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Aneurysmal subarachnoid hemorrhage

Xin Feng, Zenghui Qian, Baorui Zhang, Erkang Guo, Luyao Wang, Peng Liu, Xiaolong Wen, Wenjuan Xu, Chuhan Jiang, Youxiang Li, Zhongxue Wu, Aihua Liu
Background and purpose: We aimed to investigate the effect of smoking on the risk of intracranial aneurysm (IA) rupture (IAR), specifically relationship between the number of cigarettes smoked per day (CPD) or smoking index and the risk of IAR. Methods: We performed a single-center case-control study of consecutive patients evaluated or treated for IA at our institution from June 2015 to July 2016. Cases were patients with a ruptured IA. Two age- and sex-matched controls with an unruptured IA were included per case...
2018: Frontiers in Neurology
Spiros L Blackburn, Peeyush T Kumar, Devin McBride, Hussein A Zeineddine, Jenna Leclerc, H Alex Choi, Pramod K Dash, James Grotta, Jaroslaw Aronowski, Jessica C Cardenas, Sylvain Doré
Survivors of cerebral aneurysm rupture are at risk for significant morbidity and neurological deficits. Much of this is related to the effects of blood in the subarachnoid space which induces an inflammatory cascade with numerous downstream consequences. Recent clinical trials have not been able to reduce the toxic effects of free hemoglobin or improve clinical outcome. One reason for this may be the inability to identify patients at high risk for neurologic decline. Recently, haptoglobin genotype has been identified as a pertinent factor in diabetes, sickle cell, and cardiovascular disease, with the Hp 2-2 genotype contributing to increased complications...
2018: Frontiers in Physiology
Alberto Di Somma, Paloma Cancela, Magdalena Olivares, Teresa Somma, Antonio López-González, Alvaro Campero, Juan Emmerich, Javier Márquez-Rivas
BACKGROUND: and importance: Lesions located lateral to the lower brainstem, such as proximal posterior inferior cerebellar artery (PICA) aneurysms, are surgically challenging. In this study we report a case of a patient with a left proximal PICA aneurysm that was successfully clipped via a so-called "extended" suboccipital subtonsillar approach, which allowed to obtain proper vascular control without removal of the atlas. The anatomy relevant for this approach has been studied...
June 11, 2018: World Neurosurgery
Bong Jun Kim, Youngmi Kim, Sung-Eun Kim, Jin Pyeong Jeon
OBJECTIVE: Haptoglobin (Hp) comprising two light (α) and two heavy (β) chains has an anti-oxidant effect following free hemoglobin binding. Among three phenotypes including Hp1-1 (two α1), Hp2-1 (α1 and α2), and Hp2-2 (two α2), a higher protective effect for toxic-free hemoglobin was reported for Hp2-2 than Hp1-1. However, few studies have focused on Hp2-1 in outcome. This study examined the α1 and α2 expression, and evaluated the correlation of Hp2-1 with subarachnoid hemorrhage (SAH) outcome...
June 11, 2018: World Neurosurgery
Aran Yoo, Jonathan Jou, Jeffrey D Klopfenstein, Jorge C Kattah
Background: Infratentorial siderosis (iSS) is a progressive degenerative disorder targeting primarily the cerebellum and cranial nerve eighth; therefore, progressive ataxia and its neuro-otological findings are common. Toxicity from hemosiderin involves selectively vulnerable neurons and glia in these posterior fossa structures. Other neurologic findings may be present, though our focus relates to the cochlea-vestibular cerebellar involvement. Radiographic evidence of siderosis may be the result of recurrent, albeit covert bleeding in the subarachnoid space, or the consequence of an overt post-traumatic or aneurysmal subarachnoid hemorrhage (SAH)...
2018: Frontiers in Neurology
Andreas Jödicke, Karsten Bauer, Andrea Hajdukova
BACKGROUND:  Discharge to rehabilitation is reported in large studies as one important outcome parameter based on hospital codes. Because neurologic outcome scores (e.g., the modified Rankin Scale [mRS]) are missing in International Classification of Diseases (ICD) databases, rehabilitation indirectly serves as a kind of surrogate parameter for overall outcome. Reported fractions of patients with rehabilitation, however, largely differ between studies and seem high for patients with aneurysm clipping...
June 11, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Tasneem F Hasan, Walter Duarte, Oluwaseun O Akinduro, Eric D Goldstein, Rebecca Hurst, Neil Haranhalli, David A Miller, Robert E Wharen, Rabih G Tawk, William D Freeman
BACKGROUND: Acute aneurysmal subarachnoid hemorrhage (SAH) is a medical and neurosurgical emergency from ruptured brain aneurysm. Aneurysmal SAH is identified on brain computed tomography (CT) as increased density of basal cisterns and subarachnoid spaces from acute blood products. Aneurysmal SAH-like pattern on CT appears as an optical illusion effect of hypodense brain parenchyma and/or hyperdense surrounding cerebral cisterns and blood vessels termed as "pseudo-subarachnoid hemorrhage" (pseudo-SAH)...
