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Aneurysmal subarachnoid hemorrhage

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https://www.readbyqxmd.com/read/28224318/chemical-angioplasty-with-spasmolytics-for-vasospasm-after-subarachnoid-hemorrhage
#1
Aleš Hejčl, Filip Cihlář, Vojtěch Smolka, Petr Vachata, Robert Bartoš, Jan Procházka, Jiří Cihlář, Martin Sameš
BACKGROUND: Clinically symptomatic vasospasm leading to delayed ischemic neurological deficits occurs in up to 30% of patients with subarachnoid hemorrhage (SAH). Vasospasm can result in a serious decline in clinical conditions of patients with SAH, yet the algorithm for vasospasm treatment and prevention remains unclear. Intra-arterial administration of vasodilators is one of the modalities used for vasospasm therapy. METHODS: Over the last 7 years, we have treated 27 female and 7 male patients with vasospasm using intra-arterial administration of either nimodipine or milrinone; all had suffered aneurysm rupture...
February 21, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28217390/management-of-aneurysmal-subarachnoid-hemorrhage-state-of-the-art-and-future-perspectives
#2
REVIEW
Giovanni Grasso, Concetta Alafaci, R Loch Macdonald
BACKGROUND: Aneurysmal subarachnoid hemorrhage (SAH) accounts for 5% of strokes and carries a poor prognosis. It affects around 6 cases per 100,000 patient years occurring at a relatively young age. METHODS: Common risk factors are the same as for stroke, and only in a minority of the cases, genetic factors can be found. The overall mortality ranges from 32% to 67%, with 10-20% of patients with long-term dependence due to brain damage. An explosive headache is the most common reported symptom, although a wide spectrum of clinical disturbances can be the presenting symptoms...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28217381/concurrent-cervical-dural-and-multiple-perimedullary-arteriovenous-fistulas-presenting-with-subarachnoid-hemorrhage-the-source-of-bleeding-was-invisible-at-initial-angiography
#3
Iku Nambu, Naoyuki Uchiyama, Kouichi Misaki, Masanao Mohri, Mitsutoshi Nakada
BACKGROUND: We report the concurrence of a spinal dural arteriovenous fistula (DAVF) and multiple perimedullary arteriovenous fistulas (PAVFs) presenting with subarachnoid hemorrhage (SAH). Moreover, the bleeding site was detected 1 month after onset. CASE DESCRIPTION: A 56-year-old man was admitted to our hospital with an SAH. A DAVF and two PAVFs were detected at the C2 level by two rounds of digital subtraction angiography. The source of bleeding, an aneurysm on the feeding artery of PAVF, was detected at the second angiogram, which was performed 1 month after the onset of SAH...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28216398/engaging-in-a-keyhole-concept-for-the-management-of-ruptured-and-unruptured-aneurysms
#4
Daniel D Cavalcanti, Roberto C de Paula, Paula L Alvarenga, Paulo José P da Mata, Paulo Niemeyer Filho
OBJECTIVE: Many new endovascular devices have been used under the guidance of the International Subarachnoid Aneurysm Trial (ISAT). Clipping still offers higher occlusion rates, and its technique continues to evolve, resulting in smaller exposures and reduced manipulation to brain tissue. We sought to evaluate the routine use of the minisphenoidal approach to manage intracranial aneurysms in a high-volume institution. METHODS: We retrospectively reviewed our database of aneurysm patients from October 2013 to May 2016...
February 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28216394/the-pconus-device-for-treatment-of-complex-wide-neck-anterior-communicating-artery-aneurysms
#5
Paul Emile Labeyrie, Benjamin Gory, Marta Aguilar-Perez, Elisa Pomero, Alessandra Biondi, Roberto Riva, Francis Turjman, Hans Henkes
BACKGROUND: and Purpose: Anterior communicating artery (AcomA) aneurysms with a wide neck are often not feasible for endovascular coiling. Emerging devices for neck protection, as the pCONus stent, are promising for endovascular treatment of challenging intracranial aneurysms. We report the preliminary results with pCONus in the treatment of wide-neck AcomA aneurysms. MATERIALS AND METHODS: All consecutive patients harboring AcomA aneurysms treated with pCONus in 3 European centers were retrospectively reviewed...
