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Aneurysmal subarachnoid hemorrhage

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https://www.readbyqxmd.com/read/29224114/coated-platelet-trends-predict-short-term-clinical-outcomeafter-subarachnoid-hemorrhage
#1
Bappaditya Ray, Vijay M Pandav, Eleanor A Mathews, David M Thompson, Lance Ford, Lori K Yearout, Bradley N Bohnstedt, Shuchi Chaudhary, George L Dale, Calin I Prodan
Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high socio-economic burden. Prothrombotic states of early brain injury (EBI) and delayed cerebral ischemia (DCI) after aSAH determine morbidity and mortality. To understand how activated platelets might contribute to such prothrombotic states, we studied trends in coated-platelets during EBI and DCI periods. Serial blood samples from a prospective cohort of aSAH patients were collected and assayed for coated-platelet levels. Patient's coated-platelet level during post-hospital discharge follow-up served as an estimate of baseline...
December 9, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29219758/the-use-of-alternatives-to-clopidogrel-in-flow-diversion-treatment-with-the-pipeline-embolization-device
#2
Elias Atallah, Hassan Saad, Kimon Bekelis, Nohra Chalouhi, Stavropoula Tjoumakaris, David Hasan, Jorge Eller, David Stidd, Robert H Rosenwasser, Pascal Jabbour
OBJECTIVE Thromboembolic complications continue to be encountered with Pipeline embolization devices (PEDs) despite routine clopidogrel/aspirin antiplatelet therapy. This study examined the safety and efficacy of prasugrel in the management of clopidogrel-resistant patients treated for cerebral aneurysms. METHODS Four hundred thirty-seven consecutive patients were identified between January 2011 and May 2016. Patients allergic, or having less than 30% platelet inhibition, to a daily 75-mg dose of clopidogrel received 10 mg of prasugrel daily (n = 20) or 90 mg of ticagrelor twice daily (n = 2)...
December 8, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29217366/initially-missed-or-delayed-diagnosis-of-subarachnoid-hemorrhage-a-nationwide-survey-of-contributing-factors-and-outcomes-in-japan
#3
Yasushi Takagi, Hiromu Hadeishi, Yohei Mineharu, Kazumichi Yoshida, Kuniaki Ogasawara, Akira Ogawa, Susumu Miyamoto
BACKGROUND: Subarachnoid hemorrhage (SAH) remains a significant cause of mortality in Japan. The Japan Stroke Society set out to conduct a nationwide survey to identify contributing factors and outcomes of SAH misdiagnosis. METHODS: We initially surveyed 737 training institutes and 1259 departments in Japan between April 2012 and March 2014 for the presence of misdiagnosed SAH. Clinical information was then sought from respondents with a positive misdiagnosis. Information on 579 misdiagnosed cases was collected...
December 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29216792/quadriceps-muscle-thickness-changes-in-patients-with-aneurysmal-subarachnoid-hemorrhage-during-the-acute-phase
#4
Masafumi Nozoe, Masashi Kanai, Hiroki Kubo, Miki Kobayashi, Miho Yamamoto, Shinichi Shimada, Kyoshi Mase
Background Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition that often leads to severe disability in relatively young and healthy people. This disability is physical in many aSAH survivors, so muscle dysfunction may be an important factor in the functional level of these patients. Thus, measuring muscle thickness represents a suitable method for determining muscle function in patients with acute aSAH, because the disordered consciousness often experienced during the acute phase causes active movement to be difficult for these patients...
December 8, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/29216501/smart-coils-for-intracranial-aneurysm-embolization-initial-outcomes
#5
Adeel Ilyas, Thomas J Buell, Ching-Jen Chen, Dale Ding, Daniel M S Raper, Davis G Taylor, Jennifer D Sokolowski, Kenneth C Liu
OBJECTIVES: Endovascular technology for the treatment of intracranial aneurysms continues to rapidly evolve. The SMART coil (Penumbra Inc., Alameda, CA, USA) is a novel microcoil designed to enhance deliverability. The aim of this single-center, retrospective cohort study is to assess the initial outcomes after aneurysm embolization using SMART coils. PATIENTS AND METHODS: We reviewed consecutive patients with intracranial aneurysms who underwent endovascular embolization using SMART coils from June 2016 to January 2017...
