31,422 results match your criteria Subarachnoid Hemorrhage


Neuroprotective role of glutathione peroxidase 4 in experimental subarachnoid hemorrhage models.

Life Sci 2020 Jul 4:118050. Epub 2020 Jul 4.

Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China. Electronic address:

Background And Purpose: Early brain injury is an essential pathological process after subarachnoid hemorrhage (SAH), with many cell death modalities. Ferroptosis is a newly discovered regulated cell death caused by the iron-dependent accumulation of lipid peroxidation, which can be prevented by glutathione peroxidase 4 (GPX4). Our study aimed to investigate the role of GPX4 in neuronal cell death after experimental SAH. Read More

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http://dx.doi.org/10.1016/j.lfs.2020.118050DOI Listing

A Combination of Magnetic Resonance Imaging Techniques to Localize the Dural Defect in a Case of Superficial Siderosis-A Case Report.

Medicines (Basel) 2020 Jun 25;7(6). Epub 2020 Jun 25.

Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa 259-1193, Japan.

Superficial siderosis is a progressively disabling disease caused by recurrent subarachnoid hemorrhage with accumulation of hemosiderin in the surface of the central nervous system. Although a wide variety of conditions may cause superficial siderosis, approximately half of the cases are reported to be associated with a defect in the ventral spinal dura mater, in which case treatment entails surgical repair of the defect. Here, we report a case of superficial siderosis and report on our method to pinpoint the dural defect using a combination of magnetic resonance imaging (MRI) techniques. Read More

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http://dx.doi.org/10.3390/medicines7060036DOI Listing

Experience With the Pipeline Embolization Device for Posterior Circulations Aneurysms: A Multicenter Cohort Study.

Neurosurgery 2020 Jul 6. Epub 2020 Jul 6.

Departments of Medical Imaging & Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

Background: The Pipeline Embolization Device (PED; Medtronic) has been used off-label for the treatment of challenging posterior circulation aneurysms. Data on this modality are primarily limited to small retrospective single-center series.

Objective: To assess safety and efficacy of this treatment by establishing an international, multicenter collaboration. Read More

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http://dx.doi.org/10.1093/neuros/nyaa277DOI Listing

A Case of Reversible Cerebral Vasoconstriction Syndrome in a Healthy Adult Male.

Cureus 2020 May 31;12(5):e8374. Epub 2020 May 31.

Emergency Medicine, Queen Elizabeth II Health Science Center, Halifax, CAN.

Reversible cerebral vasoconstriction syndrome (RCVS) represents a potentially under-recognized cause of thunderclap headache in patients presenting to the ED. While a rarely made diagnosis in emergency medicine practice, RCVS may be as common as subarachnoid hemorrhage (SAH). RCVS typically presents as a sudden onset, excruciating headache that may be associated with nausea, vomiting, photophobia, or other features with overlap in the clinical presentation of both SAH and migraine headaches. Read More

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http://dx.doi.org/10.7759/cureus.8374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328700PMC

Transradial access for flow diversion of intracranial aneurysms: Case series.

Interv Neuroradiol 2020 Jul 5:1591019920938961. Epub 2020 Jul 5.

Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.

Background: Transradial access for neurointerventions offers advantages of fewer access-site complications, reduced procedure time, and greater patient comfort over transfemoral access. Data about transradial access for flow diversion are limited. We share our early experience with transradial access for flow diversion in a relatively large case series. Read More

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http://dx.doi.org/10.1177/1591019920938961DOI Listing

Long-Term Complications and Influence on Outcome in Patients Surviving Spontaneous Subarachnoid Hemorrhage.

Cerebrovasc Dis 2020 Jul 3:1-9. Epub 2020 Jul 3.

Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.

Background: While the short-term clinical outcome of patients with subarachnoid hemorrhage (SAH) is well described, there are limited data on long-term complications and their impact on social reintegration. This study aimed to assess the frequency of complications post-SAH and to investigate whether these complications attribute to functional and self-reported outcomes as well as the ability to return to work in these patients.

Methods: This retrospective single-center study included patients with atraumatic SAH over a 5-year period at a tertiary care center. Read More

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http://dx.doi.org/10.1159/000508577DOI Listing

The association between regular cocaine use, with and without tobacco co-use, and adverse cardiovascular and respiratory outcomes.

Drug Alcohol Depend 2020 Jun 27;214:108136. Epub 2020 Jun 27.

Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA.

Background: Understanding the potential impact of cocaine use on health is increasingly important as cocaine use rises in the U.S.

