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Aneurysmal subarachnoid hemorrhage

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https://www.readbyqxmd.com/read/28106497/association-of-renin-angiotensin-system-genetic-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage
#1
Christoph J Griessenauer, R Shane Tubbs, Paul M Foreman, Michelle H Chua, Nilesh A Vyas, Robert H Lipsky, Mingkuan Lin, Ramaswamy Iyer, Rishikesh Haridas, Beverly C Walters, Salman Chaudry, Aisana Malieva, Samantha Wilkins, Mark R Harrigan, Winfield S Fisher, Mohammadali M Shoja
OBJECTIVE Renin-angiotensin system (RAS) genetic polymorphisms are thought to play a role in cerebral aneurysm formation and rupture. The Cerebral Aneurysm Renin-Angiotensin System (CARAS) study prospectively evaluated common RAS polymorphisms and their relation to aneurysmal subarachnoid hemorrhage (aSAH). METHODS The CARAS study prospectively enrolled aSAH patients and controls at 2 academic centers in the United States. A blood sample was obtained from all patients for genetic evaluation and measurement of plasma angiotensin-converting enzyme (ACE) concentration...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28104522/intra-arterial-use-of-abciximab-in-thromboembolic-complications-associated-with-cerebral-aneurysm-coiling-the-london-ontario-experience
#2
R Martínez-Pérez, S P Lownie, D M Pelz
BACKGROUND: and Purpose: Experience with intra-arterial infusion of abciximab for the treatment of endovascular thrombotic complications is limited to short case series. Our objective is to evaluate the safety and effectiveness of this drug for the treatment of thromboembolic complications during aneurysm coiling and determine the risk factors. METHODS: From an aneurysm coiling database, patients treated with intra-arterial abciximab after having thrombotic complications during the coiling procedure were selected for analysis...
January 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28096478/demographic-procedural-and-30-day-safety-results-from-the-web-intra-saccular-therapy-study-web-it
#3
David Fiorella, Andrew Molyneux, Alexander Coon, Istvan Szikora, Isil Saatci, Feyyaz Baltacioglu, Ali Sultan, Adam Arthur
INTRODUCTION: The Woven EndoBridge (WEB) represents a novel intrasaccular therapeutic option for the treatment of intracranial wide-necked bifurcation aneurysms (WNBAs). The WEB-IT Study is a pivotal Investigational Device Exemption (IDE) study to determine the safety and effectiveness of the WEB device for the treatment of WNBAs located in the anterior and posterior intracranial circulations. We present the patient demographics, procedural characteristics, and 30-day adverse event data for the US WEB-IT study...
January 17, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28093563/asymptomatic-mild-hyperperfusion-for-the-prediction-of-clinical-outcome-in-postoperative-patients-after-subarachnoid-hemorrhage
#4
Manabu Nakagawa, Tatsushi Mutoh, Shunsuke Takenaka, Tomoko Mutoh, Tomoko Totsune, Yasuyuki Taki, Tatsuya Ishikawa
BACKGROUND Delayed cerebral ischemia (DCI) is one of the main causes of poor outcomes after subarachnoid hemorrhage (SAH). The early identification of DCI by noninvasive imaging modalities would provide valuable information of therapeutic intervention for improving the patient outcomes. We aimed to describe the clinical features of cerebral blood flow (CBF) data obtained from the single-photon emission computed tomography (SPECT) during the risk period for DCI after SAH. MATERIAL AND METHODS Clinical data from 94 SAH patients who underwent surgical clipping of anterior circulation aneurysms were reviewed retrospectively...
January 17, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28091826/paradigms-for-single-patient-multimodality-treatment-for-cerebral-aneurysms-single-center-eleven-year-experience
#5
Abdullah Alobaid, Erez Nossek, Katherine Wagner, Avi Setton, Amir R Dehdashti, David Langer, David Chalif
Endovascular and surgical techniques are conventional options for treating intracranial aneurysms, but criteria for selecting an optimal approach for individual patients remain variable across practitioners and institutions. While endovascular and surgical approaches are generally used alone, both modalities combined in single patients can produce efficacious outcomes. The aim of this study was to evaluate outcomes of combined, concomitant endovascular and surgical modalities in the treatment of multiple and/or complex aneurysms in single patients...
