DelveInsight launched a new report on Aneurysmal Subarachnoid Hemorrhage Pipeline Insight, 2020. "Aneurysmal Subarachnoid Hemorrhage Pipeline Insight, 2020" report by DelveInsight outlays comprehensive insights of present clinical development scenario and growth prospects across the Aneurysmal Subarachnoid Hemorrhage market. A detailed picture of the Aneurysmal Subarachnoid Hemorrhage pipeline landscape is provided, which includes the disease overview and Aneurysmal Subarachnoid Hemorrhage treatment guidelines. The assessment part of the report embraces in-depth Aneurysmal Subarachnoid Hemorrhage commercial assessment and clinical assessment of the Aneurysmal Subarachnoid Hemorrhage pipeline products from the pre-clinical developmental phase to the marketed phase. In the report, a detailed description of the drug is proffered including mechanism of action of the drug, clinical studies, NDA approvals (if any), and product development activities comprising the technology, Aneurysmal Subarachnoid ...
DelveInsight launched a new report on Aneurysmal Subarachnoid Hemorrhage Pipeline Insight, 2020. "Aneurysmal Subarachnoid Hemorrhage Pipeline Insight, 2020" report by DelveInsight outlays comprehensive insights of present clinical development scenario and growth prospects across the Aneurysmal Subarachnoid Hemorrhage market. A detailed picture of the Aneurysmal Subarachnoid Hemorrhage pipeline landscape is provided, which includes the disease overview and Aneurysmal Subarachnoid Hemorrhage treatment guidelines. The assessment part of the report embraces in-depth Aneurysmal Subarachnoid Hemorrhage commercial assessment and clinical assessment of the Aneurysmal Subarachnoid Hemorrhage pipeline products from the pre-clinical developmental phase to the marketed phase. In the report, a detailed description of the drug is proffered including mechanism of action of the drug, clinical studies, NDA approvals (if any), and product development activities comprising the technology, Aneurysmal Subarachnoid ...
TY - JOUR. T1 - APOE genotype and functional outcome following aneurysmal subarachnoid hemorrhage. AU - Gallek, Matthew J. AU - Conley, Yvette P.. AU - Sherwood, Paula R.. AU - Horowitz, Michael B.. AU - Kassam, Amin. AU - Alexander, Sheila A.. PY - 2009/1. Y1 - 2009/1. N2 - Apolipoprotein E (apoE), the major apolipoprotein in the central nervous system, has been shown to influence neurologic disease progression and response to neurologic injury in a gene-specific manner. Presence of the APOE4 allele is associated with poorer response to traumatic brain injury and ischemic stroke, but the association between APOE genotype and outcome following aneurysmal subarachnoid hemorrhage (SAH) remains unclear. The purpose of this project was to investigate the association between APOE genotype and outcome after SAH. We also explored the association of APOE4 genotype and cerebral vasospasm (CV) presence in a subsample of our population with available angiographic data. A sample of 206 aneurysmal SAH ...
TY - JOUR. T1 - Preconditioning effect on cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage. AU - Kim, Young Woo. AU - Zipfel, Gregory J.. AU - Ogilvy, Christopher S.. AU - Pricola, Katie L.. AU - Welch, Babu G.. AU - Shakir, Nabeel. AU - Patel, Bhuvic. AU - Reavey-Cantwell, John F.. AU - Kelman, Craig R.. AU - Albuquerque, Felipe C.. AU - Kalani, M. Yashar S. AU - Hoh, Brian L.. PY - 2014. Y1 - 2014. N2 - Background: Recent experimental evidence indicates that endogenous mechanisms against cerebral vasospasm can be induced via preconditioning. Objective: To determine whether these vascular protective mechanisms are also present in vivo in humans with aneurysmal subarachnoid hemorrhage. Methods: A multicenter retrospective cohort of patients with aneurysmal subarachnoid hemorrhage was examined for ischemic preconditioning stimulus: preexisting steno-occlusive cerebrovascular disease (CVD) and/or previous cerebral infarct. Generalized estimating equation models were performed ...
