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https://www.readbyqxmd.com/read/28642178/neurological-outcome-after-decompressive-craniectomy-predictors-of-outcome-in-different-pathologies
#1
Taco Goedemans, Dagmar Verbaan, Bert A Coert, Bertjan Kerklaan, René van den Berg, Jonathan M Coutinho, Tessa van Middelaar, Paul J Nederkoorn, W Peter Vandertop, Pepijn van den Munckhof
OBJECTIVE: Decompressive craniectomy (DC) has been proposed as lifesaving treatment in patients with elevated intracranial pressure, but its effectiveness on reaching favorable neurological outcome remains unclear. We identified predictors of outcome in a large, single-center cohort of patients undergoing DC for different pathologies. METHODS: This retrospective study included all patients undergoing DC from 2006-2014. One-year outcome, assessed using the Glasgow Outcome Scale (GOS), was dichotomized into favorable (GOS 4-5) and unfavorable (GOS 1-3) outcome...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28633535/changes-in-the-level-of-cardiac-troponine-and-disorders-in-pulmonary-gas-exchange-as-predictors-of-short-and-long-term-outcomes-of-patients-with-aneurysm-subarachnoid-haemorrhage
#2
Małgorzata Burzyńska, Agnieszka Uryga, Magdalena Kasprowicz, Jarosław Kędziora, Ewa Szewczyk, Jowita Woźniak, Włodzimierz Jarmundowicz, Andrzej Kübler
SUBJECT: Cardiopulmonary abnormalities are common after aneurysmal subarachnoid haemorrhage (aSAH). However, the relationship between short- and long-term outcome is poorly understood. In this paper, we present how cardiac troponine elevations (cTnI) and pulmonary disorders are associated with short- and long-term outcomes assessed by the Glasgow Outcome Scale (GOS) and Extended Glasgow Outcome Scale (GOSE). METHODS: A total of 104 patients diagnosed with aSAH were analysed in the study...
June 21, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28627225/the-relationships-between-bnp-and-neurocardiac-injury-severity-noninvasive-cardiac-output-and-outcomes-after-aneurysmal-subarachnoid-hemorrhage
#3
Amber McAteer, Marilyn Hravnak, Yuefang Chang, Elizabeth A Crago, Matthew J Gallek, Khalil M Yousef
INTRODUCTION: Neurocardiac injury, a type of myocardial dysfunction associated with neurological insult to the brain, occurs in 31-48% of aneurysmal subarachnoid hemorrhage (aSAH) patients. Cardiac troponin I (cTnI) is commonly used to diagnose neurocardiac injury. Brain natriuretic peptide (BNP), another cardiac marker, is more often used to evaluate degree of heart failure. The purpose of this study was to examine the relationships between BNP and (a) neurocardiac injury severity according to cTnI, (b) noninvasive continuous cardiac output (NCCO), and (c) outcomes in aSAH patients...
January 1, 2017: Biological Research for Nursing
https://www.readbyqxmd.com/read/28625587/a-rabbit-model-of-aneurysmal-subarachnoid-hemorrhage-by-ear-central-artery-suprasellar-cistern-shunt
#4
Jing Lu, Fuxiang Chen, Bing Cai, Fan Chen, Dezhi Kang
Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening hemorrhagic cerebrovascular disease. The concept of early brain injury (EBI), induced by sharply increased intracranial pressure (ICP) and low cerebral perfusion pressure (CPP) with cerebral global ischemia following aneurysm rupture, has been increasingly accepted. However, EBI has not been well studied partly due to lack of an ideal animal model. The purpose of this study was to establish a new aSAH model which can mimic the pathophysiological damage of EBI...
