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Aneurysmal subarachnoid hemorrhage

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https://www.readbyqxmd.com/read/29046469/-a-rare-case-of-ruptured-unruptured-miniature-aneurysms-originating-from-the-infundibular-dilatation-of-the-callosomarginal-artery-branching-from-the-infracallosal-a2-segment-of-the-azygos-anterior-cerebral-artery
#1
Shota Yoshimura, Chika Somagawa, Kei Satoh, Yutaka Fukuda, Takeshi Hiu, Tomonori Ono, Ryujiro Ushijima, Keisuke Toda, Keisuke Tsutsumi
We report the first case of two de novo miniature aneurysms(ruptured/unruptured)emerging from the infundibular dilatation(ID)of the callosomarginal artery, which branches from the infracallosal(A2)segment of the azygos anterior cerebral artery(AACA), in a 36-year-old woman. The patient had previously been diagnosed with a miniature, unruptured aneurysm, occurring in the A2 segment of the AACA, detected by CT angiography(CTA)at another hospital two years ago, and had been followed up with MR angiography(MRA)every 6 months...
October 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29043545/early-brain-injury-associated-with-systemic-inflammation-after-subarachnoid-hemorrhage
#2
Jude Savarraj, Kaushik Parsha, Georgene Hergenroeder, Sungho Ahn, Tiffany R Chang, Dong H Kim, H Alex Choi
BACKGROUND: Early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) is defined as brain injury occurring within 72 h of aneurysmal rupture. Although EBI is the most significant predictor of outcomes after aSAH, its underlying pathophysiology is not well understood. We hypothesize that EBI after aSAH is associated with an increase in peripheral inflammation measured by cytokine expression levels and changes in associations between cytokines. METHODS: aSAH patients were enrolled into a prospective observational study and were assessed for markers of EBI: global cerebral edema (GCE), subarachnoid hemorrhage early brain edema score (SEBES), and Hunt-Hess grade...
October 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29042528/-a-case-of-ruptured-anterior-communicating-artery-aneurysm-with-visual-field-defects-and-deteriorating-to-severe-vision-loss
#3
Kazuki Sakakura, Go Ikeda, Yasunobu Nakai, Noriyuki Watanabe, Masanari Shiigai, Kazuya Uemura, Tetsuya Yamamoto, Akira Matsumura
Although Terson's syndrome is a well-known cause of vision loss due to intracerebral aneurysm rupture, optic nerve neuropathy can also occur because of other causes. Here, we report such a case, i.e., a ruptured anterior communicating artery aneurysm accompanied by vision loss and visual field disturbances due to a cause other than Terson's syndrome. A 47-year-old man presented with right superior altitudinal hemianopia. Computed tomography (CT) showed subarachnoid hemorrhage (SAH), and three-dimensional CT angiography revealed an anterior communicating artery aneurysm...
October 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
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
#4
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/29041013/maternal-aneurysmal-subarachnoid-hemorrhage-during-pregnancy-as-an-interdisciplinary-task
#5
Friederike Sophie Fritzsche, Jan Regelsberger, Nils Ole Schmidt, Jakob Müller, Jan Hendrik Buhk, Anke Diemert, Manfred Westphal, Tobias Martens
Maternal aneurysmal subarachnoid hemorrhage (aSAH) during pregnancy presents a challenge regarding treatment and management. Due to the limited number of cases there are no treatment guidelines available. Thus, treatment is usually done on a case-by-case basis. Here we report on four cases of aSAH during pregnancy, describing the different management strategies and suggesting a possible treatment algorithm. Patients treated between 2003 and 2013 in our center were included in this retrospective study. Clinical data focused on time management concerning gestation week (GW), microsurgical or endovascular treatment, and outcome of the patients and the fetuses...