A case of spontaneous subarachnoid hemorrhage and intraventricular hemorrhage with negative computed tomography angiography findings
BACKGROUND: The pathophysiology of ischemic cerebral lesions following aneurysmal subarachnoid hemorrhage (SAH) is poorly understood. There is growing evidence that inflammatory reactions could be involved in the pathogenesis of such delayed occurring ischemic lesions. The aim of this study was to evaluate adhesion molecules with regard to these lesions following SAH. METHODS: Serum and cerebrospinal fluid (CSF) samples were taken daily from 15 patients up to day 9 after SAH and evaluated for intercellular adhesion molecule-1 (ICAM-1) and vascular adhesion molecule-1 (VCAM-1). RESULTS: CSF and serum samples correlated well during nearly the whole time course (p , 0.0001). A secondary increase in ICAM-1 and VCAM-1 in the serum and CSF correlated with an increase in flow velocity in the transcranial Doppler (p , 0.0001 and p , 0.007) but not to a delayed lesion in the CT scan. CONCLUSION: We believe that inflammatory processes are involved in the pathogenesis of cerebral vasospasm but they might ...
2. It has been found that majority of the cases are of Grade 1&2, followed by Grade 4&5, and least are contribute by Grade 3.. " According to Delveinsight, Aneurysmal Subarachnoid Hemorrhage (aSAH) is more common in females.". Aneurysmal Subarachnoid Hemorrhage (aSAH) is a serious condition that not just affects the brain, but multiple other organ systems as well. Despite a steady reduction of mortality from acute SAH in recent years, from over half to approximately one-third, this entity is still associated with considerable morbidity and mortality.. Aneurysmal subarachnoid hemorrhage (aSAH) is a worldwide health burden with high fatality and permanent disability rates. These aneurysms, located at the branching point of proximal intracranial arteries, are not uncommon and found in about 2% of the adult population (and even more frequently in those with a family history of aSAH or polycystic kidney disease).. Risk factors for aneurysm rupture include hypertension, smoking, heavy alcohol use, and ...
TY - JOUR. T1 - Diagnosis of cerebral vasospasm and risk of delayed cerebral ischemia related to aneurysmal subarachnoid haemorrhage. T2 - an overview of available tools. AU - Bacigaluppi, Susanna. AU - Zona, Gianluigi. AU - Secci, Francesca. AU - Spena, Gianantonio. AU - Mavilio, Nicola. AU - Brusa, Giulia. AU - Agid, Ronit. AU - Krings, Timo. AU - Ottonello, Gianandrea. AU - Fontanella, Marco. PY - 2015/3/4. Y1 - 2015/3/4. N2 - In the first weeks following aneurysmal subarachnoid haemorrhage, cerebrovascular alterations may impact the outcome significantly. Diagnosis of cerebral vasospasm and detection of alterations at risk of delayed cerebral ischemia are key targets to be monitored in the post-acute phase. Available tools include clinical monitoring, as well as studies that can detect possible arterial narrowing, alterations of perfusion, metabolism and neurophysiology. Each technique is able to investigate possible vascular impairment and has different advantages and limits. All available ...
There is no evidence on the best time for surgical treatment of aneurysmal subarachnoid haemorrhage. Aneurysmal subarachnoid haemorrhage is a life-threatening condition. It is due to the bursting of an aneurysm (a weakness in the wall of a blood vessel in the brain). This can be treated by a surgical operation to place a clip over the aneurysm neck. There is uncertainty about whether to perform the operation immediately, or to wait a few days. The review found only one randomised trial which assessed the effect of the timing of surgery. From the limited evidence available, the timing of surgery was not a critical factor in determining the outcome from an aneurysmal subarachnoid haemorrhage, but further research is needed.. ...
BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is a condition affecting relatively young patients and has high rates of morbidity and mortality. Online health communities have emerged to fill the void for patient advocacy and information, allowing individuals with shared experiences and chronic disorders to connect. OBJECTIVE: We have developed an online health community for aSAH patients, and this pilot study was conducted to evaluate it from a patients perspective. METHODS: We implemented an online, members-only, health community (MijnSAB, translation: MySAH) in addition to the usual aSAH care at Radboudumc, Nijmegen, the Netherlands. A questionnaire that was sent to consecutive aSAH patients was used to evaluate the usability and utility of MySAH. Answers were provided using a 5-point Likert scale. There was also one open-ended question asking about what was missing from the MySAH tool. RESULTS: In total, 66 consecutive patients with aneurysmal subarachnoid hemorrhage were informed ...
