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Subarachnoid haemorrhage

Muhammad AlMatter, Pervinder Bhogal, Marta Aguilar Pérez, Victoria Hellstern, Hansjörg Bäzner, Oliver Ganslandt, Hans Henkes
INTRODUCTION: The endovascular treatment (EVT) of ruptured cerebral aneurysms has been widely adopted after publication of the ISAT. In this study we sought to evaluate the safety and efficacy of the EVT for ruptured aneurysms based on 10-year series from a single centre with coil-first strategy. METHODS: All patients with aneurysmal subarachnoid haemorrhage (aSAH) treated between 2007 and 2016 were retrospectively reviewed and divided according to initial treatment into an EVT and a microsurgical clipping (MSC) group...
March 12, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
T Cesak, J Adamkov, J Habalova, P Poczos, M Kanta, M Bartos, T Hosszu
AIM: The aim of this study was to analyse the relationship between intracranial pressure (intracranial pressure monitoring) and lactate pyruvate ratio (cerebral microdialysis) in patients with ruptured intracranial aneurysms. METHODS: In a group of fifteen patients, intracranial pressure and lactate/pyruvate ratios were measured and logged in hourly intervals. The relationship between these two variables was subsequently analysed in two ways. 1) Intracranial hypertension (ICP > 20 mmHg) in the presence of energy deprivation (L/P ratio > 30) was noted...
2018: Bratislavské Lekárske Listy
Mauro Oddo, Daniele Poole, Raimund Helbok, Geert Meyfroidt, Nino Stocchetti, Pierre Bouzat, Maurizio Cecconi, Thomas Geeraerts, Ignacio Martin-Loeches, Hervé Quintard, Fabio Silvio Taccone, Romergryko G Geocadin, Claude Hemphill, Carole Ichai, David Menon, Jean-François Payen, Anders Perner, Martin Smith, José Suarez, Walter Videtta, Elisa R Zanier, Giuseppe Citerio
OBJECTIVE: To report the ESICM consensus and clinical practice recommendations on fluid therapy in neurointensive care patients. DESIGN: A consensus committee comprising 22 international experts met in October 2016 during ESICM LIVES2016. Teleconferences and electronic-based discussions between the members of the committee subsequently served to discuss and develop the consensus process. METHODS: Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles generated...
March 2, 2018: Intensive Care Medicine
Avanish Bhardwaj, Hemant Bhagat, Vinod Kumar Grover, Nidhi Bidyut Panda, Kiran Jangra, Seelora Sahu, Navneet Singla
PURPOSE: Surgery for aneurysmal clipping after subarachnoid haemorrhage (SAH) poses a unique anaesthetic challenge. However, data on the influence of anaesthetic agents in these patients are lacking. The study aims to evaluate the superiority of propofol over desflurane for postanaesthetic morbidity in patients undergoing surgery following aneurysmal SAH. METHODS: Seventy World Federation of Neurosurgeons Grade I and II patients were randomized into propofol (n = 35) and desflurane groups (n = 35)...
March 1, 2018: Journal of Anesthesia
Peter Smielewski, Luzius Steiner, Corina Puppo, Karol Budohoski, Georgios V Varsos, Marek Czosnyka
OBJECTIVE: Brain arterial critical closing pressure (CrCP) has been studied in several diseases such as traumatic brain injury (TBI), subarachnoid haemorrhage, hydrocephalus, and in various physiological scenarios: intracranial hypertension, decreased cerebral perfusion pressure, hypercapnia, etc. Little or nothing so far has been demonstrated to characterise change in CrCP during mild hypocapnia. METHOD: We retrospectively analysed recordings of intracranial pressure (ICP), arterial blood pressure (ABP) and blood flow velocity from 27 severe TBI patients (mean 39...
2018: Acta Neurochirurgica. Supplement
Adam M H Young, Joseph Donnelly, Xiuyun Liu, Mathew R Guilfoyle, Melvin Carew, Manuel Cabeleira, Danilo Cardim, Matthew R Garnett, Helen M Fernandes, Christina Haubrich, Peter Smielewski, Marek Czosnyka, Peter J Hutchinson, Shruti Agrawal
OBJECTIVE: Computed tomography (CT) of the brain can allow rapid assessment of intracranial pathology after traumatic brain injury (TBI). Frequently in paediatric TBI, CT imaging can fail to display the classical features of severe brain injury with raised intracranial pressure. The objective of this study was to determine early CT brain features that influence intracranial or systemic physiological trends following paediatric TBI. MATERIALS AND METHODS: Thirty-three patients (mean age, 10 years; range, 0...
