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Zhao Chenhui, Wei Yi
BACKGROUND: Despite great advances in treatment of Aneurysmal subarachnoid hemorrhage (aSAH), yet, a consensus as to the most optimal timing of surgery has not been reached. MATERIALS AND METHODS: PubMed and the Cochrane Library were searched for English-language studies published up to May 2015. Before conducting the meta-analysis, the studies were evaluated for publication bias and heterogeneity. Fixed and random effect models were used to estimate relative risks (RR) and the corresponding 95% confidence intervals (CIs)...
December 7, 2015: Turkish Neurosurgery
Yarelis Alvarado Reyes, Alexandra Perez, Gloria Rodriguez-Vega
OBJECTIVE: Vitamin D deficiency has been associated with increased risk and adverse outcomes in many clinical settings including cardiovascular disease, stroke, and critically ill patients. Therefore we aimed to determine whether vitamin D deficiency had any effect in aneurysmal subarachnoid hemorrhage (aSAH) clinical outcomes. METHODS: A retrospective record review was conducted in a tertiary community hospital in Puerto Rico. Adult patients admitted to the neurosurgical intensive care unit (NICU) with a diagnosis of aSAH from January 2013 to July 2014, who had a 25-hydroxyvitamin-D level drawn, were included...
October 15, 2016: World Neurosurgery
Riikka S K Takala, Riku Kiviranta, Klaus T Olkkola, Tero Vahlberg, Dan Laukka, Anna Kotkansalo, Melissa Rahi, Matti Sankinen, Jussi Posti, Ari Katila, Jaakko Rinne
PURPOSE: The aim was to assess anterior pituitary hormone levels during the acute phase of aneurysmal subarachnoid hemorrhage (aSAH) and analyze the possible association with the clinical condition and outcome. MATERIAL AND METHODS: Forty patients with aSAH whose aneurysm was secured by endovascular coiling were enrolled. Basal secretions of cortisol, testosterone, luteinizing hormone (LH), prolactin (PRL), and sex hormone binding globulin (SHBG) levels were measured up to 14 days after the incident...
October 18, 2016: Endocrine Research
Abdulrahman Aldakkan, Alireza Mansouri, Blessing N R Jaja, Naif M Alotaibi, R Loch Macdonald
BACKGROUND: Risk of delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH) patients with asymptomatic angiographic vasospasm on admission is unclear in the literature. The goal of this study is to identify predictors of clinical DCI in this group of patients. METHOD: ology: An exploratory subgroup analysis was conducted in the Subarachnoid Hemorrhage International Trialists (SAHIT) data repository to identify predictors of clinical DCI in good-grade aSAH patients (World Federation of Neurological Surgeons (WFNS) grade I and II) with angiographic vasospasm on admission...
October 4, 2016: World Neurosurgery
Linda Jayne Nichols, Seana Gall, Christine Stirling
An aneurysmal subarachnoid hemorrhage (aSAH) carries a high disability burden. The true impact of rurality as a predictor of outcome severity is unknown. Our aim is to clarify the relationship between the proposed explanations of regional and rural health disparities linked to severity of outcome following an aSAH. An initial literature search identified limited data directly linking geographical location, rurality, rural vulnerability, and aSAH. A further search noting parallels with ischemic stroke and acute myocardial infarct literature presented a number of diverse and interrelated predictors...
October 2016: Journal of Neurosciences in Rural Practice
J Hoogmoed, R van den Berg, B A Coert, G J E Rinkel, W P Vandertop, D Verbaan
BACKGROUND: In patients with poor clinical condition after aneurysmal subarachnoid haemorrhage (aSAH), treatment is often deferred until patients show signs of improvement. Early external ventricular drainage and aneurysm occlusion may improve prognosis also in poor grade patients. The clinical outcome of an expeditious approach was compared with that of a conservative approach. METHODS: In all, 285 consecutive World Federation of Neurological Surgeons (WFNS) grade V aSAH patients admitted to three university hospitals between January 2000 and June 2007 were included...
September 26, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Anqi Xiao, Ruiqi Chen, Hao Li, Lu Ma, Sen Lin, Xin Hu, Chao You
BACKGROUND: Although there have been many studies on primary hemorrhagic neurovascular diseases (PHNVDs) in different populations, a study focusing on PHNVDs in Tibetan people was still lacking. This study aimed to explore the notable characteristics of Tibetan PHNVDs by comparing the most three common PHNVDs (aneurysmal subarachnoid hemorrhage, spontaneous intracerebral hemorrhage and arteriovenous malformation) in our institution between Tibetan and Han patients. METHODS: In this retrospective observational study, the hospital information system (HIS) was utilized to access the records of patients with PHNVDs...