Cerebral vasospasm is a potentially incapacitating or lethal complication in patients with aneurysmal subarachnoid hemorrhage (SAH). The development of effective preventative and therapeutic interventions has been largely hindered by the fact that the underlying pathogenic mechanisms of cerebral vas …
We here presented a rare disease entity with a clinical presentation mimicking aneurysmal subarachnoid haemorrhage. A 43-year-old woman presented with a 1-week history of neck pain and dizziness. Computed tomography of brain showed communicating hydrocephalus and subarachnoid hyperintensity suspicious of previous subarachnoid haemorrhage. Investigations revealed no underlying vascular lesion and leptomeningeal biopsy showed diffuse melanocytosis. We go on to discuss the diagnostic features and clinical course of this entity ...
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Sara Mehrsefat, M.D. [2] Synonyms and Keywords: Subarachnoid haemorrhage; Traumatic subarachnoid haemorrhage , Aneurysmal subarachnoid haemorrhage; Nonaeurysmal subarachnoid hemorrhage; Perimesencephalic nonaneurysmal subarachnoid hemorrhage; Perimesencephalic subarachnoid hemorrhage ...
Coagulation and fibrinolytic studies were performed in 30 subarachnoid hemorrhage patients and 30 age-matched and sex-matched controls.. Systemic abnormalities were detected in the following tests: recalcification time, fibrinogen, partial thromboplastin time, K value of thromboelastogram and euglobulin lysis time.. The data suggest that subarachnoid hemorrhage patients with fibrinogen values over 400 mg% have a low probability of survival.. Test abnormalities probably reflect tissue damage and/or meningeal reaction to the subarachnoid hemorrhage. Similar abnormalities can be noted in patients with cerebral trauma and in some patients with nonhemorrhagic cerebrovascular disease.1. Our data reveal that subarachnoid hemorrhage patients may exhibit simultaneously evidence suggesting increased coagulability and activation of fibrinolytic mechanisms. Under these circumstances administration of agents to suppress lytic activity might lead to disastrous consequences such as widespread intervascular ...
... Cell Mol Neurobiol. 2019 Dec 05;: Authors: Khey KMW, Huard A, Mahmoud SH Abstract Aneurysmal subarachnoid hemorrhage (SAH) is an acute cerebrovascular emergency resulting from the rupture of a brain aneurysm. Despite only accounting for 5% of all strokes, SAH imposes a significant health burden on society due to its rel...
TY - JOUR. T1 - Ryanodine Receptor 1 Polymorphism Is Not Associated with Aneurysmal Subarachnoid Hemorrhage or its Clinical Sequelae. AU - Hendrix, Philipp. AU - Foreman, Paul M.. AU - Harrigan, Mark R.. AU - Fisher, Winfield S.. AU - Vyas, Nilesh A.. AU - Lipsky, Robert H.. AU - Lin, Minkuan. AU - Walters, Beverly C.. AU - Tubbs, R. Shane. AU - Mohajel Shoja, Mohammadali. AU - Pittet, Jean Francois. AU - Mathru, Mali. AU - Griessenauer, Christoph J.. PY - 2017/4/1. Y1 - 2017/4/1. N2 - Objective The pathophysiologic mechanisms underlying cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) remain poorly understand. Ryanodine receptors (RYR) are intracellular calcium channels involved in the regulation of vascular smooth muscle cells and cerebrovascular tone and diameter. Previous work reported an association between an RYR polymorphism and cerebral vasospasm. Here, we sought to assess the impact of that RYR polymorphism on aSAH and its clinical sequelae. Methods Blood samples from ...
J Mol Neurosci. DOI 10.1007/s12031 -017-0944-7. CrossMark. Proteomic Expression Changes in Large Cerebral Arteries After Experimental Subarachnoid Hemorrhage in Rat Are Regulated by the MEK-ERK1/2 Pathway. Anne H. Müller1 • Alistair V.G. Edwards2 • Martin R. Larsen2 • Janne Nielsen1 • Karin Warfvinge1,3 • Gro K. Povlsen1 • Lars Edvinsson1,3. Received: 22 February 2017 / Accepted: 28 June 2017 # The Author(s) 2017. This article is an open access publication. Abstract Subarachnoid hemorrhage (SAH) is a serious clinical condition where leakage of blood into the subarachnoid space causes an acute rise in intracranial pressure and reduces cerebral blood flow, which may lead to delayed cerebral ischemia and poor outcome. In experimental SAH, we have previously shown that the outcome can be significantly improved by early inhibition of the MAPK/ERK kinase/ extracellular signal-regulated kinase (MEK/ERK1/2) pathway. The aim of this study was to apply mass spectrometry to investigate the ...
