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https://www.readbyqxmd.com/read/29027862/effect-of-body-mass-index-on-outcome-after-aneurysmal-subarachnoid-hemorrhage-treated-with-clipping-versus-coiling
#1
Lorenzo Rinaldo, Joshua D Hughes, Alejandro A Rabinstein, Giuseppe Lanzino
OBJECTIVE It has been suggested that increased body mass index (BMI) may confer a protective effect on patients who suffer from aneurysmal subarachnoid hemorrhage (aSAH). Whether the modality of aneurysm occlusion influences the effect of BMI on patient outcomes is not well understood. The authors aimed to compare the effect of BMI on outcomes for patients with aSAH treated with surgical clipping versus endovascular coiling. METHODS The authors retrospectively reviewed the outcomes for patients admitted to their institution for the management of aSAH treated with either clipping or coiling...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28992906/renal-amyloidosis-associated-with-kartagener-syndrome-in-a-dog
#2
Bartolo Celona, Chiara Crinò, Carmelo Bruno, Simona Di Pietro, Elisabetta Giudice
A 4-year-old cocker spaniel, male, of 12kg body weight was presented because of the onset of polyuria or polydipsia. From the first months of its life, the dog had exhibited constant serous to mucopurulent nasal discharge, productive cough, sneezing, reverse sneezing, otitis, and recurrent episodes of fever. The respiratory signs had been treated several times with antibiotics, without ever achieving a complete resolution. Clinical examination revealed normal rectal temperature (38.3°C), increased respiratory rate (40breaths/min), a copious mucous nasal discharge and right deviation of the heart apex beat (ictus cordis)...
June 2017: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28973675/the-subarachnoid-hemorrhage-early-brain-edema-score-predicts-delayed-cerebral-ischemia-and-clinical-outcomes
#3
Sung-Ho Ahn, Jude P Savarraj, Mubashir Pervez, Wesley Jones, Jin Park, Sang-Beom Jeon, Sun U Kwon, Tiffany R Chang, Kiwon Lee, Dong H Kim, Arthur L Day, H Alex Choi
BACKGROUND: Early brain injury (EBI) after subarachnoid hemorrhage (SAH) is an important determinant of clinical outcomes. However, a major hindrance to studies of EBI is the lack of radiographic surrogate marker. OBJECTIVE: To propose a scoring system based on early changes in clinically obtained computed tomography (CT), called the Subarachnoid hemorrhage Early Brain Edema Score (SEBES). METHODS: Patients with spontaneous aneurysmal SAH and a CT within 24 h of ictus were included...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28964943/ct-angiography-spot-sign-as-an-indicator-for-ultra-early-stereotactic-aspiration-of-intracerebral-hemorrhage
#4
Yuqian Li, Jiancai Wang, Zhihong Li, Xingye Zhang, Bo Tian, Yanlong Yang, Min Li, Bao Wang, Yi Xia, Tao Ma, Yang Yang, Guodong Gao, Lihong Li
BACKGROUND: Ultra-early surgical clot removal relieves mechanical compression on adjacent normal brain tissue and limits the toxic effects of a hematoma, which might improve the outcomes in patients with intracerebral hemorrhage (ICH); however, hematoma expansion frequently occurs within 20 h after the ictus, and this limits the use of ultra-early surgery. CT-angiography (CTA) spot sign was recently validated as an important predictor of hematoma expansion in ICH patients. METHODS: 59 ICH patients with negative spot sign who received ultra-early stereotactic aspiration (< 6 h after ictus; n = 32 [Ultra-early group]) or routine stereotactic aspiration (≥ 6 h after ictus; n = 27 [Routine group]) were included in retrospective analysis...
September 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28946021/significance-of-satellite-sign-and-spot-sign-in-predicting-hematoma-expansion-in-spontaneous-intracerebral-hemorrhage
#5
Zhiyuan Yu, Jun Zheng, Hasan Ali, Rui Guo, Mou Li, Xiaoze Wang, Lu Ma, Hao Li, Chao You
OBJECTIVES: Hematoma expansion is related to poor outcome in spontaneous intracerebral hemorrhage (ICH). Recently, a non-enhanced computed tomography (CT) based finding, termed the 'satellite sign', was reported to be a novel predictor for poor outcome in spontaneous ICH. However, it is still unclear whether the presence of the satellite sign is related to hematoma expansion. MATERIAL AND METHODS: Initial computed tomography angiography (CTA) was conducted within 6h after ictus...