December 2, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29214784/contrast-induced-acute-kidney-injury-after-coil-embolization-for-aneurysmal-subarachnoid-hemorrhage
#6
Hyun Goo Lee, Won Ki Kim, Je Young Yeon, Jong Soo Kim, Keon Ha Kim, Pyoung Jeon, Seung Chyul Hong
PURPOSE: Contrast-induced acute kidney injury (CI-AKI) is associated with poor outcomes after percutaneous coronary intervention. However, CI-AKI has rarely been evaluated within the neurovascular field. The aim of this study was to investigate the incidence and clinical implication of CI-AKI after coil embolization in patients with an aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Between January 2005 and March 2016, 192 patients who underwent coil embolization were enrolled in this study...
January 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29213291/apolipoprotein-e-polymorphism-and-the-risk-of-aneurysmal-subarachnoid-hemorrhage-in-a-south-indian-population
#7
Arati Suvatha, Sibin Madathan Kandi, Dhananjaya Ishwara Bhat, Narasinga Rao, Vikas Vazhayil, Chetan Ghati Kasturirangan
Background: The rupture of a brain aneurysm causes bleeding in the subarachnoid space. This is known as aneurysmal subarachnoid hemorrhage (aSAH). We evaluated the association of apolipoprotein E (APOE) polymorphism and the risk of aSAH in a South Indian population. Methods: The study was performed on 200 subjects with aSAH and 253 healthy control subjects. Blood samples (5 ml) were used to isolate DNA and genotyping was performed for rs7412 and rs429358 using a Taqman allelic discrimination assay...
2017: Cellular & Molecular Biology Letters
https://www.readbyqxmd.com/read/29212462/pharmacological-targeting-of-secondary-brain-damage-following-ischemic-or-hemorrhagic-stroke-traumatic-brain-injury-and-bacterial-meningitis-a-systematic-review-and-meta-analysis
#8
Thomas Beez, Hans-Jakob Steiger, Nima Etminan
BACKGROUND: The effectiveness of pharmacological strategies exclusively targeting secondary brain damage (SBD) following ischemic stroke, aneurysmal subarachnoid hemorrhage, aSAH, intracerebral hemorrhage (ICH), traumatic brain injury (TBI) and bacterial meningitis is unclear. This meta-analysis studied the effect of SBD targeted treatment on clinical outcome across the pathological entities. METHODS: Randomized, controlled, double-blinded trials on aforementioned entities with 'death' as endpoint were identified...
December 7, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29204979/treatment-of-spontaneous-subarachnoid-hemorrhage-and-self-reported-neuropsychological-performance-at-6-months-results-of-a-prospective-clinical-pilot-study-on-good-grade-patients
#9
Elisabeth Bründl, Petra Schödel, Sylvia Bele, Martin Proescholdt, Judith Scheitzach, Florian Zeman, Alexander Brawanski, Karl-Michael Schebesch
AIM: Limited focus has been placed on neuropsychological patient profiles after spontaneous subarachnoid hemorrhage (sSAH). We conducted a prospective controlled study in good-grade sSAH patients to evaluate the time course of treatment-specific differences in cognitive processing after sSAH. MATERIAL AND METHODS: 26 consecutive sSAH patients were enrolled (drop out n=5). 9 patients received endovascular aneurysm occlusion (EV), 6 patients were treated microsurgically (MS), and 6 patients with perimesencephalic SAH (pSAH) underwent standardized intensive medical care...
