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https://www.readbyqxmd.com/read/28720742/-two-cases-of-ruptured-blood-blister-like-aneurysm-treated-with-x-ray-angiography-perfusion-xap-analysis
#1
Shoichi Tani, Hirotoshi Imamura, Katsunori Asai, Kampei Shimizu, Hidemitsu Adachi, So Tokunaga, Takayuki Funatsu, Mikiya Beppu, Keita Suzuki, Hiromasa Adachi, Tomohiro Okuda, Yuichi Matsui, Yasunori Yoshida, Shuhei Kawabata, Ryo Akiyama, Kazufumi Horiuchi, Nobuyuki Sakai
Two cases of ruptured blood blister-like internal carotid artery aneurysms for which low flow bypass was sufficient to attain successful treatment of trapping are reported. In the acute stage of rupture, it is troublesome to perform accurate examinations of tolerance to ischemia like balloon occlusion test(BOT)for estimating the required amount of bypass flow. In our cases, X-ray angiography perfusion(XAP)analysis was introduced, which could be performed in a couple dozen seconds without room-to-room transfer of patients, following the ordinary examination of diagnostic digital subtraction angiography...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28711533/cvs-dependent-and-cvs-independent-cerebral-infarctions-predict-outcome-after-non-aneurysmal-subarachnoid-hemorrhage-a-single-center-series-with-250-patients
#2
Juergen Konczalla, Sepide Kashefiolasl, Nina Brawanski, Markus Bruder, Florian Gessler, Christian Senft, Joachim Berkefeld, Volker Seifert, Stephanie Tritt
OBJECTIVE: The number of patients with non-aneurysmal subarachnoid hemorrhage (naSAH) has increased over the last decade. Data regarding infarctions in naSAH are still limited. Aim of the study was to identify the rate of cerebral vasospasm (CVS)-dependent and CVS-independent infarctions and their influence on clinical outcomes. METHODS: Between 1999 and 2015, 250 patients suffering from naSAH were analyzed retrospectively. A delayed infarction was analyzed whether it was associated with CVS (CVS-dependent infarction) or not (CVS-independent)...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710081/use-of-a-next-generation-multi-durometer-long-guide-sheath-for-triaxial-access-in-flow-diversion-experience-in-95-consecutive-cases
#3
Li-Mei Lin, Matthew T Bender, Geoffrey P Colby, Narlin B Beaty, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Intracranial access techniques in modern neurointerventions have shifted towards more robust access platforms. The long guide sheath is one of the building blocks of triaxial systems used in intracranial embolizations. Here we present our experience with the AXS Infinity LS long sheath in the triaxial platform for the implantation of the Pipeline embolization device (PED). METHODS: We retrospectively identified patients who underwent PED Flex treatment with the AXS Infinity LS at a single institution...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28710044/treatment-strategies-of-subarachnoid-hemorrhage-from-bilateral-vertebral-artery-dissection-a-case-report-and-literature-review-focusing-on-availability-of-stent-placement
#4
Yasuo Murai, Fumihiro Matano, Shoji Yokobori, Hidetaka Onda, Hiroyuki Yokota, Akio Morita
BACKGROUND: Bilateral vertebral artery dissection (VAD) may result in subarachnoid hemorrhage (SAH). However, a variety of factors contribute to the difficulties with treating SAH. We report a case of bilateral VAD with SAH, as well as a literature review. CASE DESCRIPTION: A 32-year-old woman developed headache. Computed tomography (CT) demonstrated diffuse SAH, and 3-dimensional CT indicated bilateral VAD. Her left vertebral artery was severely stenosed and the basilar artery was retrogradely flowed via the posterior communicating artery...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28695690/cerebral-vasospasm-in-acute-porphyria
#5
P Olivier, D Van Melkebeke, P-J Honoré, L Defreyne, D Hemelsoet
BACKGROUND AND PURPOSE: Porphyrias are a group of inherited metabolic disorders resulting from a specific deficiency along the pathway of haem biosynthesis. A clinical classification distinguishes acute from non-acute porphyrias considering the occurrence of life-threatening neurovisceral attacks, presenting with abdominal pain, neuropsychiatric disturbance and neuropathy. Vasospasm is a very rare complication that can occur in all major types of acute porphyria. METHODS: We describe a porphyric crisis with vasospasm in a woman with previously undiagnosed acute porphyria...