September 20, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28867322/recurrent-bleeding-after-perimesencephalic-hemorrhage
#6
Frans Kauw, Birgitta K Velthuis, Ufuk Kizilates, Irene C van der Schaaf, Gabriel J E Rinkel, Mervyn D I Vergouwen
BACKGROUND: Perimesencephalic hemorrhage (PMH) is a type of subarachnoid hemorrhage with excellent long-term outcomes. Only 1 well-documented case of in-hospital rebleeding after PMH is described in the literature, which occurred after initiating antithrombotic treatment because of myocardial ischemia. We describe a patient with PMH without antithrombotic treatment who had 2 episodes of recurrent bleeding on the day of ictus. To validate the radiologic findings, we conducted a case-control study...
September 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28843756/recurrent-perimesencephalic-nonaneurysmal-subarachnoid-hemorrhage-case-report-and-review-of-the-literature
#7
REVIEW
Yuan Hong, Yuanjian Fang, Ting Chen, Jianmin Zhang
BACKGROUND: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is a benign form of subarachnoid hemorrhage (SAH) with a favorable prognosis. The risk of recurrent hemorrhage of this benign entity is extremely low. CASE DESCRIPTION: We describe a rare case of recurrent, spontaneous PNSAH in a 56-year-old male patient. This hypertensive patient suffered recurrent episode of PNSAH one month after its first ictus, suggesting re-bleeding can still occur in the setting of PNSAH, although the risk is much less than that in aneurysmal SAH...
August 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28814933/inflammatory-biomarkers-and-their-value-in-predicting-survival-and-outcome-among-patients-with-spontaneous-intracerebral-haemorrhage
#8
Senthil Kumar Rajapathy, Zamzuri Idris, Regunath Kandasamy, Albert Wong Sii Hieng, Jafri Malin Abdullah
BACKGROUND: Spontaneous intracerebral haemorrhage (SICH) has emerged as one of the most devastating forms of stroke in recent decades. This disease is noted to carry a 30-day mortality rate of approximately 45%. An increasing number of studies have implicated a complex immune-mediated and inflammation-mediated cascade of responses in the pathophysiology of SICH and the resultant neurologic outcome. Several clinical studies have demonstrated an association between inflammatory markers and outcome in patients with SICH...
May 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28812108/ultra-early-detection-of-microcirculatory-injury-as-predictor-of-developing-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#9
Philipp Gölitz, Philip Hoelter, Julie Rösch, Karl Roessler, Frauke Knossalla, Arnd Doerfler
PURPOSE: Delayed cerebral ischemia (DCI) still remains a major complication after subarachnoid hemorrhage (SAH). The aim of our study was to evaluate whether flow analysis of admission digital subtraction angiography (DSA) using parametric color coding (PCC), a postprocessing algorithm, allows ultra-early identification of SAH patients at risk for developing subsequent symptomatic vasospasm. METHODS: In this study 52 patients who suffered SAH from aneurysm rupture, were retrospectively enrolled...
August 15, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28755916/early-emerging-markers-of-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage-a-literature-review
#10
REVIEW
Fawaz Al-Mufti, Krishna Amuluru, Brendan Smith, Nitesh Damodara, Mohammad El-Ghanem, Inder P Singh, Neha Dangayach, Chirag D Gandhi
BACKGROUND: Delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage is characterized by a highly complex pathophysiology and results in neurological deterioration after the inciting bleed. Despite its significant consequences, prompt diagnosis can be elusive and treatment is often administered too late. Early brain injury, which occurs within the first 72 hours post-ictus, may be an important factor for delayed cerebral ischemia and poor overall outcome. Here we explore the purported clinical and pathological manifestations of early brain injury to identify biomarkers that could have prognostic value...
