Search results for "subarachnoid hemorrhage"
showing 10 items of 89 documents
Endovascular therapy for vasospasm after aneurysmatic subarachnoid hemorrhage
2016
Balloon angioplasty and/or selective intra-arterial vasodilator therapies are treatment options in patients with vasospasm after subarachnoid hemorrhage (SAH). We analyzed the effect of balloon angioplasty and/or selective intra-arterial vasodilator therapy in our patients.Twenty-six patients (vasodilation group, VDT) were treated with intra-arterial nimodipine. The balloon angioplasty with nimodiopine-group (BAP-N group) comprised 21 patients. The primary endpoint of this study was successful angiographic vessel dilation in vasospastic vessels after balloon angioplasty, together with nimodipine (BAP-N group), compared to intra-arterial vasodilator therapy (VDT group) with nimodipine alone.…
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. Several drugs have been developed that have the potential to limit cerebral vasospasm and delayed ischaemic neurologic defi cit, thus improving outcome for patients. However, although numerous agents can prevent arterial narrowing and/or block the excitatory cascade of even…
Cerebrospinal Fluid Glucose and Lactate Levels After Subarachnoid Hemorrhage: A Multicenter Retrospective Study.
2019
BACKGROUND In patients with subarachnoid hemorrhage (SAH), abnormalities in glucose and lactate metabolism have been described using cerebral microdialysis. Glucose and lactate concentrations in cerebrospinal fluid (CSF) are more easily accessible, but scarce data are available in this setting. The aim of this study is to assess the relationship of CSF glucose and lactate with blood concentrations and with unfavorable neurological outcome after SAH. METHODS A retrospective cohort study was conducted in 5 European University intensive care units. Patients aged 18 years and above who were admitted after a nontraumatic SAH over a 4-year period (2011 to 2014) were included if they had an extern…
Endothelin: an endothelium-derived vasoactive peptide and its possible role in the pathogenesis of cerebral vasospasm
1991
The contractile response to endothelin has been examined in cerebral arteries from rats subjected to a prior subarachnoid haemorrhage (SAH) and compared with saline injected controls. Endothelin elicited strong concentration-dependent contraction of rat basilar artery segments. The response was slow in onset and long lasting. The endothelin-induced contraction was much stronger in the SAH compared to control animals. Our findings suggest a role of the peptide in the pathophysiology of cerebral vasospasm.
Impact of Health Care−Associated Infection in Patients with Aneurysmal Subarachnoid Hemorrhage
2018
In the era of antibiotics, nosocomial infections are still uncontrollable and represent a problem with a problematic solution. The terms nosocomial and health care−associated infections are both used for disease, absent at the time of admission, acquired by patients under medical care in the hospital or other health care facilities. Recently, the term health care−associated infection (HAI) has been introduced for the type of infection caused by a prolonged hospital stay, and it accounts for a significant risk factor for severe health issues leading to death. HAIs can occur during health care delivery for other diseases and even after patient discharge. Invasive devices such as catheters and…
Transient Focal Neurological Events in Cerebral Amyloid Angiopathy and the Long-term Risk of Intracerebral Hemorrhage and Death: A Systematic Review …
2021
Importance Transient focal neurological episodes (TFNEs) are a frequently overlooked presentation of cerebral amyloid angiopathy (CAA), a condition with prognostic implications that are still not well described. Objective To perform a systematic review and meta-analysis to examine the factors associated with incident lobar intracerebral hemorrhage (ICH) and death in patients with CAA presenting with TFNEs. Data Sources A systematic review and individual participant meta-analysis including (1) a hospital-based cohort and (2) the results obtained from a systematic search performed in MEDLINE and Embase completed in December 2019. Study Selection Included studies were observational reports of …
Image guidance to improve reliability and data integrity of transcranial Doppler sonography.
2012
Abstract Background Principles and accuracy of image-guided transcranial Doppler (IG TCD) sonography have been published recently. However, it remains open whether combination of image guidance and TCD offers an additional clinical advantage. This study scores the accuracy of conventional TCD examinations and investigates the potential improvement of TCD data integrity and reliability regarding the additional use of IG. Methods Conventional TCD was performed by a group of experienced investigators, who were blinded to images of a navigation system tracking the Doppler probe, whereas an independent observer documented the TCD findings, acquired by the investigators, due to saving spatial dat…
Is Aspirin a Worthy Candidate in Preventing Intracranial Aneurysm Rupture?
2020
Subarachnoid hemorrhage (SAH) usually occurs with a thunderclap headache or the worst headache of a patient's life, leading to a neurologic emergency. Among cases of nontraumatic SAH, 80%–85% are caused by ruptured intracranial aneurysms (IAs) and comprise 3% of all strokes in high-income countries In the years 2000–2008, the incidence of SAH was 4–7 per 100,000 person-years in high-income and low-to middle-income countries. Outcome after aneurysmal SAH depends on several factors, including severity of the initial hemorrhage, rebleeding, perioperative medical management, and timing and technical success for vascular malformation exclusion from the cerebral circulation. It has been estimated…
"July Effect" on Care for Aneurysmal Subarachnoid Hemorrhage.
2017
Subarachnoid hemorrhage (SAH) following a ruptured intracranial aneurysm accounts for about 5% of strokes, with an incidence of 10.5 per 100,000 person years (about 27,000 patients per year). Outcome after aneurysmal SAH depends on several factors, including the severity of the initial hemorrhage, rebleeding, perioperative medical management, and the timing and technical success for aneurysm exclusion from the cerebral circulation.The overall mortality rates range from 32% to 67% with 10%–20% of patients with long-term dependence due to brain damage. In this regard, 12% of patients die before medical treatment can be given and 25% die within the first 24 hours. A further 40%–60% mortality r…
Serum Amyloid A Is Present in Human Saccular Intracranial Aneurysm Walls and Associates With Aneurysm Rupture
2021
AbstractSaccular intracranial aneurysm (sIA) rupture leads to a disabling subarachnoid hemorrhage. Chronic inflammation and lipid accumulation in the sIA wall contribute to wall degenerative remodeling that precedes its rupture. A better understanding of the pathobiological process is essential for improved future treatment of patients carrying sIAs. Serum amyloid A (SAA) is an acute-phase protein produced in response to acute and chronic inflammation and tissue damage. Here, we studied the presence and the potential role of SAA in 36 intraoperatively resected sIAs (16 unruptured and 20 ruptured), that had previously been studied by histology and immunohistochemistry. SAA was present in all…