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https://www.readbyqxmd.com/read/28549643/hypertonic-saline-for-raised-intracranial-pressure-following-aneurysmal-subarachnoid-hemorrhage-a-systematic-review
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
May 1, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28471926/a-literature-review-of-psychosocial-comorbidities-related-to-working-capacity-after-aneurysmal-subarachnoid-hemorrhage
#9
Eleanor Turi, Yvette Conley, Ansley Grimes Stanfill
OBJECTIVE: The aim of this study was to describe literature regarding the impact of psychosocial comorbidities on working capacity after aneurysmal subarachnoid hemorrhage (aSAH). DESIGN/METHODS: This study is a review of the literature using PubMed, CINAHL, PyschINFO, and Google Scholar. RESULTS: Patients with aSAH affected by depression, anxiety, cognitive impairment, or posttraumatic stress disorder are less likely to return to work, although there are mixed results...
June 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28469595/apolipoprotein-e-%C3%AE%C2%B54-a-possible-risk-factor-of-intracranial-pressure-and-white-matter-perfusion-in-good-grade-aneurysmal-subarachnoid-hemorrhage-patients-at-early-stage
#10
Jian-Hua Peng, Xing-Hu Qin, Jin-Wei Pang, Yue Wu, Jin-Hu Dong, Chang-Ren Huang, Wei-Feng Wan, Xiao-Bo Yang, Xiao-Chuan Sun, Li-Gang Chen, Yong Jiang
Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating and complicated disease with significant morbidity and mortality. Previous studies have shown that genetic susceptibility may play an important role in the outcome of a given individual with aSAH. This study evaluates the potential association in effects of the APOE allele on the early brain injury (EBI) in light of elevated intracranial pressure (ICP) and cerebral perfusion disorders in a consecutive series of non-comatose Chinese patients with aSAH...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28468927/irregular-shape-identifies-ruptured-intracranial-aneurysm-in-subarachnoid-hemorrhage-patients-with-multiple-aneurysms
#11
Joel Björkman, Juhana Frösen, Olli Tähtinen, Daan Backes, Terhi Huttunen, Jaakko Harju, Jukka Huttunen, Mitja I Kurki, Mikael von Und Zu Fraunberg, Timo Koivisto, Hannu Manninen, Juha E Jääskeläinen, Antti E Lindgren
BACKGROUND AND PURPOSE: We investigated which aneurysm-related risk factors for rupture best discriminate ruptured versus unruptured saccular intracranial aneurysms (sIAs) in subarachnoid hemorrhage patients with multiple sIAs. METHODS: We included 264 subarachnoid hemorrhage patients with a ruptured sIA and at least one additional unruptured sIA, from the Kuopio Intracranial Aneurysm database from 2003 to 2015. These patients had 268 ruptured and 445 unruptured sIAs...
May 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28468328/heparin-and-heparin-derivatives-in-post-subarachnoid-hemorrhage-brain-injury-a-multimodal-therapy-for-a-multimodal-disease
#12
REVIEW
Erik G Hayman, Akil P Patel, Robert F James, J Marc Simard
Pharmacologic efforts to improve outcomes following aneurysmal subarachnoid hemorrhage (aSAH) remain disappointing, likely owing to the complex nature of post-hemorrhage brain injury. Previous work suggests that heparin, due to the multimodal nature of its actions, reduces the incidence of clinical vasospasm and delayed cerebral ischemia that accompany the disease. This narrative review examines how heparin may mitigate the non-vasospastic pathological aspects of aSAH, particularly those related to neuroinflammation...
May 2, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28465264/quantitative-susceptibility-mapping-as-a-possible-tool-to-radiographically-diagnose-sentinel-headache-associated-with-intracranial-aneurysm-case-report
#13
Daichi Nakagawa, Cameron Cushing, Yasunori Nagahama, Lauren Allan, David Hasan
BACKGROUND: Sentinel headache (SH) is estimated to occur prior to rupture of an aneurysm in 15-60% of aneurysmal subarachnoid hemorrhage (aSAH) cases. Non-contrasted computed tomography (CT) of brain and lumbar puncture are both negative, by definition, in patients presenting with SH. One of the theories explaining this phenomenon is micro-hemorrhage (MH) from the aneurysm wall contributing to iron deposition in the interface between the aneurysm wall and brain parenchyma. Quantitative susceptibility mapping (QSM) is a recently introduced magnetic resonance imaging (MRI) technique that has been shown capable of localizing the deposition of paramagnetic metals, particularly ferric iron...
April 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28463833/preventive-effect-of-clazosentan-against-cerebral-vasospasm-after-clipping-surgery-for-aneurysmal-subarachnoid-hemorrhage-in-japanese-and-korean-patients
#14
Miki Fujimura, Jin-Yang Joo, Jong-Soo Kim, Motonori Hatta, Yoshinari Yokoyama, Teiji Tominaga
BACKGROUND: Clazosentan has been explored worldwide for the prophylaxis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH). In a dose-finding trial (CONSCIOUS-1) conducted in Israel, Europe, and North America, clazosentan (1, 5, and 15 mg/h) significantly reduced the incidence of cerebral vasospasm, but its efficacy in Japanese and Korean patients was unknown. We conducted a double-blind comparative study to evaluate the occurrence of cerebral vasospasm in Japanese and Korean patients with aSAH...