June 15, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28623116/comparison-of-the-prevalence-of-ruptured-and-unruptured-cerebral-aneurysms-in-a-poor-urban-minority-population
#5
Todd S Miller, David Altschul, Nrupen Baxi, Joaquim Farinhas, David Pasquale, Judah Burns, David Gordon, Jacqueline Bello, Allan Brook, Eugene Flamm
BACKGROUND: Most ruptured cerebral aneurysms are small (<7 mm). Evidence suggests low rupture rates for such lesions (<1% per year). Population studies demonstrate a prevalence rate of 3.2%. This study simultaneously estimates the prevalence of aneurysms in a single geographic population while reporting the observed rate of aneurysmal subarachnoid hemorrhage (aSAH) in the same geographic region composed of a poor urban minority demographic. METHODS: This is an institutional review board-approved, Health Insurance Portability and Accountability Act of 1996-compliant retrospective study performed between 2005 and 2011 at a single center...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28619501/irreversible-total-loss-of-brain-function-and-organ-donation-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#6
Malte Mohme, Thomas Sauvigny, Jörn Grensemann, Gerold Söffker, Stefan Kluge, Manfred Westphal, Patrick Czorlich
OBJECTIVE: Aneurysmal subarachnoid hemorrhage (aSAH) is a life threatening disease with an often fatal clinical course leading to irreversible total loss of brain function, i.e. brain death. The purpose of this study is to assess the prevalence and characteristics of patients with aSAH converting into organ donors after diagnosis of brain death. METHODS: We retrospectively analyzed anonymized clinical data sets of 395 patients treated for aSAH at our university medical center within the period from 01/2011 to 12/2016...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28609751/aneurysmal-subarachnoid-hemorrhage-lead-to-systemic-upregulation-of-il-23-il-17-inflammatory-axis
#7
Shafqat Rasul Chaudhry, Erdem Güresir, Hartmut Vatter, Thomas M Kinfe, Dirk Dietrich, Alf Lamprecht, Sajjad Muhammad
IL-23 and IL-17 are pro-inflammatory cytokines. IL-23 is secreted by activated macrophages and dendritic cells, while IL-17 by Th17 cells. Serum IL-23 and IL-17 are known to be elevated in numerous inflammatory diseases including neurodegenerative diseases. The role of serum IL-23 and IL-17 in aneurysmal subarachnoid hemorrhage (aSAH) has still not been investigated. The present work investigates the serum IL-23 and IL-17 levels and their association with post hemorrhagic complications and clinical outcome in patients with aSAH...
June 10, 2017: Cytokine
https://www.readbyqxmd.com/read/28599907/association-of-plasminogen-activator-inhibitor-1-serpine1-gene-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage
#8
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: Genetic variations of the SERPINE1 gene, which encodes plasminogen activator inhibitor 1 (PAI-1), correlate with serum levels of its product and are associated with thrombophilia and coronary atherosclerosis. Various SERPINE1 gene polymorphisms have been identified. Only the functional 5G/4G polymorphism, however, has been assessed in the context of aneurysmal subarachnoid hemorrhage (aSAH). Here, we assessed associations of 6 SERPINE1 polymorphisms with the clinical sequelae of aSAH...
June 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28598279/a-novel-score-to-predict-shunt-dependency-after-aneurysmal-subarachnoid-hemorrhage
#9
Dominik Diesing, Stefan Wolf, Jenny Sommerfeld, Asita Sarrafzadeh, Peter Vajkoczy, Nora F Dengler
OBJECTIVE Feasible clinical scores for predicting shunt-dependent hydrocephalus (SDHC) after aneurysmal subarachnoid hemorrhage (aSAH) are scarce. The chronic hydrocephalus ensuing from SAH score (CHESS) was introduced in 2015 and has a high predictive value for SDHC. Although this score is easy to calculate, several early clinical and radiological factors are required. The authors designed the retrospective analysis described here for external CHESS validation and determination of predictive values for the radiographic Barrow Neurological Institute (BNI) scoring system and a new simplified combined scoring system...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28582545/stereotactic-catheter-ventriculocisternostomy-for-clearance-of-subarachnoid-hemorrhage-in-patients-with-coiled-aneurysms
#10
Roland Roelz, Christian Scheiwe, Horst Urbach, Volker A Coenen, Peter Reinacher
BACKGROUND: Cerebral vasospasm leading to delayed cerebral infarction (DCI) is a central source of poor outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). Current treatments of cerebral vasospasm are insufficient. Cisternal blood clearance is a promising treatment option. However, a generally applicable, safe, and effective method to access the cisterns of the brain is lacking. OBJECTIVE: To report on stereotactic catheter ventriculocisternostomy (STX-VCS) as a method to access the cisterns of the brain for clearance of subarachnoid hemorrhage in patients with aSAH and coiled aneurysms...
