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https://www.readbyqxmd.com/read/29043545/early-brain-injury-associated-with-systemic-inflammation-after-subarachnoid-hemorrhage
#1
Jude Savarraj, Kaushik Parsha, Georgene Hergenroeder, Sungho Ahn, Tiffany R Chang, Dong H Kim, H Alex Choi
BACKGROUND: Early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) is defined as brain injury occurring within 72 h of aneurysmal rupture. Although EBI is the most significant predictor of outcomes after aSAH, its underlying pathophysiology is not well understood. We hypothesize that EBI after aSAH is associated with an increase in peripheral inflammation measured by cytokine expression levels and changes in associations between cytokines. METHODS: aSAH patients were enrolled into a prospective observational study and were assessed for markers of EBI: global cerebral edema (GCE), subarachnoid hemorrhage early brain edema score (SEBES), and Hunt-Hess grade...
October 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29041013/maternal-aneurysmal-subarachnoid-hemorrhage-during-pregnancy-as-an-interdisciplinary-task
#2
Friederike Sophie Fritzsche, Jan Regelsberger, Nils Ole Schmidt, Jakob Müller, Jan Hendrik Buhk, Anke Diemert, Manfred Westphal, Tobias Martens
Maternal aneurysmal subarachnoid hemorrhage (aSAH) during pregnancy presents a challenge regarding treatment and management. Due to the limited number of cases there are no treatment guidelines available. Thus, treatment is usually done on a case-by-case basis. Here we report on four cases of aSAH during pregnancy, describing the different management strategies and suggesting a possible treatment algorithm. Patients treated between 2003 and 2013 in our center were included in this retrospective study. Clinical data focused on time management concerning gestation week (GW), microsurgical or endovascular treatment, and outcome of the patients and the fetuses...
October 17, 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29037840/comparison-of-plasma-copeptin-and-multiple-biomarkers-for-assessing-prognosis-of-patients-with-aneurysmal-subarachnoid-hemorrhage
#3
Yong-Ke Zheng, Xiao-Qiao Dong, Quan Du, Hao Wang, Ding-Bo Yang, Qiang Zhu, Zhi-Hao Che, Yong-Feng Shen, Li Jiang, Wei Hu, Ke-Yi Wang, Wen-Hua Yu
BACKGROUND: Increased plasma copeptin concentrations are related to poor prognosis after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to assess prognostic significance of plasma copeptin detection compared with glial fibrillary astrocyte protein, myelin basic protein, S100B, phosphorylated axonal neurofilament subunit H, neuron-specific enolase, tau and ubiquitin carboxyl-terminal hydrolase L1 in aSAH. METHODS: We detected plasma concentrations of the aforementioned biomarkers in 105 healthy controls using ELISA...
October 13, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29029314/small-aneurysms-account-for-the-majority-and-increasing-percentage-of-aneurysmal-subarachnoid-hemorrhage-a-25-year-single-institution-study
#4
Matthew T Bender, Haley Wendt, Thomas Monarch, Narlin Beaty, Li-Mei Lin, Judy Huang, Alexander Coon, Rafael J Tamargo, Geoffrey P Colby
BACKGROUND: Prospective studies of unruptured aneurysms have shown very low rates of rupture for small aneurysms (<10 mm) and suggested that the risk of treatment outweighs benefit. However, common clinical practice shows that patients with aneurysmal subarachnoid hemorrhage (aSAH) frequently have small aneurysms. OBJECTIVE: To investigate trends in size and location of ruptured aneurysms over a 25-yr period. METHODS: A prospective, Institutional Review Board-approved database of all patients presenting to our institution with aSAH from 1991 to 2016 was analyzed...
October 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29027862/effect-of-body-mass-index-on-outcome-after-aneurysmal-subarachnoid-hemorrhage-treated-with-clipping-versus-coiling
#5
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/29017981/prolonged-intracisternal-papaverine-toxicity-index-case-description-and-proposed-mechanism-of-action
#6
REVIEW
Xiaofei Zhou, Vilakshan Alambyan, Thomas Ostergard, Jonathan Pace, Maryo Kohen, Sunil Manjila, Ciro Ramos-Estebanez
Intracisternal papaverine (iPPV) is a vasodilator used for prophylaxis of intra-operative vasospasm during aneurysmal clipping. Its post-operative side effects include transient cranial nerve palsies, most commonly mydriasis due to oculomotor nerve involvement with rapid resolution. We critically review the current literature on the adverse effects of iPPV in aneurysmal surgery, with a focus on oculomotor nerve involvement. In addition, this manuscript portrays the index case of prolonged bilateral mydriasis secondary to iPPV irrigation toxicity and its putative underlying mechanism...