June 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Hubert Lee, Jeffrey J Perry, Shane W English, Fahad Alkherayf, Joanne Joseph, Steven Nobile, Linghong Linda Zhou, Howard Lesiuk, Richard Moulton, Charles Agbi, John Sinclair, Dar Dowlatshahi
OBJECTIVE The aim of this study was to derive a clinically applicable decision rule using clinical, radiological, and laboratory data to predict the development of delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH) patients. METHODS Patients presenting over a consecutive 9-year period with subarachnoid hemorrhage (SAH) and at least 1 angiographically evident aneurysm were included. Variables significantly associated with DCI in univariate analysis underwent multivariable logistic regression...
June 8, 2018: Journal of Neurosurgery
Ian A Anderson, Ahilan Kailaya-Vasan, Richard J Nelson, Christos M Tolias
OBJECTIVE Most intracranial aneurysms are now treated by endovascular rather than by microsurgical procedures. There is evidence to demonstrate superior outcomes for patients with aneurysmal subarachnoid hemorrhage (aSAH) treated by endovascular techniques. However, some cases continue to require microsurgery. The authors have examined the relationship between the number of aneurysms treated by microsurgery and outcome for patients undergoing treatment for aSAH at neurosurgical centers in England. METHODS The Neurosurgical National Audit Programme (NNAP) database was used to identify aSAH cases and to provide associated 30-day mortality rates for each of the 24 neurosurgical centers in England...
June 8, 2018: Journal of Neurosurgery
Martin Söderholm, Gunilla Nordin Fredrikson, Jan Nilsson, Gunnar Engström
BACKGROUND AND PURPOSE: Increased degradation of the extracellular matrix in the arterial wall by matrix metalloproteinases (MMPs) may be an important mechanism in the pathogenesis of intracranial aneurysms and subarachnoid hemorrhage (SAH). MMP-2 and MMP-9 have been suggested to be involved in matrix degradation preceding SAH. We studied serum levels of MMP-1, -2, -3, -7, -9, -10, and -12 and the risk of incident SAH. METHODS: A nested case-control study within the population-based cohort, Malmö Diet and Cancer study, was performed including incident cases of spontaneous SAH (n=79) and controls matched by age, sex, and follow-up time (n=232)...
June 7, 2018: Stroke; a Journal of Cerebral Circulation
Ethan A Winkler, W Caleb Rutledge, Adib A Abla
No abstract text is available yet for this article.
June 7, 2018: Neurosurgery
Shigeki Takeda, Kiyoshi Onda, Yuichi Yoshida
Neuropathological examinations of the brain in cases of brain death are usually insufficient because of autolysis. We examined a case of sporadic-type cerebral amyloid angiopathy-related hemorrhage (sCAA-H) in a 74-year-old Japanese woman who had been clinically established as brain dead 7 days before cardiac arrest. The brain was macerated, and a huge hematoma was evident in the right parieto-occipital region. Ordinary neuropathological examination was unable to clarify where the hematoma was located in the brain parenchyma or the subarachnoid space (SAS)...
June 6, 2018: Neuropathology: Official Journal of the Japanese Society of Neuropathology
Chien-Hui Lee, Sheng-Tzung Tsai, Tsung-Lang Chiu
Objectives: Direct microsurgical clipping for complex middle cerebral artery (MCA) aneurysms may require a long ischemic time. Sacrifice of the parent artery with trapping or endovascular coiling also may lead to ischemic stroke. We described our institutional experience with the treatment of complex MCA aneurysms using extracranial-intracranial (EC-IC) (superficial temporal artery [STA]-MCA) bypass. Materials and Methods: We retrospectively reviewed patients who had treatment of IC aneurysms with the assistance of STA-MCA bypass from July 2002 to December 2016...
April 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
Young Deok Kim, Jae Seung Bang, Si Un Lee, Won Joo Jeong, O-Ki Kwon, Seung Pil Ban, Tac Keun Kim, Seung Bin Kim, Chang Wan Oh
BACKGROUND: The long-term outcomes of endovascular coiling and surgical clipping for the treatment of unruptured intracranial aneurysms are unclear. METHODS: We performed a nationwide retrospective cohort study using claims data from the Korean Health Insurance Review and Assessment Service on patients undergoing surgical clipping or endovascular coiling from 2008 to 2014. Inverse probability treatment weighting for average treatment effect on the treated and the multiple imputation method were used to balance covariates and handle missing values...