June 3, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28575128/neurofibromatosis-type-1-is-not-associated-with-subarachnoid-haemorrhage
#11
Arttu Kurtelius, Roope A Kallionpää, Jukka Huttunen, Terhi J Huttunen, Katariina Helin, Timo Koivisto, Juhana Frösen, Mikael von Und Zu Fraunberg, Sirkku Peltonen, Juha Peltonen, Juha E Jääskeläinen, Antti E Lindgren
BACKGROUND: The prevalence of intracranial aneurysms (IAs) has been proposed to be elevated in the patients with neurofibromatosis type 1 (NF1). Our aims were to determine the prevalence of NF1 in a large Finnish population based cohort of IA patients and, on the other hand, the occurrences of subarachnoid haemorrhage and unruptured intracranial aneurysms in a nationwide population-based cohort of NF1 patients and its matched ten-fold control cohort. METHODS: The Kuopio IA Database (www...
2017: PloS One
https://www.readbyqxmd.com/read/28559079/respiratory-and-swallowing-outcomes-based-on-aneurysm-location-in-360-patients-with-subarachnoid-hemorrhage
#12
Isaac Josh Abecassis, Ryan P Morton, Lynn McGrath, Josiah Hanson, Anna H Xue, Cory M Kelly, Michael R Levitt, Laligam N Sekhar, Louis J Kim
INTRODUCTION: Aneurysmal subarachnoid hemorrhage (aSAH) may result in abnormal respiratory and swallowing function. We analyzed factors that may influence long-term respiratory and swallowing function in aSAH patients, and compared patients with anterior and posterior aneurysm locations. METHODS: We retrospectively reviewed 360 consecutive aSAH patients. We recorded location of the aneurysm and respiratory indices on admission, in-hospital adverse respiratory events and the need for tracheostomy (for respiratory failure) or percutaneous endoscopic gastrostomy (PEG) tube (for prolonged dysphagia)...
May 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28549643/hypertonic-saline-for-raised-intracranial-pressure-following-aneurysmal-subarachnoid-hemorrhage-a-systematic-review
#13
REVIEW
Christopher R Pasarikovski, Naif M Alotaibi, Fawaz Al-Mufti, R Loch Macdonald
BACKGROUND: The use of hyperosmolar agents such as mannitol or hypertonic saline (HTS) to control high intracranial pressure (ICP) in traumatic brain injury patients has been well studied. However, the role of HTS in the management of aneurysmal subarachnoid hemorrhage (aSAH)-associated raised ICP is still unclear. METHODS: We performed a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome of this review is to quantify ICP reduction produced by HTS and its effect on clinical outcomes defined by any standardized functional score...
May 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28548598/associations-between-endothelin-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage-clinical-vasospasm-delayed-cerebral-ischemia-and-functional-outcome
#14
Christoph J Griessenauer, Robert M Starke, Paul M Foreman, Philipp Hendrix, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Mingkuan Lin, Beverly C Walters, Jean-Francois Pittet, Mali Mathru
OBJECTIVE Endothelin-1, a potent vasoconstrictor, and its receptors may be involved in the pathogenesis of aneurysmal subarachnoid hemorrhage (aSAH), clinical vasospasm, delayed cerebral ischemia (DCI), and functional outcome following aSAH. In the present study, common endothelin single nucleotide polymorphisms (SNPs) and their relation to aSAH were evaluated. METHODS Blood samples from all patients enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study were used for genetic evaluation. The CARAS study prospectively enrolled patients with aSAH at 2 academic institutions in the US from 2012 to 2015...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28540294/management-of-spontaneous-subarachnoid-hemorrhage-patients-with-negative-initial-digital-subtraction-angiogram-findings-conservative-or-aggressive
#15
Liang Xu, Yuanjian Fang, Xudan Shi, Xianyi Chen, Jun Yu, Zeyu Sun, Jianmin Zhang, Jing Xu
Background. The ideal management of SAH patients with negative initial DSA findings remains unresolved. Objective. (i) To present risk factors, clinical courses, and outcomes in different types of SAH patients with negative DSA findings; (ii) to explore the differences of basal vein between aSAH patients and NASAH patients; and (iii) to evaluate the value of repeated DSA for these patients. Methods. All SAH patients with negative initial DSA findings between 2013 and 2015 in our hospital were enrolled and were further categorized as perimesencephalic SAH (PMN-SAH) or nonperimesencephalic SAH (nPMN-SAH)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28523215/migraine-prevalence-in-patients-with-unruptured-intracranial-aneurysms-a-case-control-study
#16
Elbert H Witvoet, Nadine Pelzer, Gisela M Terwindt, Gabriël J E Rinkel, Monique H M Vlak, Ale Algra, Marieke J H Wermer
OBJECTIVES: Migraine is a suggested risk factor for aneurysmal subarachnoid hemorrhage (aSAH). An increased risk of aSAH in migraineurs may be explained by an increased prevalence of unruptured intracranial aneurysms (UIA). We performed a case-control study to compare lifetime migraine prevalence in patients with UIA, patients with a history of transient ischemic attact (TIA) or ischemic stroke and controls without a history of aSAH, TIA or ischemic stroke. MATERIALS AND METHODS: Patients with UIA were recruited from two university hospitals...
