Search results for "SUBARACHNOID HEMORRHAGE"

Imaging funzionale per diffusione (DWI) e ischemia cerebrale in fase acuta: Potenzialità diagnostiche e confronto con metodiche convenzionali

1997

Stroke is the third leading cause of death and is a major cause of long-term disability. Neuroprotective treatment within a 4-hour «therapeutic window» has proved highly efficacious in reducing morbility and mortality in animal model. It is with this background that the need for emergent diagnosis and therapy of acute stroke in strongly suggested. Computed tomography (CT) shows the parenchymal changes of acute stroke too late to be helpful, and its role has been primarily to evaluate the possibility of intracerebral or subarachnoid hemorrhage. While conventional magnetic resonance (MR) imaging can demonstrate parenchymal abnormalities 4–6 hours after ischemia, newer techniques such as diff…

2021

Objective: Unruptured Intracranial Aneurysm (UIA) Treatment Score (UIATS) and PHASES score are used to inform treatment decision making for UIAs (treatment or observation). We assessed the ability of the scoring systems to discriminate between ruptured aneurysms and UIAs in a subarachnoid hemorrhage (SAH) cohort with multiple aneurysms.Methods: We retrospectively applied PHASES and UIATS scoring to the aneurysms of 40 consecutive patients with SAH and multiple intracranial aneurysms.Results: PHASES score discriminated better between ruptured aneurysms and UIAs than UIATS. PHASES scores and the difference between the UIATS subscores were higher for ruptured aneurysms compared with UIAs, whic…

Analysis of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage with High Frequency Transcranial Duplex Ultrasound

2021

Cerebral vasospasm that occurs in the weeks after subarachnoid hemorrhage, a type of hemorrhagic stroke, contributes to delayed cerebral ischemia. A problem encountered in experimental studies using murine models of SAH is that methods for in vivo monitoring of cerebral vasospasm in mice are lacking. Here, we demonstrate the application of high frequency ultrasound to perform transcranial Duplex sonography examinations on mice. Using the method, the internal carotid arteries (ICA) could be identified. The blood flow velocities in the intracranial ICAs were accelerated significantly after induction of SAH, while blood flow velocities in the extracranial ICAs remained low, indicating cerebral…

Stroke and cardiac arrhythmias.

2001

Stroke is frequently followed by electrocardiographic (ECG) changes. The aim of the present study was to evaluate the global incidence of these changes after ischemic or hemorrhagic strokes, but it focused on cardiac arrhythmias. In ischemic strokes, these were correlated with the side of the lesion(s). The study was retrospective, and 450 patients (out of 971 examined) were entered in the study based on the following inclusion criteria: (1) "completed" stroke (352 ischemic and 98 hemorrhagic), (2) ECG on admission, and (3) at least 1 previous ECG. We also examined 71 patients with carotid or vertebro-basilar transient ischemic attacks (TIA). As controls, 71 patients suffering from nonvascu…

The Role of Erythropoietin in Aneurysmal Subarachnoid Haemorrhage: From Bench to Bedside

2014

Subarachnoid haemorrhage (SAH) caused by a ruptured aneurysm accounts for only 5 % of strokes, but occurs at a fairly young age and carries a poor prognosis. Delayed cerebral ischaemia (DCI) is an important cause of death and dependence after aneurysmal SAH. The current mainstay of preventing DCI is nimodipine and maintenance of normovolemia, but even with this strategy DCI occurs in a considerable proportion of patients.

2020

Background: Computed tomography angiography (CTA) is frequently used with computed tomography perfusion imaging (CTP) to evaluate whether endovascular vasospasm treatment is indicated for subarachnoid hemorrhage patients with delayed cerebral ischemia. However, objective parameters for CTA evaluation are lacking. In this study, we used an automated, investigator-independent, digital method to detect vasospasm, and we evaluated whether the method could predict the need for subsequent endovascular vasospasm treatment. Methods: We retrospectively reviewed the charts and analyzed imaging data for 40 consecutive patients with subarachnoid hemorrhages. The cerebrovascular trees were digitally rec…

nrCBF for Timing of Angiography and Operation in Subarachnoid Hemorrhage

1983

Early operation on cerebral aneurysms is demanded not least because of the threat of spasm of the cerebral vessels. As is generally recognized, this is to be expected in a very high percentage within a few days after the first aneurysm hemorrhage and frequently cannot be diagnosed clinically (4, 5). Many neurosurgeons have rated the risk of operating in the presence of vasospasm so high that, like C.G. DRAKE in 1975 (2), they demanded control angiography with its own risk, especially in existing vasospasm in early angiography and the aneurysm operation itself could not take place rapidly.

Recommendations for the management of patients with aneurysmal subarachnoid hemorrhage

2005

After SAH, primary and secondary complications are frequent and often require neurosurgical interventions to avoid secondary brain damage. The authors of the present paper have summarized the available data about the treatment modalities often used for patients with SAH. The present recommendations have been developed as a neurosurgical and neuroanestesiological consensus. Evidence from prospective, randomized, double blind, placebo-controlled studies support grade A recommendations (standard) for the prophylaxis and treatment of cerebral vasospasm with oral Nimodipine in good grade patients. For intravenous Nimodipine or for oral nimodipine treatment in poor grade patients, available data …

Intracranial Venous Alteration in Patients With Aneurysmal Subarachnoid Hemorrhage: Protocol for the Prospective and Observational SAH Multicenter St…

2022

BackgroundArterial vasospasm has been ascribed as the responsible etiology of delayed cerebral infarction in patients with aneurysmal subarachnoid hemorrhage (aSAH), but other neurovascular structures may be involved. We present the protocol for a multicenter, prospective, observational study focused on analyzing morphological changes in cerebral veins of patients with aSAH.Methods and AnalysisIn a retrospective arm, we will collect head arterial and venous CT angiograms (CTA) of 50 patients with aSAH and 50 matching healthy controls at days 0–2 and 7–10, comparing morphological venous changes. A multicenter prospective observational study will follow. Patients aged ≥18 years of any gender …