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cerebral vasospasm

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https://www.readbyqxmd.com/read/29148905/serum-glucose-potassium-ratio-as-a-clinical-risk-factor-for-aneurysmal-subarachnoid-hemorrhage
#1
Yu Fujiki, Fumihiro Matano, Takayuki Mizunari, Yasuo Murai, Kojiro Tateyama, Kenta Koketsu, Asami Kubota, Shiro Kobayashi, Hiroyuki Yokota, Akio Morita
OBJECTIVE Aneurysmal subarachnoid hemorrhage (SAH) can result in poor outcomes, and biomarkers for predicting poor prognosis have not yet been established. The aim of this study was to clarify the significance of the serum glucose/potassium ratio for predicting the prognosis of aneurysmal SAH. METHODS The authors retrospectively reviewed the records of 565 patients with aneurysmal SAH between 2006 and 2016. The patient group comprised 208 men and 357 women (mean age 61.5 years, range 10-95 years). A statistical analysis was conducted of the clinical and laboratory risk factors of poor outcome, including the serum glucose/potassium ratio...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29136224/reliable-identification-of-benign-clinical-course-in-aneurysmal-subarachnoid-hemorrhage-a-simple-and-qualitative-algorithm
#2
Yifei Duan, James Wright, Christina Wright, Berje Shammassian, Curtis Tatsuoka, Nicholas Bambakidis
BACKGROUND: A reliable method to specifically identify low vasospasm risk in aneurysmal subarachnoid hemorrhage (aSAH) patients has not been previously proposed. OBJECTIVE: To develop a clinical algorithm using admission aSAH clinical severity and subarachnoid blood distribution to identify patients at low risk of clinical vasospasm. METHODS: Clinical severities, admission noncontrasted head computerized tomography (CT) scan, and incidences of vasospasm among 291 aSAH patients treated at our institution were evaluated...
November 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29118801/trends-in-endovascular-treatment-of-aneurysmal-subarachnoid-hemorrhages
#3
Tapan Mehta, Neil Datta, Smit Patel, Kathan Mehta, Mohammed Hussain, Inaam Kureshi, Martin Ollenschleger, Amre Nouh
Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) accounts for 5% of all strokes; 30-day mortality is as high as 40%. We sought to evaluate outcomes of aSAH patients treated 2004-2014 by endovascular therapy (EVT), to demonstrate associated trends, and to evaluate angioplasty use for aSAH-related cerebral vasospasm. Methods: The Nationwide Inpatient Sample (NIS) database 2004-2014 was used to derive a study cohort using ICD-9 codes. Survey procedures were used to adjust for stratified cluster design of NIS...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118800/septoplasty-scepter-balloon-angioplasty-for-vasospasm-after-aneurysmal-subarachnoid-hemorrhage
#4
Bradley A Gross, Daniel A Tonetti, Gregory M Weiner, David M Panczykowski, William J Ares, Cynthia L Kenmuir, Ashutosh P Jadhav, Tudor G Jovin, Brian T Jankowitz
Introduction: Balloon angioplasty can be a requisite approach for the treatment of symptomatic and/or severe vasospasm. Dual-lumen microcatheter balloons have multiple potential advantages for this indication including accommodating a 0.014-inch wire and the potential to deliver superselective vasodilators directly via the microcatheter prior to angioplasty. Methods: The authors reviewed a 3-year institutional experience with the Scepter XC balloon (Microvention, Tustin, CA, USA) in the treatment of postaneurysmal subarachnoid hemorrhage vasospasm, focusing on treatment methods, angiographic, and clinical results...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118793/feasibility-of-real-time-angiographic-perfusion-imaging-in-the-treatment-of-cerebral-vasospasm
#5
Christopher Donaldson, Anthea H O'Neill, Lee-Anne Slater, Winston Chong, Leon T Lai, Ronil V Chandra
Background: Objective assessment and quantification of the severity of cerebral vasospasm following aneurysmal subarachnoid hemorrhage is not routinely utilized. We investigated the feasibility of angiographic perfusion imaging derived from digital subtraction angiography (DSA) following endovascular vasospasm treatment procedures. Methodology: Real-time blood flow analysis was performed using parametric color coding on pre- and postintervention DSA. Semiquantitative parenchymal perfusion parameters (arrival time [AT] of contrast, time to peak [TTP] opacification, and mean transit time [MTT] of contrast) were calculated across 3 vascular territories (anterior cerebral artery [ACA], middle cerebral artery [MCA], and lenticulostriate arteries) using standard 2-D angiographic perfusion software...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29109695/the-role-of-thromboinflammation-in-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#6