2018: Acta Neurochirurgica. Supplement
Sven Bercker, Tanja Winkelmann, Thilo Busch, Sven Laudi, Dirk Lindner, Jürgen Meixensberger
BACKGROUND: Hydroxyethyl starch (HES) was part of "triple-H" therapy for prophylaxis and therapy of vasospasm in patients with subarachnoid haemorrhage (SAH). The European Medicines Agency restricted the use of HES in 2013 due to an increase of renal failure in critically ill patients receiving HES compared to crystalloid fluids. The occurrence of renal insufficiency in patients with SAH due to HES is still uncertain. The purpose of our study was to evaluate whether there was an association with renal impairment in patients receiving HES after subarachnoid haemorrhage...
2018: PloS One
J Todeschi, S Chibbaro, A Gubian, R Pop, F Proust, H Cebula
BACKGROUND: The rupture of an isolated spinal aneurysm is an exceptional occurrence. It might be responsible for a spinal subarachnoid haemorrhage (SSAH) that in rare cases can be complicated by arachnoiditis. Among the former the adhesive type is the most severe leading to the formation of a cyst and/or a syrinx. PATIENTS AND METHODS: The literature review was performed via a PubMed search using the following keywords. Adhesive arachnoiditis; spinal subarachnoid haemorrhage; spinal arachnoiditis; spinal arachnoid cyst; arachnoid cyst ...
February 9, 2018: Neuro-Chirurgie
Jorge Pena Mogollon, Nicolas Roydon Smoll, Rakshit Panwar
OBJECTIVE: An onsite access to neurointerventional radiology (NIR) may be useful for managing patients with aneurysmal subarachnoid haemorrhage (aSAH) after the aneurysm-securing procedure. We aimed to assess the association between neurological outcomes related to aSAH and onsite access to NIR service. METHODS: This was a sequential period study of 47 patients with aSAH admitted consecutively during the pre-NIR period (Jan 2010 to Jun 2012) compared with 81 patients with aSAH admitted consecutively during the post-NIR period (Jan 2013 to Jun 2015) at an academic tertiary referral ICU...
February 1, 2018: World Neurosurgery
Ahadi Reza, Esmail Riahi, Abdolhadi Daneshi, Ehsan Golchini
PRIMARY OBJECTIVE: To assess the demographics, causes, treatment and outcome of traumatic brain injury (TBI) in Tehran, Iran. RESEARCH DESIGN AND METHODS: This retrospective study was conducted in a major trauma centre in south of Tehran using clinical data registry of 3818 traumatic patients who admitted to the hospital from 2009 to 2013. The main factors measured were the external cause of trauma, the type of TBI, and treatment outcome. MAIN OUTCOMES AND RESULTS: The highest rate of TBIs occurred in age categories 21‒30 (31...
February 6, 2018: Brain Injury: [BI]
Adrian Pace, Sophie Mitchell, Elizabeth Casselden, Ardalan Zolnourian, James Glazier, Lesley Foulkes, Diederik Bulters, Ian Galea
Functional outcome after subarachnoid haemorrhage has traditionally been assessed using scales developed for other neurological conditions. The modified Rankin score and Glasgow Outcome Scale are most commonly used. Employment of these scales in subarachnoid haemorrhage is hampered by well recognized limitations. We set out to develop and validate a new condition-specific subarachnoid haemorrhage outcome tool (SAHOT). Items addressing diverse aspects of the impact of subarachnoid haemorrhage were collected during focus groups involving patients, next-of-kin and multidisciplinary professionals involved in subarachnoid haemorrhage management...
February 1, 2018: Brain: a Journal of Neurology
Kevin H Chu, Ibrahim Mahmoud, Xiang-Yu Hou, Craig D Winter, Rosalind L Jeffree, Nathan J Brown, Anthony Ft Brown
OBJECTIVES: To determine: (i) incidence and outcome of subarachnoid haemorrhage (SAH) in the general population; and (ii) proportions of SAH in both the general ED population and in ED patients presenting with headache. METHODS: A population-based study in Queensland from January 2010 to December 2014 was conducted. Data were sourced from the Australian Bureau of Statistics, Queensland Hospital Admitted Patient Data Collection linked to the Queensland death registry and ED Information System...
February 5, 2018: Emergency Medicine Australasia: EMA
Khoa Anh Nguyen, Mohamed Elnaggar, Natalie M Gallant, Maged Tanios
Neurofibromatosis type 1 (NF1)-related lung disease is a rare but increasingly recognised, high morbidity associated feature of the condition. We present a 48-year-old male patient with NF1, who was initially admitted for a subarachnoid haemorrhage requiring aneurysmal coil embolisation. During his recovery, he developed a left-sided pneumothorax requiring chest tube placement followed by concerns for re-expansion pulmonary oedema requiring intubation. Subsequently, the patient also developed a right-sided pneumothorax requiring additional chest tube placement but did not develop right-sided pulmonary oedema...
