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https://www.readbyqxmd.com/read/28814933/inflammatory-biomarkers-and-their-value-in-predicting-survival-and-outcome-among-patients-with-spontaneous-intracerebral-haemorrhage
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
July 19, 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28643998/survey-in-expert-clinicians-on-validity-of-automated-calculation-of-optimal-cerebral-perfusion-pressure
#14
Romy Steijn, Roy Stewart, Marek Czosnyka, Joseph Donnelly, Ari Ercole, Antony Absalom, Jan W Elting, Christina Haubrich, Peter Smielewski, Marcel Aries
BACKGROUND: Optimal cerebral perfusion pressure (CPPopt) targeting in traumatic brain injury (TBI) patients constitutes an active and controversial area of research. It has been suggested that an autoregulation guided CPP therapy may improve TBI outcome. Prerequisites of a CPPopt intervention study would be objective criteria for the CPPopt detection.. This study compared the agreement between automated and visual CPPopt detection. METHODS: Twenty-five clinicians from 18 centres worldwide, familiar with brain monitoring and using dedicated software, reviewed ten 4-hour CPPopt screenshots at 48 hrs after ictus in selected TBI patients...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28627194/s%C3%A3-ndrome-metab%C3%A3-lico-y-riesgo-cardiovascular-en-la-poblaci%C3%A3-n-diab%C3%A3-tica-de-el-hierro-islas-canarias
#15
M Candelaria Martín-González, Ana María Torres-Vega, Emilio González-Reimers, Geraldine Quintero-Platt, Camino Fernández-Rodríguez, Julio Alvisa-Negrín, Adnan Hawari-Meilud, Francisco Santolaria-Fernández
Introducción: en Canarias existe una elevada prevalencia de factores de riesgo vascular, superior a la del resto de España.Objetivo: analizar las características clínicas de 300 adultos diabéticos tipo II de El Hierro, en el Archipiélago Canario.Métodos: los pacientes fueron valorados en la Unidad de Medicina Interna del hospital entre 1982 a 2010, y seguidos hasta diciembre de 2014 o hasta su fallecimiento. La muestra se compone de 154 mujeres y 156 hombres (52%).Resultados: la edad media fue de 66...
June 5, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28602499/susceptibility-weighted-angiography-and-diffusion-weighted-imaging-in-posterior-reversible-encephalopathy-syndrome-is-there-an-association-between-hemorrhage-cytotoxic-edema-blood-pressure-and-imaging-severity
#16
Shivaprakash Basavanthaiah Hiremath, Amol Anantrao Gautam, Shilpa Anil, Reji Thomas, Geena Benjamin
PURPOSE: To assess the significance of association and possible correlation between hemorrhage, cytotoxic edema, blood pressure and imaging severity in posterior reversible encephalopathy syndrome (PRES). MATERIALS AND METHODS: This retrospective study included the medical and imaging records of 35 consecutive patients with PRES. The clinical data analysis included the highest recorded blood pressure (BP) on the day of the ictus, MRI including spin-echo echo planar diffusion-weighted imaging (DWI), susceptibility weighted angiography (SWAN) and conventional sequences...
June 8, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28585856/%C3%A2-y-despu%C3%A3-s-del-ictus-qu%C3%A3-hacemos-para-nutrirle
#17
María D Ballesteros Pomar, Laura Palazuelo Amez
Las enfermedades neurológicas conllevan, a menudo, alteraciones en el nivel de conciencia o en los mecanismos de la deglución que hacen necesario un soporte nutricional artificial. Las guías internacionales recomiendan realizar un cribado de malnutrición a los pacientes con enfermedades neurológicas. La disfagia es un problema frecuente después de un ictus. Sin embargo, la disfagia es una patología tratable y la rehabilitación de la función deglutoria permite mejorar el estado nutricional de los pacientes...
May 8, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28578111/surgical-evacuation-of-spontaneous-supratentorial-lobar-intracerebral-hemorrhage-comparison-of-safety-and-efficacy-of-stereotactic-aspiration-endoscopic-surgery-and-craniotomy
#18
Yuqian Li, Ruixin Yang, Zhihong Li, Yanping Yang, Bo Tian, Xingye Zhang, Bao Wang, Dan Lu, Shaochun Guo, Minghao Man, Yang Yang, Tao Luo, Guodong Gao, Lihong Li
BACKGROUND: The safety and efficacy of craniotomy, endoscopic surgery, and stereotactic aspiration for surgical evacuation of spontaneous supratentorial lobar intracerebral hemorrhage (ICH) is yet uncertain. The present study analyzed the clinical and radiographical data from 99 patients with spontaneous supratentorial lobar ICH, retrospectively, to address this issue. METHODS: Patients who underwent craniotomy, endoscopy surgery, or stereotactic aspiration were assigned to the craniotomy group (n = 31), endoscopy surgery group (n = 32), or stereotactic aspiration group (n = 36), respectively...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28501949/relationship-between-intracranial-internal-carotid-artery-calcification-and-enlarged-cerebral-perivascular-space
#19
Xiao-Xiao Tao, Ge-Fei Li, Yi-Lan Wu, Yi-Sheng Liu, Ying Zhao, Yan-Hui Shi, Mei-Ting Zhuang, Tian-Yu Hou, Rong Zhao, Feng-Di Liu, Xue-Mei Wang, Ying Shen, Guo-Hong Cui, Jing-Jing Su, Wei Chen, Xue-Mei Tang, Ji Sun, Jian-Ren Liu
PURPOSE: The association between intracranial internal carotid artery (IICA) calcification and lacunes, white matter hyperintensity (WMH), and cerebral microbleeds (CMBs) has been well researched. However, enlarged cerebral perivascular space (PVS) has not yet been reported to correlate with intracranial internal carotid artery calcification. Therefore, the primary aim of this study was to investigate the relationship between IICA calcification and enlarged PVS. METHODS: A total of 189 patients with ischemic stroke in the middle cerebral artery territory who presented within 7 days of ictus from 2012 to 2015 were enrolled respectively...
June 2017: Neuroradiology
https://www.readbyqxmd.com/read/28487333/enhanced-detection-of-edema-in-malignant-anterior-circulation-stroke-edema-score-a-risk-prediction-tool
#20
Charlene Jennifer Ong, Jeffrey Gluckstein, Osvaldo Laurido-Soto, Yan Yan, Rajat Dhar, Jin-Moo Lee
BACKGROUND AND PURPOSE: Rapid recognition of those at high risk for malignant edema after stroke would facilitate triage for monitoring and potential surgery. Admission data may be insufficient for accurate triage decisions. We developed a risk prediction score using clinical and radiographic variables within 24 hours of ictus to better predict potentially lethal malignant edema. METHODS: Patients admitted with diagnosis codes of cerebral edema and ischemic stroke, NIHSS score (National Institute of Health Stroke Score) of ≥8 and head computed tomographies within 24 hours of stroke onset were included...
July 2017: Stroke; a Journal of Cerebral Circulation
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