July 10, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#6
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28684727/plasmid-plxsn-mediated-adrenomedullin-gene-therapy-for-cerebral-vasospasm-following-subarachnoid-hemorrhage-in-rats
#7
Xin Li, Xiaoshuang Xia, Xin Li
BACKGROUND The aim of this study was to investigate the protective effect of ADM gene mediated by plasmid pVAX1 on cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH). MATERIAL AND METHODS The recombinant plasmid pVAX-ADM was successfully established, and 40 SD rats were randomly divided into normal saline, pVAX1, pVAX1-ADM low-dose, pVAX1-ADM mid-dose, and pVAX1-ADM high-dose groups. The circumference and diameter of basilar artery, diameter of middle cerebral artery and internal carotid artery, and thickness of basilar artery wall were observed...
July 7, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28682429/study-on-the-expression-and-mechanism-of-inflammatory-factors-in-the-brain-of-rats-with-cerebral-vasospasm
#8
Q Huang, G Wang, Y-L Hu, J-X Liu, J Yang, S Wang, H-B Zhang
OBJECTIVE: We investigated the significance of IL-1 and ICAM-1 in rat's subarachnoid hemorrhage (SAH) cerebral vasospasm (CVS) model. MATERIALS AND METHODS: A total of 30 Sprague-Dawley (SD) rats were randomly divided into the SAH group and the Sham group. Cisterna magna auto blood injection was used to prepare the CVS models. We studied and compared changes in the basilar arteries diameters before and after SAH. We measured the cerebrovascular inner diameter before and after SAH modeling using the ultrasound...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28678308/evaluation-function-of-transcranial-two-dimensional-and-color-doppler-ultrasonography-tccs-for-patients-with-different-degrees-of-cerebral-vasospasm-before-and-after-the-nimodipine-treatment
#9
J-L Wang, X-N Li, Y-H Zhang, X Li, Y-L Yang
OBJECTIVE: To evaluate the changes in cerebral hemodynamics of patients with different degrees of cerebral vasospasm before and after the nimodipine treatment using transcranial two-dimensional and color Doppler ultrasonography (TCCS). PATIENTS AND METHODS: A total of 77 patients with subarachnoid hemorrhage was collected; and the maximum peak systolic velocity (Vs), end diastolic velocity (Vd), time averaged maximum velocity (Vm), pulsatility index (PI) and resistance index (RI) of middle cerebral artery (MCA) were measured by spectral Doppler technique...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28671243/time-dependent-and-lesion-dependent-hmgb1-selective-localization-in-brains-of-patients-with-cerebrovascular-diseases
#10
Takahiko Umahara, Toshiki Uchihara, Katsuiku Hirokawa, Kentaro Hirao, Soichiro Shimizu, Takao Hashimoto, Hiroo Terasi, Haruo Hanyu
High mobility group box 1 protein (HMGB1) has multiple functions, including the maintenance of nucleosomes and the regulation of gene transcription. HMGB1 is released from activated macrophages, resulting in the induction of inflammatory cytokines. Recently, much research about the role of HMGB1 in cerebrovascular disease (CVD) has been reported. In an animal model, HMGB1 neutralization ameliorates brain infarction, there is an early release of HMGB1 from neurons, and HMGB1 antibody attenuates delayed cerebral vasospasm in experimental subarachnoid hemorrhage...
July 3, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/28669652/severe-vasospasm-of-the-middle-cerebral-artery-after-mechanical-thrombectomy-due-to-infective-endocarditis-an-autopsy-case
#11
Wataru Nishino, Yosuke Tajima, Toru Inoue, Michihiro Hayasaka, Bi Katsu, Koichi Ebihara, Daisuke Kawauchi, Masaaki Kubota, Sumio Suda
Untreated infective endocarditis (IE) often produces infective emboli in major cerebral arteries. We describe a case of middle cerebral artery occlusion due to IE, which caused severe vasospasm and reocclusion after mechanical thrombectomy (MT). We present the pathologic findings of the occluded middle cerebral artery and investigate the precautions to be taken while performing MT due to IE. A 72-year-old man with atrial fibrillation treated with dabigatran presented with right hemiparesis and aphasia. A diffusion-weighted image showed a high-intensity area in the left temporoparietal junction, and magnetic resonance angiography revealed a left M2 occlusion...
