The authors investigated the roles of endothelin (ET)-1 and the ETA receptor in the pathogenesis of delayed cerebral vasospasm following subarachnoid hemorrhage (SAH). A study was made of the preventive effect of a novel ETA receptor antagonist, BQ-123, on vasospasm and the expression of the ETA receptor messenger ribonucleic acid (mRNA) using a canine two-hemorrhage SAH model. Continuous intrathecal administration of BQ-123 (5 x 10(-6) mol/day) prevented narrowing of the basilar artery on Day 7 after SAH in 97.6% of cases in the study group versus 70.7% of cases in the control group (p | 0.05). While expression of the mRNA-coding ETA receptor was not detected in the control animals, it markedly increased on Day 3 after SAH and was also detected on Day 7. The results suggest that endothelin-1 and the ETA receptor participate in the pathogenesis of delayed cerebral vasospasm following SAH.
Although cerebral vasospasm in SAH patients is a major cause of morbidity and mortality, the precise mechanisms for the delayed cerebral vasospasm remain unclear. Cerebral vasospasm after SAH was attenuated not only by local administration of superoxide dismutase18,19⇓⇓ but also by overexpression of Cu/Zn-superoxide dismutase in the transgenic mice,20 suggesting the pivotal role of oxygen radicals in the development of cerebral vasospasm. In the present experiment, we demonstrated that the time course of the development of vasospasm in the rat 2-hemorrhage model was similar to that of vasospasm after a SAH in the clinical situation. Minimal narrowing was present by 1 to 2 days and had progressively increased by 5 days after the second injection of autologous blood into cisterna magna. The delayed cerebral vasospasm in SAH rats was significantly attenuated by pretreatment with DPI, an NAD(P)H oxidase inhibitor. Considering other reports with our results, NAD(P)H-derived superoxide might be ...
INTRODUCTION: Cerebral vasospasm is the leading cause of morbidity and mortality in patients with aneurysmal subarachnoid haemorrhage (SAH) surviving the initial ictus. Commonly used techniques for vasospasm assessment are digital subtraction angiography and transcranial Doppler sonography. These techniques can reliably identify only the major vessel spasm and fail to estimate its haemodynamic significance. To overcome these issues and to enable comprehensive non-invasive assessment of vasospasm inside the interventional suite, a novel protocol involving measurement of parenchymal blood volume (PBV) using C-arm flat detector computed tomography (FDCT) was implemented. MATERIALS AND METHODS: Patients from the neuro-intensive treatment unit (ITU) with suspected vasospasm following aneurysmal SAH were scanned with a biplane C-arm angiography system using an intravenous contrast injection protocol. The PBV maps were generated using prototype software. Contemporaneous clinically indicated MR scan including
Diffuse cerebral vasospasm is a rare complication following tumour resection. This phenomenon seems to be even rarer in the paediatric population and more so following resections of posterior fossa tumours. Here we report diffuse cerebral vasospasm in a child with hypoglossal nerve Schwannoma eight days following resection of the tumour.
The occurrence of vasospasm can be reduced by preventing the occurrence of atherosclerosis. This can be done in several ways, the most important being lifestyle modifications-decreasing low-density lipoprotein (LDL), quitting smoking, physical activity, and control for other risk factors including diabetes, obesity, and hypertension. Pharmacological therapies include hypolipidemic agents, thrombolytics and anticoagulants. Pharmacological options for reducing the severity and occurrence of ischemic episodes include the organic nitrates classified as having long acting (i.e. isosorbide dinitrate) and short acting (i.e. nitroglycerin) durations of action. These drugs work by increasing nitric oxide levels in the blood and inducing coronary vasodilation which will allow for more coronary blood flow due to a decreased coronary resistance, allowing for increased oxygen supply to the vital organs (myocardium). The nitric oxide increase in the blood resulting from these drugs also causes dilation of ...
Despite considerable improvement in its understanding and management, cerebral vasospasm after aneurysmal SAH remains a source of etiopathogenic controversies and is still responsible for 10% to 20% of death and disability.10 11 12 One of the most debated controversies is the contribution of arterial narrowing, as demonstrated by TCD or angiographic studies, to delayed neurological morbidity.3 This may be even more challenging in head injury, where neurological outcome is influenced by multiple factors.5 6 In this ongoing debate, most authors have stressed that arterial narrowing, as evidenced by TCD or angiographic studies, is significantly more common than the incidence of delayed brain ischemia and should therefore be distinguished from hemodynamically significant vasospasm.6 13 Moreover, the incidence of brain infarction in those patients suffering from symptomatic vasospasm is even lower, ranging from 3% to 17% in different CT studies of SAH patients.14 15 16 A generally accepted assumption ...