Background If acute severe headache disappears early after its onset, the question arises whether subarachnoid hemorrhage (SAH) should still be ruled out. We studied the initial time-course and minimal duration of headache in a consecutive series of neurologically intact patients with spontaneous SAH. Methods We included patients admitted between 2012 ... read more and 2015 within 48 h after spontaneous SAH with a normal level of consciousness and no focal deficits. We retrieved data on headache severity, measured with a Numeric Rating Scale (NRS), , 48 h after ictus. We analyzed the proportion of patients with a first NRS 0 and NRS , 3 within 48 h after ictus and minimal headache duration. Patients were censored in case of a decrease in level of consciousness, aneurysm treatment, or early discharge. Results We included 106 patients (62 aneurysmal SAH, 33 perimesencephalic hemorrhage, 11 other spontaneous SAH). All patients were treated with analgesics. Within 48 h after ictus, a first NRS 0 was ...
TY - JOUR. T1 - Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies. T2 - proposal of a multidisciplinary research group.. AU - Vergouwen, Mervyn D I. AU - Vermeulen, Marinus. AU - van Gijn, Jan. AU - Rinkel, Gabriel J E. AU - Wijdicks, Eelco F.. AU - Muizelaar, J. Paul. AU - Mendelow, A. David. AU - Juvela, Seppo. AU - Yonas, Howard. AU - Terbrugge, Karel G.. AU - Macdonald, R. Loch. AU - Diringer, Michael N.. AU - Broderick, Joseph P.. AU - Dreier, Jens P.. AU - Roos, Yvo B W E M. PY - 2010/10. Y1 - 2010/10. N2 - BACKGROUND AND PURPOSE: In clinical trials and observational studies there is considerable inconsistency in the use of definitions to describe delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage. A major cause for this inconsistency is the combining of radiographic evidence of vasospasm with clinical features of cerebral ischemia, although multiple factors may contribute ...
Nearly a third of patients that have suffered a subarachnoid hemorrhage have PTSD. As such, the findings of a study published this past December by Thomas Schenk, Ph.D. of Durham Universitys Wolfson Research Institute, are of great importance. According to the studys findings, published in the journal Neurosurgery, patients with PTSD who have suffered subarachnoid hemorrhage experience greater difficulty both physically and mentally with their recovery. At three months and 13 months patients with PTSD who suffered a subarachnoid hemorrhage experienced impaired mental quality of life; at 13 months this same group was found to have a lessened physical quality of life. According to the authors of the study, "these findings suggest that the frequent occurrence of PTSD after subarachnoid hemorrhage is partly to blame for the surprisingly low quality of life found in many subarachnoid hemorrhage patients who in other respects make a good recovery." The researchers went on to say that teaching ...
Patients who present with subarachnoid hemorrhage who have not had a traumatic injury have spontaneous subarachnoid hemorrhage. This is commonly due to an abnormality of the blood vessels within the subarachnoid space that has caused them to rupture and bleed on their own. The most common vascular abnormality leading to subarachnoid hemorrhage is a cerebral aneurysm, or brain aneurysm, but other vascular conditions can also cause subarachnoid hemorrhage. When a patient comes to the hospital with subarachnoid hemorrhage, studies such as CT Angiography or Cerebral Angiography are performed to look for a brain aneurysm or malformation that may have caused the bleeding.. Aneurysmal Subarachnoid Hemorrhage is a medical emergency. It strikes roughly roughly 30,000 people annually in the United States. Many of these people are critically ill. Up to 40% of patients with subarachnoid hemorrhage from a ruptured aneurysm die, and many pass away quickly. Symptoms of SAH include sudden onset severe headache ...
The exact relationship between delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) and neuropsychological impairment remains unknown, as previous studies lacked a baseline examination after aneurysm occlusion but before the DCI-period. Neuropsychological evaluation of acutely ill patients is often applied in a busy intensive care unit (ICU), where distraction represents a bias to the obtained results.; To evaluate the relationship between DCI and neuropsychological outcome after aSAH by comparing the Montreal Cognitive Assessment (MoCA) results in aSAH patients with and without DCI at 3 mo with a baseline examination before the DCI-period (part 1). To determine the reliability of the MoCA, when applied in an ICU setting (part 2).; Prospective, multicenter, and observational study performed at all Swiss neurovascular centers. For part 1, n = 240 consecutive aSAH patients and for part 2, n = 50 patients with acute brain injury are recruited.; Part 1: Effect size of ...
