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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
Bruno Zanotti, Nicola Zingaretti, Angela Verlicchi, Alex Alfieri, Pier Camillo Parodi
When a cranioplasty implant becomes infected, standard operating procedure dictates its removal and the initiation of a long course of antibiotic therapy. However, removing such a prosthesis can have a series of adverse consequences, including delayed cognitive and motor recovery, lack of brain tissue protection, unsightly deformity, and the need for two additional surgical procedures, not to mention the additional costs involved. To maintain the advantages of cranioplasty, we opted for a conservative approach (levofloxacin and rifampicin every 24 hours for 8 weeks) in a 68-year-old woman whose custom-made porous hydroxyapatite implant, fitted following aneurysm clipping, had become infected...
March 1, 2018: Journal of Craniofacial Surgery
Joan Margaret O'Donnell, Michael Kerin Morgan, Maurizio Manuguerra
OBJECTIVE Few studies have examined patients' ability to drive and quality of life (QOL) after microsurgical repair for unruptured intracranial aneurysms (uIAs). However, without a strong evidentiary basis, jurisdictional road transport authorities have recommended driving restrictions following brain surgery. In the present study, authors examined the outcomes of the microsurgical repair of uIAs by measuring patients' perceived QOL and cognitive abilities related to driving. METHODS Between January 2011 and January 2016, patients with a new diagnosis of uIA were prospectively enrolled in this study...
March 2, 2018: Journal of Neurosurgery
Deborah Karolyne Mendes Maranhão, Moysés Loiola Ponte de Souza, Maria Lúcia Gurgel da Costa, Ana Cláudia de Carvalho Vieira
PURPOSE: Characterize the profile of aphasic syndromes determined by aneurysmal subarachnoid hemorrhage (aSAH) of the left middle cerebral artery (LMCA). METHODS: An analytical, retrospective, cross-sectional study was conducted using a database of cognitive assessments of 193 patients with aSAH admitted to Hospital da Restauração between March 2007 and November 2009. Of these, a total of 26 patients with aSAH in the LMCA territory confirmed by digital angiography were selected...
February 22, 2018: CoDAS
Xiaoqin Hu, Chengwei Song, Ming Fang, Chengyan Li
Alzheimer's disease is associated with cognitive impairments that affect memory and executive functions. Simvastatin is a cholesterol-lowering statin drug that is used to control levels of cholesterol in the blood, particularly in cases of hypercholesterolemia, and may be used in the treatment of aneurysmal subarachnoid hemorrhage. Previous results have indicated that the apoptosis of hippocampal cells may serve a critical role in the progression of Alzheimer's disease. In the present study, it was determined whether Simvastatin inhibited the apoptosis of hippocampal cells in vitro and in vivo ...
February 2018: Experimental and Therapeutic Medicine
Daniel Schöni, Lara Lauber, Christian Fung, Johannes Goldberg, René Müri, Andreas Raabe, Thomas Nyffeler, Jürgen Beck
Common sequelae of subarachnoid hemorrhage (SAH) include somatic and/or cognitive impairment. This can cause emotional stress, social tensions, and difficulties in relationships. To test our hypothesis that more severe somatic and cognitive impairments increased the likelihood of disruption of a relationship after SAH, we assessed the integrity of marriage or partnership status in a well-evaluated subset of SAH patients.; Abbreviations: GOSE: extended Glasgow outcome scale;mRS: modified Rankin scale;SAH: subarachnoid hemorrhage...
February 5, 2018: World Neurosurgery
Daiichiro Ishigami, Takahiro Ota
Traumatic intracranial aneurysms are one possible complication after penetrating brain injury. A 25-year-old man with a history of major depression presented with a crossbow bolt penetrating the head. On arrival, Glasgow Coma Scale score was E4V5M6, with no apparent neurological deficit. Computed tomography (CT) of the head showed the crossbow bolt passing near the corpus callosum, with surrounding contusion. Three-dimensional rotational angiography showed no anterior cerebral artery injuries. The crossbow bolt was removed after bifrontal craniotomy, with no postoperative infection...
January 2018: NMC case report journal
Swati D Chinchure, Vijay Jaykrishnan, B P Krishna Prasad
OBJECTIVE: Endovascular treatment of vertebral intradural dissecting aneurysms is complex and requires different strategies for each case. The current study aims to classify these aneurysms for an easy selection of optimal strategies for endovascular therapy. MATERIALS AND METHODS: This study is a retrospective evaluation of 10 patients harbouring a vertebral intradural dissecting aneurysm (including 6 female and 4 male patients). The clinical, procedural, and angiographic data were evaluated...