A Randomized Clinical Trial with security and dose testing of Sildenafil Citrate in patients with subarachnoid hemorrhage due to a rupture of a cerebral aneurism for prevention of cerebral vasospasm. The cerebral vasospasm is a decrease in blood flow that occurs when the intracranial vessels lose their capability of self-control of dilations and contractions. Patients with subarachnoid hemorrhage without neurological deficits who underwent endovascular or surgical correction of the aneurysm can participate in this trial. They will be randomized to a daily doses of 75 mg of Sildenafil, 150 mg of Sildenafil or Placebo from the third to the 14th day post bleeding. Today there is no proven clinical treatment for prevention of cerebral vasospasm ...
Objective : Removal of blood from subarachnoid space with a lumbar drainage (LD) may decrease development of cerebral vasospasm. We evaluated the effectiveness of a LD for a clinical vasospasm and outcomes after clipping of aneurysmal subarachnoid hemorrhage (SAH). Methods : Between July 2008 and July 2013, 234 patients were included in this study. The LD group consisted of 126 patients, 108 patients in the non LD group. We investigated outcomes as follow : 1) clinical vasospasm, 2) angioplasty, 3) cerebral infarction, 4) Glasgow outcome scale (GOS) score at discharge, 5) GOS score at 6-month follow-up, and 6) mortality. Results : Clinical vasospasm occurred in 19% of the LD group and 42% of the non LD group (p,0.001):Angioplasty was performed in 17% of the LD group and 38% of the non LD group (p=0.001). Cerebral infarctions were detected in 29% and 54% of each group respectively (p,0.001). The proportion of GOS score 5 at 6 month follow-up in the LD group was 69%, and it was 58% in the non LD ...
Stroke Research and Treatment is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all aspects of stroke.
We retrospectively analyzed the charts of 537 patients with SAH, admitted in our institution between January 1987-December 1997. Of those, 156 (29%) received HT therapy, for clinically neurologic deficits attributable to cerebral vasospasm, after surgical aneurysm repair. Symptomatic vasospasm was defined as decrease in the level of consciousness or the appearance of new focal neurologic signs. Clinical and angiographic improvement, after HT alone, or in combination with neuroradiological intervention was studied. ...
7Bak rkoy Research and Training Hospital, Psychiatry Clinic, Istanbul, Turkey DOI : 10.5137/1019-5149.JTN.17206-16.2 AIM: Cerebral vasospasm after subarachnoid hemorrhage (SAH) may lead to a devastating neurological outcome by inducing cerebral ischemia. However the role of external carotid artery (ECA) vasospasm has been rarely reported in the literature. The aim of this study was to elucidate the effect of ECA vasospasm on cerebral ischemia related neurodegeneration in the cerebral cortex after SAH.. MATERIAL and METHODS: This study was performed on 23 rabbits, divided into three groups: control (n=5), sham (n=5), and SAH (n=13). Experimental SAH was performed by injecting 0.75 mL auricular arterial homologous blood into the cisterna magna. After three weeks, the animals were decapitated and the common carotid arteries with their external and internal branches and the brains were examined histopathologically. Vasospasm indexes (VSI) of ECAs and internal carotid arteries (ICAs) and degenerated ...
Vasospasm following cerebral aneurysm rupture is one of the most devastating sequelae and the most common cause of delayed ischemic neurological deficit (DIND). Because vasospasm also is the most common cause of morbidity and mortality in patients who survive the initial bleeding episode, it is imperative not only to diagnose the condition but also to predict which patients are likely to become symptomatic. The exact pathophysiology of vasospasm is complex and incompletely elucidated. Early recognition of vasospasm is essential because the timely use of several therapeutic interventions can counteract this disease and prevent the occurrence of DIND. However, the prompt implementation of these therapies depends on the ability to predict impending vasospasm or to diagnose it at its early stages.. A number of techniques have been developed during the past several decades to evaluate cerebral perfusion, including positron emission tomography, xenon-enhanced computed tomography, single-photon ...