July 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28754235/mechanical-thrombectomy-for-acute-ischemic-stroke-patients-aged-80-years-or-older
#11
Taichiro Imahori, Kazuhiro Tanaka, Atsushi Arai, Ryoji Shiomi, Daigo Fujiwara, Tatsuya Mori, Akiyoshi Yokote, Kazushi Matsushima, Daisaku Matsui, Makoto Kobayashi, Atsushi Fujita, Kohkichi Hosoda, Eiji Kohmura
BACKGROUND: There are limited data about the prognostic factors predicting outcomes after mechanical thrombectomy with stent retrievers for the elderly. Here, we evaluated outcomes in elderly patients in a real-world setting. METHODS: Between April 2015 and January 2017, 80 patients with anterior intracranial acute large vessel occlusion, who had lived independently before ictus, were treated with mechanical thrombectomy using a stent retriever at our institute...
July 25, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28740479/non-ischemic-cerebral-energy-dysfunction-at-the-early-brain-injury-phase-following-aneurysmal-subarachnoid-hemorrhage
#12
Laurent Carteron, Camille Patet, Daria Solari, Mahmoud Messerer, Roy T Daniel, Philippe Eckert, Reto Meuli, Mauro Oddo
BACKGROUND: The pathophysiology of early brain injury following aneurysmal subarachnoid hemorrhage (SAH) is still not completely understood. OBJECTIVE: Using brain perfusion CT (PCT) and cerebral microdialysis (CMD), we examined whether non-ischemic cerebral energy dysfunction may be a pathogenic determinant of EBI. METHODS: A total of 21 PCTs were performed (a median of 41 h from ictus onset) among a cohort of 18 comatose mechanically ventilated SAH patients (mean age 58 years, median admission WFNS score 4) who underwent CMD and brain tissue PO2 (PbtO2) monitoring...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28735140/isolated-subcallosal-artery-infarction-secondary-to-localised-cerebral-vasospasm-of-anterior-communicating-artery-complex-following-subarachnoid-haemorrhage
#13
Santhosh Kumar Kannath, Virender Malik, Jayadevan Enakshy Rajan
BACKGROUND: Subcallosal artery (ScA) infarction is a well-recognised, but uncommon complication of surgical treatment of anterior communicating artery (ACOM) aneurysms. CASE DESCRIPTION: An elderly man presented with massive subarachnoid haemorrhage due to left posterior communicating artery aneurysm with thick clots in the anterior interhemispheric fissure. The aneurysm was coiled with balloon protection and later, on the fifth day of ictus, the patient became acutely confused and developed memory disturbances...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28734791/association-between-nocturnal-blood-pressure-variation-and-wake-up-ischemic-stroke
#14
Hyuk Sung Kwon, Ji Young Kim, Hojin Choi, Seok Joon Lee, Seong-Ho Koh, Young Joo Lee, Hyun Young Kim, Hee-Tae Kim, Juhan Kim, Young Seo Kim
Ischemic stroke during nocturnal sleep, known as wake-up stroke (WUS), has been reported to have more severe symptoms and worse outcomes than non-WUS. However, studies on risk factors for WUS are scarce and the association between nocturnal blood pressure (BP) and WUS is unclear. In this study, we used ambulatory blood pressure monitoring (ABPM) to examine the association between WUS and variation in nocturnal BP. A total of 369 patients with ischemic stroke within one week were consecutively enrolled. ABPM was applied 1-2weeks after the ictus because of possible reactive increments of BP; antihypertensive medications were delayed until ABPM...
October 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28716279/the-initial-time-course-of-headache-in-patients-with-spontaneous-subarachnoid-hemorrhage
#15
Hata Čomić, Gabriel J E Rinkel, Mervyn D I Vergouwen
BACKGROUND: If acute severe headache disappears early after its onset, the question arises whether subarachnoid hemorrhage (SAH) should still be ruled out. We studied the initial time-course and minimal duration of headache in a consecutive series of neurologically intact patients with spontaneous SAH. METHODS: We included patients admitted between 2012 and 2015 within 48h after spontaneous SAH with a normal level of consciousness and no focal deficits. We retrieved data on headache severity, measured with a Numeric Rating Scale (NRS), <48h after ictus...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28709144/the-spectrum-of-peri-ictal-mri-changes-four-illustrative-cases
#16
Jennifer Williams, Gerard Mullins, Norman Delanty, Bede Peter, Colin P Doherty
PURPOSE: Seizure induced neuronal hyperexcitability and increased unmet metabolic neuronal demand results in failure of the sodium/potassium ATP pump. Sodium and water accumulates intracellularly with cellular swelling and reduced extracellular volume demonstrating hyperintensity on DWI and reduced ADC. The aim of this study was to describe 4 clinical cases where we identified abnormalities in diffusion restriction in the acute peri-ictal period and followed them longitudinally. METHODS: Patients were recruited from the emergency department, clinical consultation service and epilepsy monitoring unit of two tertiary referral centres...
