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cerebral vasospasm

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https://www.readbyqxmd.com/read/29328996/acute-and-sub-acute-neurological-toxicity-in-children-treated-for-acute-lymphoblastic-leukemia
#1
REVIEW
Natalia C Millan, Analía Pastrana, Myriam R Guitter, Pedro A Zubizarreta, María S Monges, María S Felice
Eighty percent of children with acute lymphoblastic leukemia (ALL) survive with current treatments. Neurotoxicity is an infrequent adverse event. We describe clinical presentations of neurological toxicity, phases of treatment when these adverse events were more frequent and patients ́ outcome. From January-1995 to December-2015, 1379 ALL cases were admitted. Neurotoxicity was diagnosed in 49 patients (3.6%) and classified according to neurological syndromes. Medical records, laboratory-tests and images were reviewed...
January 2, 2018: Leukemia Research
https://www.readbyqxmd.com/read/29322232/mechanical-thrombectomy-using-the-new-solitaire%C3%A2-platinum-stent-retriever-reperfusion-results-complication-rates-and-early-neurological-outcome
#2
Johannes Pfaff, Stefan Rohde, Tobias Engelhorn, Arnd Doerfler, Martin Bendszus, Markus Alfred Möhlenbruch
BACKGROUND AND PURPOSE: The application of radiopaque markers to the Solitaire™ stent-retriever for better visibility during mechanical thrombectomy (MT) has the potential to alter the well-known characteristics of the device; however, it is uncertain whether this adjustment influences efficacy or safety of the enhanced stent-retriever. METHODS: Retrospective analysis of stroke databases of three comprehensive stroke centers. Our investigation was focused on technical and angiographic parameters, including procedure times, reperfusion results (thrombolysis in cerebral infarction, TICI), periprocedural complications and favorable early neurological recovery at discharge (modified Rankin scale ≤2 or National Institutes of Health Stroke Scale, NIHSS = 0 or ∆NIHSS ≥ 10), from consecutive patients with acute anterior circulation ischemic stroke treated with a Solitaire™ Platinum stent-retriever between October 2016 and March 2017...
January 10, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29302799/early-abnormal-transient-hyperemic-response-test-can-predict-delayed-ischemic-neurologic-deficit-in-subarachnoid-hemorrhage
#3
Hosam Al-Jehani, Mark Angle, Judith Marcoux, Jeanne Teitelbaum
BACKGROUND: Early detection of vasospasm is crucial to prevent significant delayed ischemic neurological deficit post subarachnoid hemorrhage. The standard methods of detection, including cerebral angiogram and computed tomography are invasive and not safe to be repeated, as is very often indicated clinically. Transient hyperemic response test has been previously used to predict autoregulation failure in traumatic brain injury and subarachnoid hemorrhage. AIMS: We investigate the usability of transient hyperemic response test as a predictor of clinical vasospasm in a cohort of patients with aneurismal subarachnoid hemorrhage...
January 4, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29296615/minocycline-protects-against-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage-via-matrix-metalloproteinase-9-inhibition
#4
Ananth K Vellimana, Meng-Liang Zhou, Itender Singh, Diane J Aum, James W Nelson, Glenn R Harris, Umeshkumar Athiraman, Byung H Han, Gregory J Zipfel
Objective: Delayed cerebral ischemia (DCI) is an independent risk factor for poor outcome after aneurysmal subarachnoid hemorrhage (SAH) and is multifactorial in etiology. While prior studies have suggested a role for matrix metalloproteinase-9 (MMP-9) in early brain injury after SAH, its contribution to the pathophysiology of DCI is unclear. Methods: In the first experiment, wild-type (WT) and MMP-9-/- mice were subjected to sham or endovascular perforation SAH surgery...
December 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29284568/clinical-characteristics-of-subarachnoid-hemorrhage-with-an-intracerebral-hematoma-and-prognostic-factors
#5
Masaaki Nemoto, Hiroyuki Masuda, Yuki Sakaeyama, Sinichi Okonogi, Yasuhiro Node, Keita Ueda, Shunpei Ando, Kosuke Kondo, Naoyuki Harada, Nobuo Sugo
BACKGROUND: Subarachnoid hemorrhage (SAH) with an intracerebral hematoma (ICH) shows an unfavorable prognosis. In the present study, we examined the characteristics of SAH with ICH and its prognosis. METHODS: Subjects comprised 218 patients with SAH who underwent surgery between January 2007 and December 2015. We compared age, sex, the location of the aneurysm, treatment procedures, medical history (hypertension, diabetes, and heart disease), the Glasgow Coma Scale (GCS) score on admission, rerupture rate, hydrocephalus, the diameter of the aneurysm, cerebral vasospasm, perioperative cardiopulmonary complications, and the Glasgow Outcome Scale (GOS) score after 2 months between patients with SAH with and without ICH...