January 31, 2018: BMJ Case Reports
Rajesh Shankar Iyer, Ramakrishnan Tirupur Chinnappan Ramalingam, Saleem Akhtar, Karunakaran Muthukalathi
No abstract text is available yet for this article.
January 26, 2018: BMJ Case Reports
Laura Green, Joachim Tan, Joan K Morris, Raza Alikhan, Nicola Curry, Tamara Everington, Rhona Mclean, Khalid Saja, Simon Stanworth, Campbell Tait, Peter MacCallum
The outcomes of patients developing major bleeding on oral anticoagulants remain largely unquantified. Objectives are to: 1) describe the burden of major haemorrhage associated with all available oral anticoagulants in terms of: proportion of bleeds which are intracranial-haemorrhages, in-hospital mortality and duration of hospitalisation following major bleeding; 2) identify risk factors for mortality; 3) compare characteristics of major haemorrhage between warfarin and direct-oral anticoagulants for the subgroup of atrial fibrillation and venous-thromboembolism patients...
January 25, 2018: Haematologica
Siddharth Nath, Alex Koziarz, Jetan H Badhiwala, Saleh A Almenawer
No abstract text is available yet for this article.
January 24, 2018: BMJ: British Medical Journal
Y H Ng, D V Pilcher, M Bailey, C A Bain, C MacManus, T K Bucknall
We aimed to develop a predictive model for intensive care unit (ICU)-discharged patients at risk of post-ICU deterioration. We performed a retrospective, single-centre cohort observational study by linking the hospital admission, patient pathology, ICU, and medical emergency team (MET) databases. All patients discharged from the Alfred Hospital ICU to wards between July 2012 and June 2014 were included. The primary outcome was a composite endpoint of any MET call, cardiac arrest call or ICU re-admission. Multivariable logistic regression analysis was used to identify predictors of outcome and develop a risk-stratification model...
January 2018: Anaesthesia and Intensive Care
Chandramohan Sharma, Banshi Lal Kumawat, Deepika Sagar, Maulik Panchal
Unruptured aneurysm usually presents with headache and neuro-ophthalmic features; when it ruptures, it presents with subarachnoid haemorrhage. Basilar artery aneurysm represents only 3-5% of cerebral aneurysms. Non-haemorrhagic symptoms and the signs of unruptured aneurysms are manifested as mass effect, thromboembolic phenomenon or epileptical attacks. Clinical presentation of unruptured aneurysm depends on structures which are involved. In our case, the patient had insidious onset headache and spastic quadriparesis with sixth cranial nerve palsy, which implicate involvement of corticospinal pathways at the level of pons...
January 17, 2018: BMJ Case Reports
Blessing N R Jaja, Gustavo Saposnik, Hester F Lingsma, Erin Macdonald, Kevin E Thorpe, Muhammed Mamdani, Ewout W Steyerberg, Andrew Molyneux, Airton Leonardo de Oliveira Manoel, Bawarjan Schatlo, Daniel Hanggi, David Hasan, George K C Wong, Nima Etminan, Hitoshi Fukuda, James Torner, Karl L Schaller, Jose I Suarez, Martin N Stienen, Mervyn D I Vergouwen, Gabriel J E Rinkel, Julian Spears, Michael D Cusimano, Michael Todd, Peter Le Roux, Peter Kirkpatrick, John Pickard, Walter M van den Bergh, Gordon Murray, S Claiborne Johnston, Sen Yamagata, Stephan Mayer, Tom A Schweizer, R Loch Macdonald
OBJECTIVE: To develop and validate a set of practical prediction tools that reliably estimate the outcome of subarachnoid haemorrhage from ruptured intracranial aneurysms (SAH). DESIGN: Cohort study with logistic regression analysis to combine predictors and treatment modality. SETTING: Subarachnoid Haemorrhage International Trialists' (SAHIT) data repository, including randomised clinical trials, prospective observational studies, and hospital registries...
January 18, 2018: BMJ: British Medical Journal
M Munteanu, C Rosca, H Stanca
PURPOSE: To report a case of bilateral Terson Syndrome with sub inner limiting membrane hemorrhage associated with a rare finding: perimacular fold. METHODS: The patient, a 34 years old female with aneurysmal subarachnoid hemorrhage and bilateral Terson syndrome was admitted to the Ophthalmology department, complaining of blurred vision. Core vitrectomy, hyaloid detachment, peeling of the ILM and aspiration of the sub inner limiting membrane hemorrhage was performed...
January 17, 2018: International Ophthalmology
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