Objectives: This study evaluated the associations of regular cocaine use, with and without tobacco co-use, with cardiovascular and respiratory outcomes. Read More

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http://dx.doi.org/10.1016/j.drugalcdep.2020.108136DOI Listing

TH17/Treg imbalance and IL-17A increase after severe aneurysmal subarachnoid hemorrhage.

J Neuroimmunol 2020 Jun 27;346:577310. Epub 2020 Jun 27.

Laboratorio de Citometria y Biologia Molecular, Departamento Básico de Medicina, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Av Italia s/n, 11300 Montevideo, Uruguay; Cátedra de Hematología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Av Italia s/n, CP 11300 Montevideo, Uruguay. Electronic address:

To evaluate cerebrospinal fluid (CSF) and peripheral blood (PB) Treg, TH17 cells, TH1, TH2 and related cytokines in the acute phase of aSAH we assessed TH17, TH1, TH2, T regulatory cells and neutrophils in 39 aneurysmal subarachnoid hemorrhage (aSAH) patients and 56 controls. PB TH17 cells and TH17/Treg ratio were higher in CSF and PB of aSAH patients. Serum and CSF IL-17A levels were increased in aSAH. Read More

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http://dx.doi.org/10.1016/j.jneuroim.2020.577310DOI Listing

Pigments test strips: a rapid companion test to exclude sub-arachnoid haemorrhage.

Clin Chim Acta 2020 Jul 2. Epub 2020 Jul 2.

Biochemistry Department, Bordeaux University Hospital, Place Amélie Raba Léon 33076 Bordeaux France; Université de Bordeaux, France.

Objectives: Subarachnoid haemorrhage (SAH) is characterised by 25% of mortality or induces long-term care. It needs immediate diagnosis with computed tomography (CT) scan. For the inconclusive CT scans, the detection of haem pigments can be performed in the cerebrospinal fluid (CSF). Read More

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http://dx.doi.org/10.1016/j.cca.2020.06.052DOI Listing

The association between hyponatraemia and long-term functional outcome in patients with aneurysmal subarachnoid haemorrhage: A single centre prospective cohort study.

J Clin Neurosci 2020 Jul 1. Epub 2020 Jul 1.

Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia; Division of Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, Australia. Electronic address:

To assess the association between hyponatraemia and long-term functional outcome and other relevant outcomes in patients with aneurysmal subarachnoid haemorrhage (aSAH) we conducted a prospective cohort study in a Neurosciences Intensive Care Unit (ICU) in Sydney, Australia. The primary exposure variable was hyponatraemia (Na <135 mmol/L). The primary outcome was favourable outcome, a score of 5-8 on the extended Glasgow Outcome Score (GOSe) at 12 months. Read More

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http://dx.doi.org/10.1016/j.jocn.2020.06.003DOI Listing

Angioplasty with a retrievable stent to treat vasospasm secondary to subarachnoid hemorrhage due to an aneurysm: a multicenter study of safety and efficacy.

Radiologia 2020 Jul 1. Epub 2020 Jul 1.

Departmento de Radiología, Neurorradiología Intervencionista, Hospital Universitario Vall d'Hebron, Barcelona, España.

Objective: To determine the safety and efficacy of angioplasty with a retrievable stent in treating vasospasm secondary to subarachnoid hemorrhage (SAH) due to an aneurysm.

Methods: We retrospectively analyzed prospectively collected data from consecutive patients undergoing endovascular angioplasty with a retrievable stent to treat vasospasm related to SAH due to an aneurysm in four neurointerventional radiology departments between January 2018 and July 2019. We included patients aged>18 years with vasospasm>50% of the internal carotid artery (ICA), anterior cerebral artery (ACA), and / or middle cerebral artery (MCA) secondary to SAH due to an aneurysm treated with endovascular angioplasty with a retrievable stent. Read More

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http://dx.doi.org/10.1016/j.rx.2020.04.011DOI Listing

Cardiorespiratory Fitness and Incident Stroke Types: The FIT (Henry Ford ExercIse Testing) Project.

Mayo Clin Proc 2020 Jul;95(7):1379-1389

Department of Cardiac Imaging, Houston Methodist DeBakey Heart & Vascular Center, TX. Electronic address:

Objective: To study the association between cardiorespiratory fitness (CRF) and incident stroke types.

Patients And Methods: We studied a retrospective cohort of patients referred for treadmill stress testing in the Henry Ford Health System (Henry Ford ExercIse Testing Project) without history of stroke. CRF was expressed by metabolic equivalents of task (METs). Read More

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http://dx.doi.org/10.1016/j.mayocp.2019.11.027DOI Listing

Lack of impact of polycystic kidney disease on the outcome of aneurysmal subarachnoid hemorrhage: a matched case-control study.

