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Hemodynamic Disturbances in the Early Phase After Subarachnoid Hemorrhage: Regional Cerebral Blood Flow Studied by Bedside Xenon-enhanced CT

Background: The mechanisms leading to neurological deterioration and the devastating course of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) are still not well understood. Bedside xenon-enhanced computerized tomography (XeCT) enables measurements of regional cerebral blood flow (rCBF) during neurosurgical intensive care. In the present study, CBF characteristics in the early phase after severe SAH were explored and related to clinical characteristics and early clinical course outcome. Materials and Methods: Patients diagnosed with SAH and requiring mechanical ventilation were prospectively enrolled in the study. Bedside XeCT was performed within day 0 to 3. Results: Data from 64 patients were obtained. Median global CBF was 34.9 mL/100 g/min (interquartile range [IQR], 26.7 to 41.6). There was a difference in CBF related to age with higher global CBF in the younger patients (30 to 49 y). CBF was also related to the severity of SAH with lower CBF in Fisher grade 4 compared with grade 3. rCBF disturbances and hypoperfusion were common; in 43 of the 64 patients rCBF
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Clinical Report Source Type: research

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DESPITE SIGNIFICANT IMPROVEMENTS in the management of patients with cardiovascular disease, stroke remains the second leading cause of death worldwide.1 Ischemic strokes account for 87% of all strokes, whereas 10% result from intracerebral hemorrhage, and 3% are subarachnoid hemorrhage strokes.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research
We report the successful ECT treatment of depression in an older man who had developed a subarachnoid hemorrhage after a suicide attempt by ingestion of antifreeze.
Source: The Journal of ECT - Category: Psychiatry Tags: Case Reports Source Type: research
Neurocritical care as a subspecialty has grown rapidly over the last two decades, including fast-growing new techniques in neuromonitoring, neuroimaging, and various therapeutic tools.Neurosurgical Intensive Care by Javed Siddiqi is a focused, concise handbook that provides a quick review mainly for residents and fellows receiving training in neurocritical care, but also provides a useful refresher for other healthcare professionals providing care to critically ill neurosurgical patients. The book has 31 chapters with some changes in the table of contents and the addition of two chapters compared with the first edition. Ne...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Background: The mechanisms leading to neurological deterioration and the devastating course of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) are still not well understood. Bedside xenon-enhanced computerized tomography (XeCT) enables measurements of regional cerebral blood flow (rCBF) during neurosurgical intensive care. In the present study, CBF characteristics in the early phase after severe SAH were explored and related to clinical characteristics and early clinical course outcome. Materials and Methods: Patients diagnosed with SAH and requiring mechanical ventilation were prospectively enroll...
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Clinical Report Source Type: research
Publication date: Available online 5 December 2017 Source:Anaesthesia Critical Care & Pain Medicine Author(s): Quentin Mathais, Pierre Esnault, Arnaud Dagain, Aurore Sellier, Philippe Yves Simon, Bertrand Prunet, Eric Meaudre
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
This report presents a 44-year-old female patient suffering from multiple cerebral aneurysm disease, who was urgently treated after rupture by both endovascular (for multiple aneurysms) and surgical (for acute subdural hematoma) approach in the same act under general anesthesia, which resulted in complete recovery of the patient. PMID: 29117659 [PubMed - in process]
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
We report 2 cases of parent artery occlusion (PAO) for anterior cerebral artery (ACA) fusiform aneurysm embolization after superselective provocative testing was performed to confirm distal territory viability. The first case involves a patient in the second decade of life who presented with subarachnoid hemorrhage and underwent PAO after a balloon test occlusion in the distal ACA revealed no neurophysiology changes. The second case involves another patient in the forth decade of life who presented with an enlarging pseudoaneurysm and underwent PAO after a sodium amobarbital infusion in the distal ACA revealed no clinical ...
Source: Interventional Neurology - Category: Neurology Source Type: research
Conclusions: Hemorrhage was readily apparent on intraoperative imaging, and hemorrhage rates for iMRI-guided DBS implantations were comparable to those for conventional implantation approaches.Stereotact Funct Neurosurg 2017;95:307-314
Source: Stereotactic and Functional Neurosurgery - Category: Neurosurgery Source Type: research
In patients with subarachnoid hemorrhage (SAH), vasospasm remains one of the major complications. The application of intravenous magnesium sulfate (MgSO4) has been under discussion to prevent cerebral ischemia. O...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
CONCLUSION: This paper attempts to build awareness of the possibility to cause or worsen a neurological deficit if a radiculomedullary aneurysm with preserved distal flow is clipped or embolized without an optimal IOM control. We report in detail MEP monitoring during the occlusion of a unilateral T4 segmental artery that supplies an anterior radiculomedullary artery aneurysm. PMID: 28966818 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
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