Pleiotropic Effects of the Rho-kinase Inhibitor Fasudil After Subarachnoid Hemorrhage: A Review of Preclinical and Clinical Studies.

Pleiotropic Effects of the Rho-kinase Inhibitor Fasudil After Subarachnoid Hemorrhage: A Review of Preclinical and Clinical Studies. Curr Vasc Pharmacol. 2014 Jun 13; Authors: Satoh SI, Ikegaki I, Kawasaki K, Asano T, Shibuya M Abstract There is growing evidence that Rho-kinase contributes to cardiovascular disease, which has made Rho-kinase a target for the treatment of human diseases. To date, the only Rho-kinase inhibitor employed clinically in humans is fasudil, which has been used for the prevention of cerebral vasospasm and subsequent ischemic injury after surgery for subarachnoid hemorrhage (SAH). A number of pathological processes, in particular hemodynamic dysfunctions and inflammatory reactions, are thought to be related in the pathogenesis of delayed cerebral vasospasm and subsequent ischemic injury after SAH. This review focuses on fasudil's pleiotropic therapeutic effects: amelioration of hemodynamic dysfunction and inflammation, and discusses in detail the clinical studies on fasudil administered after the occurrence of SAH. PMID: 24923440 [PubMed - as supplied by publisher]
Source: Current Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Vasc Pharmacol Source Type: research

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ConclusionsSeizures are important neurologic complications of SAH of all etiologies. Nevertheless, acute as well as remote symptomatic seizures are unrelated to the short-term outcome. These results should be treated as hypothesis generating and require confirmation.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
This study included 532 aneurysms treated with coil occlusion in 505 patients. Procedure-related rupture occurred in 34 patients (6.7%) and thromboembolic events in 53 (10.5%) patients. Aneurysms of 2 to 3 mm inclusively were not more significantly associated with procedure-related rupture or thromboembolic events than those larger than 3 mm (OR 1.02, 95% CI: 0.9–1.16, p = 0.78 and OR 1.06, 95% CI: 0.96–1.17, p = 0.3, respectively). However, procedure-related rupture had a significant effect on patient mortality (OR 3.86, 95% CI: 1.42–10.53, p 
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
ConclusionPediatric aneurysms are rare, and often present as dissecting thrombosed aneurysms or giant aneurysms. ACA dissecting aneurysms are rare but often occur at a young age, and they easily cause thrombosis, which may occlude the aneurysm and the parent artery, resulting in unknown bleeding sources.It is necessary to suspect rupture of an ACA dissecting aneurysm if there is an ICH and SAH of an unknown source of bleeding where the hematoma is localized near the ACA. Craniotomy can effectively remove the hematoma and identify the bleeding source, and it is more desirable to secure the parent artery to prevent re-rupture.
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
In this study, we tried to translate this concept, the initiation of intraventricular NO application on top of continuous Molsidomine infusion, from awake to comatose patients who lack neurological –clinical monitoring but are primarily monitored using frequently applied transcranial Doppler (TCD).MethodsIn this observational, retrospective, nonrandomized feasibility study, 18 consecutive aSAH comatose/intubated patients (Hunt and Hess IV/V with/without pupil dilatation) whose poor clinical status precluded clinical monitoring received standard neuro-intensive care, frequent TCD monitoring, continuous intravenous Mol...
Source: Neurocritical Care - Category: Neurology Source Type: research
Publication date: Available online 13 August 2019Source: Journal of Clinical NeuroscienceAuthor(s): Satoru Tanioka, Fujimaro Ishida, Tomoyuki Kishimoto, Katsuhiro Tanaka, Shinichi Shimosaka, Hidenori SuzukiAbstractEndovascular coiling of a cerebral aneurysm and coil occlusion of the parent artery have been occasionally performed to treat cerebral aneurysms; however, it is difficult to predict the accurate extent of thrombus formation in the parent artery proximal to the coiled aneurysm and the coil-occluded parent artery preoperatively, and unexpected occlusion of the arterial branches can occur by thrombus extension into ...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
ConclusionThis study highlights the heterogeneity in delayed investigations and outcomes for patients with naSAH, which may be influenced by the initial pattern of bleeding. Further multi-centre prospective studies are required to clarify optimal tailored management strategies for this heterogeneous group of patients.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
AbstractBackground/ObjectivesAneurysmal subarachnoid hemorrhage (aSAH) is commonly associated with hydrocephalus due to subarachnoid hemorrhage blood products obstructing cerebrospinal fluid outflow. Hydrocephalus after aSAH is routinely managed with temporary external ventricular drainage (EVD) followed by standard EVD weaning protocols, which determine the need for ventriculoperitoneal shunting (VPS). We sought to investigate aSAH patients who initially passed EVD weaning trials and had EVD removal, but later presented with recurrent, delayed, symptomatic hydrocephalus requiring a VPS.MethodsWe conducted a retrospective ...
Source: Neurocritical Care - Category: Neurology Source Type: research
Condition:   Subarachnoid Hemorrhage Intervention:   Other: Medical condition: Subarachnoid hemorrhage Sponsors:   Rigshospitalet, Denmark;   University of Copenhagen Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Abstract BACKGROUND AND PURPOSE: The aim of this study is to identify the early predictors for delayed cerebral ischemia (DCI) and develop a risk stratification score by focusing on the early change after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: The study retrospectively reviewed aSAH patients between 2014 and 2015. Risk factors within 72 hours after aSAH were included into univariable and multivariable logistic regression analysis to screen the independent predictors for DCI and to design a risk stratification score. RESULTS: We analyzed 702 aSAH patients; four predictors were retained f...
Source: CNS Neuroscience and Therapeutics - Category: Neuroscience Authors: Tags: CNS Neurosci Ther Source Type: research
Publication date: Available online 7 August 2019Source: NeuroscienceAuthor(s): Hao Zhao, Yunjun Li, Lihua Chen, Chunsen Shen, Zongyu Xiao, Ruxiang Xu, Ji Wang, Yongchun LuoAbstractEarly brain injury (EBI) is the most important potentially treatable cause of mortality and morbidity following subarachnoid hemorrhage (SAH). Apoptosis is one of the main pathologies of SAH-induced EBI. Numerous studies suggest that human umbilical cord derived mesenchymal stem cells (hucMSCs) may exert neuroprotective effect through exosomes instead of transdifferentiation. In addition, microRNA-206 (miR-206) targets BDNF and plays a critical r...
Source: Neuroscience - Category: Neuroscience Source Type: research
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