J Neurosurg 2020 Jul 3:1-8. Epub 2020 Jul 3.

1Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, Kuopio.

Objective: The authors set out to study whether autosomal dominant polycystic kidney disease (ADPKD), an established risk factor for intracranial aneurysms (IAs), affects the acute course and long-term outcome of aneurysmal subarachnoid hemorrhage (aSAH).

Methods: The outcomes of 32 ADPKD patients with aSAH between 1980 and 2015 (median age 43 years; 50% women) were compared with 160 matched (age, sex, and year of aSAH) non-ADPKD aSAH patients in the prospectively collected Kuopio Intracranial Aneurysm Patient and Family Database.

Results: At 12 months, 75% of the aSAH patients with ADPKD versus 71% of the matched-control aSAH patients without ADPKD had good outcomes (Glasgow Outcome Scale score 4 or 5). Read More

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http://dx.doi.org/10.3171/2020.4.JNS20544DOI Listing

External Validation Demonstrated The Ottawa SAH Prediction Models Can Identify pSAH Using Health Administrative Data.

J Clin Epidemiol 2020 Jun 30. Epub 2020 Jun 30.

Department of Medicine (Clinical Epidemiology), uOttawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute; ICES-uOttawa, Administrative Services, 1053 Carling Ave Building, 1st Floor, Ottawa, ON K1Y 4E9.

Objective: To externally validate 3 pSAH identification models.

Study Design And Setting: We evaluated 3 models that identify pSAH using recursive partitioning (A), logistic regression (B), and a prevalence adjusted logistic regression(C), respectively. Blinded chart review and/or linkage to existing registries determined pSAH status. Read More

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http://dx.doi.org/10.1016/j.jclinepi.2020.06.024DOI Listing

Astragaloside IV alleviates the brain damage induced by subarachnoid hemorrhage via PI3K/Akt signaling pathway.

Neurosci Lett 2020 Jun 30:135227. Epub 2020 Jun 30.

Department of Brain Emergency, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, 061000, Hebei, China.

Subarachnoid hemorrhage (SAH) caused brain damage accounts for more than 20% death of patients with cerebrovascular diseases. We aimed to investigate the effects of Astragaloside IV (AS-IV) on SAH-induced brain damage and its underlying mechanism. SAH rat model was established and treated with or without AS-IV. Read More

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http://dx.doi.org/10.1016/j.neulet.2020.135227DOI Listing

Spontaneous Intracranial Hypotension Followed by Intracranial Hypertension.

Neurologist 2020 Jul;25(4):109-111

Departments of Neurology.

Introduction: Spontaneous intracranial hypotension is a secondary cause of headache caused by suspected cerebrospinal fluid leaks. It is associated with vascular changes that may predispose to superficial siderosis. When treated with an epidural blood patch, rebound intracranial hypertension may ensue. Read More

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http://dx.doi.org/10.1097/NRL.0000000000000285DOI Listing

Reversible Cerebral Vasoconstriction Syndrome Following Carotid Endarterectomy: A Case Report.

Neurologist 2020 Jul;25(4):104-105

Lehigh Valley Health Network, Allentown, PA.

Introduction: Reversible cerebral vasoconstriction syndrome (RCVS) is a cerebrovascular disorder associated with multifocal intracranial arterial constriction and dilation that occurs spontaneously or as a result of a stimulant. The authors present a case of RCVS in a patient who presented with a new-onset thunderclap headache a day after carotid endarterectomy (CEA). RCVS has been rarely reported after CEA. Read More

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http://dx.doi.org/10.1097/NRL.0000000000000280DOI Listing

Astrocytic histone deacetylase 2 facilitates delayed depression and memory impairment after subarachnoid hemorrhage by negatively regulating glutamate transporter-1.

Ann Transl Med 2020 Jun;8(11):691

Department of Neurosurgery and Institute for Functional Brain Disorders, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.

Background: Delayed cognitive impairment (DCI) after subarachnoid hemorrhage (SAH) is one of the most common sequelae in patients. This study aimed to investigate the characteristics of the course and glutamatergic pathogenesis of DCI after SAH in mice.

Methods: A SAH mouse model of internal carotid puncture was used. Read More

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http://dx.doi.org/10.21037/atm-20-4330DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327310PMC

Traumatic Subarachnoid Hemorrhage Resulting from Posterior Communicating Artery Rupture.

Int Med Case Rep J 2020 26;13:237-241. Epub 2020 Jun 26.

Department of Neurosurgery, Kangwon National University School of Medicine, Chuncheon-Si, Gangwon-Do, South Korea.

