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cerebral vasospasm

Daniel Appel, Miriam Seeberger, Edzard Schwedhelm, Patrick Czorlich, Alwin E Goetz, Rainer H Böger, Juliane Hannemann
BACKGROUND: Delayed cerebral ischemia (DCI) is the major cause of lethality and neuronal damage in patients who survived the primary subarachnoid hemorrhage (SAH). Asymmetric and symmetric dimethylarginines (ADMA and SDMA) inhibit nitric oxide production from L-arginine via distinct mechanisms. Elevated ADMA levels are associated with vasospasm after SAH. We aimed to study the time course of ADMA and SDMA in plasma and ventricular cerebrospinal fluid (CSF) and their associations with DCI and outcome...
March 20, 2018: Neurocritical Care
Vinayak Narayan, Hima Pendharkar, Bhagavatula Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla
Background: The conventional medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is associated with uncertainty of outcome and complications. Aims and Objectives: To examine the effect of direct intra-arterial nimodipine therapy on outcome in patients with delayed cerebral ischemia (DCI). Settings and Design: The retrospective observational study was conducted at a single neurosurgical unit and interventional neuroradiolgy suite of a center managing SAH...
March 2018: Neurology India
Yu V Pilipenko, An N Konovalov, Sh Sh Eliava, O B Belousova, D N Okishev, I A Sazonov, T F Tabasaranskiy
In recent years, the so-called primary or preventive decompressive craniectomy (DC) has been increasingly used in patients with aneurysmal subarachnoid hemorrhage (SAH). The main goal of the technique is prevention of refractory intracranial hypertension (ICH) and its consequences. PURPOSE: The study purpose was to define the CT criteria for reasonability and efficacy of DC as well as clarification of the indications for preventive DC in patients with SAH after microsurgical aneurysm exclusion...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Chenhao Zhang, Shuqin Zhao, Yanjing Zang, Weidong Zhao, Qin Song, Shanshan Feng, Lei Hu, Fang Gu
Objective Cerebral vasospasm(CVS) after Subarachnoid hemorrhage (SAH) can cause delayed cerebral ischemia,secondary cerebral infarction, and rehemorrhage, which are the leading causes of mutilation and death. Nimodipine has been shown to prevent CVS. Magnesium ion (Mg2+ ) can competitively inhibit the influx of calcium (Ca2+ ) and prevent vasospasm. There is evidence that magnesium sulfate can prevent CVS and reduce infarct volume after SAH. In this study, we evaluated the efficacy and safety of intravenous magnesium sulfate combined with oral nimodipine on CVS, delayed cerebral ischemia, secondary cerebral infarction, and rehemorrhage after SAH...
April 2018: Neurological Research
Marcel Ritter, Sandesh Neupane, Raphael A Seidel, Christoph Steinbeck, Georg Pohnert
A new bilirubin oxidation end product (BOX) was isolated and characterized. The formation of the so-called Z-BOX C proceeds from bilirubin via propentdyopents as intermediates. This BOX was detected in pathological human bile samples using liquid chromatography/mass spectrometry and has potential relevance for liver dysfunction and cerebral vasospasms.
March 13, 2018: Organic & Biomolecular Chemistry
Won-Sang Cho, Jeong Eun Kim, Sukh Que Park, Jun Kyeung Ko, Dae-Won Kim, Jung Cheol Park, Je Young Yeon, Seung Young Chung, Joonho Chung, Sung-Pil Joo, Gyojun Hwang, Deog Young Kim, Won Hyuk Chang, Kyu-Sun Choi, Sung Ho Lee, Seung Hun Sheen, Hyun-Seung Kang, Byung Moon Kim, Hee-Joon Bae, Chang Wan Oh, Hyeon Seon Park
Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, worldwide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs...
March 2018: Journal of Korean Neurosurgical Society
Isabel Fragata, Nuno Canto-Moreira, Patrícia Canhão
PURPOSE: Perimesencephalic hemorrhage (PMH) is a benign subtype of nonaneurysmal subarachnoid hemorrhage (SAH). We aimed to investigate if cerebral perfusion in PMH is less affected than in aneurysmal SAH (aSAH). METHODS: From a prospective cohort of 80 patients with spontaneous SAH, we included PMH patients (n = 15) and selected aSAH patients (n = 39) with similar clinical grade at admission (World Federation of Neurosurgeons Scale-WFNS I/II). Computed tomography (CT) perfusion was performed at < 72 h and/or at 8-10 days...