October 17, 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29038077/the-effects-of-red-blood-cell-transfusion-on-functional-outcome-after-aneurysmal-subarachnoid-hemorrhage
#6
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
#7
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
https://www.readbyqxmd.com/read/29030499/unexpected-early-radiographic-findings-associated-with-a-ruptured-blister-like-carotid-wall-aneurysm
#8
James West, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
A 33-year-old man presented with aneurysmal subarachnoid hemorrhage from a ruptured, blister-type sidewall internal carotid artery (ICA) aneurysm. Balloon-assisted coiling was performed with residual neck. He subsequently developed severe vasospasm requiring intra-arterial therapies on multiple occasions, during which it was noted that despite widespread vasospasm, a focal segment of the ICA at the site of the aneurysm showed no significant spasm, suggesting underlying vessel abnormality. He was discharged without deficit and scheduled for flow diversion given concern over this potentially pathologic segment of vessel...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29030496/ruptured-aneurysm-of-the-artery-of-adamkiewicz-is-conservative-management-the-standard-of-treatment-in-the-current-era
#9
Pedro Aguilar-Salinas, Jussie Lima, Leonardo B C Brasiliense, Ricardo A Hanel, Eric Sauvageau
Spinal aneurysms are rare lesions, and their natural history is not well known. In particular, aneurysms arising from the artery of Adamkiewicz (AA) are an extremely rare phenomenon, and given the lack of solid evidence its management remains unclear. We present the case of a 54-year-old woman with spinal subarachnoid hemorrhage. A spinal angiogram demonstrated a fusiform aneurysm arising from the AA. Based on the location, the absence of evident collateral circulation to the anterior spinal artery, and the available literature supporting spontaneous thrombosis, we opted for conservative management...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29030464/computed-tomography-interobserver-agreement-in-the-assessment-of-aneurysmal-subarachnoid-hemorrhage-and-predictors-for-clinical-outcome
#10
Peter Y M Woo, Teresa P K Tse, Robert S K Chan, Lianne N Y Leung, Stephanie K K Liu, Andrew Y T Leung, Hoi-Tung Wong, Kwong-Yau Chan
BACKGROUND: The severity of aneurysmal subarachnoid hemorrhage (SAH) is often assessed by the clinical state of the patient on presentation, but radiological evaluation of the extent of hemorrhage has rarely been examined in the literature. Several CT scan based grading systems exist yet only a few studies have investigated interobserver agreement. We evaluated five radiological grading systems and assessed their clinical value for early prognostication. METHODOLOGY: This was a retrospective study of patients diagnosed with aneurysmal SAH with a CT scan performed within 72 hours of symptom onset...
November 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29030048/increased-prevalence-of-cerebrovascular-disease-in-hospitalized-patients-with-marfan-syndrome
#11
Sarasa T Kim, Harry Cloft, Kelly D Flemming, David F Kallmes, Giuseppe Lanzino, Waleed Brinjikji
BACKGROUND AND PURPOSE: Small studies have suggested that Marfan syndrome is associated with a number of cerebrovascular complications. We sought to determine whether a clinical diagnosis of Marfan syndrome is associated with a higher prevalence of cerebrovascular diseases than the general population by performing a case-control study of hospitalized patients in the Nationwide Inpatient Sample (NIS). METHODS: Using the 2000-2012 NIS, we performed a case-control study matching cases of Marfan syndrome to controls without such a diagnosis...
October 10, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29029314/small-aneurysms-account-for-the-majority-and-increasing-percentage-of-aneurysmal-subarachnoid-hemorrhage-a-25-year-single-institution-study
#12
Matthew T Bender, Haley Wendt, Thomas Monarch, Narlin Beaty, Li-Mei Lin, Judy Huang, Alexander Coon, Rafael J Tamargo, Geoffrey P Colby
BACKGROUND: Prospective studies of unruptured aneurysms have shown very low rates of rupture for small aneurysms (<10 mm) and suggested that the risk of treatment outweighs benefit. However, common clinical practice shows that patients with aneurysmal subarachnoid hemorrhage (aSAH) frequently have small aneurysms. OBJECTIVE: To investigate trends in size and location of ruptured aneurysms over a 25-yr period. METHODS: A prospective, Institutional Review Board-approved database of all patients presenting to our institution with aSAH from 1991 to 2016 was analyzed...
October 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29027870/flow-diversion-of-a-recurrent-iatrogenic-basilar-tip-aneurysm-in-a-pediatric-patient-case-report
#13
Rahul A Sastry, Matthew J Koch, Benjamin L Grannan, Christopher J Stapleton, William E Butler, Aman B Patel
Endoscopic third ventriculostomy (ETV) is a common treatment for noncommunicating hydrocephalus. Although rare, vascular injury and traumatic pseudoaneurysm development during ETV have been reported. The authors present the case of a 13-year-old boy who underwent repeat ETV (rETV) for shunt and ETV failure, and who suffered an intraoperative subarachnoid hemorrhage due to iatrogenic injury to the basilar tip, with subsequent development of a pseudoaneurysm. Despite initial primary coil embolization, the aneurysm recurred and was definitively treated with flow diversion...
October 13, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29027862/effect-of-body-mass-index-on-outcome-after-aneurysmal-subarachnoid-hemorrhage-treated-with-clipping-versus-coiling
#14
Lorenzo Rinaldo, Joshua D Hughes, Alejandro A Rabinstein, Giuseppe Lanzino
OBJECTIVE It has been suggested that increased body mass index (BMI) may confer a protective effect on patients who suffer from aneurysmal subarachnoid hemorrhage (aSAH). Whether the modality of aneurysm occlusion influences the effect of BMI on patient outcomes is not well understood. The authors aimed to compare the effect of BMI on outcomes for patients with aSAH treated with surgical clipping versus endovascular coiling. METHODS The authors retrospectively reviewed the outcomes for patients admitted to their institution for the management of aSAH treated with either clipping or coiling...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29023523/the-role-of-glutamate-in-neuronal-ion-homeostasis-a-case-study-of-spreading-depolarization
#15
Niklas Hübel, Mahshid S Hosseini-Zare, Jokūbas Žiburkus, Ghanim Ullah
Simultaneous changes in ion concentrations, glutamate, and cell volume together with exchange of matter between cell network and vasculature are ubiquitous in numerous brain pathologies. A complete understanding of pathological conditions as well as normal brain function, therefore, hinges on elucidating the molecular and cellular pathways involved in these mostly interdependent variations. In this paper, we develop the first computational framework that combines the Hodgkin-Huxley type spiking dynamics, dynamic ion concentrations and glutamate homeostasis, neuronal and astroglial volume changes, and ion exchange with vasculature into a comprehensive model to elucidate the role of glutamate uptake in the dynamics of spreading depolarization (SD)-the electrophysiological event underlying numerous pathologies including migraine, ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hematoma, and trauma...