Traumatic subarachnoid hemorrhage (SAH), a common finding following head trauma, is usually a benign condition with a favorable outcome, seldom requiring surgical intervention. Unlike nontraumatic aneurysmal SAH, most cases of traumatic SAH occur in the sulci of the cerebral convexities, and only rarely arise at the base of the brain. Basal traumatic SAH can be life-threatening and is primarily associated with rupture of vertebrobasilar arteries. Read More

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http://dx.doi.org/10.2147/IMCRJ.S254160DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326191PMC

Early versus Delayed Microsurgical Clipping of Additional Unruptured Aneurysms in Patients with Aneurysmal Subarachnoid Hemorrhage.

World Neurosurg 2020 Jun 29. Epub 2020 Jun 29.

Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA. Electronic address:

Introduction: The optimal timing for the surgical treatment of additional unruptured aneurysms in patients with multiple aneurysms and aneurysmal subarachnoid hemorrhage (aSAH) is unknown. Therefore, we analyzed results from early versus delayed microsurgical treatment of unruptured aneurysms when multiple aneurysms are present in the setting of aSAH.

Methods: Charts from a consecutive, single-surgeon, 19-year experience of all patients with aSAH and additional unruptured aneurysms treated with a second surgery were reviewed retrospectively. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.186DOI Listing

Aneurysmal subarachnoid hemorrhage in a SARS-CoV-2 positive testing: casual or causal?

Br J Neurosurg 2020 Jul 2:1-2. Epub 2020 Jul 2.

Department of Neurosurgery, San Bortolo Hospital, Vicenza, Italy.

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http://dx.doi.org/10.1080/02688697.2020.1787343DOI Listing

Is Optic Nerve Sheath Diameter a Reliable Proxy for Intracranial Pressure in Patients with Subarachnoid Hemorrhage?

Neurocrit Care 2020 Jul 1. Epub 2020 Jul 1.

Neuroanesthesia Division, Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.

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http://dx.doi.org/10.1007/s12028-020-01038-7DOI Listing

Cerebrospinal Fluid from Aneurysmal Subarachnoid Hemorrhage Patients Leads to Hydrocephalus in Nude Mice.

Neurocrit Care 2020 Jul 1. Epub 2020 Jul 1.

Department of Neurosurgery, University of Michigan, 3552 Taubman Center, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.

Objective: Our prior studies have found that intracerebroventricular injection of blood components can cause hydrocephalus and choroid plexus epiplexus cell activation in rats. To minimize the cross-species reaction, the current study examines whether intraventricular injection of acellular components of cerebrospinal fluid (CSF) from subarachnoid hemorrhage patients can cause hydrocephalus and epiplexus macrophage activation in nude mice which lack a T cell inflammatory response.

Methods: Adult male nude mice received intraventricular injections of acellular CSF from subarachnoid hemorrhage patients or a control patient. Read More

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http://dx.doi.org/10.1007/s12028-020-01031-0DOI Listing

Response by Morotti and Fainardi to Letter Regarding Article, "Subarachnoid Extension Predicts Lobar Intracerebral Hemorrhage Expansion".

Stroke 2020 Jul 2:STROKEAHA120030415. Epub 2020 Jul 2.

Dipartimento di Dipartimento di Scienze Biomediche, Sperimentali e Cliniche, Neuroradiologia, Università degli Studi di Firenze, Ospedale Universitario Careggi, Italia (E.F.).

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http://dx.doi.org/10.1161/STROKEAHA.120.030415DOI Listing

Letter by Xiao et al Regarding Article, "Subarachnoid Extension Predicts Lobar Intracerebral Hemorrhage Expansion".

Stroke 2020 Jul 2:STROKEAHA120030070. Epub 2020 Jul 2.

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.

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http://dx.doi.org/10.1161/STROKEAHA.120.030070DOI Listing

Cangrelor dose titration using platelet function testing during cerebrovascular stent placement.

Interv Neuroradiol 2020 Jul 1:1591019920936923. Epub 2020 Jul 1.

Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.

Background: Optimal antiplatelet inhibition is vital during cerebrovascular stenting procedures, yet no standardized recommendation exists for antithrombotic therapy in these scenarios. Cangrelor is an intravenous P2Y12 inhibitor with a favorable pharmacokinetic profile for use during neuroendovascular stenting.

Methods: A retrospective review of all neuroendovascular patients who underwent stenting between 1 January 2019 and 22 March 2020 and were treated with cangrelor was conducted. Read More

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http://dx.doi.org/10.1177/1591019920936923DOI Listing

HMGB1-Mediated Neuroinflammatory Responses in Brain Injuries: Potential Mechanisms and Therapeutic Opportunities.