December 25, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29277532/levels-of-il-1%C3%AE-il-18-and-tnf-%C3%AE-in-cerebrospinal-fluid-of-aneurysmal-subarachnoid-hemorrhage-patients-may-be-predictors-of-early-brain-injury-and-clinical-prognosis
#6
Sheng-Yin Lv, Qi Wu, Jing-Peng Liu, Jiang Shao, Li-Li Wen, Jin Xue, Xiang-Sheng Zhang, Qing-Rong Zhang, Xin Zhang
BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is a severe cerebrovascular accident with high morbidity and mortality. The aim of this study is to investigate the relationship between level of inflammatory cytokines in cerebrospinal fluid of aSAH patients, the severity of aSAH and the outcome of aSAH patients. METHODS: aSAH patients were prospectively included and followed-up 6 months. CSF samples were collected at 1-3 days, 4-6 days and 7-9 days after aSAH onset, respectively...
December 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29274300/unconjugated-bilirubin-modulates-neuronal-signaling-only-in-wild-type-mice-but-not-after-ablation-of-the-r-type-cav-2-3-voltage-gated-calcium-channel
#7
Walid Albanna, Felix Neumaier, Jan Niklas Lüke, Konstantin Kotliar, Catharina Conzen, Ute Lindauer, Jürgen Hescheler, Hans Clusmann, Toni Schneider, Gerrit Alexander Schubert
INTRODUCTION: The relationship between blood metabolites and hemoglobin degradation products (BMHDPs) formed in the cerebrospinal fluid and the development of vasospasm and delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) has been the focus of several previous studies, but their molecular and cellular targets remain to be elucidated. METHODS: Because BMHDP-induced changes in Cav 2.3 channel function are thought to contribute to DCI after aSAH, we studied their modulation by unconjugated bilirubin (UCB) in an organotypical neuronal network from wild-type (WT) and Cav 2...
December 23, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29273947/correction-to-vasomodulatory-effects-of-the-angiotensin-ii-type-1-receptor-antagonist-losartan-on-experimentally-induced-cerebral-vasospasm-after-subarachnoid-haemorrhage
#8
Stefan Wanderer, Jan Mrosek, Florian Gessler, Volker Seifert, Juergen Konczalla
The original version of this paper unfortunately captured the names of Florian Gessler and Volker Seifert incorrectly and are now corrected in this paper.
December 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29262433/aneurysmal-subarachnoid-hemorrhage-strategies-for-preventing-vasospasm-in-the-intensive-care-unit
#9
Michael N Diringer, Allyson R Zazulia
This article addresses the intensive care unit (ICU) management of patients with aneurysmal subarachnoid hemorrhage (SAH), with an emphasis on the prevention of cerebral vasospasm and delayed cerebral ischemia (DCI), which are major contributors to morbidity and mortality. Interventions addressing various steps in the development of vasospasm have been attempted, with variable success. Enteral nimodipine remains the only approved measure to potentially prevent DCI. Since oral and intravenous administrations are limited by hypotension, direct administration via sustained-release pellets and intraventricular administration of sustained-release microparticles are being investigated...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29246935/cocaine-induced-pseudo-wellens-syndrome-a-wellens-phenocopy
#10
Aung Naing Lin, Sithu Lin, Rahul Gokhroo, Deepika Misra
Wellens' syndrome represents critical occlusion of the proximal left anterior descending coronary artery. Electrocardiographic changes similar to Wellens' wave are not exceptional to acute coronary occlusion and can also be seen in cardiac and non-cardiac conditions, such as left ventricular hypertrophy, persistent juvenile T wave, bundle branch blocks, cerebral haemorrhage, pulmonary oedema, pulmonary embolism, pheochromocytoma, Takotsubo syndrome, digitalis and cocaine-induced coronary vasospasm. Cocaine-induced pseudo-Wellens' syndrome should be considered as one of the differentials, since cocaine is used frequently by young adults and can cause left anterior descending coronary vasospasm mimicking Wellens' syndrome...