REVIEW
Devin W McBride, Spiros L Blackburn, Kumar T Peeyush, Kanako Matsumura, John H Zhang
Delayed cerebral ischemia (DCI) is a major determinant of patient outcome following aneurysmal subarachnoid hemorrhage. Although the exact mechanisms leading to DCI are not fully known, inflammation, cerebral vasospasm, and microthrombi may all function together to mediate the onset of DCI. Indeed, inflammation is tightly linked with activation of coagulation and microthrombi formation. Thromboinflammation is the intersection at which inflammation and thrombosis regulate one another in a feedforward manner, potentiating the formation of thrombi and pro-inflammatory signaling...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29104730/haptoglobin-genotype-and-outcome-after-subarachnoid-haemorrhage-new-insights-from-a-meta-analysis
#7
Ben Gaastra, James Glazier, Diederik Bulters, Ian Galea
Haptoglobin (Hp) is a plasma protein involved in clearing extracellular haemoglobin and regulating inflammation; it exists as two genetic variants (Hp1 and Hp2). In a meta-analysis of six published studies, we confirm that Hp genotype affects short-term outcome (cerebral vasospasm and/or delayed cerebral ischemia) after subarachnoid haemorrhage (SAH) but not long-term outcome (Glasgow Outcome Score and modified Rankin Scale between one and three months). A closer examination of the heterozygous group revealed that the short-term outcome of Hp2-1 individuals clustered with that of Hp1-1 and not Hp2-2, suggesting that the presence of one Hp1 allele was sufficient to confer protection...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29099296/dual-antiplatelet-therapy-in-aneurysmal-subarachnoid-hemorrhage-association-with-reduced-risk-of-clinical-vasospasm-and-delayed-cerebral-ischemia
#8
Yasunori Nagahama, Lauren Allan, Daichi Nakagawa, Mario Zanaty, Robert M Starke, Nohra Chalouhi, Pascal Jabbour, Robert D Brown, Colin P Derdeyn, Enrique C Leira, Joseph Broderick, Marc Chimowitz, James C Torner, David Hasan
OBJECTIVE Clinical vasospasm and delayed cerebral ischemia (DCI) are devastating complications of aneurysmal subarachnoid hemorrhage (aSAH). Several theories involving platelet activation have been postulated as potential explanations of the development of clinical vasospasm and DCI. However, the effects of dual antiplatelet therapy (DAPT; aspirin and clopidogrel) on clinical vasospasm and DCI have not been previously investigated. The objective of this study was to evaluate the effects of DAPT on clinical vasospasm and DCI in aSAH patients...
November 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29098173/the-roles-of-endoglin-gene-in-cerebrovascular-diseases
#9
Wan Zhu, Li Ma, Rui Zhang, Hua Su
Endoglin (ENG, also known as CD105) is a transforming growth factor β (TGFβ) associated receptor and is required for both vasculogenesis and angiogenesis. Angiogenesis is important in the development of cerebral vasculature and in the pathogenesis of cerebral vascular diseases. ENG is an essential component of the endothelial nitric oxide synthase activation complex. Animal studies showed that ENG deficiency impairs stroke recovery. ENG deficiency also impairs the regulation of vascular tone, which contributes to the pathogenesis of brain arteriovenous malformation (bAVM) and vasospasm...
2017: Neuroimmunology and Neuroinflammation
https://www.readbyqxmd.com/read/29097330/effect-of-progesterone-on-cerebral-vasospasm-and-neurobehavioral-outcomes-in-a-rodent-model-of-subarachnoid-hemorrhage
#10
Nefize Turan, Brandon A Miller, J Russell Huie, Robert A Heider, Jun Wang, Bushra Wali, Seema Yousuf, Adam R Ferguson, Iqbal Sayeed, Donald G Stein, Gustavo Pradilla
BACKGROUND: Subarachnoid hemorrhage (SAH) induces widespread inflammation leading to cellular injury, vasospasm and ischemia. Evidence suggests that progesterone (PROG) can improve functional recovery in acute brain injury due to its anti-inflammatory and neuroprotective properties, which could also be beneficial in SAH. We hypothesized that PROG treatment attenuates inflammation mediated cerebral vasospasm and microglial activation, improves synaptic connectivity, and ameliorates functional recovery after SAH...