May 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28512045/early-diagnosis-of-delayed-cerebral-ischemia-possible-relevance-for-inflammatory-biomarkers-in-routine-clinical-practice
#17
Bishwas Chamling, Stefan Gross, Birgit Stoffel-Wagner, Gerrit A Schubert, Hans Clusmann, Mark Coburn, Anke Höllig
BACKGROUND: Delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is one of the main causes of neurological deterioration. However, it frequently evades timely detection. Early identification and effective reversal may improve the clinical outcome. In this prospective study, we evaluate several serum inflammatory markers after aSAH with regard to the occurrence of DCI. METHODS: On days 1, 4, 7, 10 and 14 after SAH leucocyte count, C-reactive protein, interleukin-6, E-selectin, matrix metallopeptidase 9, intercellular adhesion molecule 1 and leukemia inhibitory factor were assessed in patients´ serum samples...
May 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28502692/what-factors-determine-treatment-outcome-in-aneurysmal-subarachnoid-haemorrhage-in-the-modern-era-a-post-hoc-stash-analysis
#18
Mario Teo, Mathew R Guilfoyle, Carole Turner, Peter J Kirkpatrick
INTRODUCTION: The management of aneurysmal SAH has changed dramatically in the last few decades with the publication of a few major studies including The International Cooperative Study on the Timing of Aneurysm Surgery Study, International Subarachnoid Aneurysm Trial (ISAT). The aim of this study is to analyse the outcome of patients with aSAH based on a contemporary series, identify the risk factors for poor outcome, and focusing on patients with good grades aSAH (to match the ISAT cohort)...
May 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28499903/utilization-of-paine-s-technique-projecting-puncture-point-to-the-skull-and-skin
#19
Hiroaki Matsuzaki, Tadahiro Otsuka, Ken Uekawa, Takashi Nakagawa, Nobuyuki Tsubota
OBJECTIVE: Ventriculostomy from Paine's point is an effective technique to obtain a slack brain for aneurysm surgery. This study aimed to use Paine's point for other neurosurgical procedures (except for those that require pterional approach) by delineation of surface landmarks for identification of Paine's point on the cranium and scalp. METHODS: Based on the anatomical knowledge and examination of 3D CT images of skull, we determined novel surface landmarks to identify Paine's point on cranium and scalp...
May 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28499220/effects-of-preadmission-beta-blockers-on-neurogenic-stunned-myocardium-after-aneurysmal-subarachnoid-hemorrhage-a-meta-analysis
#20
Hai Luo, Wei-Xin Song, Jin-Wen Jiang, Jian-Lan Zhao, Wei-Lin Rong, Mei-Hua Li
OBJECTIVE: Spontaneous subarachnoid hemorrhage is mostly caused by the rupture of an aneurysm. Neurogenic stunned myocardium (NSM) is one of the most frequent complications caused by aneurysmal subarachnoid hemorrhage (aSAH). The possible pathogenesis of NSM may be that the catecholamine peak resulting from aSAH leads to subendocardial ischemia or coronary artery spasm. We designed this meta-analysis to find out whether beta-blockers (BB) can significantly reduce the incidence of NSM and improve the outcomes of aSAH...
July 2017: Clinical Neurology and Neurosurgery
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