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https://www.readbyqxmd.com/read/29309289/anesthesia-for-same-day-discharge-after-craniotomy-review-of-a-single-center-experience
#1
Veena Sheshadri, Lashmi Venkatraghavan, Pirjo Manninen, Mark Bernstein
Same day discharge or outpatient surgery for intracranial procedures has become possible with the advent of image-guided minimally invasive approaches to surgery and availability of short-acting anesthetic agents. In addition, patient satisfaction and the benefits of avoiding hospital stay have resulted in the evolution of neurosurgical day surgery. We reviewed our experience and the available literature to determine the perioperative factors involved which have promoted and will improve this concept in the future...
January 5, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29307022/fluorescein-videoangiography-during-extracranial-to-intracranial-bypass-surgery-preliminary-results
#2
Alessandro Narducci, Julia Onken, Marcus Czabanka, Nils Hecht, Peter Vajkoczy
BACKGROUND: Over the last years, intraoperative use of fluorescein is gaining ground in the field of neurosurgery, due to development of a microscope-integrated YELLOW 560 module, with reported experiences in brain malignancies, aneurysms, and arteriovenous malformation surgery. The aim of this study is to determine the feasibility and value of fluorescein videoangiography during bypass procedures. METHODS: The authors enrolled 11 patients who underwent extracranial-to-intracranial bypass for moyamoya disease, atherosclerotic steno-occlusive cerebrovascular disease, and flow replacement during a giant middle cerebral artery (MCA) aneurysm treatment...
January 6, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29301971/intracranial-aneurysm-associated-single-nucleotide-polymorphisms-alter-regulatory-dna-in-the-human-circle-of-willis
#3
Melanie D Laarman, Marit W Vermunt, Rachel Kleinloog, Jelkje J de Boer-Bergsma, Netherlands Brain Bank, Gabriël J E Rinkel, Menno P Creyghton, Michal Mokry, Jeroen Bakkers, Ynte M Ruigrok
BACKGROUND AND PURPOSE: Genome-wide association studies significantly link intracranial aneurysm (IA) to single-nucleotide polymorphisms (SNPs) in 6 genomic loci. To gain insight into the relevance of these IA-associated SNPs, we aimed to identify regulatory regions and analyze overall gene expression in the human circle of Willis (CoW), on which these aneurysms develop. METHODS: We performed chromatin immunoprecipitation and sequencing for histone modifications H3K4me1 and H3K27ac to identify regulatory regions, including distal enhancers and active promoters, in postmortem specimens of the human CoW...
January 4, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29299821/brain-protection-in-aortic-arch-aneurysm-antegrade-or-retrograde
#4
Amer Harky, Matthew Fok, Mohamad Bashir, Anthony L Estrera
During open aortic arch repair, there is an interruption of cerebral perfusion and to prevent neurological sequelae, the hypothermic circulatory arrest has been established to provide sufficient brain protection coupled with adjuncts including retrograde and antegrade cerebral perfusion. To date, brain protection during open aortic arch repair is a contested topic as to which provides superior brain protection with little evidence existing to suggest supremacy of one modality over the other. This article reviews current literature reflecting on key and emerging studies in brain protection and their associated outcomes in patients undergoing open aortic arch surgery...
January 3, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29296615/minocycline-protects-against-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage-via-matrix-metalloproteinase-9-inhibition
#5
Ananth K Vellimana, Meng-Liang Zhou, Itender Singh, Diane J Aum, James W Nelson, Glenn R Harris, Umeshkumar Athiraman, Byung H Han, Gregory J Zipfel
Objective: Delayed cerebral ischemia (DCI) is an independent risk factor for poor outcome after aneurysmal subarachnoid hemorrhage (SAH) and is multifactorial in etiology. While prior studies have suggested a role for matrix metalloproteinase-9 (MMP-9) in early brain injury after SAH, its contribution to the pathophysiology of DCI is unclear. Methods: In the first experiment, wild-type (WT) and MMP-9-/- mice were subjected to sham or endovascular perforation SAH surgery...
December 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29288107/memory-deficits-after-aneurysmal-subarachnoid-hemorrhage-an-fmri-study
#6
Jiabin Su, Tongzhou E, Qihao Guo, Yu Lei, Yuxiang Gu
BACKGROUND: Patients suffer from aneurysmal subarachnoid hemorrhage (aSAH) are thought to have cognitive impairment. However, little is known about characteristics of functional imaging in aSAH patients OBJECTIVE: To explore the whole brain activity pattern in aSAH patients using amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC). METHOD: 50 aSAH patients and 30 healthy controls were recruited and subjected to a resting-state functional magnetic resonance imaging scan and cognitive tasks...
