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https://www.readbyqxmd.com/read/28327595/x-linked-inhibitor-of-apoptosis-inhibits-apoptosis-and-preserves-the-blood-brain-barrier-after-experimental-subarachnoid-hemorrhage
#1
Cheng Gao, Hongwei Yu, Cong Yan, Wenyang Zhao, Yao Liu, Dongdong Zhang, Jingwei Li, Nan Liu
Early brain injury following subarachnoid hemorrhage (SAH) strongly determines the prognosis of patients suffering from an aneurysm rupture, and apoptosis is associated with early brain injury after SAH. This study was designed to explore the role of X-linked inhibitor of apoptosis (XIAP) in early brain injury following SAH. The expression of XIAP was detected using western blotting and real-time RT-PCR in an autologous blood injection model of SAH. We also studied the role of XIAP in early brain injury and detected apoptosis-related proteins...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28322077/enteral-nutrition-increases-interstitial-brain-glucose-levels-in-poor-grade-subarachnoid-hemorrhage-patients
#2
Mario Kofler, Alois J Schiefecker, Ronny Beer, Maxime Gaasch, Paul Rhomberg, John Stover, Bettina Pfausler, Claudius Thomé, Erich Schmutzhard, Raimund Helbok
Low brain tissue glucose levels after acute brain injury are associated with poor outcome. Whether enteral nutrition (EN) reliably increases cerebral glucose levels remains unclear. In this retrospective analysis of prospectively collected observational data, we investigate the effect of EN on brain metabolism in 17 poor-grade subarachnoid hemorrhage (SAH) patients undergoing cerebral microdialysis (CMD) monitoring. CMD-values were obtained hourly. A nutritional intervention was defined as the clinical routine administration of EN without supplemental parenteral nutrition...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28321414/medical-and-interventional-therapy-for-spontaneous-vertebral-artery-dissection-in-the-craniocervical-segment
#3
Guiyun Zhang, Zuoquan Chen
Background and Purpose. Spontaneous vertebral artery dissection (SVAD) is an important reason for posterior-circulation-ischemic stroke in the young and middle-aged population. Although some previous reports reveal a favorable outcome with conservative therapy, it is still controversial in the treatment of SVAD in some specific patients. Herein, we present our 10 years of clinical experience for SVAD at this location. Material and Methods. 20 patients with 20 SVADs in V2 and V3 segments were retrospectively studied...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28303209/mixed-aneurysm-a-new-proposed-nomenclature-for-a-rare-condition
#4
Cassiano U Crusius, Paulo Henrique P de Aguiar, Marcelo U Crusius
BACKGROUND: Mixed intracranial aneurysms are vascular lesions appearing in the ruptured saccular aneurysms whose blood is contained by perivascular tissues forming another cavity called pseudoaneurysm. All cases until now have been reported in the literature with subarachnoid hemorrhage. CASE DESCRIPTION: A 65-year-old woman presented with multiple brain aneurysms with no history of subarachnoid hemorrhage. Endovascular treatment was chosen for left-sided aneurysms [lateral carotid wall (LCW) and posterior communicating (PCom)]...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28303207/management-strategies-for-neoplastic-and-vascular-brain-lesions-presenting-during-pregnancy-a-series-of-29-patients
#5
Celestino Esteves Pereira, Jose Carlos Lynch
BACKGROUND: The occurrence of a brain tumor or intracranial vascular lesion during pregnancy is a rare event, but when it happens, it jeopardizes the lives of both the mother and infant. It also creates challenges of a neurosurgical, obstetric, and ethical nature. A multidisciplinary approach should be used for their care. METHODS: Between 1986 and 2015, 12 pregnant women diagnosed with brain tumors and 17 women with intracranial vascular lesion underwent treatment at the Neurosurgery Department of the Servidores do Estado Hospital and Rede D'Or/São Luis...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28302138/congenital-giant-left-atrial-appendage-aneurysm-a-case-report
#6
Yan Chen, Yun Mou, Li-Jun Jiang, Shen-Jiang Hu
BACKGROUND: Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially serious complications, including life-threatening systemic thromboembolism, atrial tachyarrhythmia, and cardiac dysfunction. Currently, early surgical intervention is generally recommended to prevent these complications. CASE PRESENTATION: We present a case of congenital giant LAAA in a female patient who successfully completed pregnancy and underwent caesarean section with no obvious complications...