December 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29243981/assessment-of-intracranial-venous-blood-flow-after-subarachnoid-hemorrhage-a-new-approach-to-diagnose-vasospasm-with-transcranial-color-coded-duplex-sonography
#11
Florian Connolly, Stephan J Schreiber, Christoph Leithner, Georg Bohner, Peter Vajkoczy, José M Valdueza
OBJECTIVE Transcranial color-coded duplex sonography (TCCS) is a reliable tool that is used to assess vasospasm in the M1 segment of the middle cerebral artery (MCA) after subarachnoid hemorrhage (SAH). A distinct increase in blood flow velocity (BFV) is the principal criterion for vasospasm. The MCA/internal carotid artery (ICA) index (Lindegaard Index) is also widely used to distinguish between vasospasm and cerebral hyperperfusion. However, extracranial ultrasonography assessment of the neck vessels might be difficult in an intensive care unit...
December 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29219760/direct-visualization-of-microcirculation-impairment-after-acute-subdural-hemorrhage-in-a-novel-animal-model
#12
Huan-Chih Wang, Jui-Chang Tsai, Jing-Er Lee, Sheng-Jean Huang, Abel Po-Hao Huang, Wei-Chou Lin, Sung-Tsang Hsieh, Kuo-Chuan Wang
OBJECTIVE Direct brain compression and secondary injury due to increased intracranial pressure are believed to be the pathognomic causes of a grave outcome in acute subdural hemorrhage (aSDH). However, ischemic damage from aSDH has received limited attention. The authors hypothesized that cerebral microcirculation is altered after aSDH. Direct visualization of microcirculation was conducted in a novel rat model. METHODS A craniectomy was performed on each of the 18 experimental adult Wistar rats, followed by superfusion of autologous arterial blood onto the cortical surface...
December 8, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29214400/vasomodulatory-effects-of-the-angiotensin-ii-type-1-receptor-antagonist-losartan-on-experimentally-induced-cerebral-vasospasm-after-subarachnoid-haemorrhage
#13
Stefan Wanderer, Jan Mrosek, Gessler Florian, Seifert Volker, Juergen Konczalla
BACKGROUND: Cerebral vasospasm following subarachnoid haemorrhage (SAH) remains one of the major factors contributing to poor overall patient outcome. Prostaglandin F2-alpha (PGF2a) induces vasoconstriction. After SAH, PGF2a leads to cerebral inflammation and enhanced vasoconstriction, resulting in cerebral vasospasm. Losartan is already known to have beneficial effects in stroke models and also on several cerebral inflammatory processes. Therefore, the aim of the study was to analyse the effect of losartan on PGF2a-enhanced vasoconstriction after SAH...
December 6, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29201854/traumatic-intracerebral-and-subarachnoid-hemorrhage-due-to-a-ruptured-pseudoaneurysm-of-middle-meningeal-artery-accompanied-by-a-medial-sphenoid-wing-dural-arteriovenous-fistula
#14
Jae Won Park, Jong Young Lee
Traumatic pseudoaneurysms of middle meningeal artery (MMA) and medial sphenoid wing dural arteriovenous fistula (dAVF) are rare. These lesions usually result from traumatic brain injury, and associated with skull fracture. In this paper, the authors report a case of a patient with a ruptured traumatic pseudoaneurysm of MMA and medial sphenoid wing dAVF presented with an intracerebral hemorrhage in the left temporal region and subarachnoid hemorrhage. These lesions were completely obliterated by endovascular treatment, and the patient was recovered without any neurologic deficit...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29194369/elevated-systemic-il-6-levels-in-patients-with-aneurysmal-subarachnoid-hemorrhage-is-an-unspecific-marker-for-post-sah-complications
#15
Shafqat Rasul Chaudhry, Birgit Stoffel-Wagner, Thomas Mehari Kinfe, Erdem Güresir, Hartmut Vatter, Dirk Dietrich, Alf Lamprecht, Sajjad Muhammad
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is still a fatal and morbid disease, although bleeding aneurysms can be secured in almost all cases. Occurrence of post-SAH complications including cerebral vasospasm, delayed cerebral ischemia, hydrocephalus, epilepsy, and infections are the main determinants of clinical outcome. Hence, it is important to search for early predictors for specific post-SAH complications to treat these complications properly. Both cellular and molecular (cytokines) inflammation play a key role after aSAH during the phase of occurrence of post-SAH complications...
