhage-and-subarachnoid-hemorrhage-shortly-after-cerebral-infarction-onset-in-an-adult-patient-with-moyamoya-disease
#17
Jun Yoshida, Yoshitaka Kubo, Kenji Yoshida, Kohei Chida, Masakazu Kobayashi, Kuniaki Ogasawara
Here we describe the case of a patient with moyamoya disease who developed cerebral infarction followed shortly by subarachnoid hemorrhage and intracerebral hemorrhage. A 50-year-old woman presenting with sudden and transient weakness of the left lower limb was transferred to a local hospital. Magnetic resonance imaging(MRI)revealed cerebral infarction in the corpus callosum and in the bilateral frontal lobes induced by moyamoya disease. Pyramidal tract was not affected. The patient was treated with an anti-platelet agent(ozagrel sodium 160mg/day)and did not undergo intentional antihypertensive therapy...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28201763/the-barrow-neurological-institute-scale-revisited-predictive-capabilities-for-cerebral-infarction-and-clinical-outcome-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#18
Nora F Dengler, Dominik Diesing, Asita Sarrafzadeh, Stefan Wolf, Peter Vajkoczy
No abstract text is available yet for this article.
February 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28201539/endovascular-rescue-therapies-for-refractory-vasospasm-after-subarachnoid-hemorrhage-a-prospective-evaluation-study-using-multimodal-continuous-event-neuromonitoring
#19
Walid Albanna, Miriam Weiss, Marguerite Müller, Marc Alexander Brockmann, Annette Rieg, Catharina Conzen, Hans Clusmann, Anke Höllig, Gerrit Alexander Schubert
No abstract text is available yet for this article.
February 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28199398/a-segmentation-based-volumetric-approach-to-localize-and-quantify-cerebral-vasospasm-based-on-tomographic-imaging-data
#20
Axel Neulen, Tobias Pantel, Michael Kosterhon, Stefanie Kirschner, Marc A Brockmann, Sven R Kantelhardt, Alf Giese, Serge C Thal
INTRODUCTION: Quantification of cerebral vasospasm after subarachnoid hemorrhage (SAH) is crucial in animal studies as well as clinical routine. We have developed a method for computer-based volumetric assessment of intracranial blood vessels from cross-sectional imaging data. Here we demonstrate the quantification of vasospasm from micro computed tomography (micro-CT) data in a rodent SAH model and the transferability of the volumetric approach to clinical data. METHODS: We obtained rodent data by performing an ex vivo micro-CT of murine brains after sham surgery or SAH by endovascular filament perforation on day 3 post hemorrhage...
2017: PloS One
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