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Subarachnoid haemorrhage

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https://www.readbyqxmd.com/read/28213906/impact-of-dexamethasone-in-patients-with-aneurysmal-subarachnoid-haemorrhage
#1
P Czorlich, T Sauvigny, F Ricklefs, T Abboud, A Nierhaus, E Vettorazzi, D A Reuter, J Regelsberger, M Westphal, N O Schmidt
BACKGROUND AND PURPOSE: The role of corticosteroids in the treatment of patients with aneurysmal subarachnoid haemorrhage (SAH) has remained controversial for decades. Recent studies have suggested that the administration of corticosteroids in SAH patients is associated with favourable outcomes. Given their significant adverse effects, it is essential to identify those patients who will benefit from treatment with corticosteroids. METHODS: A retrospective analysis of a prospectively collected cohort (n = 306) with SAH who were treated by microsurgical clipping or endovascular intervention was performed...
February 17, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28203386/concurrent-subarachnoid-haemorrhage-and-st-elevation-myocardial-infarction
#2
Joon H Tan, Akhlaque Uddin, Juan P Fernandez
Rare case of concurrent subarachnoid haemorrhage and ST elevation myocardial infarction, highlighting the importance of detailed history in an emergency.
February 2017: JRSM Open
https://www.readbyqxmd.com/read/28201864/recurrent-contrast-induced-encephalopathy-following-coronary-angiography
#3
Roberto Spina, Neil Simon, Romesh Markus, David W M Muller, Krishna Kathir
Contrast-induced encephalopathy (CIE) is an acute and reversible neurological disturbance associated with the intra-arterial administration of iodinated contrast medium during cardiac catheterisation. It may manifest with encephalopathy, motor and sensory disturbances; vision disturbances, including cortical blindness, ophthalmoplegia, aphasia; and seizures. Disruption of the blood-brain barrier and direct neuronal toxicity are believed to be implicated in the pathophysiology of the syndrome. Symptoms appear soon after contrast administration and resolve completely within 24-48 h...
February 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28197790/surgical-treatment-of-anterior-cranial-fossa-dural-arterio-venous-fistulas-davfs-a-two-centre-experience
#4
Pietro Meneghelli, Alberto Pasqualin, Luigi Andrea Lanterna, Claudio Bernucci, Roberto Spinelli, Gianluigi Dorelli, Piergiuseppe Zampieri
BACKGROUND: Anterior cranial fossa dural arterio-venous fistulas (DAVFs) represent 6% of all intracranial DAVFs; characteristically they show an aggressive behaviour with high risk of intracranial haemorrhage. Peculiar anatomical features, such as feeding by the ethmoidal arteries and the pattern of venous drainage (frequently with varices that mimic aneurysmal dilatation), can be evaluated in detail only by digital subtraction angiography (DSA), which represents the "gold standard" in the diagnosis of such cranial fistulas...
February 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28193628/management-of-endocrine-disease-neuroendocrine-surveillance-and-management-of-neurosurgical-patients-non-pituitary
#5
Aoife Garrahy, Mark Sherlock, Chris J Thompson
Advances in the management of traumatic brain injury, subarachnoid haemorrhage and intracranial tumours have led to improved survival rates and an increased focus on quality of life of survivors. Endocrine sequelae of the acute brain insult and subsequent neurosurgery, peri-operative fluid administration and/or cranial irradiation are now well described. Unrecognized acute hypopituitarism, particularly ACTH/cortisol deficiency and diabetes insipidus, can be life-threatening. While hypopituitarism may be transient, up to 30% of survivors of TBI have chronic hypopituitarism, which can diminish quality of life and hamper rehabilitation...