January 14, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28089808/stress-induced-hyperglycemia-after-spontaneous-subarachnoid-hemorrhage-and-its-role-in-predicting-cerebrospinal-fluid-diversion
#6
Bappaditya Ray, Ayumi Ludwig, Lori K Yearout, David M Thompson, Bradley N Bohnstedt
BACKGROUND: Stress induced hyperglycemia (SIH) after acute cerebrovascular disease is common and is associated with adverse clinical outcomes. Incidence of SIH after spontaneous subarachnoid hemorrhage (SAH) and its role in shunt placement has not been systematically investigated. Present study is designed to investigate the incidence of SIH after spontaneous SAH and its determinants. Role of SIH and premorbid hyperglycemia (using glycated hemoglobin, HbA1c) in predicting external ventricular drainage (EVD) and ventriculoperitoneal shunt (VPS) placement is also investigated...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089197/long-term-follow-up-analysis-of-microsurgical-clip-ligation-and-endovascular-coil-embolization-for-dorsal-wall-blister-aneurysms-of-the-internal-carotid-artery
#7
Mason A Brown, Cristian F Guandique, Jonathan Parish, Aubrey C McMillan, Stephen Lehnert, Nassir Mansour, Michael Tu, Bradley N Bohnstedt, Troy D Payner, Thomas J Leipzig, Andrew J DeNardo, John A Scott, Aaron A Cohen-Gadol
: Blister aneurysms at non-branching sites of the dorsal internal carotid artery (dICA) are fragile, rare, and often difficult to treat. The purpose of this study is to address the demographics, treatment modalities, and long-term outcome of patients treated for dICA blister aneurysms. A retrospective review of medical records identified all consecutive patients who presented with a blister aneurysm from 2002 to 2011 at our institution. Eighteen patients (M=7, F=11; mean age: 48.4±15...
January 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28088803/small-versus-large-ruptured-intracranial-aneurysm-concerns-with-the-site-of-aneurysm
#8
Bum Joon Kim, Hyun Goo Kang, Byeong-Duk Kwun, Jae-Sung Ahn, Jisung Lee, Sung Ho Lee, Dong-Wha Kang, Jong S Kim, Sun U Kwon
BACKGROUND: Although size is one of the strongest predictors, small aneurysms often rupture. We compared the characteristics of small and large ruptured intracranial aneurysms (RIAs) according to their location to find the factors associated with small RIAs in each location. METHODS: Patients with subarachnoid hemorrhage due to saccular RIAs were consecutively enrolled. The sizes were dichotomized as small (<5 mm) or large, and the location was classified as paraclinoid-distal internal carotid artery, sidewalls of anterior or middle cerebral artery (MCA; sidewall), MCA-bifurcation, anterior or posterior communicating artery (Acom or Pcom, respectively), and posterior circulation RIAs...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28087430/ryanodine-receptor-1-polymorphism-is-not-associated-with-aneurysmal-subarachnoid-hemorrhage-or-its-clinical-sequelae
#9
Philipp Hendrix, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
OBJECTIVE: The pathophysiological mechanisms underlying cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remain poorly understand. Ryanodine receptors (RYR) are intracellular calcium channels involved in the regulation of vascular smooth muscle cells and cerebrovascular tone and diameter. Previous work reported an association between a RYR polymorphism and cerebral vasospasm. Here, we sought to assess the impact of that RYR polymorphism on aSAH and its clinical sequelae...
January 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28087184/clinical-characteristics-of-ruptured-distal-middle-cerebral-artery-aneurysms-review-of-the-literature
#10
REVIEW
Keiji Tsutsumi, Tetsuyoshi Horiuchi, Alhusain Nagm, Yasuyuki Toba, Kazuhiro Hongo
Middle cerebral artery (MCA) aneurysms usually arise at the primary MCA bifurcation or trifurcation. Distal MCA aneurysms are rarely considered as sources of aneurysmal subarachnoid hemorrhage (SAH). It has been reported that ruptured distal MCA aneurysms are associated with head trauma, neoplastic emboli, arterial dissection, or bacterial infection. We experienced five cases of ruptured distal MCA aneurysms and evaluated their clinical characteristics. Retrospective analysis of aneurysmal SAH at Kobayashi Neurosurgical Neurological Hospital was performed from January, 2004 to December, 2014...