February 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28216212/-sentinel-seizure-as-a-warning-sign-preceding-fatal-rupture-of-a-giant-middle-cerebral-artery-aneurysm
#6
Lukas Andereggen, Robert H Andres
BACKGROUND: Sentinel headache is a well-known warning sign preceding subarachnoid hemorrhage (SAH) due to rupture of an intracranial aneurysm. New-onset seizure or "sentinel seizure" preceding aneurysmal SAH, however, is uncommon. CASE DESCRIPTION: We report on a 51-year-old man who presented with a new-onset seizure. Diagnostic work-up revealed a giant middle cerebral artery aneurysm without evidence of subarachnoid or intracerebral hemorrhage. Anti-epileptic therapy was initiated, elective diagnostic angiography and subsequent treatment was scheduled and the patient discharged home...
February 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28215029/an-introduction-to-the-pathophysiology-of-aneurysmal-subarachnoid-hemorrhage
#7
REVIEW
Jasper H van Lieshout, Maxine Dibué-Adjei, Jan F Cornelius, Philipp J Slotty, Toni Schneider, Tanja Restin, Hieronymus D Boogaarts, Hans-Jakob Steiger, Athanasios K Petridis, Marcel A Kamp
Pathophysiological processes following subarachnoid hemorrhage (SAH) present survivors of the initial bleeding with a high risk of morbidity and mortality during the course of the disease. As angiographic vasospasm is strongly associated with delayed cerebral ischemia (DCI) and clinical outcome, clinical trials in the last few decades focused on prevention of these angiographic spasms. Despite all efforts, no new pharmacological agents have shown to improve patient outcome. As such, it has become clear that our understanding of the pathophysiology of SAH is incomplete and we need to reevaluate our concepts on the complex pathophysiological process following SAH...
February 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28213195/blunt-traumatic-brain-injury-patients-a-role-for-ct-angiography-of-the-head-to-evaluate-non-traumatic-etiologies
#8
REVIEW
Ha Nguyen, Ninh Doan, Michael Gelsomino, Saman Shabani
BACKGROUND: In the setting of trauma, the etiology of intracranial hemorrhage (ICH) is frequently attributed to the physical, traumatic event. Caution should still be directed towards non-traumatic (or spontaneous) etiologies responsible for the trauma, such as hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformation, and hemorrhagic infarcts. The role for immediate CT angiography (CTA) remains controversial to evaluate for non-traumatic etiologies. METHODS: A systematic review of the available literature in Medline PubMed database...
February 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28207524/in-stent-stenosis-in-the-patient-with-internal-carotid-aneurysm-after-treated-by-the-willis-covered-stent-two-case-reports-and-literature-review
#9
Lun-Xin Liu, Meng-Yuan Song, Xiao-Dong Xie
: In-stent stenosis after treated by Willis covered stent-case reports. BACKGROUND: Advancements in minimally invasive technology have allowed endovascular reconstruction of internal carotid aneurysm. However, in-stent stenosis is an important and well-characterized complication of stenting after the treatment of internal carotid aneurysm. CASE DESCRIPTION: We would present 2 patients who were diagnosed with in-stent stenosis after the treatment of Willis covered stent...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28201763/the-barrow-neurological-institute-scale-revisited-predictive-capabilities-for-cerebral-infarction-and-clinical-outcome-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#10
Nora F Dengler, Dominik Diesing, Asita Sarrafzadeh, Stefan Wolf, Peter Vajkoczy
No abstract text is available yet for this article.