Int J Mol Sci 2020 Jun 29;21(13). Epub 2020 Jun 29.

Neuropharmacology Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia.

Brain injuries are devastating conditions, representing a global cause of mortality and morbidity, with no effective treatment to date. Increased evidence supports the role of neuroinflammation in driving several forms of brain injuries. High mobility group box 1 (HMGB1) protein is a pro-inflammatory-like cytokine with an initiator role in neuroinflammation that has been implicated in Traumatic brain injury (TBI) as well as in early brain injury (EBI) after subarachnoid hemorrhage (SAH). Read More

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http://dx.doi.org/10.3390/ijms21134609DOI Listing
June 2020
2.862 Impact Factor

Cerebral autoregulation after aneurysmal subarachnoid haemorrhage. A preliminary study comparing dexmedetomidine to propofol and/or midazolam.

Acta Anaesthesiol Scand 2020 Jul 1. Epub 2020 Jul 1.

Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland.

Background: Cerebral autoregulation is often impaired after aneurysmal subarachnoid haemorrhage (aSAH). Dexmedetomidine is being increasingly used, but its effects on cerebral autoregulation in patients with aSAH have not been studied before. Dexmedetomidine could be a useful sedative in patients with aSAH as it enables neurological assessment during the infusion. Read More

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http://dx.doi.org/10.1111/aas.13663DOI Listing

Use of CPAP as an alternative to the apnea test during the determination of brain death in hypoxemic patients. Report of two cases.

Rev Bras Ter Intensiva 2020 Jun 24. Epub 2020 Jun 24.

Medicina Intensiva, Faculdades Integradas Padre Albino - Catanduva (SP), Brasil.

The apnea test, which involves disconnection from the mechanical ventilator, presents risks during the determination of brain death, especially in hypoxemic patients. We describe the performance of the apnea test without disconnection from the mechanical ventilator in two patients. The first case involved an 8-year-old boy admitted with severe hypoxemia due to pneumonia. Read More

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http://dx.doi.org/10.5935/0103-507X.20200032DOI Listing

Sex differences in aneurysmal subarachnoid haemorrhage (aSAH): aneurysm characteristics, neurological complications, and outcome.

Acta Neurochir (Wien) 2020 Jun 30. Epub 2020 Jun 30.

Menzies Institute for Medical Research, Hobart, Tasmania, University of Tasmania, Hobart, Australia.

Background: Women are over-represented in aSAH cohorts, but whether their outcomes differ to men remains unclear. We examined if sex differences in neurological complications and aneurysm characteristics contributed to aSAH outcomes.

Methods: In a retrospective cohort (2010-2016) of all aSAH cases across two hospital networks in Australia, information on severity, aneurysm characteristics and neurological complications (rebleed before/after treatment, postoperative stroke < 48 h, neurological infections, hydrocephalus, seizures, delayed cerebral ischemia [DCI], cerebral infarction) were extracted. Read More

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http://dx.doi.org/10.1007/s00701-020-04469-5DOI Listing

Nimodipine Improves Cognitive Impairment After Subarachnoid Hemorrhage in Rats Through IncRNA NEAT1/miR-27a/MAPT Axis.

Drug Des Devel Ther 2020 10;14:2295-2306. Epub 2020 Jun 10.

Department of Neurosurgery, The People's Hospital of Shanxi Province, Taiyuan, Shanxi Province, People's Republic of China.

Background: Subarachnoid hemorrhage (SAH) is a cerebral hemorrhage disease that severely damages the brain and causes cognitive impairment (CI). Therefore, accurate and appropriate treatment strategies are urgently needed. The application of nimodipine can not only improve blood circulation in patients with SAH but also repair ischemic neuron injury. Read More

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http://dx.doi.org/10.2147/DDDT.S248115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293909PMC

TT01001 attenuates oxidative stress and neuronal apoptosis by preventing mitoNEET-mediated mitochondrial dysfunction after subarachnoid hemorrhage in rats.

Neuroreport 2020 Aug;31(11):845-850

Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China.

Oxidative stress and neuronal apoptosis are considered crucial therapeutic targets against early brain injury (EBI) after subarachnoid hemorrhage (SAH). Emerging evidence indicates that mitochondrial dysfunction is the main reason for oxidative stress and neuronal apoptosis. MitoNEET, an outer mitochondrial membrane protein, has been shown to regulate mitochondrial function. Read More

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http://dx.doi.org/10.1097/WNR.0000000000001492DOI Listing

Pituitary Dysfunction After Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study.

J Neurosurg Anesthesiol 2020 Jun 26. Epub 2020 Jun 26.

