Elevated Neutrophil-Lymphocyte Ratio is Predictive of Poor Outcomes Following Aneurysmal Subarachnoid Hemorrhage

Background Recent studies of patients with intracerebral hemorrhage suggest an association between peripheral blood neutrophil-lymphocyte ratio and neurologic deterioration. We aimed to study the prognostic utility of neutrophil-lymphocyte ratio in predicting inpatient mortality in aneurysmal subarachnoid hemorrhage. Methods We conducted a retrospective electronic medical record review of the clinical, laboratory, and radiographic data of patients with aneurysmal subarachnoid hemorrhage 18 years of age or older presenting to the neuroscience intensive care unit from January 1, 2011, to December 31, 2017.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research

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Conclusion: We identified a novel non-sense mutation in MTHFR gene in a single Egyptian family with severe MTHFR deficiency. The present investigation is clinically important, as it adds to the growing list of MTHFR mutations, which might help in genetic counseling of families of affected children and proper genotype-phenotype correlation. Background Severe 5,10-Methylenetetrahydrofolate reductase (MTHFR; OMIM 236250) deficiency is a rare inborn error of metabolism and inherited in an autosomal recessive fashion. It is a very common disorder of folate metabolism and is clinically characterized with low plasma methion...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
AbstractPurpose of ReviewCerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication.Recent FindingsExisting data suggest that CA is general...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research
Publication date: Available online 10 January 2018 Source:The Lancet Neurology Author(s): Mark A Rodrigues, Neshika Samarasekera, Christine Lerpiniere, Catherine Humphreys, Mark O McCarron, Philip M White, James A R Nicoll, Cathie L M Sudlow, Charlotte Cordonnier, Joanna M Wardlaw, Colin Smith, Rustam Al-Shahi Salman Background Identification of lobar spontaneous intracerebral haemorrhage associated with cerebral amyloid angiopathy (CAA) is important because it is associated with a higher risk of recurrent intracerebral haemorrhage than arteriolosclerosis-associated intracerebral haemorrhage. We aimed to develop a predict...
Source: The Lancet Neurology - Category: Neurology Source Type: research
AbstractAlcohol consumption may be a modifiable risk factor for rupture of intracranial aneurysms. Our aim is to evaluate the association between ruptured aneurysms and alcohol consumption, intensity, and cessation. The medical records of 4701 patients with 6411 radiographically confirmed intracranial aneurysms diagnosed at the Brigham and Women ’s Hospital and Massachusetts General Hospital between 1990 and 2016 were reviewed. Individuals were divided into cases with ruptured aneurysms and controls with unruptured aneurysms. Univariable and multivariable logistic regression analyses were performed to determine the a...
Source: Translational Stroke Research - Category: Neurology Source Type: research
Conclusions:This report indicates that intravenous continuous infusion of verapamil may be used for rescue therapy in transiently responsive cerebral vasospasm to IA verapamil. This therapy did not seem to compromise hemodynamic stability or increase ICP.Disclosure: Dr. Mehta has nothing to disclose. Dr. Kulhari has nothing to disclose. Dr. Z Arango has nothing to disclose. Dr. Suhan has nothing to disclose. Dr. DeCarvalho has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Kirmani has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Subarachnoid Hemorrhage, Intracranial Aneurysm, and Other Cerebrovascular Malformations Source Type: research
Conclusions:Diagnostic or therapeutic angiography is frequently performed for acute ischemic or hemorrhagic stroke. Clinicians should be aware of contrast induced encephalopathy and consider it in cases of neurologic deterioration after angiography in order to initiate appropriate treatment and avoid unnecessary invasive tests.Disclosure: Dr. Bakradze has nothing to disclose. Dr. Pasquale has nothing to disclose. Dr. Kirchoff-Torres has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Cerebrovascular Disease Case Reports II Source Type: research
Vertebral artery dissection (VAD) is an important cause of ischemic stroke and subarachnoid hemorrhage (SAH). Dissections presenting with ischemia rarely cause SAH after more than a few hours, especially without radiographic evidence of pseudoaneurysm. We successfully treated a patient for persistent vessel injury presenting with SAH 7 years after presenting with extracranial subocclusive dissection of the right vertebral artery and an associated right posterior inferior cerebellar artery stroke. This is one of only three reported cases of delayed SAH occurring more than 2 weeks after an initial ischemic presenta...
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Hemorrhagic stroke Source Type: research
In conclusion, T2 lesion, WMI, and hydrocephalus were the most prevalent MRI characteristics 24 h after experimental SAH. The T2 lesion area matched with fibrinogen/fibrin positive staining in the acute phase of SAH. SAH induced more s evere brain injury in females compared to males in the acute phase of SAH.
Source: Translational Stroke Research - Category: Neurology Source Type: research
Conclusions Severe angiographic vasospasm may be linked to infarction in patients who present late. These infarcts are mostly large despite maximal treatment. We question the notion that proximal vasospasm has a minor role in delayed ischemia.
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Hemorrhagic stroke Source Type: research
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