January 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28070645/middle-cerebral-artery-aneurysms-with-intracerebral-hematoma-the-impact-of-side-and-volume-on-final-outcome
#11
Ondrej Navratil, Kamil Duris, Vilem Juran, Eduard Neuman, Karel Svoboda, Martin Smrcka
BACKGROUND: Middle cerebral artery aneurysms (MCA aneurysms) belong to the most frequent type of intracranial aneurysms forming an intracerebral hematoma. The consequences of the hematoma-the laterality, the impact of ICH volume and size of the aneurysm with the final outcome of these patients had not been studied in detail in this location, and we focused on the analysis of these factors. METHODS: Patients with MCA aneurysms and associated intracerebral hematomas with a volume ≥10 ml were studied; these were treated from January 2006 to December 2015...
January 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28062803/posterior-circulation-perforator-aneurysms-a-proposed-management-algorithm
#12
Thomas J Buell, Dale Ding, Daniel M S Raper, Ching-Jen Chen, Harry R Hixson, R Webster Crowley, Avery J Evans, Mary E Jensen, Kenneth C Liu
INTRODUCTION: Subarachnoid hemorrhage (SAH) from posterior circulation perforator aneurysms (PCPAs) is rare and its natural history is unknown. Diagnosis may be difficult, acute management is poorly defined, and long-term recurrent SAH rates and clinical outcome data are lacking. METHODS: We searched our institution's records for cases of PCPA rupture and analyzed patient demographics, Hunt and Hess (HH) grades, diagnostic imaging, management, and clinical outcomes...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28059660/effects-of-decompressive-craniectomy-on-functional-outcomes-and-death-in-poor-grade-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#13
Naif M Alotaibi, Ghassan Awad Elkarim, Nardin Samuel, Oliver G S Ayling, Daipayan Guha, Aria Fallah, Abdulrahman Aldakkan, Blessing N R Jaja, Airton Leonardo de Oliveira Manoel, George M Ibrahim, R Loch Macdonald
OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to assess the impact of DC on functional outcome and death in patients after poor-grade aSAH. METHODS A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059659/antiplatelet-therapy-for-the-prevention-of-peri-coiling-thromboembolism-in-high-risk-patients-with-ruptured-intracranial-aneurysms
#14
Nancy J Edwards, Wesley H Jones, Aditya Sanzgiri, Juan Corona, Mark Dannenbaum, Peng Roc Chen
OBJECTIVE The most frequent procedural complication of the endovascular treatment of intracranial aneurysms is a thromboembolic event (TEE); in a subset of patients, such events will cause permanent neurological disability. In patients with unruptured aneurysms, increasing evidence supports the use of periprocedural antiplatelet therapy to prevent TEEs. The object of this study was to evaluate whether patients with ruptured aneurysms and subarachnoid hemorrhage would also benefit from periprocedural antiplatelet therapy...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059632/pseudoaneurysm-formation-due-to-rupture-of-intracranial-aneurysms-case-series-and-literature-review
#15
Motohiro Nomura, Kentaro Mori, Akira Tamase, Tomoya Kamide, Syunsuke Seki, Yu Iida, Tatsu Nakano, Yuichi Kawabata, Taro Kitabatake, Teruyuki Nakajima, Kiyoyuki Yasutake, Kei Egami, Tatsunori Takahashi, Mitsuyuki Takahashi, Kunio Yanagimoto
Background Intracranial pseudoaneurysm formation due to a ruptured non-traumatic aneurysm is extremely rare. We describe the radiological findings and management of pseudoaneurysms due to ruptured cerebral aneurysms in our case series and previously reported cases. Patients and methods Four additional and 20 reported patients presenting with subarachnoid hemorrhage (SAH) are included. Radiological findings and clinical features of these patients were reviewed. Results In our series, three-dimensional computed tomographic angiography (3D-CTA) and/or angiography showed an irregular- or snowman-shaped cavity extending from the parent artery...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28035993/brain-monitoring-in-critically-neurologically-impaired-patients
#16
REVIEW
Salazar Jones, Gary Schwartzbauer, Xiaofeng Jia
Assessment of neurologic injury and the evolution of severe neurologic injury is limited in comatose or critically ill patients that lack a reliable neurologic examination. For common yet severe pathologies such as the comatose state after cardiac arrest, aneurysmal subarachnoid hemorrhage (aSAH), and severe traumatic brain injury (TBI), critical medical decisions are made on the basis of the neurologic injury. Decisions regarding active intensive care management, need for neurosurgical intervention, and withdrawal of care, depend on a reliable, high-quality assessment of the true state of neurologic injury, and have traditionally relied on limited assessments such as intracranial pressure monitoring and electroencephalogram...