March 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28298047/development-of-a-prediction-rule-for-diagnosing-postoperative-meningitis-a-cross-sectional-study
#7
Olga Helena Hernández Ortiz, Héctor Iván García García, Fabián Muñoz Ramírez, Juan Sebastián Cardona Flórez, Bladimir Alejandro Gil Valencia, Salvador Ernesto Medina Mantilla, María Juliana Moreno Ochoa, Jorge Eliécer Sará Ochoa, Fabián Jaimes
OBJECTIVE Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. METHODS A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants...
March 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28298024/reduction-of-inflammation-after-administration-of-interleukin-1-receptor-antagonist-following-aneurysmal-subarachnoid-hemorrhage-results-of-the-subcutaneous-interleukin-1ra-in-sah-scil-sah-study
#8
James Galea, Kayode Ogungbenro, Sharon Hulme, Hiren Patel, Sylvia Scarth, Margaret Hoadley, Karen Illingworth, Catherine J McMahon, Nikolaos Tzerakis, Andrew T King, Andy Vail, Stephen J Hopkins, Nancy Rothwell, Pippa Tyrrell
OBJECTIVE Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating cerebrovascular event with long-term morbidity and mortality. Patients who survive the initial bleeding are likely to suffer further early brain injury arising from a plethora of pathological processes. These may result in a worsening of outcome or death in approximately 25% of patients and may contribute to longer-term cognitive dysfunction in survivors. Inflammation, mediated by the cytokine interleukin-1 (IL-1), is an important contributor to cerebral ischemia after diverse forms of brain injury, including aSAH...
February 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28289923/tocilizumab-reverses-cerebral-vasculopathy-in-a-patient-with-homozygous-samhd1-mutation
#9
REVIEW
Michael Henrickson, Heng Wang
An auto-inflammatory syndrome consequent to SAMHD1 mutations involves cerebral vasculopathy characterized by multifocal stenosis and aneurysms within large arteries, moyamoya, chronic ischemia, and early-onset strokes (SAMS). While this condition involves the innate immune system, additional clinical features mimic systemic lupus erythematosus. Mutations in this gene can also cause a subset of the rare genetic condition Aicardi-Goutières syndrome. To date, no established therapy successfully prevents disease progression...
March 13, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28277457/advanced-mri-measures-of-cerebral-perfusion-and-their-clinical-applications
#10
Bryan Lanzman, Jeremy J Heit
Cerebral blood flow measurement by magnetic resonance imaging perfusion (MRP) techniques is broadly applied to patients with acute ischemic stroke, vasospasm following aneurysmal subarachnoid hemorrhage, chronic arterial steno-occlusive disease, cervical atherosclerotic disease, and primary brain neoplasms. MRP may be performed using an exogenous tracer, most commonly gadolinium-based intravenous contrast, or an endogenous tracer, such as arterial spin labeling (ASL) or intravoxel incoherent motion (IVIM). Here, we review the technical basis of commonly performed MRP techniques, the interpretation of MRP imaging maps, and how MRP provides valuable clinical information in the triage of patients with cerebral disease...
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28272703/the-study-of-endogenous-hepatocyte-growth-factor-in-the-pathogenesis-of-intracranial-aneurysms
#11
L-L Yu, Y-J Liu, Z-H Wang, L Shi, L-X Liu
OBJECTIVE: Inflammation as a significant influence factor plays an important role in the formation and rupture of intracranial aneurysms. However, based on plenty of related studies, it is believed that the hepatocyte growth factor (HGF) is able to prevent vascular inflammation. This paper, therefore, explored the role and mechanism of endogenous HGF in the pathogenesis of intracranial aneurysms. MATERIALS AND METHODS: 16 blood samples were collected from the intracranial aneurysms and the lumens of the femoral artery of 16 patients...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28268106/right-brachial-access-is-safe-for-branched-endovascular-aneurysm-repair-in-complex-aortic-disease
#12
Beatrice Fiorucci, Tilo Kölbel, Fiona Rohlffs, Franziska Heidemann, Sebastian Eike Debus, Nikolaos Tsilimparis
BACKGROUND: The risk of perioperative cerebrovascular events in endovascular repair of thoracic and thoracoabdominal aneurysms is reported from 2% to 15%. The unavoidable use of an upper extremity access during branched endovascular aneurysm repair (b-EVAR) may play a role in embolic brain injuries. For this reason, some advocate the use of a left-sided upper access to avoid crossing the origin of supra-aortic vessels. However, the assumption that right brachial access has a higher risk for stroke during b-EVAR has not been confirmed in the literature...