September 16, 2016: World Neurosurgery
Tatjana Gazivoda Kraljević, Anja Harej, Mirela Sedić, Sandra Kraljević Pavelić, Višnja Stepanić, Domagoj Drenjančević, Jasminka Talapko, Silvana Raić-Malić
The 4-substituted 1,2,3-triazole core in designed coumarin hybrids (4-35) with diverse physicochemical properties was introduced by eco-friendly copper(I)-catalyzed Huisgen 1,3-dipolar cycloaddition under microwave irradiation. Coumarin-1,2,3-triazole-benzofused heterocycle hybrids emerged as the class of compounds exhibiting the highest antiproliferative activity. The strong relationship between lipophilicity and antiproliferative activities was observed indicating that lipophilic 1,2,3-triazole-coumarin hybrids containing phenylethyl (13), 3,5-difluorophenyl (14), 5-iodoindole (30) and benzimidazole (33 and 35) subunits showed the most potent cytostatic effects...
August 31, 2016: European Journal of Medicinal Chemistry
Hadie Adams, Vin Shen Ban, Ville Leinonen, Salah G Aoun, Jukka Huttunen, Taavi Saavalainen, Antti Lindgren, Juhana Frosen, Mikael Fraunberg, Timo Koivisto, Juha Hernesniemi, Babu G Welch, Juha E Jaaskelainen, Terhi J Huttunen
BACKGROUND AND PURPOSE: Shunt dependent hydrocephalus after aneurysmal subarachnoid hemorrhage (aSAH) is a common sequela that may lead to poor neurological outcome and predisposes to various interventions, admissions, and complications. We reviewed post-aSAH shunt dependency in a population-based sample and tested the feasibility of a clinical risk score to identify subgroups of aSAH patients with increasing risk of shunting for hydrocephalus. METHODS: A total of 1533 aSAH patients from the population-based Eastern Finland Saccular Intracranial Aneurysm Database (Kuopio, Finland) were used in a recursive partitioning analysis to identify risk factors for shunting after aSAH...
October 2016: Stroke; a Journal of Cerebral Circulation
Andjela Milovanovic, Danica Grujicic, Vojislav Bogosavljevic, Milos Jokovic, Natasa Mujovic, Ivana Petronic Markovic
AIM: To develop a specific rehabilitation protocol for patients who have undergone surgical repair of acute aneurysmal subarachnoid hemorrhage (aSAH), and to determine the time at which verticalization should be initiated after aSAH. MATERIAL AND METHODS: Sixty-five patients who underwent acute-term surgery for aSAH and early rehabilitation were evaluated in groups: Group 1 (n=34) started verticalization on Days 2-5 post-bleeding whereas Group 2 (n=31) started verticalization approximately Day 12 post-bleeding...
June 1, 2016: Turkish Neurosurgery
Elizabeth A Crago, Thomas J Price, Catherine M Bender, Dianxu Ren, Samuel M Poloyac, Paula R Sherwood
BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is a sudden debilitating condition affecting individuals during the most productive times of their lives. Treatment advances have reduced mortality rates but increased the number of survivors facing deficits in physical and neuropsychological function. OBJECTIVE: This study examined associations between neuropsychological function and work productivity after aSAH. METHODS: Fifty-two patients with aSAH, employed before hemorrhage, were recruited from an ongoing National Institutes of Health study...
October 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Hirokazu Sadahiro, Satoshi Shirao, Hiroshi Yoneda, Hideyuki Ishihara, Takayuki Oku, Akinori Inamura, Akiko Yamane, Kazutaka Sugimoto, Yuichi Fujiyama, Michiyasu Suzuki
BACKGROUND AND OBJECTIVE: Despite intensive therapy, vasospasm remains a major cause of delayed cerebral ischemia (DCI) in worsening patient outcome after aneurysmal subarachnoid hemorrhage (aSAH). Transcranial Doppler (TCD) and transcranial color-coded duplex sonography (TCCS) are noninvasive modalities that can be used to assess vasospasm. However, high flow velocity does not always reflect DCI. The purpose of this study was to investigate the utility of TCD/TCCS in decreasing permanent neurological deficits...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
James E Siegler, Christy Marcaccio, Kelsey Nawalinski, Francis Quattrone, Danielle K Sandsmark, Eileen Maloney-Wilensky, Suzanne Frangos, Joshua M Levine, Sherman C Stein, Scott E Kasner, Monisha A Kumar
BACKGROUND: Elevated red blood cell distribution width (RDW) has been associated with thrombotic disorders including myocardial infarction, venous thromboembolism, and ischemic stroke, independent of other inflammatory and coagulation biomarkers. The purpose of this study was to determine whether elevated RDW is associated with cerebral infarction and poor outcome after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: In this retrospective single-center cohort of aSAH patients (October 2009-September 2014), elevated RDW was defined as a mean RDW >14...
