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https://www.readbyqxmd.com/read/29675720/initial-misdiagnosis-of-aneurysmal-subarachnoid-hemorrhage-associating-factors-and-its-prognosis
#1
Se-Yang Oh, Yong Cheol Lim, Yu Shik Shim, Jihye Song, Sang Kyu Park, Sook Young Sim, Myeong Jin Kim, Yong Sam Shin, Joonho Chung
BACKGROUND: Predicting the fate of patients who are given a misdiagnosis of aneurysmal subarachnoid hemorrhage (aSAH) remains unclear. The purpose was to examine factors associated with initial misdiagnosis of aSAH and to investigate the impact of initial misdiagnosis of aSAH on clinical outcomes. METHODS: Between January 2007 and December 2015, medical records and radiographic data for 3118 consecutive patients with aSAH were reviewed. There were 33 patients who had been documented with an initial misdiagnosis of aSAH, and all met the following criteria: (1) failure to correctly identify aSAH upon initial presentation to health care professionals; and 2) subsequently documented aSAH after the initial misdiagnosis...
April 20, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29672747/stress-in-patients-with-un-ruptured-intracranial-aneurysms-vs-population-based-controls
#2
Arno de Wilde, Paut Greebe, Gabriël J E Rinkel, Ale Algra
BACKGROUND: Stress is associated with increased risk of stroke and might predispose to presence and rupture of intracranial aneurysms. OBJECTIVE: To study the association of recent and lifelong stress with unruptured intracranial aneurysm (UIA) and aneurysmal subarachnoid hemorrhage (ASAH). METHODS: In 227 UIA patients (mean age 61 ± 11 yr), 490 ASAH patients (59 ± 11 yr), and 775 controls (51 ± 15 yr) who were randomly retrieved from the general population, we assessed occurrence of major life events and perceived stress during the preceding 12 mo and the entire life...
April 17, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29660554/effect-of-early-brain-infarction-after-subarachnoid-haemorrhage-a-systematic-review-and-meta-analysis
#3
Bruno Gonçalves, Ricardo Turon, Antenor Mendes, Nivea Melo, Paula Lacerda, Pedro Brasil, Fernando Augusto Bozza, Pedro Kurtz, Cassia Righy
OBJECTIVE: Aneurysmal subarachnoid haemorrhage (aSAH) is an acute cerebrovascular event that leads to devastating consequences. Early brain infarction (EBI) develops very early, within the first 72 hours after bleeding, but may have a significant impact on long-term outcomes. The incidence and impact of EBI in the prognosis of aSAH remain uncertain. We performed a systematic review and meta-analysis to evaluate the incidence of EBI in patients with aSAH and determine the effect of EBI on mortality and functional outcomes...
April 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29660038/external-ventricular-drain-and-hemorrhage-in-aneurysmal-subarachnoid-hemorrhage-patients-on-dual-antiplatelet-therapy-a-retrospective-cohort-study
#4
Joseph S Hudson, Benjamin S Prout, Yasunori Nagahama, Daichi Nakagawa, Waldo R Guerrero, Mario Zanaty, Nohra Chalouhi, Pascal Jabbour, Sudeepta Dandapat, Lauren Allan, Santiago Ortega-Gutierrez, Edgar A Samaniego, David Hasan
BACKGROUND: Stenting and flow diversion for aneurysmal sub arachnoid hemorrhage (aSAH) require the use of dual antiplatelet therapy (DAPT). OBJECTIVE: To investigate whether DAPT is associated with hemorrhagic complication following placement of external ventricular drains (EVD) in patients with aSAH. METHODS: Rates of radiographically identified hemorrhage associated with EVD placement were compared between patients who received DAPT for stenting or flow diversion, and patients who underwent microsurgical clipping or coiling and did not receive DAPT by way of a backward stepwise multivariate analysis...
April 11, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29659999/increased-body-mass-index-associated-with-reduced-risk-of-delayed-cerebral-ischemia-and-subsequent-infarction-after-aneurysmal-subarachnoid-hemorrhage
#5
Lorenzo Rinaldo, Alejandro A Rabinstein, Giuseppe Lanzino
BACKGROUND: Increased body mass index (BMI) may be protective against cerebral ischemia in certain clinical contexts. OBJECTIVE: To investigate whether increased BMI was associated with delayed cerebral ischemia (DCI) and subsequent infarction after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: We retrospectively reviewed the clinical course of patients presenting to our institution for management of aSAH. Patient were segregated according to BMI< or ≥29...