TY - JOUR. T1 - Dehydroepiandrosterone sulphate. T2 - Diabolical hormone or epiphenomenon in aneurysmal subarachnoid hemorrhage?. AU - Murthy, Santosh B.. AU - Naval, Neeraj S.. PY - 2015/10/6. Y1 - 2015/10/6. N2 - Inflammation is purported to play an important role in the clinical course of subarachnoid hemorrhage. The current study by Höllig et al. entails using dehydroepiandrosterone sulfate, a hormone that inhibits key inflammatory pathways, as a predictor of functional outcome in these patients.. AB - Inflammation is purported to play an important role in the clinical course of subarachnoid hemorrhage. The current study by Höllig et al. entails using dehydroepiandrosterone sulfate, a hormone that inhibits key inflammatory pathways, as a predictor of functional outcome in these patients.. UR - http://www.scopus.com/inward/record.url?scp=84943398445&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84943398445&partnerID=8YFLogxK. U2 - 10.1186/s13054-015-1069-4. DO - ...
Background In patients with aneurysmal subarachnoid hemorrhage, elevation of the head of the bed during vasospasm has been limited in an attempt to minimize vasospasm or its sequelae or both. Consequently, some patients have remained on bed rest for weeks.. • Objectives To determine how elevations of the head of the bed of 20° and 45° affect cerebrovascular dynamics in adult patients with mild or moderate vasospasm after aneurysmal subarachnoid hemorrhage and to describe the response of mild or moderate vasospasm to head-of-bed elevations of 20° and 45° with respect to variables such as grade of subarachnoid hemorrhage and degree of vasospasm.. • Methods A within-patient repeated-measures design was used. The head of the bed was positioned in the sequence of 0°-20°-45°-0° in 20 patients with mild or moderate vasospasm between days 3 and 14 after aneurysmal subarachnoid hemorrhage. Continuous transcranial Doppler recordings were obtained for 2 to 5 minutes after allowing approximately ...
References. 1.Vermeulen M, van Gijn J (1990) The diagnosis of subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 53:365-372.. 2. Morgenstern LB, Luna-Gonzales H, Huber JC, Jr, et al. (1998) Worst headache and subarachnoid hemorrhage: prospective, modern computed tomography and spinal fluid analysis. Ann Emerg Med 32:297-304.. 3. Sidman R, Connolly E, Lemke T (1996) Subarachnoid hemorrhage diagnosis: lumbar puncture is still needed when the computed tomography scan is normal. Acad Emerg Med 3:827-831.. 4. van Gijn J, van Dongen KJ (1982) The time course of aneurysmal haemorrhage on computed tomograms. Neuroradiology 23:153-156.. 5. van Gijn J, van Dongen KJ (1980) Computed tomography in the diagnosis of subarachnoid haemorrhage and ruptured aneurysm. Clin Neurol Neurosurg 82:11-24.. 6. Vermeulen M, Hasan D, Blijenberg BG, et al. (1989) Xanthochromia after subarachnoid haemorrhage needs no revisitation. J Neurol Neurosurg Psychiatry 52:826-828.. 7. Noguchi K, Ogawa T, Inugami A, et al. (1994) ...
Hyponatraemia following aneurysmal subarachnoid haemorrhage is associated with an increased risk of cerebral infarction. Whether the development of hyponatraemia was related to enlargement of the third ventricle on the admission CT scan was investigated in a consecutive series of 133 patients who were seen within 72 hours of aneurysmal haemorrhage. Hyponatraemia occurred significantly more often in patients with enlargement of the third ventricle (with or without dilatation of the lateral ventricles) than in patients with a normal ventricular system (20/41 versus 24/92, p = 0.016). After ventricular drainage, the sodium levels returned to normal in two patients in whom the size of the third ventricle decreased and not in four patients with persistent enlargement of the third ventricle. The significant relationship between enlargement of the third ventricle and hyponatraemia remained after adjustment for the amount of cisternal blood, but not after adjustment for the amount of intraventricular ...