November 1, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29204037/staged-multimodality-treatment-of-a-large-ruptured-fusiform-supraclinoid-internal-carotid-artery-aneurysm-microsurgical-clip-assisted-endovascular-coiling
#10
Dale Ding, Thomas J Buell, Ching-Jen Chen, Daniel M Raper, Kenneth C Liu, Dennis G Vollmer
In the contemporary era of aneurysm management, large fusiform aneurysms presenting with subarachnoid hemorrhage (SAH) remain particularly challenging lesions to successfully manage. We describe a staged, multimodal treatment strategy for a 71-year-old patient who presented with a large ruptured fusiform aneurysm of the supraclinoid internal carotid artery (ICA) and a fetal posterior communicating artery which originated from the inferomedial aspect of the aneurysm. In the first stage, we performed a partial microsurgical clip reconstruction of the fusiform aneurysm and secured its rupture site, which was identified intraoperatively...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29204036/flow-diverting-stent-assisted-coil-embolization-of-a-ruptured-internal-carotid-artery-blister-aneurysm-with-the-pipeline-flex-embolization-device
#11
Dale Ding, Robert M Starke, Ayton Hope, Stefan Brew
Internal carotid artery (ICA) blister aneurysms are rare and challenging to successfully treat, using contemporary surgical or endovascular approaches, without partial or complete compromise of the parent vessel. We describe the use of a resheathable flow diverter, the Pipeline Flex Embolization Device (PFED) to perform stent-assisted coiling of a ruptured supraclinoid ICA blister aneurysm in a 56-year-old female who presented with a high-grade subarachnoid hemorrhage (SAH). The first PFED was deployed across the aneurysm neck to jail a microcatheter within the aneurysm dome, and then, two small coils were delivered into the aneurysm...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29204032/subarachnoid-hemorrhage-due-to-ruptured-intracranial-aneurysm-arising-from-a-vertebral-artery-bihemispheric-posterior-inferior-cerebellar-artery-bifurcation
#12
Yasushi Ogasawara, Hiroshi Kashimura, Kenta Aso, Hiroaki Saura
Although the anatomy of the posterior inferior cerebellar artery (PICA) is highly variable, a solitary PICA supplying both hemispheres of the cerebellum is rare. A 76-year-old woman presented with severe headache and subsequent loss of consciousness and was admitted to our hospital. Initial computed tomography showed subarachnoid hemorrhage. Three-dimensional digital subtraction angiography revealed a saccular aneurysm arising from the right vertebral artery (VA)-PICA bifurcation. The PICA branching from the right VA was enlarged, tortuous, and crossed the midline to supply both cerebellar hemispheres...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29203688/antihyperglycemic-agents-are-inversely-associated-with-intracranial-aneurysm-rupture
#13
Anil Can, Victor M Castro, Sheng Yu, Dmitriy Dligach, Sean Finan, Vivian S Gainer, Nancy A Shadick, Guergana Savova, Shawn Murphy, Tianxi Cai, Scott T Weiss, Rose Du
BACKGROUND AND PURPOSE: Previous studies have suggested a protective effect of diabetes mellitus on aneurysmal subarachnoid hemorrhage risk. However, reports are inconsistent, and objective measures of hyperglycemia in these studies are lacking. Our aim was to investigate the association between aneurysmal subarachnoid hemorrhage and antihyperglycemic agent use and glycated hemoglobin levels. METHODS: The medical records of 4701 patients with 6411 intracranial aneurysms, including 1201 prospective patients, diagnosed at the Massachusetts General Hospital and Brigham and Women's Hospital between 1990 and 2016 were reviewed and analyzed...
December 4, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29199247/utility-of-indocyanine-green-video-angiography-for-sylvian-fissure-dissection-in-subarachnoid-hemorrhage-patients-sylvian-icg-technique
#14
Hiroyuki Toi, Nobuhisa Matsushita, Yukari Ogawa, Keita Kinoshita, Kohei Satoh, Hiroki Takai, Satoshi Hirai, Keijiro Hara, Shunji Matsubara, Masaaki Uno
Indocyanine green (ICG) emits fluorescence in the far-red domain under light excitation. ICG video angiography (ICG-VA) has been established as a useful method to evaluate blood flow in the operative field. We report the usefulness of ICG-VA for Sylvian fissure dissection in patients with subarachnoid hemorrhage (SAH). Subjects comprised 7 patients who underwent ICG-VA before opening the Sylvian fissure during neck clipping for ruptured cerebral aneurysm. We observed contrasted Sylvian veins before opening the Sylvian fissure using surgical microscopes...
