Hemiparesis without responsible hematomas in patients with subarachnoid hemorrhage undergoing early aneurysmal repair

The presence of hemiparesis on arrival in patients with subarachnoid hemorrhage (SAH) is presumed to affect their prognosis, and intracranial hematomas with a mass effect responsible for the hemiparesis are frequently observed in these patients. The purpose of this study was to clarify the characteristics and outcomes of patients who presented with hemiparesis on arrival and showed no responsible hematomas (hemiparesis w/o hematoma) having a mass effect on computed tomography.
Source: World Neurosurgery - Category: Neurosurgery Authors: Tags: Original article Source Type: research

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Conclusion: Proximal occlusion of the basilar artery combined with STA-SCA bypass was successful in preventing rerupture of BAD and ensuring blood flow in the upper basilar region. Although there is controversy regarding acute treatment for ruptured BAD, direct proximal occlusion with sufficient revascularization using bypass skull base technique may be one of the optimal treatments even in this era of endovascular treatment. PMID: 33024594 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
CONCLUSIONS: This rare type of DAVF, combines two aggressive venous drainage patterns. For that reason, patients with type IV+V DAVF probably have a more aggressive natural history and worst outcome due to risk of intracranial and/or spinal hemorrhage and myelopathy, thus requiring urgent diagnostic and treatment. Larger studies are needed to better understand this type of DAVF. PMID: 33023355 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
AbstractBackgroundThe World Federation of Neurosurgical Societies (WFNS) scale is widely accepted for predicting outcomes for subarachnoid hemorrhage (SAH) patients. However, it is difficult to definitely predict outcomes for the most poor grade, WFNS grade 5. The present study aimed to investigate the prognostic ability of a novel classification using computed tomography perfusion (CTP) findings, called the cortical blood flow insufficiency (CBFI) scores.MethodsCTP was performed on admission for aneurysmal SAH followed by radical treatments within 72 hours of onset. Twenty-four cerebral cortex regions of interest (ROIs) w...
Source: Neurocritical Care - Category: Neurology Source Type: research
AbstractOxidative stress is a key component of the pathological cascade in subarachnoid hemorrhage (SAH). Fucoxanthin (Fx) possesses a strong antioxidant property and has shown neuroprotective effects in acute brain injuries such as ischemic stroke and traumatic brain injury. Here, we investigated the beneficial effects of Fx against SAH-induced oxidative insults and the possible molecular mechanisms. Our data showed that Fx could significantly inhibit SAH-induced reactive oxygen species production and lipid peroxidation, and restore the impairment of endogenous antioxidant enzymes activities. In addition, Fx supplementati...
Source: Molecular Neurobiology - Category: Neurology Source Type: research
Publication date: March 2021Source: Interdisciplinary Neurosurgery, Volume 23Author(s): Francesco Corrivetti, Carmine Franco Muccio, Pierluigi Granaroli, Giuseppina Iorio, Matteo De Notaris
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
AbstractPurposeDelayed cerebral ischemia represents a significant cause of poor functional outcome for patients with vasospasm after subarachnoid hemorrhage. We investigated whether delayed cerebral ischemia could be detected by the arterial opacification of internal carotid artery at the level of the skull base.MethodsIn this exploratory, nested retrospective cohort diagnostic accuracy study, patients with clinical and/or transcranial Doppler suspicion of vasospasm who underwent four-dimensional computed tomography angiography were included. They were split into two groups for the main endpoint analysis, according to the ...
Source: International Journal of Computer Assisted Radiology and Surgery - Category: Intensive Care Source Type: research
Authors: Sivakumar S, Lazaridis C Abstract Management of volume status, arterial blood pressure, and cardiac output are core elements in approaching the patients with aneurysmal subarachnoid hemorrhage (SAH). For the prevention and treatment of delayed cerebral ischemia (DCI), euvolemia is advocated and caution is made towards the avoidance of hypervolemia. Induced hypertension and cardiac output augmentation are the mainstays of medical management during active DCI, whereas the older triple-H paradigm has fallen out of favor due to lack of demonstrable physiological or clinical benefits and serious concern for adv...
Source: Critical Care Research and Practice - Category: Intensive Care Tags: Crit Care Res Pract Source Type: research
AbstractUnruptured intracranial saccular aneurysms occur in 3 –5% of the general population. As the use of diagnostic medical imaging has steadily increased over the past few decades with the increased availability of computed tomography (CT) and magnetic resonance imaging (MRI), so has the detection of incidental aneurysms. The management of an unruptured i ntracranial saccular aneurysm is challenging for both patients and physicians, as the decision to intervene must weigh the risk of rupture and resultant subarachnoid hemorrhage against the risk inherent to the surgical or endovascular procedure. The purpose of th...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research
Propylthiouracil-induced otitis media with anti-neutrophil cytoplasmic antibody-associated vasculitis: a ‍case report and review of the literature. Endocr J. 2020 Sep 29;: Authors: Hiruma M, Sasano Y, Watanabe N, Yoshihara A, Ishii S, Yaguchi Y, Yoshimura Noh J, Sugino K, Ito K Abstract Propylthiouracil (PTU)-induced otitis media with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) is an extremely rare adverse event associated with anti-thyroid drugs and is not well recognized. A 42-year-old woman with Graves' disease undergoing PTU therapy for 8 years visited our hospital...
Source: Endocrine Journal - Category: Endocrinology Tags: Endocr J Source Type: research
Authors: Suzuki H, Kanamaru H, Kawakita F, Asada R, Fujimoto M, Shiba M Abstract Aneurysmal subarachnoid hemorrhage (SAH) remains a serious cerebrovascular disease. Even if SAH patients survive the initial insults, delayed cerebral ischemia (DCI) may occur at 4 days or later post-SAH. DCI is characteristics of SAH, and is considered to develop by blood breakdown products and inflammatory reactions, or secondary to early brain injury, acute pathophysiological events that occur in the brain within the first 72 hours of aneurysmal SAH. The pathology underlying DCI may involve large artery vasospasm and/or microcircula...
Source: Histology and Histopathology - Category: Cytology Tags: Histol Histopathol Source Type: research
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