October 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987853/early-hemodynamic-changes-based-on-initial-color-coding-angiography-as-a-predictor-for-developing-subsequent-symptomatic-vasospasm-after-aneurysmal-sah
#7
Jan-Karl Burkhardt, Xiaolin Chen, Ethan A Winkler, Miriam Weiss, John Yue, Daniel L Cooke, Helen Kim, Michael T Lawton
INTRODUCTION: Prediction of vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remains imperfect and currently relies on clinical and radiographic characteristics. Whether early hemodynamic changes may refine risk stratification for delayed vasospasm (DV) after aSAH was analyzed. METHODS: Patients with aSAH (n=53) and a control of unruptured intracranial aneurysms (UIA) (n=12) with initial color-coding angiography at admission were included in this study (n=65)...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28983801/electronic-health-data-predict-outcomes-after-aneurysmal-subarachnoid-hemorrhage
#8
Sahar F Zafar, Eva N Postma, Siddharth Biswal, Lucas Fleuren, Emily J Boyle, Sophia Bechek, Kathryn O'Connor, Apeksha Shenoy, Durga Jonnalagadda, Jennifer Kim, Mouhsin S Shafi, Aman B Patel, Eric S Rosenthal, M Brandon Westover
BACKGROUD: Using electronic health data, we sought to identify clinical and physiological parameters that in combination predict neurologic outcomes after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: We conducted a single-center retrospective cohort study of patients admitted with aSAH between 2011 and 2016. A set of 473 predictor variables was evaluated. Our outcome measure was discharge Glasgow Outcome Scale (GOS). For laboratory and physiological data, we computed the minimum, maximum, median, and variance for the first three admission days...
October 5, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28978659/polycystic-kidney-disease-among-4-436-intracranial-aneurysm-patients-from-a-defined-population
#9
Heidi J Nurmonen, Terhi Huttunen, Jukka Huttunen, Mitja I Kurki, Katariina Helin, Timo Koivisto, Mikael von Und Zu Fraunberg, Juha E Jääskeläinen, Antti E Lindgren
OBJECTIVE: To define the association of autosomal dominant polycystic kidney disease (ADPKD) with the characteristics of aneurysmal subarachnoid hemorrhage (aSAH) and unruptured intracranial aneurysm (IA) disease. METHODS: We fused data from the Kuopio Intracranial Aneurysm database (n = 4,436 IA patients) and Finnish nationwide registries into a population-based series of 53 IA patients with ADPKD to compare the aneurysm- and patient-specific characteristics of IA disease in ADPKD and in the general IA population, and to identify risks for de novo IA formation...
October 4, 2017: Neurology
https://www.readbyqxmd.com/read/28973260/multivariable-and-bayesian-network-analysis-of-outcome-predictors-in-acute-aneurysmal-subarachnoid-hemorrhage-review-of-a-pure-surgical-series-in-the-postinternational-subarachnoid-aneurysm-trial-era
#10
Zsolt Zador, Wendy Huang, Matthew Sperrin, Michael T Lawton
BACKGROUND: Following the International Subarachnoid Aneurysm Trial (ISAT), evolving treatment modalities for acute aneurysmal subarachnoid hemorrhage (aSAH) has changed the case mix of patients undergoing urgent surgical clipping. OBJECTIVE: To update our knowledge on outcome predictors by analyzing admission parameters in a pure surgical series using variable importance ranking and machine learning. METHODS: We reviewed a single surgeon's case series of 226 patients suffering from aSAH treated with urgent surgical clipping...
July 31, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28973194/shunt-dependent-hydrocephalus-after-aneurysmal-subarachnoid-hemorrhage-predictors-and-long-term-functional-outcomes
#11
Gabriella M Paisan, Dale Ding, Robert M Starke, R Webster Crowley, Kenneth C Liu
BACKGROUND: Although chronic hydrocephalus requiring shunt placement is a known sequela of aneurysmal subarachnoid hemorrhage (aSAH), its effect on long-term functional outcomes is incompletely understood. OBJECTIVE: To identify predictors of shunt-dependent hydrocephalus and shunt complications after aSAH and determine the effect of shunt dependence on functional outcomes in aSAH patients. METHODS: We evaluated a database of patients treated for aSAH at a single center from 2000 to 2015...