January 2018: Neurology India
Jiabin Su, Tongzhou E, Qihao Guo, Yu Lei, Yuxiang Gu
BACKGROUND: Patients suffer from aneurysmal subarachnoid hemorrhage (aSAH) are thought to have cognitive impairment. However, little is known about characteristics of functional imaging in aSAH patients OBJECTIVE: To explore the whole brain activity pattern in aSAH patients using amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC). METHOD: 50 aSAH patients and 30 healthy controls were recruited and subjected to a resting-state functional magnetic resonance imaging scan and cognitive tasks...
December 26, 2017: World Neurosurgery
Kentaro Mori, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Satoshi Tomura, Satoru Takeuchi, Takuji Yamamoto, Yasuaki Nakao, Hajime Arai
BACKGROUND: Treatments for unruptured anterior communicating artery (AcomA) aneurysm have relatively high morbidity. OBJECTIVE: To assess the lateral supraorbital keyhole approach for safe and complete clipping of unruptured AcomA aneurysm and evaluate the long-term clinical and radiological outcomes, including cognitive and depressive status. METHODS: A total of 63 patients (aged 41-79 yr, mean 64 yr) with relatively small AcomA aneurysms clipped via the lateral supraorbital approach were retrospectively analyzed among the 105 AcomA aneurysms treated by clipping from 2005 to 2014...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Bappaditya Ray, Vijay M Pandav, Eleanor A Mathews, David M Thompson, Lance Ford, Lori K Yearout, Bradley N Bohnstedt, Shuchi Chaudhary, George L Dale, Calin I Prodan
Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high socio-economic burden. Prothrombotic states of early brain injury (EBI) and delayed cerebral ischemia (DCI) after aSAH determine morbidity and mortality. To understand how activated platelets might contribute to such prothrombotic states, we studied trends in coated-platelets during EBI and DCI periods. Serial blood samples from a prospective cohort of aSAH patients were collected and assayed for coated-platelet levels. Patient's coated-platelet level during post-hospital discharge follow-up served as an estimate of baseline...
December 9, 2017: Translational Stroke Research
Elisabeth Bründl, Petra Schödel, Sylvia Bele, Martin Proescholdt, Judith Scheitzach, Florian Zeman, Alexander Brawanski, Karl-Michael Schebesch
AIM: Limited focus has been placed on neuropsychological patient profiles after spontaneous subarachnoid hemorrhage (sSAH). We conducted a prospective controlled study in good-grade sSAH patients to evaluate the time course of treatment-specific differences in cognitive processing after sSAH. MATERIAL AND METHODS: 26 consecutive sSAH patients were enrolled (drop out n=5). 9 patients received endovascular aneurysm occlusion (EV), 6 patients were treated microsurgically (MS), and 6 patients with perimesencephalic SAH (pSAH) underwent standardized intensive medical care...
November 1, 2017: Turkish Neurosurgery
Ljiljana Pačić-Turk, Tena Šulentić, Ana Havelka Meštrović, Josip Paladino, Goran Mrak
Neuropsychological testing of patients in the course of their recovery from brain injuries enables analysis of cognitive deficiencies and/or emotional changes. The principle study objective was to define organic and/or reactive personality changes and the course of these changes in the function of the time span following brain artery aneurysm surgery in both female and male patients. The study was carried out at the Clinical Department of Neurosurgery, Zagreb University Hospital Center in Zagreb. The data refer to the period from 1989 to 2012 collected in two time intervals, i...
December 2016: Acta Clinica Croatica
Achmet Ali, Gamze Tanirgan, Pulat Akin Sabanci, Nukhet Sivrikoz, Taner Abdullah, Altay Sencer, Serra Sencer, Mukadder Orhan-Sungur, Ibrahim Ozkan Akinci
BACKGROUND: In the present study, we hypothesized that a low gray matter-white matter ratio (GWR) is associated with poor cognitive function and low quality of life in patients with mild to moderate (WFNS ≤3) aneurysmal subarachnoid hemorrhage (aSAH). METHODS: All patients with aSAH who were admitted to the neurointensive care unit (Neuro ICU) and whose WFNS score was ≤ 3 were enrolled in the study. During the Neuro ICU follow-up period, the following variables were recorded: demographics, neurological status, comorbidities, time elapsed between onset of bleeding and Neuro ICU admission, treatment method, number of days with vasospasm symptoms (DVS) and vasopressor usage...