June 29, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28665071/feasibility-and-safety-of-mild-therapeutic-hypothermia-in-poor-grade-subarachnoid-hemorrhage-prospective-pilot-study
#12
Wookjin Choi, Soon Chan Kwon, Won Joo Lee, Young Cheol Weon, Byungho Choi, Hyeji Lee, Eun Suk Park, Ryeok Ahn
Therapeutic hypothermia (TH) improves the neurological outcome in patients after cardiac arrest and neonatal hypoxic brain injury. We studied the safety and feasibility of mild TH in patients with poor-grade subarachnoid hemorrhage (SAH) after successful treatment. Patients were allocated randomly to either the TH group (34.5°C) or control group after successful clipping or coil embolization. Eleven patients received TH for 48 hours followed by 48 hours of slow rewarming. Vasospasm, delayed cerebral ischemia (DCI), functional outcome, mortality, and safety profiles were compared between groups...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28661267/clinical-evidence-of-efficacy-of-simvastatin-for-aneurysmal-subarachnoid-hemorrhage
#13
Jinghui Lin, Houxian Liu, Jianjun Jiang, Conglin Jia, Bin Zhang, Xiang Gao
Objective The present study was performed to explore the therapeutic potential of simvastatin in subarachnoid hemorrhage (SAH) in the context of the Simvastatin in Aneurysmal Subarachnoid Hemorrhage (STASH) trial. Methods MEDLINE, EMBASE, and the Cochrane Library were searched for all randomized controlled trials (RCTs) investigating the therapeutic effect of simvastatin on aneurysmal SAH. We applied a random-effects model to calculate the data. Results Five RCTs involving 951 patients met the eligibility criteria...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28644100/influence-of-smoking-on-aneurysm-recurrence-after-endovascular-treatment-of-cerebrovascular-aneurysms
#14
John Futchko, Jordan Starr, Darryl Lau, Matthew R Leach, Christopher Roark, Aditya S Pandey, B Gregory Thompson
OBJECTIVE Smoking is a known risk factor for aneurysm development and aneurysmal subarachnoid hemorrhage, as well as subsequent vasospasm in both untreated individuals and patients who have undergone surgical clipping of cerebrovascular aneurysms. However, there is a lack of data in the current scientific literature about the long-term effects that smoking has on the integrity of endovascular repairs of cerebral aneurysms. This study was designed to determine if any smoking history increased the risk of poorer outcomes and/or aneurysm recurrence in patients who have had endovascular repair of cerebral aneurysms...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28634501/subarachnoid-hemorrhage-and-long-term-stroke-risk-after-traumatic-brain-injury
#15
Nicholas A Morris, Joséphine Cool, Alexander E Merkler, Hooman Kamel
BACKGROUND: Recent studies suggest that traumatic brain injury (TBI) is a risk factor for subsequent ischemic stroke, even years after the initial insult. The mechanisms of the association remain unclear. The presence of traumatic subarachnoid hemorrhage (tSAH) may mediate the effect of TBI on long-term stroke risk, as it has previously been linked to short-term vasospasm and delayed cerebral ischemia. METHODS: Using administrative claims data, we conducted a retrospective cohort study of acute care hospitalizations...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28634064/subarachnoid-hemorrhage-in-advanced-age-comparison-of-patients-aged-70-79-years-and-80-years-and-older
#16
N Brawanski, F Kunze, M Bruder, S Tritt, C Senft, J Berkefeld, V Seifert, J Konczalla
OBJECTIVE: Clinical routine shows an increasing admission rate of elderly patients suffering from SAH. We retrospectively compared patients aged 70-79 and over 80 years (80+). Aim of the study was to identify differences in outcome and prognostic factors to better anticipate clinical course and therefore treat this special subgroup better. METHODS: Patients were entered into a prospectively collected database. Between 1999 and 06/2014 191 patients suffered from SAH and aged ≥70 years...