December 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29285410/the-clinical-examination-in-the-patient-with-subarachnoid-hemorrhage-is-still-the-most-reliable-parameter-for-predicting-pathophysiological-changes
#7
Athanasios K Petridis, Kerim Beseoglu, Hans J Steiger
Background: Macrovasospasms and delayed cerebral injury are factors which correlate with high morbidity in patients suffering a subarachnoid hemorrhage. Transcranial Doppler (TCD) ultrasonography and perfusion computed tomography (PCT) are diagnostic tools used to diagnose such pathologies. However, TCD is not very reliable and PCT exposes patients to radiation and cannot be performed daily. Case Description: We present the case of a 47-year-old female with subarachnoid hemorrhage caused by rupture of an intracranial aneurysm...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29282438/management-of-unruptured-traumatic-middle-meningeal-artery-pseudoaneurysms-through-onyx-embolization
#8
Nicolas K Khattar, Andrew C White, Enzo M Fortuny, Rob T Hruska, Robert F James
Traumatic pseudoaneurysms of the middle meningeal artery (MMA) represent less than 1% of all intracranial aneurysms, and occur mostly in association with temporal bone fractures following head trauma. Given the unknown natural history, it is unclear whether they should be treated. We present two cases of MMA pseudoaneurysms discovered during trauma workups. The first patient is a 44-year-old male with severe traumatic brain injury (TBI) following a motor vehicle accident. The patient was found to have two right-sided middle meningeal artery pseudoaneurysms that were treated successfully with Onyx® (Medtronic, Minneapolis, MN) embolization...
October 23, 2017: Curēus
https://www.readbyqxmd.com/read/29277532/levels-of-il-1%C3%AE-il-18-and-tnf-%C3%AE-in-cerebrospinal-fluid-of-aneurysmal-subarachnoid-hemorrhage-patients-may-be-predictors-of-early-brain-injury-and-clinical-prognosis
#9
Sheng-Yin Lv, Qi Wu, Jing-Peng Liu, Jiang Shao, Li-Li Wen, Jin Xue, Xiang-Sheng Zhang, Qing-Rong Zhang, Xin Zhang
BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is a severe cerebrovascular accident with high morbidity and mortality. The aim of this study is to investigate the relationship between level of inflammatory cytokines in cerebrospinal fluid of aSAH patients, the severity of aSAH and the outcome of aSAH patients. METHODS: aSAH patients were prospectively included and followed-up 6 months. CSF samples were collected at 1-3 days, 4-6 days and 7-9 days after aSAH onset, respectively...
December 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29260015/evolution-into-moyamoya-disease-in-an-infant-with-internal-carotid-artery-aneurysms
#10
Ryosuke Tanaka, Satoru Takahashi, Satomi Okano, Akie Okayama, Nao Suzuki, Shigeo Kure, Hiroshi Azuma
Introduction: Moyamoya disease (MMD) is characterized by progressive stenosis and occlusion in the terminal portion of both internal carotid arteries (ICAs) and the formation of an abnormal vascular network. Because of the fragile structure of the collateral vessels, MMD is frequently accompanied by intracranial aneurysms that are mainly located within the abnormal basal network or the circle of Willis. However, the association between MMD and aneurysms of the ICAs has never been reported previously...
March 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/29260012/time-courses-of-plasma-il-6-and-hmgb-1-reflect-initial-severity-of-clinical-presentation-but-do-not-predict-poor-neurologic-outcome-following-subarachnoid-hemorrhage
#11
Heikki Kiiski, Jaakko Långsjö, Jyrki Tenhunen, Marika Ala-Peijari, Heini Huhtala, Mari Hämäläinen, Eeva Moilanen, Juha Öhman, Jukka Peltola
Objective: Patients with aneurysmal subarachnoid hemorrhage (aSAH) experience high mortality and morbidity. Neuroinflammation causes brain damage expansion after aSAH. Due to the complexity of the inflammatory response multiple biomarkers are needed to evaluate its' progression. We studied inflammatory process after aSAH by measuring two inflammatory biomarkers, interleukin-6 (IL-6) and high-mobility group box 1 (HMGB1) at simultaneous time-points after aSAH. Methods: In this prospective population-based study, IL-6 and HMGB1 were measured in aSAH patients (n = 47) for up to five days...