October 12, 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28993037/reversible-stress-cardiomyopathy-secondary-to-aneurysmal-subarachnoid-hemorrhage-a-case-report
#16
Konstantinos Lampropoulos, Evangelos Giannoulis, Bazoukis George, Gary Tse, Epameinondas Triantafyllou, Athanasios Triantafyllou
BACKGROUND: Acute cerebral incidents have been correlated with cardiac manifestations. Specifically, subarachnoid hemorrhage has been correlated with a syndrome described as neurogenic stress cardiomyopathy and mimics acute coronary syndrome. CASE REPORT: A 55-year-old woman presented at the Emergency Department of our hospital complaining of vomiting and headache of sudden onset. Computed tomography angiography revealed a ruptured aneurysm at the tip of the basilar artery and the patient underwent a successful complete embolism of the sac of the aneurysm...
October 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28988732/rupture-of-an-occult-intracranial-mycotic-aneurysm-after-intravenous-thrombolysis-with-recombinant-tissue-plasminogen-activator-for-acute-ischemic-stroke
#17
Jared Glenn, Margaret Strecker-McGraw, Ian McGraw, Karim Jabbar, Nathan A James, C Keith Stone
BACKGROUND: The treatment of acute ischemic stroke with recombinant tissue plasminogen activator (rtPA) has become the mainstay of treatment, but its use carries a risk of subsequent intracranial hemorrhage (ICH). Guidelines have been developed to aid in the selection of the appropriate candidates to treat with rtPA to reduce this risk. We present a case of a stroke patient who was an appropriate candidate and was treated with rtPA who experienced a fatal subarachnoid hemorrhage due to a ruptured mycotic aneurysm (MA)...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28988651/association-between-polymorphism-of-smad3-gene-and-risk-of-sporadic-intracranial-arterial-aneurysms-in-the-chinese-han-population
#18
Mao-Fan Liao, Qiu-Wen Gong, Liang Liu, Xiao-Yi Xiong, Qin Zhang, Chang-Xiong Gong, Qing-Wu Yang
Intracranial arterial aneurysms (IAAs) are locally abnormal dilations of the cerebral arteries and often result in subarachnoid hemorrhages (SAH). Genetic, molecular and cellular mechanisms of sporadic IAAs forms are poorly understood. In this study, we investigate the association between mothers against decapentaplegic homolog 3 (SMAD3) genotypes and the risk of sporadic intracranial arterial aneurysms among the Chinese Han population. A case-control study was conducted examining 330 IAA patients and 313 controls...
October 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28987853/early-hemodynamic-changes-based-on-initial-color-coding-angiography-as-a-predictor-for-developing-subsequent-symptomatic-vasospasm-after-aneurysmal-sah
#19
Jan-Karl Burkhardt, Xiaolin Chen, Ethan A Winkler, Miriam Weiss, John Yue, Daniel L Cooke, Helen Kim, Michael T Lawton
INTRODUCTION: Prediction of vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remains imperfect and currently relies on clinical and radiographic characteristics. Whether early hemodynamic changes may refine risk stratification for delayed vasospasm (DV) after aSAH was analyzed. METHODS: Patients with aSAH (n=53) and a control of unruptured intracranial aneurysms (UIA) (n=12) with initial color-coding angiography at admission were included in this study (n=65)...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987850/suturing-and-dural-wrapping-for-a-blood-blister-like-aneurysm-on-the-supraclinoid-segment-of-the-ica-due-to-dissection
#20
Yunbao Guo, Jinlu Zhang, Hao Chen, Kan Xu, Jinlu Yu
BACKGROUND: Internal carotid artery (ICA) reconstruction is still the most effective treatment for a blood blister-like aneurysm (BBA) on the supraclinoid segment of the ICA, and clipping after wrapping has the most precise effects. However, the materials used are most often artificial. This study examined the use of autologous dura to replace the artificial materials used for wrapping after suturing a BBA. CASE DESCRIPTION: A 38-year-old man was hospitalized for subarachnoid hemorrhage (SAH)...
October 5, 2017: World Neurosurgery
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