February 13, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28192263/cholesterol-reducing-agents-for-treatment-of-aneurysmal-subarachnoid-haemorrhage-systematic-review-and-meta-analyses-of-randomized-controlled-trials
#6
REVIEW
T Akhigbe, A Zolnourian, D Bulters
BACKGROUND: Aneurysmal haemorrhage induced cerebral vasospasm; DIND, poor neurological outcome and mortality are major causes of mortality and morbidity. The effects of cholesterol lowering agents in these patients remain controversial. This up to date systematic review and meta-analyses aimed to evaluate the efficacy of statin use in patients with aneurysmal subarachnoid haemorrhage METHODS: Systematic review of literature conducted using electronic database searched up to September 2016 included Cochrane Central Register of Controlled trials in the Cochrane library, Medline, Embase and Science Citation Index Expanded database to identify relevant studies...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28174188/cervical-spine-arteriovenous-fistula-associated-with-hereditary-haemorrhagic-telangiectasia
#7
Iain John McGurgan, Roisin Lonergan, Ronan Killeen, Christopher McGuigan
Reported is a case of a man aged 55 years who presented with progressive spastic paraparesis. Examination demonstrated multiple cutaneous telangiectases. Subsequent development of upper limb weakness, acute urinary retention and eventual respiratory compromise resulted in the requirement for intensive care unit admission and mechanical ventilation. MRI spine revealed diffuse T2 hyperintensity in the cervical cord with enhancement and cord expansion. Immunomodulatory therapy for a presumed diagnosis of transverse myelitis yielded no response, so a vascular aetiology was suspected...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28169020/description-of-stroke-mimics-after-complete-neurovascular-assessment
#8
C Avellaneda-Gómez, A Rodríguez Campello, E Giralt Steinhauer, A Gómez González, M Serra Martínez, P de Ceballos Cerrajería, A Zabalza de Torres, E Cuadrado-Godia, A Ois Santiago, J Jiménez-Conde, J Roquer
INTRODUCTION: A considerable percentage of events initially diagnosed as ischaemic stroke have non-cerebrovascular causes; these are called stroke mimics (SM). Currently available evidence about these events is heterogeneous and comes from studies with small samples. OBJECTIVE: The purpose of our study is to identify conditions that may present as SM, define their epidemiological and clinical characteristics, and determine the percentage of cases of SM treated with intravenous fibrinolysis...
February 4, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28154972/convexity-subarachnoid-haemorrhage-has-a-high-risk-of-intracerebral-haemorrhage-in-suspected-cerebral-amyloid-angiopathy
#9
D Wilson, I C Hostettler, G Ambler, G Banerjee, H R Jäger, D J Werring
The risk of future symptomatic intracerebral haemorrhage (sICH) remains uncertain in patients with acute convexity subarachnoid haemorrhage (cSAH) associated with suspected cerebral amyloid angiopathy (CAA). We assessed the risk of future sICH in patients presenting to our comprehensive stroke service with acute non-traumatic cSAH due to suspected CAA, between 2011 and 2016. We conducted a systematic search and pooled analysis including our cohort and other published studies including similar cohorts. Our hospital cohort included 20 patients (mean age 69 years; 60% male); 12 (60%) had probable CAA, and 6 (30%) had possible CAA according to the modified Boston criteria; two did not meet CAA criteria because of age <55 years, but were judged likely to be due to CAA...
February 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28133987/ruptured-intracranial-vertebral-artery-dissecting-aneurysms-an-evaluation-of-prognostic-factors-of-treatment-outcome
#10
K Urasyanandana, P Withayasuk, D Songsaeng, T Aurboonyawat, E Chankaew, A Churojana
Objective Intracranial spontaneous vertebral artery dissecting aneurysms commonly occur in the third to fifth decades of life, and are mostly associated with hypertension. Patients present with intracranial haemorrhage or thromboembolic events. Patients who present with intracranial haemorrhage carry about a 70% risk of recurrent bleeding. Patients with a posterior-inferior cerebellar artery (PICA) or ipsilateral dominant vertebral artery involve selecting which parent vessel could not be sacrificed. Recent reconstructive techniques such as stent-assisted coiling embolisation and flow-diverting stents are effective treatments of choice...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28125090/loss-of-gcn5-leads-to-increased-neuronal-apoptosis-by-upregulating-e2f1-and-egr-1-dependent-bh3-only-protein-bim
#11
Yanna Wu, Shanshan Ma, Yong Xia, Yangpeng Lu, Shiyin Xiao, Yali Cao, Sidian Zhuang, Xiangpeng Tan, Qiang Fu, Longchang Xie, Zhiming Li, Zhongmin Yuan
Cellular acetylation homeostasis is a kinetic balance precisely controlled by histone acetyl-transferase (HAT) and histone deacetylase (HDAC) activities. The loss of the counterbalancing function of basal HAT activity alters the precious HAT:HDAC balance towards enhanced histone deacetylation, resulting in a loss of acetylation homeostasis, which is closely associated with neuronal apoptosis. However, the critical HAT member whose activity loss contributes to neuronal apoptosis remains to be identified. In this study, we found that inactivation of GCN5 by either pharmacological inhibitors, such as CPTH2 and MB-3, or by inactivation with siRNAs leads to a typical apoptosis in cultured cerebellar granule neurons...