April 4, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29649648/ultra-early-treatment-for-poor-grade-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#6
Yangyun Han, Feng Ye, Xiaodong Long, Aiguo Li, Hong Xu, Linbo Zou, Yumin Yang, Md Chao You
OBJECTIVE: It remains unknown if ultra-early (within 24 hours after SAH onset) treatment could improve prognosis in poor-grade aneurysmal subarachnoid hemorrhage (aSAH). We aimed to evaluate the effect of ultra-early treatment on the functional outcome and mortality in poor-grade aSAH patients via systematic review and meta-analysis. METHODS: We performed a literature search in PubMed, MEDLINE and Web of Science databases. Primary outcomes were death and functional outcome assessed at any time period...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29649643/estimating-the-global-incidence-of-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-for-central-nervous-system-vascular-lesions-and-meta-analysis-of-ruptured-aneurysms
#7
REVIEW
Joshua D Hughes, Kamila M Bond, Rania A Mekary, Michael C Dewan, Abbas Rattani, Ronnie Baticulon, Yoko Kato, Hildo Azevedo-Filho, Jacques J Morcos, Kee B Park
INTRODUCTION: There is increasing acknowledgement that surgical care is important in global health initiatives. In particular, neurosurgical care is as limited as 1-to-10 million people in parts of the world. We performed a systematic literature review to examine the worldwide incidence of central nervous system vascular lesions (CNS-VL) and a meta-analysis of aneurysmal subarachnoid hemorrhage (ASAH) in order to define the disease burden and inform neurosurgical global health efforts...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29619659/spontaneous-elevation-of-blood-pressure-after-sah-an-epiphenomenon-of-disease-severity-and-demand-but-not-a-surrogate-for-outcome
#8
F Teping, W Albanna, H Clusmann, H Schulze-Steinen, M Mueller, A Hoellig, G A Schubert
BACKGROUND: Spontaneous blood pressure increase is frequently observed after aneurysmal subarachnoid hemorrhage (aSAH). These episodes of spontaneous blood pressure alterations are usually tolerated under the assumption of an endogenous response to maintain cerebral perfusion. The relevance of blood pressure variability and its relationship to disease severity and outcome, however, remain obscure. METHODS: A total of 115 consecutive patients with aSAH were included for this retrospective analysis of a continuously collected data pool...
April 4, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29611451/permeability-imaging-as-a-predictor-of-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#9
Jonathan J Russin, Axel Montagne, Francesco D'Amore, Shuhan He, Mark S Shiroishi, Robert C Rennert, Jena Depetris, Berislav V Zlokovic, William J Mack
Blood-brain barrier (BBB) dysfunction has been implicated in ischemic risk following aneurysmal subarachnoid hemorrhage (aSAH), but never directly imaged. We prospectively examined whether post-bleed day 4 dynamic contrast-enhanced magnetic resonance (DCE-MR) BBB permeability imaging could predict development of delayed cerebral ischemia (DCI). Global MR-derived BBB permeability ( Ktrans ) was significantly higher in aSAH patients who subsequently developed DCI (five patients; 2.28 ± 0.09 × 10-3 min-1 ) compared to those who experienced radiographic vasospasm only (three patients; 1...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29603031/does-the-subspecialty-of-an-intensive-care-unit-icu-has-an-impact-on-outcome-in-patients-suffering-from-aneurysmal-subarachnoid-hemorrhage
#10
Dorothee Mielke, Vesna Malinova, Onnen Moerer, Patricia Suntheim, Martin Voit, Veit Rohde
We retrospectively compared the outcome of aneurysmal subarachnoid hemorrhage (aSAH) patients treated in a neurosurgical ICU (nICU) between 1990 and 2005 with that of patients treated in a general ICU (gICU) between 2005 and 2013 with almost identical treatment strategies. Among other parameters, we registered the initial Hunt and Hess grade, Fisher score, the incidence of vasospasm, and outcome. A multivariate analysis (logistic regression model) was performed to adjust for different variables. In total, 755 patients were included in this study with 456 patients assigned to the nICU and 299 patients to the gICU...