July 31, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28964945/validation-of-a-predictive-scoring-system-for-ventriculoperitoneal-shunt-insertion-following-aneurysmal-subarachnoid-hemorrhage
#12
Raghav Gupta, Luis C Ascanio, Alejandro Enriquez-Marulanda, Christoph J Griessenauer, Anu Chinnadurai, Ray Jhun, Abdulrahman Alturki, Christopher S Ogilvy, Ajith J Thomas, Justin M Moore
INTRODUCTION: Hydrocephalus is a frequently encountered complication in the context of aneurysmal subarachnoid hemorrhage (aSAH). Here, we performed an external validation of the recently proposed Post-Subarachnoid Shunt Scoring (PS3) system, which aims to stratify patients presenting with aSAH based on their relative risk of requiring ventriculoperitoneal (VP) shunt insertion. MATERIALS AND METHODS: A retrospective review of all patients presenting with aSAH to our institution between July 2007 and December 2016, who underwent CT imaging at the time of hospital admission, was performed...
September 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28948141/simulation-of-spreading-depolarization-trajectories-in-cerebral-cortex-correlation-of-velocity-and-susceptibility-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#13
Denny Milakara, Cristian Grozea, Markus Dahlem, Sebastian Major, Maren K L Winkler, Janos Lückl, Michael Scheel, Vasilis Kola, Karl Schoknecht, Svetlana Lublinsky, Alon Friedman, Peter Martus, Jed A Hartings, Johannes Woitzik, Jens P Dreier
In many cerebral grey matter structures including the neocortex, spreading depolarization (SD) is the principal mechanism of the near-complete breakdown of the transcellular ion gradients with abrupt water influx into neurons. Accordingly, SDs are abundantly recorded in patients with traumatic brain injury, spontaneous intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage (aSAH) and malignant hemispheric stroke using subdural electrode strips. SD is observed as a large slow potential change, spreading in the cortex at velocities between 2 and 9 mm/min...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28946178/the-impact-of-temporary-clipping-during-aneurysm-surgery-on-the-incidence-of-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#14
Vesna Malinova, Bawarjan Schatlo, Martin Voit, Patricia Suntheim, Veit Rohde, Dorothee Mielke
OBJECTIVE Clipping of a ruptured intracranial aneurysm requires some degree of vessel manipulation, which in turn is believed to contribute to vasoconstriction. One of the techniques used during surgery is temporary clipping of the parent vessel. Temporary clipping may either be mandatory in cases of premature rupture (rescue) or represent a precautionary or facilitating surgical step (elective). The aim of this study was to study the association between temporary clipping during aneurysm surgery and the incidence of vasospasm and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage (aSAH) in a large clinical series...
September 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28945859/high-dose-nadroparin-following-endovascular-aneurysm-treatment-benefits-outcome-after-aneurysmal-subarachnoid-hemorrhage
#15
Rene Post, IJsbrand A J Zijlstra, Rene van den Berg, Bert A Coert, Dagmar Verbaan, W Peter Vandertop
BACKGROUND: Delayed cerebral ischemia (DCI) is one of the major causes of delayed morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: To evaluate the effect of high-dose nadroparin treatment following endovascular aneurysm treatment on the occurrence of DCI and clinical outcome. METHODS: Medical records of 158 adult patients with an aSAH were retrospectively analyzed. Those patients treated endovascularly for their ruptured aneurysm were included in this study...
July 27, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28940973/prediction-of-cerebral-infarction-and-patient-outcome-in-aneurysmal-subarachnoid-hemorrhage-comparison-of-new-and-established-radiographic-clinical-and-combined-scores
#16
Nora F Dengler, Jenny Sommerfeld, Dominik Diesing, Peter Vajkoczy, Stefan Wolf
BACKGROUND: There are numerous grading scales to describe the severity of aneurysmal subarachnoid hemorrhage (aSAH) and to predict outcome. Historically, outcome measures are heterogenous and comparability of grading scales is therefore limited. We designed this study to compare radiographic, clinical and combined grading systems in aSAH. METHODS: Data of 423 consecutive patients with aSAH were analyzed. Modified Fisher, Barrow Neurological Institute (BNI), Hunt and Hess, World Federations of Neurosurgeons (WFNS), VASOGRADE and HAIR scores were calculated from clinical and radiographic data or the combination of both...