March 4, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28266007/coincidental-feeding-artery-aneurysm-presenting-during-glioblastoma-surgery-a-case-report-and-literature-review
#13
Ümit Eroğlu, Eyyub S Al-Beyati, Elçin Özçelik Eroğlu, Gökmen Kahiloğullari
The medical literature reports an association between cerebral neoplasms and aneurysm formation. Some related aneurysms are detected during preoperative screening, whereas others are detected during or after surgery. We report a case of a patient with a de novo cerebral feeding artery aneurysm that we managed during glioblastoma surgery. We present a brief review of the literature on the co-existence of brain tumours, particularly that related to high-grade glioma and aneurysms. The literature discusses several mechanisms underlying tumour formation accompanied by aneurysm formation...
February 15, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28264515/fabrication-and-optimal-design-of-biodegradable-polymeric-stents-for-aneurysms-treatments
#14
Xue Han, Xia Wu, Michael Kelly, Xiongbiao Chen
An aneurysm is a balloon-like bulge in the wall of blood vessels, occurring in major arteries of the heart and brain. Biodegradable polymeric stent-assisted coiling is expected to be the ideal treatment of wide-neck complex aneurysms. This paper presents the development of methods to fabricate and optimally design biodegradable polymeric stents for aneurysms treatment. Firstly, a dispensing-based rapid prototyping (DBRP) system was developed to fabricate coil and zigzag structures of biodegradable polymeric stents...
February 28, 2017: Journal of Functional Biomaterials
https://www.readbyqxmd.com/read/28258681/-evaluation-of-the-effectiveness-of-endovascular-embolization-for-the-treatment-of-ruptured-cerebral-aneurysms
#15
Grzegorz Turek, Andrzej Lewszuk, Jan Kochanowicz, Justyna Zielińska-Turek, Paweł Wilk, Zenon Mariak
Endovascular embolization of ruptured intracranial aneurysms is a relatively new and still developing technique, therefore its efficiency and risks should be assessed recurrently, including also results obtained in national centers. AIM: The aim of the study was to present a synthetic review of the literature, which, including the data published by the Polish centers, typify the global assessment of the effectiveness and early complication of endovascular embolization in patients with ruptured brain aneurysms...
February 20, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28254599/invasive-orbital-apex-aspergillosis-with-mycotic-aneurysm-formation-and-subarachnoid-hemorrhage-in-immunocompetent-patients
#16
Saleh S Baeesa, Mohamad Bakhaidar, Naushad A B Ahamed, Tariq A Madani
BACKGROUND: Invasive orbital apex aspergillosis (IOAA) is an aggressive form of aspergillus infection that usually affects immunocompromised patients. It can cause orbital apex syndrome and, if not treated promptly, may progress rapidly causing fatal complications. Subarachnoid hemorrhage (SAH) secondary to ruptured mycotic aneurysms is a very rare complication of invasive aspergillosis. We aim to describe our management and the outcome of six immunocompetent patients with IOAA with subsequent SAH secondary to ruptured mycotic aneurysms...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28224318/chemical-angioplasty-with-spasmolytics-for-vasospasm-after-subarachnoid-hemorrhage
#17
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
#18
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/28216398/engaging-in-a-keyhole-concept-for-the-management-of-ruptured-and-unruptured-aneurysms
#19
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/28215029/an-introduction-to-the-pathophysiology-of-aneurysmal-subarachnoid-hemorrhage
#20
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
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