January 2018: Acta Neurochirurgica
Isidro Ferrer, Noemi Vidal
The chapter describes the epidemiology of cerebrovascular diseases, anatomy of the cerebral blood vessels, pathophysiology of ischemia, hypoxia, hypoxemia, anemic hypoxia, histotoxic hypoxia, carbon monoxide damage, hyperoxid brain damage and decompression sickness, and selective cell and regional vulnerability; diseases of the blood vessels including atherosclerosis, hypertensive angiopathy, small vessel disease, inflammatory vascular diseases, cerebral amyloid angiopathies, CADASIL, CARASIL and other diseases that can lead to cerebrovascular occlusion; intracranial and intraspinal aneurysms and vascular malformations; hematologic disorders that can cause cerebral infarct or hemorrhage; brain ischemic damage; and spontaneous intracranial bleeding...
2017: Handbook of Clinical Neurology
Maogui Li, Jun Wu, Xin Chen, Pengjun Jiang, Fan Yang, Yonggang Ma, Zhengsong Li, Yong Cao, Shuo Wang
Cerebral infarction (CI) associated with clipping of unruptured intracranial aneurysms (UIAs) has not been completely studied. The role of individual and operative characteristics is not known, and the risk of silent CI has not been well described. To determine the incidence, risk factors, and clinical outcome of postoperative CI, we retrospectively analyzed 388 consecutive patients undergoing clipping of UIAs between January 2012 and December 2015. We reviewed the pre- and postoperative computed tomography (CT) images of each patient...
October 5, 2017: Neurosurgical Review
Ryuta Nakae, Yu Fujiki, Shoji Yokobori, Yasutaka Naoe, Hiroyuki Yokota
Intracranial aneurysms (IAs) that undergo rupture causing subarachnoid hemorrhage (SAH), are common in young patients with coarctation of the aorta (CoA), but rarer in middle-aged and elderly patients. The pathogenesis of IAs associated with CoA remains unclear. We report the case of a 50-year-old woman who presented with SAH. On evaluation, six IAs were distributed among the anterior communicating artery (ACoA) (ruptured), distal segments of both anterior cerebral arteries (ACA), the left internal carotid artery (ICA), the bifurcation of the left middle cerebral artery (MCA)/MCA early branch, and the inferior trunk of the left MCA...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Hideaki Ono, Tomohiro Inoue, Takeo Tanishima, Akira Tamura, Isamu Saito, Nobuhito Saito
High-flow bypass followed by ligation of the internal carotid artery (ICA) is an effective treatment, but the impact of abrupt occlusion of the ICA is unpredictable, especially on postoperative cognitive function. The present study evaluated the clinical results as well as cognitive performances after high-flow bypass using radial artery graft (RAG) with supportive superficial temporal artery (STA)-middle cerebral artery (MCA) bypass, followed by ICA ligation. Ten consecutive patients underwent high-flow bypass surgery for large or giant ICA aneurysms of cavernous or cervical portion...
September 27, 2017: Neurosurgical Review
Henriette Holm Stabel, Asger Roer Pedersen, Søren Paaske Johnsen, Jørgen Feldbæk Nielsen
OBJECTIVE: Patients with non-traumatic rupture of an aneurysm located at the anterior communicating artery (ACoA) often experience cognitive disabilities. It is unknown whether location of aneurysm also affects the possibility for improvement in functional independence compared to patients with an aneurysmal subarachnoid hemorrhage (a-SAH) located elsewhere. The aim was to explore the association between location of aneurysm (ACoA versus other) and level of functional independence, measured by Functional Independence Measure (FIM), at discharge from rehabilitation...
September 18, 2017: Topics in Stroke Rehabilitation
Bertine L Stehouwer, Lisa A van der Kleij, Jeroen Hendrikse, Gabriel Je Rinkel, Jill B De Vis
Background Case-fatality rates after aneurysmal subarachnoid hemorrhage have decreased over the past decades. However, many patients who survive an aneurysmal subarachnoid hemorrhage have long-term functional and cognitive impairments. Aims We sought to review all data on conventional brain MRI obtained in the chronic phase after aneurysmal subarachnoid hemorrhage to (1) analyze the proportion of patients with cerebral infarction or brain volume changes; (2) investigate baseline determinants predictive of MRI-detected damage; and (3) assess if brain damage is predictive of patient outcome...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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