February 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28195428/blood-brain-barrier-breakdown-in-reversible-cerebral-vasoconstriction-syndrome-implications-for-pathophysiology-and-diagnosis
#11
Mi Ji Lee, Jihoon Cha, Hyun Ah Choi, Sook-Young Woo, Seonwoo Kim, Shuu-Jiun Wang, Chin-Sang Chung
OBJECTIVE: Diagnosis of reversible cerebral vasoconstriction syndrome (RCVS) is currently based on luminographic findings of vasoconstriction. In addition to vasoconstriction, the blood-brain barrier (BBB) breakdown has been postulated as a central mechanism of RCVS. Our aim was to document BBB breakdown in patients with RCVS and its role for the pathophysiology-based diagnosis of RCVS. METHODS: We prospectively recruited 72 consecutive patients with thunderclap headache who did not have aneurysmal subarachnoid hemorrhage from April 2015 to July 2016 at the Samsung Medical Center...
February 13, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28188419/angiographic-doughnut-shaped-aneurysm-of-intracranial-internal-carotid-artery
#12
Chung-Hsin Lee, Chih-Hsiang Liao, Wen-Hsien Chen, Hsu-Tung Lee, Yuang-Seng Tsuei
Morphologic characteristics of angiographic doughnut-shaped aneurysms of the intracranial internal carotid artery (ICA) have been rarely reported in the literature and were discussed only radiologically. In this case, surgical clipping was performed, and the specimen from the aneurysm was examined to correlate the pathologic findings and morphologic characteristics. A 59-year-old male presented with diffuse subarachnoid hemorrhage secondary to a ruptured vascular lesion originating from the intracranial portion of the right ICA...
February 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28187814/neurocardiology
#13
N D Osteraas, V H Lee
Neurocardiology refers to the interplay between the nervous system and the cardiovascular system. Stress-related cardiomyopathy exemplifies the brain-heart connection and occurs in several conditions with acute brain injury that share oversympathetic activation. The brain's influences on the heart can include elevated cardiac markers, arrhythmias, repolarization abnormalities on electrocardiogram, myocardial necrosis, and autonomic dysfunction. The neurogenic stunned myocardium in aneurysmal subarachnoid hemorrhage represents one end of the spectrum, and is associated with an explosive rise in intracranial pressure that results in excess catecholamine state and possibly CBN...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187800/management-of-aneurysmal-subarachnoid-hemorrhage
#14
N Etminan, R L Macdonald
Spontaneous subarachnoid hemorrhage (SAH) affects people with a mean age of 55 years. Although there are about 9/100 000 cases per year worldwide, the young age and high morbidity and mortality lead to loss of many years of productive life. Intracranial aneurysms account for 85% of cases. Despite this, the majority of survivors of aneurysmal SAH have cognitive deficits, mood disorders, fatigue, inability to return to work, and executive dysfunction and are often unable to return to their premorbid level of functioning...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186453/effects-of-distance-and-transport-method-on-intervention-and-mortality-in-aneurysmal-subarachnoid-hemorrhage
#15
Jonathan Weyhenmeyer, Cristian F Guandique, Adam Leibold, Stephen Lehnert, Jonathan Parish, Woody Han, Chad Tuchek, Janit Pandya, Thomas Leipzig, Troy Payner, Andrew DeNardo, John Scott, Aaron A Cohen-Gadol
OBJECTIVE Most patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) initially present to a hospital that lacks a neurosurgical unit. These patients require interhospital transfer (IHT) to tertiary facilities capable of multidisciplinary neurosurgical intervention. Yet, little is known about the effects of IHT on the outcomes of patients suffering from aSAH. In this study, the authors examined the effects of IHT and transport method on the timing of treatment, rebleed rates, and overall outcomes of patients who have experienced aSAH...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28186451/techniques-and-outcomes-of-microsurgical-management-of-ruptured-and-unruptured-fusiform-cerebral-aneurysms
#16