June 6, 2018: Journal of Neurointerventional Surgery
Shannon K Burns, Kacie J Brewer, Courtney Jenkins, Sally Miller
Aneurysmal subarachnoid hemorrhage is potentially fatal and is associated with poor outcomes in many patients. Advances in neurosurgical and medical management of ruptured aneurysms have improved mortality rates in patients with aneurysmal subarachnoid hemorrhage. Surgical and endovascular interventions, such as external ventricular drain placement, aneurysm clipping, and endovascular coiling, have been developed over the past few decades. Patients with aneurysmal subarachnoid hemorrhage are also at risk for cerebral vasospasm and delayed cerebral ischemia...
2018: AACN Advanced Critical Care
Spiros L Blackburn, Christa B Swisher, Andrew W Grande, Alba Rubi, Laura Zitella Verbick, Aaron McCabe, Shivanand P Lad
BACKGROUND AND IMPORTANCE: The amount of subarachnoid blood and the presence of toxic blood breakdown products in the cerebrospinal fluid (CSF) have long been associated with poor outcomes in aneurysmal subarachnoid hemorrhage. The Neurapheresis™ system (Minnetronix Inc, St. Paul, Minnesota) has been developed to filter CSF and remove blood products, and is being investigated for safety and feasibility in the ExtracorPoreal FILtration of subarachnoid hemorrhage via SpinaL CAtheteR (PILLAR) study...
June 5, 2018: Operative Neurosurgery (Hagerstown, Md.)
Hyun Ho Choi, Young Dae Cho, Dong Hyun Yoo, Sang Jun Ahn, Won-Sang Cho, Hyun-Seung Kang, Jeong Eun Kim, Jeong Jun Lee, Jong Hyun Moon, Moon Hee Han
INTRODUCTION: Stent-assisted coil (SAC) embolization is an alternative treatment option for anterior communicating artery (AcoA) aneurysms. This study was undertaken to assess the safety and effectiveness of SAC embolization in treating AcoA aneurysms and to determine risk factors for related procedural complications or recanalization. METHODS: Between August 2008 and December 2016, 184 patients with AcoA aneurysms were treated with SAC embolization. Cumulative medical record and radiologic data were analyzed using binary logistic regression to identify factors predisposing to procedural complications or recanalization...
June 5, 2018: Journal of Neurointerventional Surgery
Nathalie Nasr, Rita Gaio, Marek Czosnyka, Karol Budohoski, Xiuyun Liu, Joseph Donnelly, Marek Sykora, Peter Kirkpatrick, Anne Pavy-Le Traon, Christina Haubrich, Vincent Larrue, Peter Smielewski
BACKGROUND AND PURPOSE: Aneurysmal subarachnoid hemorrhage (SAH) is characterized by important changes in the autonomic nervous system with potentially adverse consequences. The baroreflex has a key role in regulating the autonomic nervous system. Its role in SAH outcome is not known. The purpose of this study was to evaluate the association between the baroreflex and the functional 3-month outcome in SAH. METHODS: The study used a prospective database of 101 patients hospitalized for SAH...
June 4, 2018: Stroke; a Journal of Cerebral Circulation
Wouter J Harmsen, Gerard M Ribbers, Majanka H Heijenbrok-Kal, Ladbon Khajeh, Emiel Sneekes, Fop van Kooten, Sebastian J C M M Neggers, Rita J van den Berg-Emons
To investigate whether low physical fitness and inactive and sedentary lifestyles play a role in the severity of fatigue in patients with aneurysmal subarachnoid hemorrhage (a-SAH). DESIGN: Prospective one-year follow-up study, including a total of 52 patients with a-SAH. Outcome measures included the Fatigue Severity Scale -score, peak oxygen uptake (V[Combining Dot Above]O2peak), isokinetic knee muscle strength (peak torque), physical activity (%24h period) and sedentary behavior (% waking hours), and were evaluated at six and twelve months post onset...
May 31, 2018: American Journal of Physical Medicine & Rehabilitation
Sarah S Pickard, Kimberlee Gauvreau, Michelle Gurvitz, Joshua J Gagne, Alexander R Opotowsky, Kathy J Jenkins, Ashwin Prakash
BACKGROUND: Adults with repaired coarctation of the aorta (CoA) have reduced long-term survival compared with the general population. This study aimed to determine whether CoA is independently associated with premature ischemic and hemorrhagic stroke in the contemporary era. METHODS AND RESULTS: This was a cross-sectional study utilizing the National Inpatient Sample database from 2005 to 2014. We hypothesized that patients with CoA are hospitalized with ischemic and hemorrhagic stroke at a younger age compared with the general population...
June 1, 2018: Journal of the American Heart Association
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