March 30, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29600883/investigational-drugs-for-vasospasm-after-subarachnoid-hemorrhage
#11
Roberta T Tallarico, Michael A Pizzi, William D Freeman
Aneurysmal subarachnoid hemorrhage (aSAH) represents 3% of all strokes in the US. When the patient survives it can lead to permanent incapacity especially if the patient develops vasospasm. The vasospasm is a multifactorial disorder and can lead to delayed cerebral ischemia (DCI). Most of the drugs tested to treat vasospasm failed to improve outcome and the only exception is nimodipine. Areas covered: In this review, the authors describe the multifactorial process of vasospasm leading DCI after aSAH, discussing the treatments available based on the past and latest researches...
April 6, 2018: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/29599745/treatment-modality-and-quality-benchmarks-of-aneurysmal-subarachnoid-hemorrhage-at-a-comprehensive-stroke-center
#12
Wengui Yu, Tapan Kavi, Tamara Majic, Kimberly Alva, Asma Moheet, Patrick Lyden, Wouter Schievink, Gregory Lekovic, Michael Alexander
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is the most severe type of stroke. In 2012, the Joint Commission, in collaboration with the American Heart Association/American Stroke Association (AHA/ASA), launched the Advanced Certification for Comprehensive Stroke Centers (CSCs). This new level of certification was designed to promote higher standard of care for patients with complex stroke. Objective: The goal of this study was to examine the treatment modality and quality benchmarks of aSAH at one of the first five certified CSCs in the United States...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29595109/levosimendan-reduces-prostaglandin-f2a-dependent-vasoconstriction-in-physiological-vessels-and-after-experimentally-induced-subarachnoid-hemorrhage
#13
Stefan Wanderer, Jan Mrosek, Florian Gessler, Volker Seifert, Juerge Konczalla
Background Delayed cerebral vasospasm (dCVS) following aneurysmal subarachnoid hemorrhage (aSAH) is (next to possible aneurysm rebleeding, cortical spreading depression and early brain injury) one of the main factors contributing to poor overall patient outcome. Since decades intensive research has been ongoing with the goal of improving our understanding of the pathophysiological principles underlying dCVS. Endothelin-1 (ET-1) and prostaglandin F2 alpha (PGF2a) seem to play a major role during dCVS. The synthesis of ET-1 is enhanced after subarachnoid hemorrhage (SAH) to mediate a long-lasting vasoconstriction, and PGF2a contributes to cerebral inflammation and vasoconstriction...
March 28, 2018: Current Neurovascular Research
https://www.readbyqxmd.com/read/29548966/significant-injury-of-the-mammillothalamic-tract-without-injury-of-the-corticospinal-tract-after-aneurysmal-subarachnoid-hemorrhage-a-retrospective-diffusion-tensor-imaging-study
#14
Rami Darwazeh, Miao Wei, Jianjun Zhong, Zhaosi Zhang, Fajin Lv, Mazhar Darwazeh, Yi Guo, Yi Yan, Samer S Hoz, Xiaochuan Sun
OBJECTIVE: Little is known about the pathophysiological mechanisms of white matter injury after aneurysmal subarachnoid hemorrhage (aSAH). The purpose of this study is to investigate whether mammillothalamic tract (MTT) or corticospinal tract (CST) is more affected by aSAH in the same patients with good-outcome (Grade 5 on Glasgow Outcome Scale (GOS) at 3 months) using diffusion tensor imaging (DTI). METHODS: Between June 2013 to September 2016, 21 good-outcome patients with aSAH and 21 sex-and age-matched normal healthy control participants were recruited...
March 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29544998/evaluation-of-safety-efficacy-and-clinical-outcome-after-endovascular-treatment-of-aneurysmal-subarachnoid-haemorrhage-in-coil-first-setting-a-10-year-series-from-a-single-centre
#15
Muhammad AlMatter, Pervinder Bhogal, Marta Aguilar Pérez, Victoria Hellstern, Hansjörg Bäzner, Oliver Ganslandt, Hans Henkes
INTRODUCTION: The endovascular treatment (EVT) of ruptured cerebral aneurysms has been widely adopted after publication of the ISAT. In this study we sought to evaluate the safety and efficacy of the EVT for ruptured aneurysms based on 10-year series from a single centre with coil-first strategy. METHODS: All patients with aneurysmal subarachnoid haemorrhage (aSAH) treated between 2007 and 2016 were retrospectively reviewed and divided according to initial treatment into an EVT and a microsurgical clipping (MSC) group...