To identify patients with spontaneous subarachnoid hemorrhage for whom CT angiography alone can exclude ruptured aneurysms. An observational retrospective review was carried out of all consecutive patients with non-traumatic subarachnoid hemorrhage who underwent both CT angiography and catheter angiography to exclude an aneurysm. CT angiography negative cases (no aneurysm) were classified according to their CT hemorrhage pattern as aneurismal, perimesencephalic or as no-hemorrhage. Two hundred and forty-one patients were included. A CT angiography aneurysm detection sensitivity and specificity of 96.4% and 96.0% were observed. All 35 cases of perimesencephalic or no-hemorrhage out of 78 CT angiography negatives also had negative angiography findings. CT angiography is self-reliant to exclude ruptured aneurysms when either a perimesencephalic hemorrhage or no-hemorrhage pattern is identified on the CT within a week of symptom onset.
Title: Predictors of early and late vasospasm in Aneurysmal Subarachnoid Hemorrhage. Background:The peak incidence of vasospasm in aneurysmal subarachnoid hemorrhage occurs between the fourth and 10th day post bleed, occurring in up to 70% of patients.1 Occasionally patients develop early (within 48 hours) or late (beyond 10 days) from initial aneurysm rupture. Different mechanisms account for the temporal differences in occurrence of vasospasm in aneurysmal subarachnoid hemorrhage.2 The purpose of this study is to determine predictors of early and late vasospasm to select patients who may benefit from early intervention (for patients at risk for early vasospasm) or prolonged observation (for patients at risk for late vasospasm). Hypothesis:We hypothesize that we can identify clinical predictors of early and late vasospasm in aneurysmal subarachnoid hemorrhage. Methods: 226 consecutive patients with aneurysmal subarachnoid hemorrhage who developed vasospasm were studied. Patients were grouped ...
This study was a predefined subsidy of the Canadian subarachnoid hemorrhage (SAH) rule and provides data to classify the likelihood of a subarachnoid hemorrhage based on LP results. Using a threshold of 2000x106/L in the final CSF tube provides for a sensitivity of 100% (CI 74.7-100%) and specificity of 91.2% (88.6-93.3%). For xanthochromia however the sensitivity was only 46.6% (CI 22-72.6%) for diagnosing subarachnoid. Combining the RBC threshold with xanthochromia the sensitivity for subarachnoid hemorrhage is 100%[2] ...
Article abstract-Some patients with aneurysmal subarachnoid hemorrhage (SAH) never reach the hospital alive ("sudden death") and, although their numbers are significant, they are not included in most studies of SAH. To clarify the clinical profile of sudden death from aneurysmal SAH, we reviewed the epidemiology and clinicopathologic features of patients with aneurysmal SAH who never reached medical attention. Using the medical record linkage system employed for epidemiologic studies for the population of Rochester, Minnesota, we identified all patients who were diagnosed with aneurysmal SAH between 1960 and 1989. There were 80 women and 33 men with a mean age of 55 years. Of these 113 patients, 13 (12%) died without reaching medical attention. The proportion of those with sudden death remained stable during the study period. In comparing patients with sudden death with those who reached medical attention, the only significant variable was the frequency of posterior circulation aneurysms that ...
When you hear "sudden-onset, severe headache," Chris Ogilvy, MD, (former, 2013) Director of Operative Neurovascular Surgery at Massachusetts General Hospital, wants you to think "aneurysmal subarachnoid hemorrhage." Its not that these ruptures are that common-they account for only about 1% of all emergency department headaches, he says. "But if you miss it, the implications are huge.". The best chance for a good outcome following aneurysmal subarachnoid hemorrhage comes from rapid diagnosis, rapid treatment by an experienced team, and extended post-treatment follow-up. That diagnosis most often arises in the emergency department, with a patient presenting with a sudden-onset, severe headache. "Weve done a big outreach program to get physicians to think about this diagnosis," Dr. Ogilvy says. "Once you think about it, you think about doing what you need to do to diagnose it." That means first obtaining a CT scan, and if that is negative, a lumbar puncture to look for blood in the cerebrospinal ...