Department of Anesthesiology, University of Rome "Sapienza", Rome, Italy.

Background: The prevalence of pituitary dysfunction after aneurysmal subarachnoid hemorrhage (aSAH) remains incompletely elucidated. Furthermore, it is not clear whether these abnormalities impact patient outcomes. The aim of this study was to evaluate the prevalence of pituitary dysfunction after aSAH and its effect on outcomes. Read More

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http://dx.doi.org/10.1097/ANA.0000000000000705DOI Listing

Clinical features associated with the development of hydrocephalus following TBI in the paediatric age group.

Childs Nerv Syst 2020 Jun 29. Epub 2020 Jun 29.

Department of Neurosurgery, University Hospital Wales, 4th Floor, Heath Park Way, Cardiff, CF14 4XW, UK.

Introduction: Predictive factors for post-traumatic hydrocephalus (PTH) in adults have been elucidated but remain uncertain for children. We aimed to identify the prevalence of PTH in paediatric patients and identify clinical/radiological factors which may increase the probability of children developing PTH.

Methods: This was a retrospective study of all patients < 16 years old admitted to our unit with traumatic brain injury (TBI) between March 2013 and June 2018, 108 patients in total. Read More

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http://dx.doi.org/10.1007/s00381-020-04764-7DOI Listing

Incidence and case fatality of aneurysmal subarachnoid hemorrhage admitted to hospital between 2008 and 2014 in Norway.

Acta Neurochir (Wien) 2020 Jun 30. Epub 2020 Jun 30.

Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

Background: To provide age- and sex-specific incidence and case fatality rates for non-traumatic aneurysmal subarachnoid hemorrhage (aSAH) in Norway. We also studied time trends in incidence and case fatality, as well as predictors of death following aSAH.

Methods: A nationwide study using discharge data for patients admitted with aSAH between 2008 and 2014. Read More

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http://dx.doi.org/10.1007/s00701-020-04463-xDOI Listing

Endovascular Treatment of Giant Intracranial Aneurysms.

Cureus 2020 May 26;12(5):e8290. Epub 2020 May 26.

Radiology, Miami Cardiac & Vascular Institute/Miami Neuroscience Institute, Miami, USA.

Objective Giant intracranial aneurysms (GIAs) are associated with a high risk of rupture and have a high mortality rate when they rupture (65-100%). The traditional microsurgical approach to secure these lesions is challenging, and as such endovascular embolization has been increasingly selected as a treatment option. Methods We performed a retrospective analysis of consecutive patients with ruptured and unruptured GIAs at three medical centers from October 2008 to April 2016. Read More

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http://dx.doi.org/10.7759/cureus.8290DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317134PMC

Acute systematic inflammatory response syndrome and serum biomarkers predict outcomes after subarachnoid hemorrhage.

J Clin Neurosci 2020 Jun 26. Epub 2020 Jun 26.

Department of Neurosurgery, Teine Keijinkai Hospital, Maeda 1-12-1-40, Teine-Ku, Sapporo, Hokkaido 006-0811, Japan. Electronic address:

Subarachnoid hemorrhage (SAH) can trigger immune activation sufficient to induce systematic inflammatory response syndrome (SIRS). Serum inflammatory biomarkers and SIRS can predict a poor outcome. The relationship between surgical stress and inflammatory response is well known but described in few reports in the neurosurgical population. Read More

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http://dx.doi.org/10.1016/j.jocn.2020.05.055DOI Listing

Angioplasty with the scepter C dual lumen balloon catheter and postprocedural result evaluation in patients with subarachnoid hemorrhage related vasospasms.

BMC Neurol 2020 Jun 29;20(1):260. Epub 2020 Jun 29.

Department of Neuroradiology, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Gottingen, Germany.

Background: Delayed cerebral ischemia is one of the leading causes of death and disability in patients with subarachnoid hemorrhage (SAH). Transluminal balloon angioplasty (TBA) is a therapeutic option for vasospasms affecting proximal intracranial arteries.

Methods: Aim of this study was to report our experience using the Scepter C balloon catheter in the treatment of cerebral vasospasms due to SAH and evaluate the postprocedural result with the iFlow tool. Read More

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http://dx.doi.org/10.1186/s12883-020-01792-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322884PMC

Trends in Incidence and Mortality by Hospital Teaching Status and Location in Aneurysmal Subarachnoid Hemorrhage.

World Neurosurg 2020 Jun 26. Epub 2020 Jun 26.