March 9, 2018: Neuroradiology
Alexander Pschibul, Wibke G Janzarik, Peter Franck, Markus Hufnagel, Christopher Beck, Rudolf Korinthenberg
Despite the availability of modern antibiotics, pneumococcal meningitis in both children and adults remains a severe disease-one known to frequently cause grave complications and residual disability. Although the appearance of arterial vasospasms in bacterial meningitis systematically has been investigated and reported on for adult patients, such research is lacking when it comes to infants. We report on a 4-week-old infant who, 6 days after onset of pneumococcal meningitis, suffered severe neurological deterioration with treatment-resistant seizures and coma...
March 9, 2018: Neuropediatrics
Ljubisa Borota, Ehab Mahmoud, Christoffer Nyberg, Anders Lewén, Per Enblad, Elisabeth Ronne-Engström
The aim of this study was to describe our experience in the treatment of various pathological conditions of the cranial and spinal blood vessels and hypervascularized lesions using dual lumen balloon catheters. Twenty-five patients were treated with endovascular techniques: two with vasospasm of cerebral blood vessels caused by subarachnoid hemorrhage, one with a hypervascularized metastasis in the vertebral body, two with spinal dural fistula, four with cerebral dural fistula, three with cerebral arteriovenous malformations, and 13 with aneurysms...
February 23, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Muhammad AlMatter, Marta Aguilar Péreza, Pervinder Bhogal, Victoria Hellstern, Oliver Ganslandt, Hans Henkes
OBJECTIVES: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high rates of morbidities and fatalities. The continuous evolution of neurosurgical, endovascular and neuro-intensive cares has improved the overall mortality. In this study we sought to evaluate the clinical outcome after aSAH from a single tertiary center. PATIENTS AND METHODS: We retrospectively identified and reviewed all consecutive patients with aSAH treated at our center between 2007 and 2016...
February 13, 2018: Clinical Neurology and Neurosurgery
Yunchang Mo, Luping Huang, Linbi Chen, Michael Veronesi, Yiyi Shi, Sijia Chen, Linli Peng, Leping Zhou, Yonglin Pu, Junlu Wang
Cerebral vasospasm (CVS) is a severe complication that occurs following aneurysmal subarachnoid hemorrhage (SAH). Magnetic resonance angiography (MRA) has been used to evaluate brain injury following SAH in humans. The present study was designed to assess a rabbit model of symptomatic CVS (SCVS) and the utility of MRA in evaluating SCVS in rabbits. Japanese white rabbits (n=24) were randomly divided into 2 equal groups: A sham group and a SAH group. Neurological scores were evaluated for 7 days following SAH...
March 2018: Experimental and Therapeutic Medicine
Daniel Dubinski, Sae-Yeon Won, Bedjan Behmanesh, Sepide Kashefiolasl, Christof Geisen, Volker Seifert, Christian Senft, Juergen Konczalla
BACKGROUND: In patients with non-aneurysmal subarachnoid hemorrhage (NA-SAH), the etiology is unknown and the bleeding source remains unidentified. However, the ABO blood type system has a profound role in patient's hemostasis and thrombosis. To date, the aspect of ABO blood type in incidence, clinical course, and outcome after NA-SAH has not been investigated. METHODS: In this retrospective analysis, 81 patients with non-traumatic and non-aneurysmal subarachnoid hemorrhage treated between 2010 and 2014 at the author's institution were included...
February 17, 2018: Acta Neurochirurgica
Jeremy J Heit, Max Wintermark, Blake W Martin, Guangming Zhu, Michael P Marks, Greg Zaharchuk, Robert L Dodd, Huy M Do, Gary K Steinberg, Maarten G Lansberg, Gregory W Albers, Christian Federau
BACKGROUND AND PURPOSE: Proximal artery vasospasm and delayed cerebral ischemia (DCI) after cerebral aneurysm rupture result in reduced cerebral perfusion and microperfusion and significant morbidity and mortality. Intravoxel incoherent motion (IVIM) magnetic resonance imaging extracts microvascular perfusion information from a multi-b value diffusion-weighted sequence. We determined whether decreased IVIM perfusion may identify patients with proximal artery vasospasm and DCI. METHODS: We performed a pilot retrospective cohort study of patients with ruptured cerebral aneurysms...
March 2018: Stroke; a Journal of Cerebral Circulation
Luchen Wang, Ziyun Gao
The purpose of the present study was to investigate the expression of matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6) in patients with subarachnoid hemorrhage (SAH) and the clinical significance thereof. Forty-three patients with SAH and 23 healthy individuals were enrolled in this study. Patients were divided into the cerebral vasospasm (CVS) and non-cerebral vasospasm (non-CVS) groups, or the good and poor prognosis groups. Serum levels of MMP-9 and IL-6 were detected by ELISA. Expression levels of MMP-9 and IL-6 mRNAs were detected by RT-qPCR...