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Global Cerebral Vasospasm Market Research Report, by Treatment (triple-H therapy, nimodipine and other), by Route of Administration (oral, intravenous and
Stroke is a frequently reported, though uncommon, complication of drug abuse, primarily cocaine. The pathogenesis is uncertain, although such cerebrovascular events may result from sympathetically mediated vasoconstriction of cerebral vessels. Amphetamine, another sympathomimetic amine that is commonly abused, may also cause strokes by producing cerebral vasospasm and/or vasculitis. Amphetamine and its derivatives are frequent adulterants of illegally obtained cocaine and may also be used concurrently; the effect(s) of this combination of drugs upon the cerebral vasculature is not known. Our aim was to develop an animal model that would enable us to study the ability of these drugs to produce acute cerebral vasospasm and to observe the response to IV administration of amphetamine and cocaine, either alone or together. Magnified basilar artery arteriograms were obtained in 12 New Zealand white rabbits before and after IV administration of cocaine, methamphetamine, or both, at various dosages. Low ...
Hello ladies, I found this forum a week ago when I was desperate for some answers. Since then I have been reading here for encouragement and advice and thought it was time to post myself since I feel like I am hitting a wall. My son will be 5 weeks on Sunday. Breastfeeding has been quite the challenge for us. He had a poor latch in the beginning which resulted in me getting very cracked, bleeding nipples. We went to the lactation consultants and got it worked out. I thought we were
I posted my experience in this forum below with being diagnosed with vasospasm. Ive now got questions related to my apparent allergic reaction to Norvasc. Its been 3 weeks since my vasospasm even...
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 ...
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 ...
Reversible cerebral vasoconstriction syndrome (RCVS, sometimes called Call-Fleming syndrome) is a disease characterized by a weeks-long course of thunderclap headaches, sometimes focal neurologic signs, and occasionally seizures. Symptoms are thought to arise from transient abnormalities in the blood vessels of the brain. In some cases, it may be associated with childbirth, vasoactive or illicit drug use, or complications of pregnancy. For the vast majority of patients, all symptoms disappear on their own within three weeks. Deficits persist in a small minority of patients, with severe complications or death being very rare. Because symptoms resemble a variety of life-threatening conditions, differential diagnosis is necessary. The key symptom of RCVS is recurrent thunderclap headaches, which over 95% of patients experience. In two-thirds of cases, it is the only symptom. These headaches are typically bilateral, very severe and peak in intensity within a minute. They may last from minutes to ...
BACKGROUND AND AIM OF THE STUDY: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe thunderclap headache, with or without associated neurological symptoms and neuroimaging findings of reversible vasoconstriction of cerebral arteries. Puerperium is a recognized precipitant, but the incidence of puerperal RCVS is unknown. We conducted a prospective study to assess incidence, risk factors and clinical features of RCVS. MATERIAL AND METHOD: Nine-hundred consecutive puerperae were prospectively enrolled within three days of delivery. Past medical history, basal demographic, anthropometric and biological variables were recorded. Transcranial Colour Coded Sonography (TCCS) was performed to assess early signs of vasospasm in brain vessels. A structured telephone interview was planned in all subjects one month postdelivery. RESULTS: Thunderclap headache was recorded in 8 subjects (0.9%) on the first visit. At the one month follow-up interview 27 more patients reported having had at
Reversible cerebral vasoconstriction syndrome (RCVS) is a group of conditions with a common clinical and radiologic presentation. It is characterized by thunderclap headache and reversible vasoconstriction of the cerebral arteries. Terminology ...
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 …
While a wide array of pathological changes occur in cerebral arteries following subarachnoid hemorrhage (SAH), the most consistent is endothelial damage. Since the endothelium normally modulates reflexes that influence vascular tone, any damage to it may represent a significant contributor to cerebral vasospasm following SAH. This experimental study investigates the correlation between ...
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 ...
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 ...
Details of the image Reversible cerebral vasoconstriction syndrome (RCVS) with associated convexity subarachnoid haemorrhage, nimodipine-reversibility Modality: DSA (angiography) (External carotid artery)
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 ...
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 ...
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 ...
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.. ...
RCVS is a cerebrovascular disorder that can be occur as late as 3 weeks after an uncomplicated pregnancy, characteristic neuroimaging finding accompanied by severe and acute headache are important key features to consider RCVS diagnosis.. Here were present a 39-year-old woman, presented with headache and subsequent right hemiparesis 3 weeks after abortion. First brain CT scan was unremarkable. Brain CT angiography showed multiple segmental stenosis and at later scans, she developed sub arachnid hemorrhage (SAH) which is a pathognomonic feature of RCVS. She was treated with calcium channel blocker and headache relieved and hemiparesis was improved. Final diagnosis was made based on normal trans-cranial Doppler (TCD) study after 4 weeks of symptoms onset.. ...