December 27, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28034814/outcome-prognostic-factors-and-follow-up-results-after-subarachnoid-hemorrhage-from-pericallosal-artery-aneurysms
#17
Nazife Dinc, Stephanie Lescher, Johanna Quick-Weller, Joachim Berkefeld, Johannes Platz, Christian Senft, Volker Seifert, Juergen Konczalla
OBJECTIVE: Pericallosal artery aneurysms (PAA) are usually rare (2-5%) and treatment is challenging for both modalities, surgical and endovascular. The authors performed this analysis to determine the outcome and prognostic factors after subarachnoidal hemorrhage due to ruptured pericallosal artery aneurysms. MATERIALS AND METHODS: A total of 32 patients with ruptured PAA were admitted to our hospital between 1999 and 2014, added to our prospective database and analyzed retrospectively...
December 26, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28034809/trends-in-ventriculostomy-associated-infections-and-mortality-in-aneurysmal-subarachnoid-hemorrhage-data-from-the-nationwide-inpatient-sample
#18
Roy Poblete, Ling Zheng, Ranjita Raghavan, Steven Cen, Arun Amar, Nerses Sanossian, William Mack, May Kim-Tenser
BACKGROUND: Patients with aneurysmal subarachnoid hemorrhage (aSAH) are susceptible to various medical complications, including ventriculostomy-associated infections (VAIs) in those who undergo external ventricular drain (EVD) placement. Many VAI preventative strategies have been utilized over the last 20 years, but their overall effect is unknown. Using the Nationwide (National) Inpatient Sample (NIS), this study examines trends in VAI rates and mortality over a recent 12-year period in the aSAH population...
December 26, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28033279/the-effect-of-fenestration-of-the-lamina-terminalis-on-the-incidence-of-shunt-dependent-hydrocephalus-after-aneurysmal-subarachnoid-hemorrhage-fish-study-protocol-for-a-randomized-controlled-trial
#19
Chuanyuan Tao, Chaofeng Fan, Xin Hu, Junpeng Ma, Lu Ma, Hao Li, Yi Liu, Hong Sun, Min He, Chao You
BACKGROUND: Shunt-dependent hydrocephalus (SDH) is a well-known sequela following aneurysmal hemorrhage, adversely affecting the outcome after securing ruptured aneurysm. Fenestration of lamina terminalis (FLT) creates an anterior ventriculostomy, facilitates cerebrospinal fluid circulation and clot clearance in the basal cistern. However, controversy exists over whether microsurgical FLT during aneurysm repair can decrease the incidence of SDH. AIMS: The study is designed to determine the efficacy of lamina terminalis fenestration on the reduction of SDH after aneurysm clipping...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28028791/clinical-value-of-neutrophil-to-lymphocyte-and-platelet-to-lymphocyte-ratio-after-aneurysmal-subarachnoid-hemorrhage
#20
Chuanyuan Tao, Jiajing Wang, Xin Hu, Junpeng Ma, Hao Li, Chao You
BACKGROUND: Inflammation and thrombosis are associated with the pathogenesis of aneurysmal subarachnoid hemorrhage (aSAH) and neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are emerging as novel inflammatory markers in stroke. We aimed to identify the association of NLR and PLR with delayed cerebral ischemia (DCI) and 3-month outcome after aSAH. METHODS: Two hundred and forty-seven patients diagnosed with aSAH within 24 h of symptoms onset were enrolled...
December 27, 2016: Neurocritical Care
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