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https://www.readbyqxmd.com/read/28566094/assessment-of-cerebral-blood-flow-in-adult-patients-with-aortic-coarctation
#1
Rachel Wong, Waheed Ahmad, Allan Davies, Neil Spratt, Andrew Boyle, Christopher Levi, Peter Howe, Nicholas Collins
BACKGROUND: Survival into adult life in patients with aortic coarctation is typical following surgical and catheter-based techniques to relieve obstruction. Late sequelae are recognised, including stroke, hypertension, and intracerebral aneurysm formation, with the underlying mechanisms being unclear. We hypothesised that patients with a history of aortic coarctation may have abnormalities of cerebral blood flow compared with controls. METHODS: Patients with a history of aortic coarctation underwent assessment of cerebral vascular function...
June 1, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28471926/a-literature-review-of-psychosocial-comorbidities-related-to-working-capacity-after-aneurysmal-subarachnoid-hemorrhage
#2
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/28452618/long-term-reintegration-and-quality-of-life-in-patients-with-subarachnoid-hemorrhage-and-a-good-neurological-outcome-findings-after-more-than-20-years
#3
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/28414666/just-a-puff-of-smoke
#4
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28386838/minimally-invasive-medial-supraorbital-combined-subfrontal-interhemispheric-approach-to-the-anterior-communicating-artery-complex-a-cadaveric-study
#5
Alexander Spiessberger, F Baumann, E Nevzati, K F Kothbauer, J Fandino, C Muroi
INTRODUCTION: In selected cases, microsurgical clipping remains a valuable treatment alternative to endovascular occlusion of anterior communicating artery (AComA) aneurysms. Their clipping is challenging and carries a risk of postsurgical cognitive impairment. We evaluate the microsurgical anatomy of a new, minimally invasive combined interhemispheric-subfrontal approach to the AComA complex via a medial supraorbital craniotomy. METHODS: In this descriptive anatomic study, four alcohol-embedded, silicon-injected human cadaver heads were used...
June 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28298024/reduction-of-inflammation-after-administration-of-interleukin-1-receptor-antagonist-following-aneurysmal-subarachnoid-hemorrhage-results-of-the-subcutaneous-interleukin-1ra-in-sah-scil-sah-study
#6
James Galea, Kayode Ogungbenro, Sharon Hulme, Hiren Patel, Sylvia Scarth, Margaret Hoadley, Karen Illingworth, Catherine J McMahon, Nikolaos Tzerakis, Andrew T King, Andy Vail, Stephen J Hopkins, Nancy Rothwell, Pippa Tyrrell
OBJECTIVE Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating cerebrovascular event with long-term morbidity and mortality. Patients who survive the initial bleeding are likely to suffer further early brain injury arising from a plethora of pathological processes. These may result in a worsening of outcome or death in approximately 25% of patients and may contribute to longer-term cognitive dysfunction in survivors. Inflammation, mediated by the cytokine interleukin-1 (IL-1), is an important contributor to cerebral ischemia after diverse forms of brain injury, including aSAH...
February 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28187800/management-of-aneurysmal-subarachnoid-hemorrhage
#7
REVIEW
N Etminan, R L Macdonald
Spontaneous subarachnoid hemorrhage (SAH) affects people with a mean age of 55 years. Although there are about 9/100 000 cases per year worldwide, the young age and high morbidity and mortality lead to loss of many years of productive life. Intracranial aneurysms account for 85% of cases. Despite this, the majority of survivors of aneurysmal SAH have cognitive deficits, mood disorders, fatigue, inability to return to work, and executive dysfunction and are often unable to return to their premorbid level of functioning...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28119832/characteristics-of-patients-with-aneurysmal-subarachnoid-hemorrhage-and-risk-factors-related-to-dysphagia
#8
Seung Hwa Rhie, Ji Won Choi, Se Jeong Jeon, Sung Don Kang, Min Cheol Joo, Min Su Kim
OBJECTIVE: To investigate the characteristics and risk factors of dysphagia with the Videofluoroscopic Dysphagia Scale (VDS) using a videofluoroscopic swallowing study (VFSS) in patients with ruptured aneurysmal subarachnoid hemorrhage (aSAH). METHODS: Data of 64 patients presenting with first-ever ruptured aSAH were analyzed. Characteristics of dysphagia were evaluated using VFSS and all subjects were divided into a high (>47) and low risk group (≤47) by the VDS score...