February 2018: Experimental and Therapeutic Medicine
Benjamin Z Ball, Panayiotis E Pelargos, Catherine Christie, Kiarash Golshani
Background: Direct, Type A, cavernous-carotid fistulas (CCFs) are predominantly caused by head trauma, especially when basilar skull fractures are present. Transarterial endovascular treatment of direct CCFs is the preferred method of treatment. Bilateral CCFs are estimated to be present in 1-2% of the cases. The treatment of bilateral CCFs is difficult often requiring a combination of endovascular and open surgical approaches. Case Description: We present a case of traumatic bilateral CCFs presenting with vasospasm of the anterior circulation seen on the initial angiogram on day 1 and our treatment paradigm...
2018: Surgical Neurology International
Hirofumi Nishikawa, Hidenori Suzuki
Aneurysmal subarachnoid hemorrhage (SAH) is known as one of the most devastating diseases in the central nervous system. In the past few decades, research on SAH has focused on cerebral vasospasm to prevent post-SAH delayed cerebral ischemia (DCI) and to improve outcomes. However, increasing evidence has suggested that early brain injury (EBI) is an important mechanism contributing to DCI, cerebral vasospasm as well as poor outcomes. Though the mechanism of EBI is very complex, inflammation is thought to play a pivotal role in EBI...
February 7, 2018: Brain Sciences
Saif Afat, Carolin Brockmann, Omid Nikoubashman, Marguerite Muller, Kolja M Thierfelder, Wolfgang G Kunz, Ulrike Haberland, Marc A Brockmann, Konstantin Nikolaou, Martin Wiesmann, Ahmed E Othman
PURPOSE: To assess the diagnostic utility of different perfusion algorithms for the detection of angiographical arterial spasm. METHOD: During a 2-year period, 45 datasets from 29 patients (54.2±10,75y,20F) with suspected cerebral vasospasm after aneurysmal subarachnoid hemorrhage were included. Volume Perfusion CT (VPCT), Non-enhanced CT (NCT) and angiography were performed within 6hours post-ictus. Perfusion maps were generated using a maximum slope (MS) and a deconvolution-based approach (DC)...
February 2, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Claudia Ditz, Alexander Neumann, Jann Wojak, Emma Smith, Jan Gliemroth, Volker Tronnier, Jan Küchler
OBJECTIVE: Endovascular interventions in patients with subarachnoid hemorrhage (SAH) and symptomatic cerebral vasospasm (sCVS) are commonly performed. But potential benefits of repeated interventions have not been proven. The aim of this study was to show the potential burden and opportunities of repeated endovascular interventions in case of recurrent sCVS. METHODS: We reviewed 15 patients with SAH who underwent more than 2 endovascular treatments of recurrent sCVS (CVS group) regarding the radiation doses, their clinical course and their functional outcome...
January 31, 2018: World Neurosurgery
Yuling Wang, Yongqian Ma, Peiquan Hui, Guangheng Liu, Yanyan Luan, Chunguang Wang
Objective This study aimed to explore the application value of transcranial doppler (TCD) in the inspection of cerebral vasospasm (CVS) after the treatment of intracranial aneurysm. METHODS: 105 cases of patients with confirmed intracranial aneurysm were divided into two groups based on the two different treatments - craniotomy and aneurysmal clipping or interventional emboli-zation therapy. TCD was applied to monitor the conditions of CVS of 105 cases, and case study re-search method was used to analyze and conclude the TCD inspection data of patients with intracrani-al aneurysm detected after operation...
February 2018: Current Medical Imaging Reviews
Juan Sun, Yan Zhang, Jianfei Lu, Weiguang Zhang, Junhao Yan, Lei Yang, Changman Zhou, Renyu Liu, Chunhua Chen
OBJECTIVES: This study aimed to demonstrate the potential of Salvinorin A (SA) for cerebral vasospasm after subarachnoid hemorrhage (SAH) and investigate mechanisms of therapeutic effect using rat SAH model. METHODS: SA was injected intraperitoneally and the neurobehavioral changes were observed at 24h, 48h and 72h after SAH. Basilar artery was observed by Magnetic Resonance Imaging (MRI). The inner diameter and thickness of basilar artery were measured. The morphological changes and the apoptosis in CA1 area of hippocampus were detected...
January 27, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
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