September 23, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28934895/high-early-fluid-input-after-aneurysmal-subarachnoid-hemorrhage-combined-report-of-association-with-delayed-cerebral-ischemia-and-feasibility-of-cardiac-output-guided-fluid-restriction
#17
Leonie J M Vergouw, Mohamud Egal, Bas Bergmans, Diederik W J Dippel, Hester F Lingsma, Mervyn D I Vergouwen, Peter W A Willems, Annemarie W Oldenbeuving, Jan Bakker, Mathieu van der Jagt
BACKGROUND: Guidelines on the management of aneurysmal subarachnoid hemorrhage (aSAH) recommend euvolemia, whereas hypervolemia may cause harm. We investigated whether high early fluid input is associated with delayed cerebral ischemia (DCI), and if fluid input can be safely decreased using transpulmonary thermodilution (TPT). METHODS: We retrospectively included aSAH patients treated at an academic intensive care unit (2007-2011; cohort 1) or managed with TPT (2011-2013; cohort 2)...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28890998/neurodegenerative-cerebrospinal-fluid-biomarkers-tau-and-amyloid-beta-predict-functional-quality-of-life-and-neuropsychological-outcomes-after-aneurysmal-subarachnoid-hemorrhage
#18
Holger Joswig, Wolfgang Korte, Severin Früh, Lorenz Epprecht, Gerhard Hildebrandt, Jean-Yves Fournier, Martin Nikolaus Stienen
Cerebrospinal fluid (CSF) biomarkers might be useful in predicting outcome after aneurysmal subarachnoid hemorrhage (aSAH). It was the aim to determine whether tau and amyloid beta CSF concentrations predict functional, health-related quality of life (hrQoL), and neuropsychological outcomes after aSAH. Ventricular CSF was obtained from n = 24 aSAH patients at admission (D0), day 2 (D2), and day 6 (D6). CSF total (t)Tau, phosphorylated (p)Tau(181P), and amyloid beta(1-40 and 1-42) (Aβ40/Aβ42) levels were compared between patients with favorable and unfavorable functional (modified Rankin Scale (mRS)), hrQoL (Euro-Qol (EQ-5D)), and neuropsychological outcomes at 3 (3 m) and 12 months (12 m)...
September 10, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28887072/minimum-clinically-important-difference-of-montreal-cognitive-assessment-in-aneurysmal-subarachnoid-hemorrhage-patients
#19
George Kwok Chu Wong, Jodhy Suk Ying Mak, Adrian Wong, Vera Zhi Yuan Zheng, Wai Sang Poon, Jill Abrigo, Vincent Chung Tong Mok
Cognitive impairment is a major factor contributing to poor functional outcome after subarachnoid hemorrhage caused by a ruptured cerebral aneurysm (aSAH). Montreal Cognitive Assessment (MoCA) has been shown to be superior to the Mini-Mental State Examination in screening for cognitive domain deficit and correlating to functional outcome in aSAH patients. The aim of the current study was to determine the Montreal Cognitive Assessment (MoCA) score change that was associated with change of health in general in an aSAH patient cohort...
September 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28867328/the-volume-of-the-third-ventricle-as-a-prognostic-marker-for-shunt-dependency-after-aneurysmal-subarachnoid-hemorrhage
#20
Daniel Pinggera, Johannes Kerschbaumer, Ondra Petr, Martin Ortler, Claudius Thomé, Christian F Freyschlag
BACKGROUND: Hydrocephalus is a common sequelae of aneurysmal subarachnoid hemorrhage (aSAH). In daily routine it is difficult, however, to predict a patient's need for ventricular shunt placement in the course of the disease. OBJECTIVE: The purpose of this study was to identify radiological predictors for development of a shunt-dependent hydrocephalus after aSAH. METHODS: A cohort of 217 aSAH patients with adequate pretreatment CT imaging was retrospectively reviewed...
August 31, 2017: World Neurosurgery
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