October 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29088959/traumatic-brain-injury-and-intracranial-hemorrhage-induced-cerebral-vasospasm-a-systematic-review
#11
Fawaz Al-Mufti, Krishna Amuluru, Abhinav Changa, Megan Lander, Neil Patel, Ethan Wajswol, Sarmad Al-Marsoummi, Basim Alzubaidi, I Paul Singh, Rolla Nuoman, Chirag Gandhi
OBJECTIVE Little is known regarding the natural history of posttraumatic vasospasm. The authors review the pathophysiology of posttraumatic vasospasm (PTV), its associated risk factors, the efficacy of the technologies used to detect PTV, and the management/treatment options available today. METHODS The authors performed a systematic review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the following databases: PubMed, Google Scholar, and CENTRAL (the Cochrane Central Register of Controlled Trials)...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29079662/endovascular-treatment-for-cerebral-vasospasm-following-aneurysmal-subarachnoid-hemorrhage-predictors-of-outcome-and-retreatment
#12
Jennifer D Sokolowski, Ching-Jen Chen, Dale Ding, Thomas J Buell, Daniel M Raper, Natasha Ironside, Davis G Taylor, Robert M Starke, Kenneth Liu
OBJECTIVE: Although endovascular therapy has been widely adopted for the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH), its effect on clinical outcomes remains incompletely understood. The aims of this retrospective cohort study are to evaluate the outcomes of endovascular intervention for post-aSAH vasospasm and identify predictors of functional independence at discharge and repeat endovascular vasospasm treatment. METHODS: We assessed the baseline and outcomes data for patients with aSAH who underwent endovascular vasospasm treatment at our institution, including intra-arterial (IA) vasodilator infusion and angioplasty...
October 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29077161/expression-and-significance-of-vwf-gmp-140-and-adamts13-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#13
W-H Li, C-J Hui, H Ju
OBJECTIVE: The aim of this study was to investigate the role of the von Willebrand factor (vWF) in patients with aneurysmal subarachnoid hemorrhage (aSAH), platelet membrane glycoprotein-140 (GMP-140). The aim is also to discover the expression and clinical significance of von Willebrand factor (vWF) cleaving protease (ADAMTS13). PATIENTS AND METHODS: 83 patients with aSAH were selected from January 2014 to December 2016. The patients were divided into cerebral vasospasm group (CVS group) (n = 37) and no convulsion group (non-CVS group) (n = 46); delayed cerebral ischemia group (DCI group) (n = 31) and non-delayed cerebral ischemia group (non-DCI group) (n = 52)...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29075584/subarachnoid-hemorrhage-associated-with-intratumoral-aneurysm-rupture-within-a-posterior-fossa-hemangioblastoma-the-importance-of-continued-surveillance-for-cerebral-vasospasm
#14
Connie Ju, Christina H Wright, James Wright, Yifei Duan, Nicholas C Bambakidis
Cerebellar hemangioblastomas are rare tumors of the neuraxis. Only seven cases of hemangioblastoma associated with a cerebral aneurysm have been reported. We report a case of a patient who presented with acute onset headache as a result of subarachnoid hemorrhage (SAH) and hydrocephalus. Radiographic workup revealed a hemangioblastoma with an intratumoral aneurysm. Preoperative cerebral angiography was performed for both embolization as well as characterization of the aneurysm. The patient underwent a suboccipital craniotomy for tumor resection...
August 24, 2017: Curēus
https://www.readbyqxmd.com/read/29065954/the-relationship-between-obstructive-sleep-apnea-and-ruptured-intracranial-aneurysms
#15
Oleg Y Chernyshev, Shyamal C Bir, Tanmoy K Maiti, Devi Prasad Patra, Hai Sun, Bharat Guthikonda, Cesar Liendo, Hugo Cuellar, Alireza Minagar, Anil Nanda
STUDY OBJECTIVES: The role of obstructive sleep apnea (OSA) in the overall outcome of ruptured intracranial aneurysms (RIAs) is unknown. We have investigated the role of OSA in overall outcome of RIAs. METHODS: Data from 159 consecutive patients were retrospectively reviewed. A chi-square test and regression analysis were performed to determine the significant difference. A value of P< .05 was considered significant. RESULTS: The prevalence of OSA in RIAs was fivefold higher in the nonaneurysm patient group, P = ...