1. Rosamond W, Flegal K, Furie K. et al. Heart disease and stroke statistics-2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008;117:25-146 2. Lai L, Morgan MK. Incidence of subarachnoid hemorrhage: an Australian national hospital morbidity database analysis. J Clin Neurosci. 2012;19:733-739 3. Bakker AM, Dorhout Mees SM, Algra A. et al. Extent of acute hydrocephalus after aneurismal subarachnoid hemorrhage as a risk factor for delayed cerebral infarction. Stroke. 2007;38:2496-2499 4. Fatima A. Sehba, Jack Hou, Ryszard M. Pluta, et al. The importance of early brain injury after subarachnoid hemorrhage. Prog Neurobiol. 2012;97:14-37 5. Yushu Dong, Yue Li, Dayun Feng. et al. Protective effect of HIF-1α against hippocampal apoptosis and cognitive dysfunction in an experimental rat model of subarachnoid hemorrhage. Brain Res. 2013;1517:114-121 6. Doczi T, Joo F, Adam G. et al. Blood-brain barrier damage during the ...
Background: The outcomes of the grade V subarachnoid hemorrhage (SAH) patients have been dismal. Considering rapid advancement in techniques and devices in endovascular treatment (EVT), however, the outcomes of grade V SAH patients treated endovascularly may have been improved chronologically.. Methods: A single-center, retrospective study was conducted to evaluate whether the outcomes of World Federation of Neurosurgical Societies (WFNS) grade V SAH patients treated endovascularly were improved chronologically during the last 15 years (January 2000- December 2014). Coiling has been the first-line treatment for WFNS grade V SAH patients in our institution since 2000, and 115 patients who underwent EVT were trichotomized based on the admission year: 2000-04 (n=44), 2005-09 (n=37), and 2010-14 (n=34). Demographics and the outcomes were compared among the three groups. The outcomes at discharge were evaluated with the Glasgow Outcome Scale (GOS) score, and GOS 4/5 were defined as favorable ...
Subarachnoid hemorrhage is an often devastating intracranial hemorrhage resulting from acute bleeding into the subarachnoid space. Although its overall incidence is less than that of acute ischemic stroke, sub-arachnoid hemorrhage carries increased risks of both mortality and disability. Although many patients with subarachnoid hemorrhage are transferred to specialty centers, they might initially present to small community-based hospitals. Treatment for these patients is complex, requiring specialized care and knowledge, and various complications can occur quickly and without warning. Therefore, all members of the health care team who care for these patients must understand proper management. Nurses in the intensive care unit play an important role in influencing outcomes, as they are best positioned to recognize neurological decline and provide rapid intervention. This article discusses the anatomy relevant to, and the epidemiology and pathophysiology of, subarachnoid hemorrhage and provides an ...
Predictors and outcome of acute symptomatic cerebral infarctions following aneurysmal subarachnoid hemorrhage. Feng-Wen Su; Yu-Jun Lin; Wen-Neng Chang; Jih-Tsun Ho; Hung-Chen Wang; Tzu-Ming Yang; Thung-Ming Su; Wei-Che Lin; Nai-Wen Tsai; Yu-Ling Ding; Cheng-Hsien Lu // Journal of Neurology;Feb2010, Vol. 257 Issue 2, p264 The leading cause of unfavorable outcomes following aneurysmal subarachnoid hemorrhage (SAH) is cerebral infarction. In this 3-year retrospective study, we have retrospectively evaluated 172 hospitalized patients with aneurysmal SAH, and compared those who developed a complicated cerebral... ...
A sudden, severe headache - so powerful its like a thunderclap inside your head - is a classic symptom of a less common type of stroke.. Aneurysmal subarachnoid hemorrhage (aSAH) is a bleeding stroke. Survivors often describe the "thunderclap headache" as "the worst headache of my life." It occurs most […]. ...
This Phase III single blind study aims to evaluate the impact of intraventricular fibrinolysis in aneurysmal subarachnoid hemorrhage(SAH) on functional outcome
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Driesing et al reported the SDASH score for evaluating a patient after aneurysmal subarachnoid hemorrhage (aSAH). The authors are from Charite Universitatsmedizin Berlin and Universitatsklinikum Heidelberg in Germany.
The aim of this s tudy is to evalua te compu ted tomography perfusion (CT P) during admission baseline period (days 0-3) in aneurysmal subarachnoid hemorrhage (A-SAH) for developmen t of vasospasm. Re
Antifibrinolytic therapy for aneurysmal subarachnoid haemorrhage: Cochrane systematic review answers are found in the Cochrane Abstracts powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.
Complications and outcome in patients with aneurysmal subarachnoid haemorrhage: a prospective hospital based cohort study in The Netherlands ...
