Brain hemorrhage surgery boosts survival, but disability risk still high

A new meta-analysis offers insight into which among the 35,000 annual intracerebral hemorrhage patients in Europe and America would most benefit from surgery.
Source: Yale Science and Health News - Category: Universities & Medical Training Source Type: news

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AbstractAimsImpaired autonomic nervous system regulation is frequently observed in patients with stroke. The aim of this prospective study was to evaluate the impact of cardiac autonomic tone on functional outcome after the early post ‐stroke rehabilitation.Methods and resultsOne hundred and three consecutive patients (67  ± 11 years, body mass index (BMI) 27.1 ± 5.4 kg/m2, 64% men) with ischaemic (84% of patients) and haemorrhagic stroke were studied. Depressed heart rate variability (HRV), as a surrogate marker of increased sympathetic tone, was defined by the standard deviat...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
DiscussionIf this randomized clinical trial demonstrates reductions in inflammatory cytokines, it would provide evidence for a multicenter clinical trial to evaluate the efficacy of vitamin D supplementation in neurocritically ill patients. Since vitamin D supplements are inexpensive and safe, this clinical trial could have the potential to improve clinical outcomes in traumatic brain injury patients through reduction of inflammation and infection-associated morbidity and mortality rates.Trial registrationIranian Registry of Clinical Trials,IRCT20180619040151N3. Registered on 10 August 2019.
Source: Trials - Category: Research Source Type: clinical trials
Acute stroke treatment requires clear protocols to rapidly triage patients – using appropriate investigations – for endovascular thrombectomy and intravenous thrombolysis. Computed tomography (CT) excludes haemorrhage, CT angiography locates the occluded vessel, and perfusion magnetic resonance imaging identifies viable tissue. An organized approach to stroke care in a specialist environment reduces disability and saves lives. Adoption of a ‘care bundle’ approach including the active management of pyrexia and hyperglycaemia, and early screening for swallowing difficulties, is beneficial.
Source: Medicine - Category: Internal Medicine Authors: Tags: Acute neurology Source Type: research
Abstract Ataxia, characterized by uncoordinated movement, is often found in patients with cerebellar hemorrhage (CH), leading to long-term disability without effective management. Microglia are among the first responders to CNS insult. Yet the role and mechanism of microglia in cerebellar injury and ataxia after CH are still unknown. Using Ki20227, an inhibitor for colony-stimulating factor 1 receptor which mediates the signaling responsible for the survival of microglia, we determined the impact of microglial depletion on cerebellar injury and ataxia in a murine model of CH. Microglial depletion reduced cerebella...
Source: Brain, Behavior, and Immunity - Category: Neurology Authors: Tags: Brain Behav Immun Source Type: research
Abstract External ventricular drainage (EVD) is widely used in patients with a traumatic brain injury (TBI). However, the EVD weaning trial protocol varies and insufficient studies focus on the intracranial pressure (ICP) during the weaning trial. We aimed to establish the relationship between ICP during an EVD weaning trial and the outcomes of TBI. We enrolled 37 patients with a TBI with an EVD from July 2018 to September 2019. Among them, 26 were allocated to the favorable outcome group and 11 to the unfavorable outcome group (death, post-traumatic hydrocephalus, persistent vegetative state, and severe disabilit...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Well studied in patients with ischemic stroke after reperfusion therapies (RT), hemorrhagic transformation (HT) is also common in patients not treated with RT and can lead to disability even in initially asymptomatic cases. The best predictors of HT in patients not treated with RT are not well established. Therefore, we aimed to identify predictors of HT in patients not submitted to RT and create a user-friendly predictive score (PROpHET).
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Intracerebral hemorrhage (ICH), caused by a rupture of a brain artery into brain parenchyma, is the second most common form of stroke after ischemic stroke.1 Approximately 40% of the patients die within one month, and many remain with major disabilities.2 There is no effective medical or surgical treatment option, and those in clinical use are mainly supportive in nature, even though management in dedicated stroke units will likely reduce mortality and morbidity.3 Several chronic risk factors such as hypertension, older age, and high alcohol consumption have been shown to associate with ICH.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Cerebral microbleeds (CMBs), lacunar infarctions, periventricular hyperintensities (PVH), and deep white matter hyperintensities (DWMH) are markers of intrinsic brain damage. Recent studies have suggested that the total small vessel disease (SVD) score, which integrates all individual SVD markers, may better represent the total brain burden than a single marker.1 In patients after intracerebral hemorrhage (ICH), each SVD marker is an independent predictor for poor prognosis2 –4; however, few studies have examined the association between functional disabilities and the global SVD burden.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Abstract Acute brain injury is the leading cause of human death and disability worldwide, which includes intracerebral haemorrhage, subarachnoid haemorrhage, cerebral ischaemia, traumatic brain injury and hypoxia-ischaemia brain injury. Currently, clinical treatments for neurological dysfunction of acute brain injury have not been satisfactory. Osteopontin (OPN) is a complex adhesion protein and cytokine that interacts with multiple receptors including integrins and CD44 variants, exhibiting mostly neuroprotective roles and showing therapeutic potential for acute brain injury. OPN-induced tissue remodelling and fu...
Source: J Cell Mol Med - Category: Molecular Biology Authors: Tags: J Cell Mol Med Source Type: research
Abstract Stroke is a major cause of death and disability in China, and no therapies have proven effective to prevent it. Popular belief holds that the lunar cycle affects human physiology, behavior, and health. The aim of our study is to determine whether the lunar cycle impacts the incidence of stroke subtypes [intracerebral hemorrhage (ICH), transient ischemic attack (TIA) and ischemic stroke (IS)]. We retrospectively extracted the discharge registry data of all patients with first-ever acute stroke hospitalized in the affiliated hospital of Beijing University of Traditional Chinese Medicine during 2002-2015. Th...
Source: Chronobiology International - Category: Biology Authors: Tags: Chronobiol Int Source Type: research
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