March 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/29231793/acute-rerupture-after-coil-embolization-of-ruptured-intracranial-saccular-aneurysms-a-literature-review
#12
Kailing Li, Yunbao Guo, Ying Zhao, Baofeng Xu, Kan Xu, Jinlu Yu
Acute rerupture after coil embolization is defined as rerupture within three days after treatment; its prognosis is worse than that of rebleeding at other time periods. However, to date, little is known about complications during the acute phase. Therefore, we used the PubMed database to perform a review of acute rerupture after coil embolization of ruptured intracranial saccular aneurysms and increase our understanding. After reviewing the complications, we found that the cause of acute rerupture is unclear, but the following risk factors are involved: incomplete occlusion of the initial aneurysm, the presence of a hematoma adjacent to a ruptured aneurysm, an aneurysmal outpouching, poor Hunt-Hess grade at the time of treatment, and the location of the aneurysm in an anterior communicating artery...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29224114/coated-platelet-trends-predict-short-term-clinical-outcomeafter-subarachnoid-hemorrhage
#13
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/29213291/apolipoprotein-e-polymorphism-and-the-risk-of-aneurysmal-subarachnoid-hemorrhage-in-a-south-indian-population
#14
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
#15
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/29209882/hemodynamics-of-focal-versus-global-growth-of-small-cerebral-aneurysms
#16
Paolo Machi, Rafik Ouared, Olivier Brina, Pierre Bouillot, Hasan Yilmaz, Maria I Vargas, Renato Gondar, Philippe Bijlenga, Karl O Lovblad, Zsolt Kulcsár
BACKGROUND AND PURPOSE: Hemodynamics play a driving role in the life cycle of brain aneurysms from initiation through growth until eventual rupture. The specific factors behind aneurysm growth, especially in small aneurysms, are not well elucidated. The goal of this study was to differentiate focal versus general growth and to analyze the hemodynamic microenvironment at the sites of enlargement in small cerebral aneurysms. MATERIALS AND METHODS: Small aneurysms showing growth during follow-up were identified from our prospective aneurysm database...
December 5, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29209856/accelerated-whole-brain-intracranial-vessel-wall-imaging-using-black-blood-fast-spin-echo-with-compressed-sensing-cs-space
#17
Chengcheng Zhu, Bing Tian, Luguang Chen, Laura Eisenmenger, Esther Raithel, Christoph Forman, Sinyeob Ahn, Gerhard Laub, Qi Liu, Jianping Lu, Jing Liu, Christopher Hess, David Saloner
OBJECTIVE: Develop and optimize an accelerated, high-resolution (0.5 mm isotropic) 3D black blood MRI technique to reduce scan time for whole-brain intracranial vessel wall imaging. MATERIALS AND METHODS: A 3D accelerated T1-weighted fast-spin-echo prototype sequence using compressed sensing (CS-SPACE) was developed at 3T. Both the acquisition [echo train length (ETL), under-sampling factor] and reconstruction parameters (regularization parameter, number of iterations) were first optimized in 5 healthy volunteers...
December 5, 2017: Magma
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#18
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29192858/head-up-display-may-facilitate-safe-keyhole-surgery-for-cerebral-aneurysm-clipping
#19
Terushige Toyooka, Naoki Otani, Kojiro Wada, Arata Tomiyama, Satoru Takeuchi, Kazuya Fujii, Kosuke Kumagai, Takashi Fujii, Kentaro Mori
OBJECTIVE The head-up display (HUD) is a modern technology that projects images or numeric information directly into the observer's sight line. Surgeons will no longer need to look away from the surgical view using the HUD system to confirm the preoperative or navigation image. The present study investigated the usefulness of the HUD system for performing cerebral aneurysm clipping surgeries. METHODS Thirty-five patients underwent clipping surgery, including 20 keyhole surgeries for unruptured cerebral aneurysm, using the HUD system...
December 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29191646/-thrombotic-and-haemorrhagic-complications-in-patients-with-cerebral-aneurysms-treated-by-endovascular-approach-and-their-association-with-the-use-of-antiplatelet-agents-descriptive-evaluation
#20
Juan Carlos Puentes, Silvia Tatiana Quintero, Luís Felipe Uriza, Maria Alejandra Rueda, Adriana Piedrahita, Victor Contreras
OBJECTIVE: The protocol for optimal antiplatelet therapy to prevent thrombotic complications following brain aneurysm embolisation is not clear. Our objective is to describe the characteristics of patients presenting with thrombotic or haemorrhagic complications secondary to endovascular treatment. METHODS: A cross sectional descriptive study was performed, which included all patients that required endovascular treatment for brain aneurysm at San Ignacio University Hospital from November 2007 to January 2016...
November 27, 2017: Neurocirugía
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