December 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29197939/postmortem-angiography-revealing-traumatic-rupture-of-the-intracranial-internal-carotid-artery
#15
Fumiko Chiba, Go Inokuchi, Yohsuke Makino, Suguru Torimitsu, Ayumi Motomura, Rutsuko Yamaguchi, Mari Hashimoto, Yumi Hoshioka, Sayaka Nasgasawa, Ayaka Sakuma, Daisuke Yajima, Hisako Saito, Hirotaro Iwase
Diagnosis of traumatic subarachnoid hemorrhage (SAH), although relatively rare, is important in forensic medicine. It is mostly associated with rupture of the vertebrobasilar artery. Traumatic aneurysm of the intracranial part of the internal carotid artery (ICA) is also rare but has been reported in several studies. It is thought that the intracranial ICA is injured by blunt force to the head, neck, and chest. However, traumatic SAH with fatal acute course resulting from rupture of the ICA is especially uncommon: only two fatal cases without an associated aneurysm have been reported in the English-language literature...
December 2, 2017: International Journal of Legal Medicine
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
#16
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/29187685/-a-case-of-subarachnoid-hemorrhage-due-to-infective-endocarditis-by-methicillin-resistant-coagulase-negative-staphylococcus
#17
Shunsuke Kajikawa, Tomoko Oeda, Kwiyoung Park, Kenji Yamamoto, Hiroshi Sugiyama, Hideyuki Sawada
A 77-year-old man visited our hospital with unstable gait following 2 months of anorexia. Brain MRI showed multiple infarcts; cardiac echocardiography revealed mitral-valve vegetation; and blood culture revealed methicillin-resistant coagulase-negative staphylococci. The patient was diagnosed with infective endocarditis (IE). Subarachnoid hemorrhage (SAH) developed ten days after antibiotic treatment. Intracranial aneurysm was not found. We speculated that chronic inflammation of the cerebral arterial walls by bacteria of low virulence was associated with SAH complication...
November 28, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29186595/treatment-of-recurrent-intracranial-aneurysms-after-neck-clipping-novel-classification-scheme-and-management-strategies
#18
Shinya Kobayashi, Junta Moroi, Kentaro Hikichi, Shotaro Yoshioka, Hiroshi Saito, Jun Tanabe, Tatsuya Ishikawa
BACKGROUND: Recurrent aneurysms after initial clipping have been discussed as an important issue in the surgical management of aneurysm. OBJECTIVE: To report our experience with recurrent cerebral aneurysms after neck clipping and to discuss classification and recommended management. METHODS: Aneurysm treatments from a single institution over a 20-year period were retrospectively reviewed. Twenty-three recurrent aneurysms in 23 patients were managed during the study period...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29181806/-coil-mainly-policy-in-management-of-intracranial-acoa-aneurysms-single-centre-experience-with-the-systematic-review-of-literature-and-meta-analysis
#19
Anna Steklacova, Ondrej Bradac, Patricia de Lacy, Jiri Lacman, Frantisek Charvat, Vladimir Benes
Endovascular techniques are still expanding in their capability by introducing novel technologies. Nevertheless, anterior communicating artery (ACoA) remains the region with high propensity for aneurysm (AN) re-growth after endovascular intervention. The purpose of this study is to highlight the ongoing importance for microsurgical treatment. The authors conducted a single-institution retrospective study of ACoA AN treatment between January 2000 and December 2016 maintaining "coil mainly" policy. The results are supplied with a systematic review of the literature...
November 28, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/29181160/secondary-central-nervous-system-lymphoma-surrounding-a-region-injured-by-subarachnoid-hemorrhage-and-subsequent-aneurysmal-clipping
#20
Yoriko Murata, Yasuhiro Hata, Yoshihiro Noda, Satoshi Matsusaka, Naoki Fukui, Tomohito Kadota, Jun Iwata, Takuya Machida, Takuji Yamagami
The present case study describes a rare case of secondary central nervous system (CNS) lymphoma that infiltrated the dura and leptomeninges around the area injured by subarachnoid hemorrhage and subsequent aneurysmal clipping. Invasion of the CNS was observed by computed tomography as slurred fissures of the right parietal lobe adjacent to the surgery area. Subdural and subarachnoid enhancement overlapping the area injured by past surgical procedures was observed by contrast-enhanced magnetic resonance imaging...
November 2017: Biomedical Reports
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