June 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28632329/postictal-hypoperfusion-hypoxia-provides-the-foundation-for-a-unified-theory-of-seizure-induced-brain-abnormalities-and-behavioral-dysfunction
#17
REVIEW
Jordan S Farrell, Roberto Colangeli, Marshal D Wolff, Alexandra K Wall, Thomas J Phillips, Antis George, Paolo Federico, G Campbell Teskey
A recent article by Farrell et al. characterizes the phenomenon, mechanisms, and treatment of a local and severe hypoperfusion/hypoxia event that occurs in brain regions following a focal seizure. Given the well-established role of cerebral ischemia/hypoxia in brain damage and behavioral dysfunction in other clinical settings (e.g., stroke, cerebral vasospasm), we put forward a new theory: postictal hypoperfusion/hypoxia is responsible for the negative consequences associated with seizures. Fortunately, inhibition of two separate molecular targets, cyclooxygenase-2 (COX-2) and l-type calcium channels, can prevent the expression of postictal hypoperfusion/hypoxia...
June 20, 2017: Epilepsia
https://www.readbyqxmd.com/read/28619499/results-of-early-high-flow-bypass-and-trapping-for-ruptured-blood-blister-like-aneurysms-of-the-internal-carotid-artery
#18
Yuichiro Kikkawa, Toshiki Ikeda, Ririko Takeda, Hiroyuki Nakajima, Takeshi Ogura, Hidetoshi Ooigawa, Hiroki Kurita
OBJECTIVE: The aim of this study is to clarify the efficacy and safety of early surgery using trapping of the affected internal carotid artery (ICA) and high-flow bypass between second portion of the middle cerebral artery and cervical external carotid artery with radial artery graft for ruptured blood blister-like aneurysms (BBAs) arising from anterior wall of the ICA. METHODS: Medical chart of consecutive 16 patients (M:F=7:9, mean 59 years) with subarachnoid hemorrhage (WFNS grade I:2, II:5, III:2, IV:4, V:3) due to ruptured BBA surgically treated between July 2010 and October 2015 were retrospectively reviewed...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28614161/multiple-cerebral-infarcts-in-a-young-patient-associated-with-marijuana-use
#19
Leila Costa Volpon, Camila Lacerda Muniz de Melo Sousa, Silvia Keiko Kavaguti Moreira, Sara Reis Teixeira, Ana Paula de Carvalho Panzeri Carlotti
: Cerebrovascular events associated with marijuana use have been reported previously. This association is plausible, but not well-established yet. A 14-year-old girl, long-term heavy cannabis user, presented with generalized tonic-clonic seizures and decreased level of consciousness a few hours after smoking cannabis. Brain magnetic resonance imaging showed multiple areas of acute, subacute and chronic ischemic lesions in the left frontal lobe, basal ganglia, and corpus callosum. History of other illicit drug use and other known causes of stroke were ruled out...
June 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28610434/isoflavones-and-gastrointestinal-infection-two-potential-triggers-for-reversible-cerebral-vasoconstriction-syndrome
#20
Björn Machner, Tobias Boppel, Thomas Münte
Background Reversible cerebral vasoconstriction syndrome (RCVS) is an important differential diagnosis of singular or recurrent thunderclap headache. Prognosis is generally good, however complications of the transient segmental vasospasms of cerebral arteries such as stroke, subarachnoidal hemorrhage and brain edema may worsen the clinical outcome. Although the exact pathomechanism is still unclear, various vasoactive substances and conditions (e.g. post partum) have been identified as triggering RCVS. Cases We report on the clinical course and management of two cases of typical RCVS that were associated with two different precipitants previously not described: A gastrointestinal infection and isoflavones, which are phytoestrogens used for menopausal vasomotor symptoms...
January 1, 2017: Cephalalgia: An International Journal of Headache
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