December 1, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29191548/evaluation-of-enterprise-stent-assisted-coiling-and-telescoping-stent-technique-as-treatment-of-supraclinoid-blister-aneurysms-of-the-internal-carotid-artery
#16
Ding Xu, Changwei Zhang, Ting Wang, Chaohua Wang, David F Kallmes, Giuseppe Lanzino, Chao You, Xiaodong Xie
BACKGROUND: Supraclinoid blister aneurysms (BAs) of the internal carotid artery are uncommon and deadly, and appropriate treatment is controversial. Endovascular reconstruction may allow treatment through aneurysm isolation. We report a single-institution experience in the use of Enterprise stent-assisted coiling (ESAC) for treating BAs to appraise the safety and efficacy of this technique. METHODS: Patients treated with ESAC for a BA at our institution between 2013 and 2016 were retrospectively included in this study...
November 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29183679/angiographic-perfusion-imaging-of-intracranial-stenting
#17
Chibawanye I Ene, Ryan P Morton, Cory M Kelly, Michael R Levitt, Basavaraj Ghodke
Two-dimensional angiographic perfusion imaging (2DAP) is a new technique permitting perfusion imaging during angiography, and has been used to study cerebral vasospasm. Here we report our experience with this technique following angioplasty and stent placement in a patient with symptomatic and medically refractory stenosis of the right supraclinoid internal carotid artery. We found that intraprocedural angiographic perfusion imaging provided real-time and objective evidence of improved cerebral perfusion during intervention...
November 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29172058/rapid-and-simplified-synthesis-of-18-f-fluoromisonidazole-and-its-use-in-pet-imaging-in-an-experimental-model-of-subarachnoid-hemorrhage
#18
Laura Fernandez-Maza, Juan Jose Egea-Guerrero, Marcin Balcerzyk, Gemma Civantos-Jubera, Elena Gordillo-Escobar, Angel Vilches-Arenas, Isabel Fernandez-Gomez, Angel Parrado-Gallego, Francisco Murillo-Cabezas
Cerebral damage secondary to the vasospasm due to subarachnoid hemorrhage (SAH) is an important cause of morbid-mortality. We propose the use of the PET tracer [(18)F]Fluoromisonidazole to visualize the hypoxia due to the vasospasm. On the other hand [(18)F]Fluoromisonidazole synthesis process was optimized, avoiding HPLC purification using SPE cartridges instead, and reducing some synthesis steps. [(18)F]Fluoromisonidazole in vitro stability was tested for ten hours, and in vivo PET/CT images showed higher cerebral uptake in hemorrhagic animals than in control rats...
October 3, 2017: Applied Radiation and Isotopes
https://www.readbyqxmd.com/read/29171362/complications-of-endovascular-treatment-for-acute-ischemic-stroke-prevention-and-management
#19
Joyce S Balami, Philip M White, Peter J McMeekin, Gary A Ford, Alastair M Buchan
Endovascular mechanical thrombectomy (MT) for the treatment of acute stroke due to large vessel occlusion has evolved significantly with the publication of multiple positive thrombectomy trials. MT is now a recommended treatment for acute ischemic stroke. Mechanical thrombectomy is associated with a number of intra-procedural or post-operative complications, which need to be minimized and effectively managed to maximize the benefits of thrombectomy. Procedural complications include: access-site problems (vessel/nerve injury, access-site hematoma and groin infection); device-related complications (vasospasm, arterial perforation and dissection, device detachment/misplacement); symptomatic intracerebral hemorrhage; subarachnoid hemorrhage; embolization to new or target vessel territory...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29164612/seizures-csf-neurofilament-light-and-tau-in-patients-with-subarachnoid-haemorrhage
#20
I Halawa, P Vlachogiannis, Å Amandusson, K Elf, E-R Engström, H Zetterberg, E Kumlien
OBJECTIVES: Patients with severe subarachnoid haemorrhage (SAH) often suffer from complications with delayed cerebral ischaemia (DCI) due to vasospasm that is difficult to identify by clinical examination. The purpose of this study was to monitor seizures and to measure cerebrospinal fluid (CSF) concentrations of neurofilament light (NFL) and tau, and to see whether they could be used for predicting preclinical DCI. METHODS: We prospectively studied 19 patients with aneurysmal SAH who underwent treatment with endovascular coiling...
November 21, 2017: Acta Neurologica Scandinavica
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