January 26, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28108855/causes-of-poor-outcome-in-patients-admitted-with-good-grade-subarachnoid-haemorrhage
#12
Vladimír Beneš, Lubomír Jurák, Radim Brabec, Nina Nechanická, Miroslav Šercl, Ladislav Endrych, Pavel Buchvald, Petr Suchomel
BACKGROUND: Surgical risk in patients with unruptured aneurysms is well known. The relative impact of surgery and natural history of subarachnoid haemorrhage (SAH) on patients in good clinical condition (World Federation of Neurological Surgeons [WFNS] grades 1 and 2) is less well quantified. The aim of this study was to determine causes of poor outcome in patients admitted in good grade SAH. METHODS: A retrospective study of prospectively collected data among WFNS-1 and -2 patients: demographics, SAH and aneurysm-related data, surgical complications and outcome as assesed by the Glasgow Outcome Scale (GOS)...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28107401/how-many-patients-become-functionally-dependent-after-a-stroke-a-3-year-population-based-study-in-joinville-brazil
#13
Lívia Mizuki de Campos, Bruna Mariah Martins, Norberto Luiz Cabral, Selma Cristina Franco, Octávio Marques Pontes-Neto, Suleimy Cristina Mazin, Felipe Ibiapina Dos Reis
The decrease in stroke mortality will increase the burden of survivors with functional dependence (FD). The aim of this study was to evaluate how many patients become functionally dependent over 3 years after an incident event in Joinville, Brazil. The proportion of FD (defined as a modified Rankin score 3 to 5) among stroke survivors from the Joinville Stroke Registry was assessed using a validated telephone interview. Incidence of FD after stroke in Joinville in one year was 23.24 per 100,000 population. The overall proportion of FD among stroke survivors at discharge was 32...
2017: PloS One
https://www.readbyqxmd.com/read/28102428/plasma-adamts13-activity-and-von-willebrand-factor-antigen-and-activity-in-patients-with-subarachnoid-haemorrhage
#14
Monisha Kumar, Wenjing Cao, Jenny K McDaniel, Huy P Pham, Dheeraj Raju, Kelsey Nawalinski, Suzanne Frangos, David Kung, Eric Zager, Scott E Kasner, Joshua M Levine, X Long Zheng
Increased von Willebrand factor (VWF) and reduced ADAMTS13 activity are associated with arterial thrombosis. This may also be the culprit mechanism implicated in delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage (SAH). It was our objective to determine plasma VWF and ADAMTS13 in patients with SAH and healthy subjects; and to explore the levels of those markers and outcome after SAH. Forty consecutive patients were enrolled between September 2007 and April 2014 in a pilot study. Plasma samples were collected from SAH patients on post-bleed day (PBD) 0, 1, 3, 5, 7 and 10 and healthy controls...
