Search results for "subarachnoid hemorrhage"

Management of aneurysmal subarachnoid hemorrhage: State of the art and future perspectives

2017

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. Brain computed tomography (CT) allow the diagnosis of SAH. The subsequent CT angiography (CTA) or digital subtraction …

An overview of new pharmacological treatments for cerebrovascular dysfunction after experimental subarachnoid hemorrhage

2004

Cerebral vasospasm and the resulting cerebral ischemia occurring after subarachnoid hemorrhage (SAH) are still responsible for the considerable morbidity and mortality in patients affected by cerebral aneurysms. Mechanisms contributing to the development of vasospasm, abnormal reactivity of cerebral arteries and cerebral ischemia after SAH have been intensively investigated in recent years. It has been suggested that the pathogenesis of vasospasm is related to a number of pathological processes, including endothelial damage, smooth muscle cell contraction resulting from spasmogenic substances generated during lyses of subarachnoid blood clots, changes in vascular responsiveness and inflamma…

A rare case of ruptured aneurysm of the paramedian artery of Percheron.

2018

Introduction The artery of Percheron is a rare anatomic variant supplying bilateral medial thalamic nuclei and a variable portion of the rostral part of midbrain. Case report A 48-year-old female with massive subarachnoid hemorrhage due to a ruptured aneurysm of the paramedian artery of Percheron presented to the emergency room. Because of significant risk of recurrent intracranial hemorrhage, it was decided to proceed with endovascular embolization of the aneurysm. The patient was ultimately sent to a rehabilitation center and her presenting neurologic deficits showed significant improvements in the weeks following endovascular embolization treatment. Discussion The paramedian artery of Pe…

Vasospasm in Aneurysmal Subarachnoid Hemorrhage: An Evolving Knowledge

2014

During the last decade, accumulating experimental and clinical evidence has demonstrated that the presence of delayed vasospasm of the major cerebral vessels may just be a contributing factor but not necessarily the principal determinant of delayed cerebral ischemia and delayed ischemic neurologic deficit. Cerebral infarction can occur when vasospasm is not angiographically detected in the territorial artery, and poor outcome in aSAH seems to be directly dependent on infarction but independent of vasospasm . There is increasing evidence that other contributing factors may be involved in the development of delayed cerebral ischemia, and their characterization and treatment could improve the …

Longitudinal imaging and evaluation of SAH-associated cerebral large artery vasospasm in mice using micro-CT and angiography

2019

Longitudinal in vivo imaging studies characterizing subarachnoid hemorrhage (SAH)-induced large artery vasospasm (LAV) in mice are lacking. We developed a SAH-scoring system to assess SAH severity in mice using micro CT and longitudinally analysed LAV by intravenous digital subtraction angiography (i.v. DSA). Thirty female C57Bl/6J-mice (7 sham, 23 SAH) were implanted with central venous ports for repetitive contrast agent administration. SAH was induced by filament perforation. LAV was assessed up to 14 days after induction of SAH by i.v. DSA. SAH-score and neuroscore showed a highly significant positive correlation (rsp = 0.803, p < 0.001). SAH-score and survival showed a negative sig…

Hemodynamic Monitoring in Patients With Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis

2020

Aneurysmal subarachnoid hemorrhage (aSAH) often causes cardiopulmonary dysfunction. Therapeutic strategies can be guided by standard (invasive arterial/central venous pressure measurements, fluid balance assessment), and/or advanced (pulse index continuous cardiac output, pulse dye densitometry, pulmonary artery catheterization) hemodynamic monitoring. We conducted a systematic review and meta-analysis of the literature to determine whether standard compared with advanced hemodynamic monitoring can improve patient management and clinical outcomes after aSAH. A literature search was performed for articles published between January 1, 2000 and January 1, 2019. Studies involving aSAH patients …

Changes in the adrenergic mechanisms of cerebral arteries after subarachnoid hemorrhage in goats.

1994

We have examined the effects of experimental subarachnoid hemorrhage (SAH), induced by delivering autologous blood into the subarachnoid space, on the adrenergic mechanisms of the goat cerebrovascular bed. To achieve this, the response to noradrenaline was recorded both in vivo, by measuring cerebral blood flow in unanesthetized animals, and in vitro, by recording isometric tension in isolated cerebral arteries. In addition, we checked the function of adrenergic innervation by measuring the tritium efflux evoked by electrical stimulation in cerebral arteries preloaded with [3H]-noradrenaline, and we examined this innervation by using both fluorescent and electron transmission microscopy. Al…

Erythropoietin for Subarachnoid Hemorrhage: Is There a Reason for Hope?

2011

I b S a r a S ubarachnoid hemorrhage (SAH) associated with a ruptured cerebral aneurysm remains a source of significant morbidity and mortality, not only from the initial hemorrhage but lso from the delayed complications, such as cerebral vasospasm ften severe enough to induce irreversible changes in cerebral erfusion. Several drugs have been developed that have the otential to limit cerebral vasospasm and delayed ischemic eurologic deficit, thus improving outcome for patients. Howver, although numerous agents that can prevent arterial narrowng and/or block the excitatory cascade of events leading to schemic neuronal death in experimental conditions, there is still o pharmacologic agent tha…

Letter to the Editor Regarding “Small Aneurysms with Low PHASES Scores Account for a Majority of Subarachnoid Hemorrhage Cases”

2020

Subarachnoid Hemorrhage Revealing Moyamoya Syndrome in a Patient With May-Hegglin Anomaly.

2017

Etude de cas; Introduction: Moyamoya syndrome is a rare progressive cerebrovascular occlusive disease for which several associated conditions have been described. Case Report: We report the case of a 76-year-old woman with a history of May-Hegglin anomaly who presented with an isolated unusual diffuse headache. Initial laboratory investigations showed only thrombocytopenia (platelet count 95000/mu L). Unenhanced brain computed tomography scan revealed a small subarachnoid hemorrhage in the left frontal lobe. Computed tomography angiography showed occlusion of the terminal portion of the left internal carotid artery (ICA) and narrowing of the terminal portion of the right ICA with abnormal c…