Sam Safavi-Abbasi, M Yashar S Kalani, Ben Frock, Hai Sun, Kaan Yagmurlu, Felix Moron, Laura A Snyder, Randy J Hlubek, Joseph M Zabramski, Peter Nakaji, Robert F Spetzler
OBJECTIVE Fusiform cerebral aneurysms represent a small portion of intracranial aneurysms; differ in natural history, anatomy, and pathology; and can be difficult to treat compared with saccular aneurysms. The purpose of this study was to examine the techniques of treatment of ruptured and unruptured fusiform intracranial aneurysms and patient outcomes. METHODS In 45 patients with fusiform aneurysms, the authors retrospectively reviewed the presentation, location, and shape of the aneurysm; the microsurgical technique; the outcome at discharge and last follow-up; and the change in the aneurysm at last angiographic follow-up...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28184353/spontaneous-regression-of-aneurysm-remnant-after-incomplete-surgical-clipping-in-a-patient-with-ruptured-cerebral-aneurysm
#17
Hyo Sub Jun, JunHyong Ahn, Joon Ho Song, In Bok Chang
Cases of spontaneous regression of cerebral aneurysm remnant after incomplete surgical clipping have been rarely reported. This paper reports the regression of an aneurysm remnant after incomplete surgical clipping during postsurgical follow-up. A 50-year-old male presented with subarachnoid hemorrhage because of rupture of an anterior communicating artery aneurysm. An emergency clipping of the aneurysm was performed. A cerebral angiography, which was performed two weeks postoperatively, revealed an aneurysm remnant...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184003/a-survey-of-intracranial-aneurysm-treatment-practices-among-united-states-physicians
#18
Kyle M Fargen, Hector E Soriano-Baron, Julia T Rushing, William Mack, J Mocco, Felipe Albuquerque, Andrew F Ducruet, Maxim Mokin, Italo Linfante, Stacey Q Wolfe, John A Wilson, Joshua A Hirsch
BACKGROUND: Recent surveys have failed to examine cerebrovascular aneurysm treatment practices among US physicians. OBJECTIVE: To survey physicians who are actively involved in the care of patients with cerebrovascular aneurysms to determine current aneurysm treatment preferences. METHODS: A 25-question SurveyMonkey online survey was designed and distributed electronically to members of the Society of NeuroInterventional Surgery, Society of Vascular and Interventional Neurology, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Combined Cerebrovascular Section...
February 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28183143/rapid-documented-growth-of-aneurysm-bleb-led-to-rupture-of-an-incidental-intracranial-anterior-communicating-artery-aneurysm
#19
Jan-Karl Burkhardt, Jorn Fierstra, Giuseppe Esposito, Gerasimos Baltsavias, Oliver Bozinov, Luca Regli
Background A major challenge in the management of patients with unruptured intracranial aneurysms (UIAs) is to identify criteria indicating a higher risk of future UIA rupture. We report a rare patient with documented short-term bleb growth of an UIA followed by a fatal aneurysm rupture supporting the high risk of rupture of short-term shape changes in UIAs. Case Description A 72-year-old man with an incidental unruptured anterior communicating artery aneurysm of 9 mm showed a bleb growth on the aneurysm sac at 6-week follow-up computed tomography angiography (CTA)...
February 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28179175/-to-operate-versus-not-to-operate-in-low-resource-settings-an-example-of-aneurysm-surgery-in-rural-iran-and-the-impact-of-mastery-of-neurosurgical-anatomy
#20
Dylan Griswold, Arnau Benet, Halima Tabani, Michael T Lawton, Ali Tayebi Meybodi
Subarachnoid hemorrhage (SAH) has a global incidence of 9/100,000. In low-resource settings, where neurosurgical capacity is diminished through fewer human and technological resources, neurosurgeons may not be prepared to operate on aneurysmal SAH. Through a case illustration of an Iranian neurosurgeon faced with a decision to operate on a patient presenting with aneurysmal SAH in a low-resource setting, we highlight the importance of mastery of neurosurgical anatomy, which was critical in achieving a favorable patient outcome...
February 4, 2017: World Neurosurgery
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