January 19, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28100721/meta-analysis-of-timing-of-endovascular-aneurysm-treatment-in-subarachnoid-haemorrhage-inconsistent-results-of-early-treatment-within-1-day
#15
Sapna Rawal, Paula Alcaide-Leon, R Loch Macdonald, Gabriel J E Rinkel, J Charles Victor, Timo Krings, Moira K Kapral, Andreas Laupacis
BACKGROUND AND PURPOSE: To systematically review and meta-analyse the data on impact of timing of endovascular treatment in aneurysmal subarachnoid haemorrhage (SAH) to determine if earlier treatment is associated with improved clinical outcomes and reduced case fatality. METHODS: We searched MEDLINE, Cochrane database, EMBASE and Web of Science to identify studies for inclusion. The measures of effect utilised were unadjusted/adjusted ORs. Effect estimates were combined using random effects models for each outcome (poor outcome, case fatality); heterogeneity was assessed using the I(2) index...
January 18, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28074401/adipsic-diabetes-insipidus-in-adult-patients
#16
REVIEW
Martín Cuesta, Mark J Hannon, Christopher J Thompson
INTRODUCTION: Adipsic diabetes insipidus (ADI) is a very rare disorder, characterized by hypotonic polyuria due to arginine vasopressin (AVP) deficiency and failure to generate the sensation of thirst in response to hypernatraemia. As the sensation of thirst is the key homeostatic mechanism that prevents hypernatraemic dehydration in patients with untreated diabetes insipidus (DI), adipsia leads to failure to respond to aquaresis with appropriate fluid intake. This predisposes to the development of significant hypernatraemia, which is the typical biochemical manifestation of adipsic DI...
January 10, 2017: Pituitary
https://www.readbyqxmd.com/read/28065963/complications-of-in-patient-cerebral-angiography-comparison-between-patients-with-and-without-sub-arachnoid-haemorrhage
#17
Yaseen Rauf, Usman Tariq Siddiqui, Gohar Javed
OBJECTIVE: To compare complications of cerebral angiography among patients with and without subarachnoid haemorrhage. METHODS: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients undergoing inpatient therapeutic and diagnostic cerebral angiographies from 2001 to 2010. The patients were divided into subarachnoid and non-subarachnoid haemorrhage groups. During the study period no modifications were made to the operational protocol and all patients were subjected to the same procedure and prophylactic care...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28060696/acute-pancreatitis-and-posterior-reversible-encephalopathy-syndrome-a-case-report
#18
Vítor Magno Pereira, Luís Marote Correia, Tiago Rodrigues, Gorete Serrão Faria
The posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28055227/clinical-evaluation-of-post-operative-cerebral-infarction-in-traumatic-epidural-haematoma
#19
Suojun Zhang, Sheng Wang, Xueyan Wan, Shengwen Liu, Kai Shu, Ting Lei
BACKGROUND: Patients with traumatic epidural haematoma, undergoing the prompt and correct treatment, usually have favourable outcomes. However, secondary cerebral infarction may be life-threatening condition, as it is difficult to be identified before neurological impairment occurs. OBJECTIVE: To evaluate the clinical data of patients with traumatic EDH and assess potential risk factors for post-operative cerebral infarction. METHODS: The clinical data of patients with traumatic EDH were collected and analysed retrospectively...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28052979/prevalence-incidence-and-mortality-of-stroke-in-china-results-from-a-nationwide-population-based-survey-of-480-687-adults
#20
Wenzhi Wang, Bin Jiang, Haixin Sun, Xiaojuan Ru, Dongling Sun, Linhong Wang, Limin Wang, Yong Jiang, Yichong Li, Yilong Wang, Zhenghong Chen, Shengping Wu, Yazhuo Zhang, David Wang, Yongjun Wang, Valery L Feigin
BACKGROUND: -China bears the biggest stroke burden in the world. However, little is known about the current prevalence, incidence, and mortality of stroke at the national level, and the trend in the last 30 years. METHODS: -In 2013 a nationally-representative door-to-door survey was conducted in 155 urban and rural centres in 31 provinces in China, totalling 480,687 adults aged ≥20 years. All stroke survivors were considered as prevalent stroke cases at the prevalent time (August 31, 2013)...
January 4, 2017: Circulation
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