July 6, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28687123/dynamics-of-cerebral-perfusion-deficits-after-aneurysmal-sah%C3%A2-%C3%A2-predictive-value-of-early-mtt-for-subsequent-mtt-deterioration
#17
Christian Rubbert, Julian Caspers, Athanasios Konstandinou Petridis, Bernd Turowski, Rebecca May
BACKGROUND AND PURPOSE: The pathogenesis of poor functional outcome after aneurysmal subarachnoid hemorrhage (aSAH) is not fully understood. Microcirculatory dysfunction, which can be indirectly measured by CT perfusion (CTP), is assumed to play a central role. We evaluated the predictive value of early changes in microcirculation for secondary critical perfusion changes. MATERIALS AND METHODS: Out of 351 consecutive aSAH patients, 166 patients with ≥1 CTP within 72h of ictus (early CTP) and ≥3 CTPs in total were included in the retrospective analysis (53...
July 4, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28663045/appropriateness-assessment-in-antiplatelet-therapy-apathy-registry-insight-from-current-clinical-practice
#18
Nazario Carrabba, Benedetta Bellandi, Guido Parodi, Emanuele Cecchi, Giorgio Baldereschi, Cristina Giglioli, Angela Migliorini, Renato Valenti, Serafina Valente, Rossella Marcucci, Niccolò Marchionni, David Antoniucci
BACKGROUND: In clinical practice there is a gap between guidelines recommendation and antiplatelet strategies used for acute coronary syndrome (ACS). We sought to evaluate appropriateness of antiplatelet strategies employed in a tertiary center. METHODS AND RESULTS: From January to June 2014, 430 ACS were treated with percutaneous coronary intervention by 3 groups of interventional cardiologists. Aspirin and clopidogrel (52%) were the most commonly used antiplatelet therapies, being prasugrel associated with aspirin in 110 (25...
October 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28659854/role-of-interleukin-10-in-acute-brain-injuries
#19
REVIEW
Joshua M Garcia, Stephanie A Stillings, Jenna L Leclerc, Harrison Phillips, Nancy J Edwards, Steven A Robicsek, Brian L Hoh, Spiros Blackburn, Sylvain Doré
Interleukin-10 (IL-10) is an important anti-inflammatory cytokine expressed in response to brain injury, where it facilitates the resolution of inflammatory cascades, which if prolonged causes secondary brain damage. Here, we comprehensively review the current knowledge regarding the role of IL-10 in modulating outcomes following acute brain injury, including traumatic brain injury (TBI) and the various stroke subtypes. The vascular endothelium is closely tied to the pathophysiology of these neurological disorders and research has demonstrated clear vascular endothelial protective properties for IL-10...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28658989/serum-albumin-level-in-spontaneous-subarachnoid-haemorrhage-more-than-a-mere-nutritional-marker
#20
Ankur Kapoor, Sivashanmugam Dhandapani, Sachin Gaudihalli, Manju Dhandapani, Harminder Singh, Kanchan K Mukherjee
BACKGROUND: The role of nutritional markers on outcome following subarachnoid hemorrhage (SAH) has been scarcely described. METHODS: This is a prospective study of 273 patients with SAH, in which haemoglobin, serum protein and albumin were measured within 24 hours and again at one week following ictus, and analysed with respect to other variables. New neurologic deficits (NND), infarct, mortality and Glasgow outcome scale (GOS) at 3 months were assessed. RESULTS: The values of haemoglobin, total protein and albumin showed significant (p < ...
June 29, 2017: British Journal of Neurosurgery
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