March 12, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29535904/delayed-spinal-arachnoiditis-following-aneurysmal-subarachnoid-hemorrhage-a-case-report
#16
Rimal H Dossani, Devi P Patra, Hai Sun, Anil Nanda, Hugo Cuellar
Spinal arachnoiditis (SA) is a rare and delayed complication of aneurysmal subarachnoid hemorrhage (aSAH). We present a case of delayed SA associated with thoracic and lumbar arachnoid cysts in a patient with aSAH secondary to a ruptured vertebral artery aneurysm. The patient underwent a thoracic laminectomy for decompression of the spinal cord, lysis of arachnoid adhesions, and fenestration of an arachnoid cyst. We present the pathogenesis, diagnosis, treatment, and management of spinal arachnoiditis as a rare complication of aSAH...
January 6, 2018: Curēus
https://www.readbyqxmd.com/read/29529609/risk-factors-and-clinical-impact-of-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage-analysis-from-the-china-national-stroke-registry
#17
Wanying Duan, Yuesong Pan, Chunjuan Wang, Yilong Wang, Xingquan Zhao, Yongjun Wang, Liping Liu
BACKGROUND: Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) is a significant cause of morbidity and mortality. While it is important to detect early signs of DCI, patients with high risk of DCI are difficult to identify, and the potential risk factors are uncertain. This study aimed to identify independent risk factors of DCI and clarify their clinical impact on outcome and the disease course. METHODS: For this nationwide, multicenter, prospective clinical study involving consecutive patients with aSAH recruited from the China National Stroke Registry, demographic, clinical, radiological, and laboratorial data during hospitalisation, in-hospital complications, functional outcomes, and mortality at 3, 6, and 12 months were recorded...
March 12, 2018: Neuroepidemiology
https://www.readbyqxmd.com/read/29528448/white-blood-cell-count-improves-prediction-of-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage
#18
Fawaz Al-Mufti, Kalina Anna Misiolek, David Roh, Aws Alawi, Andrew Bauerschmidt, Soojin Park, Sachin Agarwal, Philip M Meyers, E Sander Connolly, Jan Claassen, J Michael Schmidt
BACKGROUND: Immune dysregulation has long been implicated in the development of delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: To determine the relationship of inflammatory cell biomarkers with DCI. METHODS: We evaluated 849 aSAH patients who were enrolled into a prospective observational cohort study and had a white blood cell (WBC) differential obtained within 72 h of bleed onset. RESULTS: WBC count > 12...
March 8, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29526058/korean-clinical-practice-guidelines-for-aneurysmal-subarachnoid-hemorrhage
#19
REVIEW
Won-Sang Cho, Jeong Eun Kim, Sukh Que Park, Jun Kyeung Ko, Dae-Won Kim, Jung Cheol Park, Je Young Yeon, Seung Young Chung, Joonho Chung, Sung-Pil Joo, Gyojun Hwang, Deog Young Kim, Won Hyuk Chang, Kyu-Sun Choi, Sung Ho Lee, Seung Hun Sheen, Hyun-Seung Kang, Byung Moon Kim, Hee-Joon Bae, Chang Wan Oh, Hyeon Seon Park
Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, worldwide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29523945/comparison-of-cerebral-perfusion-in-perimesencephalic-subarachnoid-hemorrhage-and-aneurysmal-subarachnoid-hemorrhage
#20
Isabel Fragata, Nuno Canto-Moreira, Patrícia Canhão
PURPOSE: Perimesencephalic hemorrhage (PMH) is a benign subtype of nonaneurysmal subarachnoid hemorrhage (SAH). We aimed to investigate if cerebral perfusion in PMH is less affected than in aneurysmal SAH (aSAH). METHODS: From a prospective cohort of 80 patients with spontaneous SAH, we included PMH patients (n = 15) and selected aSAH patients (n = 39) with similar clinical grade at admission (World Federation of Neurosurgeons Scale-WFNS I/II). Computed tomography (CT) perfusion was performed at < 72 h and/or at 8-10 days...
March 9, 2018: Neuroradiology
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