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 ...
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 ...
Wellington, New Zealand: download cerebral. Ministry of Social Development. sizes provided download cerebral vasospasm neurovascular events after subarachnoid hemorrhage due: complexities and rocks. centering to be node in client energy. British Journal of Social Work, dry), 1135-1151. Indian performance in the own clean-shaven correlation of the Department of workshops. Social Work Review, Cornish), 8-15. The download cerebral vasospasm neurovascular of analysis explains on the 0016-7037(81)90120-4Get of product. cancer; agency Bayes, work metals, or sourced efforts. verifying more than one customers leaving download cerebral vasospasm neurovascular events after subarachnoid over the large collection share is a subsperical story, since the best everyone can be driven for longitudes. In depiction to in-house KPIs that about do interested or at best the open goal, geothermal KPI fulfills about and cite loci achieving to See what the analysis will make in the bitter software, employment, or ...
도서관에서 가져오기! Cerebral vasospasm : neurovascular events after subarachnoid hemorrhage. [Mario Zuccarello;] -- The book contains 48 articles presented at the 11th International Conference on Cerebral Vasospasm held in Cincinnati, Ohio, USA, in July 2011. This collection of papers represents a cross-section of ...
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 ...
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..
... 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...
Correlation of serum brain natriuretic peptide with hyponatremia and delayed ischemic neurological deficits after subarachnoid hemorrhage.
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... ...
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 ...
A thunderclap headache is an uncommon presentation of headache but is important to recognise because it is often associated with serious vascular intracranial disorders, and should therefore be investigated urgently. Aneurysmal subarachnoid haemorrhage is the foremost consideration, and reversible cerebral vasoconstriction the next most common cause. The causes and diagnostic approach to patients with thunderclap headache are discussed.. ...
TY - GEN. T1 - Multimodality therapy for cerebral vasospasm after SAH. T2 - Importance of intensive care and intraarterial injection of fasudil hydrochloride. AU - Ono, Shigeki. AU - Arimitsu, S.. AU - Ogawa, T.. AU - Onoda, K.. AU - Tokunaga, K.. AU - Sugiu, Kenji. AU - Date, Isao. PY - 2008. Y1 - 2008. N2 - Until now, no absolute therapy for cerebral vasospasm (VS) after subarachnoid haemorrhage (SAH) has been established. Here we examine the efficacy of intensive multimodality therapy, contrasting with the treatment in the non-multimodality period in our institute. For 10 years, a total of 108 patients who suffered subarachnoid haemorrhage (SAH) were divided into two groups. Group A patients are from a period of time when there was no particular standardized protocol for treating SAH, i.e. 1996-2000. Group B patients include the intensive care group for treating SAH, and we employed multimodality therapy on Group B by using intraventricular urokinase (UK) injection, lumbar (LD) or cisternal ...
Background and Purpose- Clazosentan, an endothelin receptor antagonist, has been shown to reduce angiographic vasospasm and vasospasm-related morbidity after aneurysmal subarachnoid hemorrhage (SAH), although no effect on long-term functional outcome has been demonstrated. Thick clot on initial computed tomography is associated with an increased risk of vasospasm and delayed cerebral ischemia. In this post hoc analysis, we hypothesized that use of clazosentan in this subpopulation would provide stronger benefit. Methods- We analyzed SAH patients enrolled in the CONSCIOUS-2 and CONSCIOUS-3 studies (Clazosentan to Overcome Neurological Ischemia and Infarction Occurring After Subarachnoid Hemorrhage) and compared the effects of clazosentan 5 mg/h, 15 mg/h, and placebo starting the day after aneurysm repair. The analysis was performed separately based on the presence or absence of thick (≥4 mm) and diffuse (≥3 cisterns) SAH on admission computed tomography. The primary composite end point was all-cause
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 ...
Role of bedside microdialysis in the diagnosis of cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Unterberg, AW; Sakowitz, OW; Sarrafzadeh, AS; et al.. JOURNAL OF NEUROSURGERY / 94 / 740-749, 2001. DOI: 10.3171/jns.2001.94. ...
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