December 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28059648/validation-of-effectiveness-of-keyhole-clipping-in-nonfrail-elderly-patients-with-unruptured-intracranial-aneurysms
#9
Kentaro Mori, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Kazuya Fujii, Kosuke Kumagai, Satoru Takeuchi, Satoshi Tomura, Takuji Yamamoto, Yasuaki Nakao, Hajime Arai
OBJECTIVE Advanced age is known to be associated with a poor prognosis after surgical clipping of unruptured intracranial aneurysms (UIAs). Keyhole clipping techniques have been introduced for less invasive treatment of UIAs. In this study, the authors compared the complications and clinical and radiological outcomes after keyhole clipping between nonfrail elderly patients (≥ 70 years) and nonelderly patients. METHODS Keyhole clipping (either supraorbital or pterional) was performed to treat 260 cases of relatively small (≤ 10 mm) anterior circulation UIAs...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28017208/subjective-hearing-impairment-after-subarachnoid-haemorrhage-prevalence-and-risk-factors
#10
Erik M Vos, Paut Greebe, J M Anne Visser-Meily, Gabriel J E Rinkel, Mervyn D I Vergouwen
BACKGROUND: Sensorineural hearing impairment is a key symptom in patients with superficial siderosis of the central nervous system, a disease caused by chronic or intermittent haemorrhage into the subarachnoid space. We investigated the prevalence and risk factors of subjective hearing impairment after SAH. METHODS: We systematically interviewed all SAH patients admitted between June 2011 and December 2014, who were able to visit the SAH outpatient clinic six to eight weeks after hospital discharge...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27995510/mechanisms-of-global-cerebral-edema-formation-in-aneurysmal-subarachnoid-hemorrhage
#11
Erik G Hayman, Aaron Wessell, Volodymyr Gerzanich, Kevin N Sheth, J Marc Simard
A growing body of clinical literature emphasizes the impact of cerebral edema in early brain injury following aneurysmal subarachnoid hemorrhage (aSAH). Aneurysm rupture itself initiates global cerebral edema in up to two thirds of cases. Although cerebral edema is not a universal feature of aSAH, it portends a poor clinical course, with quantitative analysis revealing a direct correlation between cerebral edema and poor outcome, including mortality and cognitive deficits. Mechanistically, global cerebral edema has been linked to global ischemia at the time of aneurysm rupture, dysfunction of autoregulation, blood breakdown products, neuroinflammation, and hyponatremia/endocrine abnormalities...
April 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27977657/delayed-recovery-of-adipsic-diabetes-insipidus-adi-caused-by-elective-clipping-of-anterior-communicating-artery-and-left-middle-cerebral-artery-aneurysms
#12
Jeffrey Tan, Samuel Ndoro, Uchenna Okafo, Aoife Garrahy, Amar Agha, Danny Rawluk
Adipsic diabetes insipidus (ADI) is an extremely rare complication following microsurgical clipping of anterior communicating artery aneurysm (ACoA) and left middle cerebral artery (MCA) aneurysm. It poses a significant challenge to manage due to an absent thirst response and the co-existence of cognitive impairment in our patient. Recovery from adipsic DI has hitherto been reported only once. A 52-year-old man with previous history of clipping of left posterior communicating artery aneurysm 20 years prior underwent microsurgical clipping of ACoA and left MCA aneurysms without any intraoperative complications...
December 16, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27847765/relationship-between-gyrus-rectus-resection-and-cognitive-impairment-after-surgery-for-ruptured-anterior-communicating-artery-aneurysms
#13
Myung Sung Joo, Dong Sun Park, Chang Taek Moon, Young Il Chun, Sang Woo Song, Hong Gee Roh
OBJECTIVE: The gyrus rectus (GR) is known as a non-functional gyrus; hence, its resection is agreed to be a safe procedure frequently practiced to achieve a better surgical view during specific surgeries. This study aimed at comparing the cognitive outcomes following GR resection in patients who underwent surgery for ruptured anterior communicating artery (ACoA) aneurysms. MATERIALS AND METHODS: From 2012 to 2015, 39 patients underwent surgical clipping for ruptured ACoA aneurysms...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847145/short-and-long-term-neurobehavioral-effects-of-lumbar-puncture-and-shunting-in-patients-with-malabsorptive-hydrocephalus-after-subarachnoid-haemorrhage-an-explorative-case-study
#14
Bernd-Otto Hütter, Joachim-Michael Gilsbach
BACKGROUND: The neuropsychological effects of lumbar puncture and shunting in terms of cognitive functioning and quality of life were analyzed prospectively in four patients with malabsorptive hydrocephalus who became symptomatic in the chronic state after aneurysmal subarachnoid haemorrhage (SAH). METHODS: A comprehensive battery of neuropsychological tests was applied to four patients before and shortly after lumbar puncture and six months later. In three of them a shunt has been inserted, one patient was treated by repeated lumbar punctures...