October 18, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29063300/delayed-cerebral-ischemia-after-subarachnoid-hemorrhage-beyond-vasospasm-and-towards-a-multifactorial-pathophysiology
#16
REVIEW
Joseph R Geraghty, Fernando D Testai
PURPOSE OF REVIEW: Delayed cerebral ischemia (DCI) is common after subarachnoid hemorrhage (SAH) and represents a significant cause of poor functional outcome. DCI was mainly thought to be caused by cerebral vasospasm; however, recent clinical trials have been unable to confirm this hypothesis. Studies in humans and animal models have since supported the notion of a multifactorial pathophysiology of DCI. This review summarizes some of the main mechanisms under investigation including cerebral vascular dysregulation, microthrombosis, cortical spreading depolarizations, and neuroinflammation...
October 23, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29058091/disturbance-of-ct-perfusion-within-24%C3%A2-h-after-onset-is-associated-with-wfns-grade-but-not-development-of-dci-in-patients-with-aneurysmal-sah
#17
Yuichi Takahashi, Atsushi Sasahara, Kei Yamazaki, Mayuko Inazuka, Hidetoshi Kasuya
BACKGROUND: Delayed cerebral ischemia (DCI) is a serious complication following aneurysmal SAH (aSAH) and remains a leading cause of morbidity and mortality. We investigated whether data from CT perfusion (CTP) within 24 h after onset are associated with DCI and its outcome. METHODS: We retrospectively examined plain CT, CTP, and CT angiography (CTA) of aSAH patients on arrival. We measured the average mean transit time (aMTT) and compared it with several clinical factors, such as the age, WFNS grade, Fisher group, delayed cerebral infarction, cerebral vasospasm, and modified Rankin scale (mRS), at 1 month...
October 23, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29041920/intraoperative-continuous-cerebral-microcirculation-measurement-in-patients-with-aneurysmal-subarachnoid-hemorrhage-preliminary-data-on-the-early-administration-of-magnesium-sulfate
#18
Bjoern Sommer, Cornelia S Weidinger, Dennis Wolf, Michael Buchfelder, Hubert Schmitt
BACKGROUND: In patients with subarachnoid hemorrhage (SAH), vasospasm remains one of the major complications. The application of intravenous magnesium sulfate (MgSO4) has been under discussion to prevent cerebral ischemia. Our aim was to examine the impact of early MgSO4 administration on local cerebral microcirculation during microsurgical clipping of SAH-related aneurysms. METHODS: The non-invasive laser-Doppler spectrophotometry system "Oxygen-to-See (O2C)" was used in 14 consecutive patients (11 female, 3 male, median age 56...
October 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29038077/the-effects-of-red-blood-cell-transfusion-on-functional-outcome-after-aneurysmal-subarachnoid-hemorrhage
#19
Monisha A Kumar, Joshua Levine, Jennifer Faerber, J Paul Elliott, H Richard Winn, Sean Doerfler, Peter Le Roux
BACKGROUND: The optimal red blood cell transfusion (RBCT) trigger for patients with aneurysmal subarachnoid hemorrhage (SAH) is unknown. In patients with cerebral vasospasm, anemia may increase susceptibility to ischemic injury; conversely, RBCT may worsen outcome given known deleterious effects. OBJECTIVE: To examine the association between RBCT, delayed cerebral ischemia, vasospasm, and outcome after SAH. METHODS: 421 consecutive SAH patients, admitted to a Neurocritical Care Unit at a University affiliated hospital and who underwent surgical occlusion of their ruptured aneurysm were retrospectively identified from a prospective observational database...
October 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29037840/comparison-of-plasma-copeptin-and-multiple-biomarkers-for-assessing-prognosis-of-patients-with-aneurysmal-subarachnoid-hemorrhage
#20
Yong-Ke Zheng, Xiao-Qiao Dong, Quan Du, Hao Wang, Ding-Bo Yang, Qiang Zhu, Zhi-Hao Che, Yong-Feng Shen, Li Jiang, Wei Hu, Ke-Yi Wang, Wen-Hua Yu
BACKGROUND: Increased plasma copeptin concentrations are related to poor prognosis after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to assess prognostic significance of plasma copeptin detection compared with glial fibrillary astrocyte protein, myelin basic protein, S100B, phosphorylated axonal neurofilament subunit H, neuron-specific enolase, tau and ubiquitin carboxyl-terminal hydrolase L1 in aSAH. METHODS: We detected plasma concentrations of the aforementioned biomarkers in 105 healthy controls using ELISA...
October 13, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
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