Department of Neurosurgery, Mount Sinai Hospital, New York, NY 10029. Electronic address:

Objective: Few studies have examined the impact of teaching status and location on outcomes in subarachnoid hemorrhage (SAH). The objective of the present study was to compare mortality and functional outcomes between urban teaching, urban nonteaching, and rural centers for hospitalizations with SAH.

Methods: The National Inpatient Sample (NIS) years 2003-2016 was queried for hospitalizations with aneurysmal SAH from 2003 to 2017. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.180DOI Listing

Middle meningeal artery embolization to treat progressive epidural hematoma: a case report.

J Cerebrovasc Endovasc Neurosurg 2020 Mar 31;22(1):20-25. Epub 2020 Mar 31.

Department of Neurosurgery, Cheju Halla General Hospital, Jeju, Korea.

Progressive epidural hematoma is a form of acute epidural hematoma that gradually expands from a small initial hematoma; in cases that are clinically aggravated due to the presence of a mental illness or neurological condition, patients should be surgically treated for evacuation of the hematoma, but poorer outcomes are expected if the patient has several medical co-morbidities for surgery. We experienced two cases of progressive epidural hematoma which were successfully managed by endovascular treatment: an 85-year-old male with medical co-morbidities and a 51-year-old female with a poor-grade subarachnoid hemorrhage resulting from the rupture of a dissecting aneurysm of the vertebral artery. In both cases, a middle meningeal artery embolization was performed and contrast leakage was observed and controlled using cerebral angiography, halting the progression of their epidural hematomas. Read More

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http://dx.doi.org/10.7461/jcen.2020.22.1.20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307609PMC

Cerebral Venous Thrombosis in a Patient with Immune Thrombocytopenia, an Apparent Paradox.

Case Rep Oncol 2020 May-Aug;13(2):588-594. Epub 2020 Jun 4.

Department of Medical Oncology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.

We present a paradoxical case of immune thrombocytopenia (ITP) that presented with cerebral venous thrombosis. A 39-year-old female patient diagnosed with chronic ITP, who failed treatment on multiple-line agents, was started on eltrombopag (thrombopoietin receptor agonist), which she was not compliant to. The patient later developed extensive cerebral venous thrombosis, along with venous infarcts, and intracranial and subarachnoid hemorrhage. Read More

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http://dx.doi.org/10.1159/000507389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315189PMC

Nafamostat mesylate attenuates the pathophysiologic sequelae of neurovascular ischemia.

Neural Regen Res 2020 Dec;15(12):2217-2234

Department of Neurological Surgery, University of California San Francisco, San Francisco, CA; Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, USA.

Nafamostat mesylate, an apparent soi-disant panacea of sorts, is widely used to anticoagulate patients undergoing hemodialysis or cardiopulmonary bypass, mitigate the inflammatory response in patients diagnosed with acute pancreatitis, and reverse the coagulopathy of patients experiencing the commonly preterminal disseminated intravascular coagulation in the Far East. The serine protease inhibitor nafamostat mesylate exhibits significant neuroprotective effects in the setting of neurovascular ischemia. Nafamostat mesylate generates neuroprotective effects by attenuating the enzymatic activity of serine proteases, neuroinflammatory signaling cascades, and the endoplasmic reticulum stress responses, downregulating excitotoxic transient receptor membrane channel subfamily 7 cationic currents, modulating the activity of intracellular signal transduction pathways, and supporting neuronal survival (brain-derived neurotrophic factor/TrkB/ERK1/2/CREB, nuclear factor kappa B. Read More

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http://dx.doi.org/10.4103/1673-5374.284981DOI Listing
December 2020

Using antifibrinolytics to tackle neuroinflammation.

Neural Regen Res 2020 Dec;15(12):2203-2206

Institute of Anatomy, University of Bern, Bern, Switzerland.

Plasmin is generally known as a promotor of inflammation. Recent advancement suggests that it has a complex role as immunity modulator. Pharmacological inhibition of plasmin production and activity has been proven to improve neurological outcomes in traumatic brain injury and subarachnoid hemorrhage, most probably by preventing re-bleeding. Read More

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http://dx.doi.org/10.4103/1673-5374.284979DOI Listing
December 2020

A New Scoring System for Prediction of Underlying Vascular Pathology in Patients with Intracerebral Hemorrhage: The Modified Secondary Intracerebral Hemorrhage Score (mSICH).

World Neurosurg 2020 Jun 25. Epub 2020 Jun 25.

Department of Neurosurgery, University of Illinois at Chicago, Chicago, Il, USA; Department of Neurosurgery, Stony Brook University, Stony Brook, NY, USA.

Background: Secondary intracerebral hemorrhage (SICH) score is used to predict risk of intracranial hemorrhage (ICH) associated vascular lesions. However, it has low clinical utility in identifying patients without need for neurovascular imaging.