February 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27809575/a-systematic-review-of-postoperative-cognitive-decline-following-open-and-endovascular-aortic-aneurysm-surgery
#15
REVIEW
R A Benson, B A Ozdemir, D Matthews, I M Loftus
OBJECTIVES Postoperative cognitive decline (POCD) is a well-recognised neurological phenomenon following major surgery. Most commonly seen in elderly patients, it has direct links to increased long-term morbidity and reduced quality of life. Its incidence following open and endovascular abdominal and thoracic aneurysm surgery is unclear. The purpose of this systematic review is to collate available evidence for POCD following abdominal and thoracic aortic surgery, and to identify continuing controversies directing future research...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27754012/me-02-1-is-lower-really-better-issue-of-the-j-curve-hypothesis-in-hypertension
#16
Bo Carlberg
The J curve hypothesis propose that the relation between blood pressure and risk for cardiovascular events is non-linear. Instead of a decreased risk with lower blood pressure, the risk increases at lower blood pressures. This issue has been discussed for many years, and is still a hot topic. The debates have most often had its origin in the question about how far blood pressure should be lowered with antihypertensive drugs.One one hand, we know that many patients with hypertension is not treated to targets according to guidelines and that this contributes to the high risk for cardiovascular diseases in patients with hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27752513/longitudinal-profile-of-iron-accumulation-in-good-grade-subarachnoid-hemorrhage
#17
Christoph Scherfler, Alois Josef Schiefecker, Margarete Delazer, Ronny Beer, Thomas Bodner, Georg Spinka, Mario Kofler, Bettina Pfausler, Christian Kremser, Michael Schocke, Thomas Benke, Elke R Gizewski, Erich Schmutzhard, Raimund Helbok
OBJECTIVE: MRI parameters of iron concentration (R2*, transverse relaxation rate), microstructural integrity (mean diffusivity and fractional anisotropy), as well as gray and white matter volumes were analyzed in patients with subarachnoid hemorrhage (SAH) and uncomplicated clinical course to detect the evolution of brain tissue changes 3 weeks and 12 months after ictus. METHODS: MRI scans of 14 SAH patients (aneurysm of the anterior communicating artery, n = 5; no aneurysm n = 9) were compared with 14 age-matched healthy control subjects...
October 2016: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/27647023/bypass-revascularization-applied-to-the-posterior-cerebral-artery
#18
Nakao Ota, Felix Goehre, Takanori Miyazaki, Yu Kinoshita, Hidetoshi Matsukawa, Takeshi Yanagisawa, Humihiro Sakakibara, Norihiro Saito, Shiro Miyata, Kosumo Noda, Toshiyuki Tsuboi, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada, Rokuya Tanikawa
BACKGROUND: The application of bypass procedures to the posterior cerebral artery (PCA) in combination with proximal clipping or trapping is a useful option for the treatment of complex posterior circulation aneurysms, especially those of the PCA. Due to its course around the midbrain through various cisterns, different approaches are required to access the PCA. OBJECTIVE: The presented study analyzes a retrospective case series of bypass procedures to the PCA to investigate the relevant treatment strategies and their outcomes...
September 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27642923/me-02-1-is-lower-really-better-issue-of-the-j-curve-hypothesis-in-hypertension
#19
Bo Carlberg
The J curve hypothesis propose that the relation between blood pressure and risk for cardiovascular events is non-linear. Instead of a decreased risk with lower blood pressure, the risk increases at lower blood pressures. This issue has been discussed for many years, and is still a hot topic. The debates have most often had its origin in the question about how far blood pressure should be lowered with antihypertensive drugs.One one hand, we know that many patients with hypertension is not treated to targets according to guidelines and that this contributes to the high risk for cardiovascular diseases in patients with hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27637674/spontaneous-subarachnoid-haemorrhage
#20
REVIEW
R Loch Macdonald, Tom A Schweizer
Subarachnoid haemorrhage is an uncommon and severe subtype of stroke affecting patients at a mean age of 55 years, leading to loss of many years of productive life. The rupture of an intracranial aneurysm is the underlining cause in 85% of cases. Survival from aneurysmal subarachnoid haemorrhage has increased by 17% in the past few decades, probably because of better diagnosis, early aneurysm repair, prescription of nimodipine, and advanced intensive care support. Nevertheless, survivors commonly have cognitive impairments, which in turn affect patients' daily functionality, working capacity, and quality of life...
February 11, 2017: Lancet
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