Kramer AH, Gurka MJ, Nathan B, Dumont AS, Kassell NF, Bleck TP. Complications associated with anemia and blood transfusion in patients with aneurysmal subarachnoid hemorrhage. Crit Care Med. 2008 Jul; 36(7):2070-5 ...
Tirilazad for aneurysmal subarachnoid haemorrhage: Cochrane systematic review answers are found in the Cochrane Abstracts powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.
TY - JOUR. T1 - Cumulative radiation dose in patients with aneurysmal subarachnoid hemorrhage. AU - Mamourian, A.. AU - OShea, M.. AU - Maidment, A. D.A.. PY - 2010/11/1. Y1 - 2010/11/1. UR - http://www.scopus.com/inward/record.url?scp=78649648606&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=78649648606&partnerID=8YFLogxK. U2 - 10.3174/ajnr.A2260. DO - 10.3174/ajnr.A2260. M3 - Letter. C2 - 20966050. AN - SCOPUS:78649648606. VL - 31. SP - E87-E88. JO - American Journal of Neuroradiology. JF - American Journal of Neuroradiology. SN - 0195-6108. IS - 10. ER - ...
Abstract Apoptosis in the endothelium of major cerebral arteries may play a role in the initiation and maintenance of cerebral vasospasm after subarachnoid hemorrhage (SAH). We tes..
TY - JOUR. T1 - Proof of concept. T2 - Endogenous antiangiogenic factors predict the occurrence of symptomatic vasospasm post subarachnoid hemorrhage. AU - Testai, Fernando D.. AU - Aiyagari, Venkatesh. AU - Hillmann, Maureen. AU - Amin-Hanjani, Sepideh. AU - Dawson, Glyn. AU - Gorelick, Philip. PY - 2011/12. Y1 - 2011/12. N2 - Background The pathogenesis of vasospasm (VS) post aneurysmal subarachnoid hemorrhage (SAH) is multifactorial and not completely understood. The authors hypothesize that circulating antiangiogenic factors play an important role in brain injury post SAH and that elevated levels predict the occurrence of symptomatic vasospasm. Methods In this study the authors measured the serum and cerebrospinal fluid (CSF) levels of soluble endoglin (sEng) and soluble fms-like tyrosine kinase 1 (sFlt1) in controls and SAH patients within 48 h of the bleed. Patients were prospectively followed and subcategorized into those with (sVS) and without symptomatic vasospasm (no-sVS). Results ...
Tom Bleck - Subarachnoid haemorrhage: what matters?. Tom Bleck gives an overview of the pertinent facts regarding the complications and management of aneurysmal subarachnoid haemorrhage (SAH).. The complications of aneurysmal SAH can be divided into immediate, early and late. The risk of re-bleeding is maximal on the first day, it is fatal in 75% of patients and the best management is to secure the aneurysm by coiling or clipping. Blood pressure control is utilised widely but parameters are arbitrary and the data is scarce.. Early complications (days 1 - 3) include early brain injury in its various forms, stress cardiomyopathy, neurogenic pulmonary oedema and cerebral salt wasting. The most important late complication (day 4 onwards) is vasospasm.. Tom briefly discusses the mechanisms and manifestations of SAH-associated brain injury including ischaemia, blood brain barrier breakdown, sustained depolarisation, hydrocephalus, vasospasm, seizures, hyperglycaemia and fever. He goes on to discuss in ...
TY - JOUR. T1 - CT evaluation of lateral ventricular dilatation after subarachnoid hemorrhage. T2 - Baseline bicaudate index balues. AU - Dupont, Stefan. AU - Rabinstein, Alejandro. PY - 2013/1/1. Y1 - 2013/1/1. N2 - Objectives: To define baseline bicaudate index (BCI) values in patients with subarachnoid hemorrhage (SAH). Methods: We reviewed the clinical and radiological information on consecutive adult patients admitted with acute SAH to our hospital between 1 January 2002 and 1 January 2008. Patients without diagnosis of acute hydrocephalus were entered into this study. Age-stratified BCI values were calculated. Results: Our study cohort comprised 108 patients (66 women, 61%). The clinical status at presentation was excellent with a median score of 1 on the World Federation of Neurological Surgeons Scale. Cisternal blood burden was mild to moderate with a median Hijdra score of 17 (out of 30). The upper limits of normal (ninety-fifth percentile) for BCI were 0.12 at age 45 years and under, ...
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