Objective: This study aims to develop a modified scoring system to capture patients with low risk of underlying vascular pathology, thereby decreasing need for vascular imaging and its associated morbidity. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.139DOI Listing

Multimodal non-invasive assessment of intracranial hypertension: an observational study.

Crit Care 2020 Jun 26;24(1):379. Epub 2020 Jun 26.

Department of Intensive Care Medicine, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070, Brussels, Belgium.

Background: Although placement of an intra-cerebral catheter remains the gold standard method for measuring intracranial pressure (ICP), several non-invasive techniques can provide useful estimates. The aim of this study was to compare the accuracy of four non-invasive methods to assess intracranial hypertension.

Methods: We reviewed prospectively collected data on adult intensive care unit (ICU) patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), or intracerebral hemorrhage (ICH) in whom invasive ICP monitoring had been initiated and estimates had been simultaneously collected from the following non-invasive indices: optic nerve sheath diameter (ONSD), pulsatility index (PI), estimated ICP (eICP) using transcranial Doppler, and the neurological pupil index (NPI) measured using automated pupillometry. Read More

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http://dx.doi.org/10.1186/s13054-020-03105-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318399PMC

Precision Medicine in Acute Brain Injury: A Narrative Review.

J Neurosurg Anesthesiol 2020 Jun 23. Epub 2020 Jun 23.

Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India.

Over the past few years, the concept of personalized medicine has percolated into the management of different neurological conditions. Improving outcomes after acute brain injury (ABI) continues to be a major challenge. Unrecognized individual multiomic variations in addition to multiple interacting processes may explain why we fail to observe comprehensive improvements in ABI outcomes even when applied treatments appear to be beneficial logically. Read More

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http://dx.doi.org/10.1097/ANA.0000000000000710DOI Listing

Preoperative factors associated with adverse events during awake craniotomy: analysis of 609 consecutive cases.

J Neurosurg 2020 Jun 26:1-9. Epub 2020 Jun 26.

Objective: Awake surgery is becoming more standard and widely practiced for neurosurgical cases, including but not limited to brain tumors. The optimal selection of patients who can tolerate awake surgery remains a challenge. The authors performed an updated cohort study, with particular attention to preoperative clinical and imaging characteristics that may have an impact on the viability of awake craniotomy in individual patients. Read More

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http://dx.doi.org/10.3171/2020.4.JNS20378DOI Listing

Haptoglobin Therapeutics and Compartmentalization of Cell-Free Hemoglobin Toxicity.

Trends Mol Med 2020 Jul 21;26(7):683-697. Epub 2020 Mar 21.

Division of Internal Medicine, University Hospital, Zurich, Switzerland. Electronic address:

Hemolysis and accumulation of cell-free hemoglobin (Hb) in the circulation or in confined tissue compartments such as the subarachnoid space is an important driver of disease. Haptoglobin is the Hb binding and clearance protein in human plasma and an efficient antagonist of Hb toxicity resulting from physiological red blood cell turnover. However, endogenous concentrations of haptoglobin are insufficient to provide protection against Hb-driven disease processes in conditions such as sickle cell anemia, sepsis, transfusion reactions, medical-device associated hemolysis, or after a subarachnoid hemorrhage. Read More

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http://dx.doi.org/10.1016/j.molmed.2020.02.004DOI Listing

An investigation into the effects of hemodynamic changes on the patient's clinical condition during the treatment of patients undergoing aneurysmal subarachnoid hemorrhage.

Ulus Travma Acil Cerrahi Derg 2020 Jun;26(4):563-567

Department of Intensive Care Unit, Taksim Acıbadem Hospital, İstanbul-Turkey.

Background: In this study, we investigated the hemodynamic changes in patients with aneurysmal subarachnoid hemorrhage (aSAH) during the intensive care unit and the effects of PiCCO on the hemodynamic clinical course during hydration and hypertension treatment.

Methods: In our study, 15 adult aSAH patients, whose aneurysm had been treated by surgery or coiling, were examined for the signs of vasospasm in between the dates 03/01/2015 and 01/03/2016. The PICCO measurement was made at least twice in a day. Read More

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http://dx.doi.org/10.14744/tjtes.2020.24412DOI Listing

Pretruncal Subarachnoid Hemorrhage in a Patient with Cerebrospinal Fluid Leak.

Neurocrit Care 2020 Jun 25. Epub 2020 Jun 25.

Department of Neurocritical Care and Hospital Neurology, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA.

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http://dx.doi.org/10.1007/s12028-020-01030-1DOI Listing