August 16, 2016: Neurocritical Care
Kazutaka Sugimoto, Satoshi Shirao, Hiroyasu Koizumi, Takao Inoue, Fumiaki Oka, Yuichi Maruta, Eiichi Suehiro, Hirokazu Sadahiro, Takayuki Oku, Hiroshi Yoneda, Hideyuki Ishihara, Sadahiro Nomura, Michiyasu Suzuki
Delayed cerebral ischemia (DCI) is a prominent complication after aneurysmal subarachnoid hemorrhage (aSAH). Although vasospasm of proximal cerebral arteries has been regarded as the main cause of DCI, vasospasm of distal arteries, microthrombosis, impaired autoregulation, cortical spreading depolarization (CSD), and spreading ischemia are thought to be involved in DCI after aSAH. Here, we describe a patient with aSAH in whom CSD and cerebrovascular autoregulation were evaluated using simultaneous electrocorticography and monitoring of the pressure reactivity index (PRx) after surgical clipping of a ruptured posterior communicating artery aneurysm...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Yuko Goto, Satoru Oshino, Akio Nishino, Toshiyuki Fujinaka, Hajime Nakamura, Takamichi Yuguchi, Shintaro Mori, Toshiki Yoshimine, Youichi Saitoh
To elucidate the pituitary function of Japanese patients after aneurysmal subarachnoid hemorrhage (aSAH) and implicative factors related to growth hormone deficiency (GHD) after aSAH. We evaluated basal pituitary hormone levels among 59 consecutive aSAH patients with a modified Rankin Scale (mRS) ⩽4 at 3months after aSAH onset. Patients with low insulin-like growth factor 1 (IGF-1) SD score (SDS) or who seemed to develop pituitary dysfunction underwent provocative endocrine testing during a period of 3-36months after SAH onset...
August 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Christoph J Griessenauer, Christopher S Ogilvy, Paul M Foreman, Michelle H Chua, Mark R Harrigan, Lucy He, Matthew R Fusco, J D Mocco, Christopher J Stapleton, Aman B Patel, Ashish Sonig, Adnan H Siddiqui, Ajith J Thomas
BACKGROUND: To date, the use of the flow-diverting Pipeline Embolization Device (PED) for small intracranial aneurysms (≤ 7 mm) has been reported only in single-center series. OBJECTIVE: To evaluate the safety and efficacy of the PED in a multicenter cohort. METHODS: Five major academic institutions in the United States provided data on patient demographics, aneurysm features, and treatment characteristics of consecutive patients with aneurysms ≤ 7 mm treated with a PED between 2009 and 2015...
August 1, 2016: Neurosurgery
Alfred P See, Kyle C Wu, Pui Man Rosalind Lai, Bradley A Gross, Rose Du
Hyponatremia occurs commonly in patients with aneurysmal subarachnoid hemorrhage (aSAH). Our objective was to determine the time course of, and factors associated with, hyponatremia after aSAH. We performed a retrospective review of 259 patients with ruptured aneurysms at a single institution. Multivariate regression analysis was performed to determine the factors associated with hyponatremia. Increasing age was significantly associated with lower initial sodium (p=0.04) and incidence of delayed hyponatremia (p=0...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Christopher L Kramer, Marianna Pegoli, Jay Mandrekar, Giuseppe Lanzino, Alejandro A Rabinstein
INTRODUCTION: We analyzed the impact of cause, severity, and duration of fever on functional outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). METHODS: Fever characteristics were analyzed in 584 consecutive patients with aSAH. Fever was defined as core body temperature ≥38.3 °C on ≥2 consecutive days. Subfebrile measurements were those between 37 and 38.2 °C. Febrile and subfebrile loads were the number of hours with fever or subfebrile measurements, respectively...
July 14, 2016: Neurocritical Care
Altaib Al Yassin, Bichun Ouyang, Richard Temes
Although survival has dramatically improved following aneurysmal subarachnoid hemorrhage (aSAH), the reasons for persistent high rates of unemployment in this population remain unknown. Retrospective review for medical records of patients with aSAH admitted to Rush University Medical Center was undertaken. Multivariate logistic regression models were used to test the association of either depression or anxiety with the 6-month employment status. Among the 29 patients who developed depression or anxiety, 86...
July 15, 2016: Journal of Neuropsychiatry and Clinical Neurosciences
Pernilla Y Ackermark, Vera P Schepers, Marcel W Post, Gabriel J Rinkel, Patricia E Passier, Johanna M Visser-Meily
BACKGROUND: Symptoms of anxiety and depression are present in almost half of the patients who survive an aneurysmal subarachnoid hemorrhage (aSAH), but the long-term course is unknown. AIM: To study the longitudinal course and predictors of symptoms of anxiety and depression after aSAH. METHODS: Patients visiting our outpatient clinic 3 months after aSAH and living independently in the community completed the Beck Depression Inventory-II-NL and the State-Trait Anxiety Inventory at 3 months (T1), one year (T2) and 2-5 years (T3)...
July 14, 2016: European Journal of Physical and Rehabilitation Medicine
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