May 3, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28459827/circulating-micrornas-in-patients-with-intracranial-aneurysms
#15
John A L Meeuwsen, Femke N G van T Hof, Wouter van Rheenen, Gabriel J E Rinkel, Jan H Veldink, Ynte M Ruigrok
INTRODUCTION: We compared circulating microRNA (miRNA) levels in plasma of patients with intracranial aneurysms (IA) to those of controls as a first step towards finding potential biomarkers for individuals at high risk of IA development and its subsequent rupture. PATIENTS AND METHODS: Using a PCR array we measured 370 miRNAs in plasma of 15 patients with prior aneurysmal subarachnoid hemorrhage (aSAH), of whom 11 had an additional unruptured IA (UIA), and of 15 controls...
2017: PloS One
https://www.readbyqxmd.com/read/28458650/plasma-soluble-urokinase-type-plasminogen-activator-receptor-is-not-associated-with-neurological-outcome-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#16
Heikki Kiiski, Ville Jalkanen, Marika Ala-Peijari, Mari Hämäläinen, Eeva Moilanen, Jukka Peltola, Jyrki Tenhunen
OBJECT: Aneurysmal subarachnoid hemorrhage (aSAH) is a common cause of death or long-term disability. Despite advances in neurocritical care, there is still only a very limited ability to monitor the development of secondary brain injury or to predict neurological outcome after aSAH. Soluble urokinase-type plasminogen activator receptor (suPAR) has shown potential as a prognostic and as an inflammatory biomarker in a wide range of critical illnesses since it displays an association with overall immune system activation...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28456071/gender-related-differences-in-aneurysmal-subarachnoid-hemorrhage-a-hospital-based-study
#17
Gian Marco De Marchis, Chris Schaad, Christian Fung, Juergen Beck, Jan Gralla, Jukka Takala, Stephan M Jakob
OBJECTIVES: Aneurysmal subarachnoid hemorrhage (aSAH) is more common in women than in men. Despite its clinical relevance, knowledge about the potential gender differences in the clinical course and outcome of aSAH is sparse - we aimed at elucidating such differences. PATIENTS AND METHODS: Retrospective cohort study including patients ≥18years of age with aSAH admitted to an interdisciplinary intensive-care center at the University Hospital of Bern (Switzerland)...
April 6, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28452618/long-term-reintegration-and-quality-of-life-in-patients-with-subarachnoid-hemorrhage-and-a-good-neurological-outcome-findings-after-more-than-20-years
#18
Bengt Sonesson, Erik Kronvall, Hans Säveland, Lennart Brandt, Ola G Nilsson
OBJECTIVE The goal of this study was to examine long-term quality of life (QOL) and reintegration in patients with good neurological recovery after aneurysmal subarachnoid hemorrhage (aSAH) and SAH of unknown cause (SAH NUD). METHODS A long-term follow-up was performed in an original cohort of 113 individuals who had suffered SAH (93 with aSAH and 20 with SAH NUD) between 1977 and 1984. Self-reporting assessments, performed > 20 years after the bleeding episode, included the Quality of Life Scale (QOLS), Psychological General Well-Being (PGWB) index, and Reintegration to Normal Living (RNL) index, along with information on sleep disturbances and work status...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28436243/comparison-of-the-timing-of-intervention-and-treatment-modality-of-poor-grade-aneurysmal-subarachnoid-hemorrhage
#19
Tomasz Tykocki, Marcin Czyż, Małgorzata Machaj, Dorota Szydlarska, Bogusław Kostkiewicz
OBJECTIVES: The timing and modality of intervention in the treatment of poor-grade aneurysmal subarachnoid haemorrhage (aSAH) has not been defined. The purpose of the study is to analyse whether early treatment and type of intervention influence the clinical outcomes of poor-grade aSAH patients. MATERIAL AND METHODS: Patients with poor-grade aSAH were retrieved. Demographics, Fisher grade, radiological characteristics and clinical outcomes were recorded. Outcomes were compared using the modified Rankin Scale (mRS), for groups treated early within 24 hours of aSAH or later and by clipping or endovascular therapy...
April 24, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28431602/a-comprehensive-analysis-of-the-relationship-between-aca-velocities-and-aca-infarction-following-aneurysmal-subarachnoid-hemorrhage
#20
Michael Moussouttas, Jocelyn Cheng, Joseph Antonakakis, Ameesh Patel, Maria Iuanow
PURPOSE: To evaluate the relationship between anterior cerebral artery (ACA) velocities (and ancillary parameters) and ACA infarction following aneurysmal subarachnoid hemorrhage (aSAH), and to examine the factors that influence velocities. METHODS: Retrospective investigation of 500 consecutive aSAH patients. ACA mean velocities (Vm) were evaluated by daily transcranial ultrasound during the early (days 1-4) and late (days 5-20) periods posthemorrhage. Presence and timing of acute ACA infarctions were identified by serial retrospective review of cerebral computerized tomography (CT) scans...
May 15, 2017: Journal of the Neurological Sciences
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