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Impact of Cerebral Autoregulation Monitoring in Cerebrovascular Disease: A Systematic Review
AbstractCerebral autoregulation (CA) prevents brain injury by maintaining a relatively constant cerebral blood flow despite fluctuations in cerebral perfusion pressure. This process is disrupted consequent to various neurologic pathologic processes, which may result in worsening neurologic outcomes. Herein, we aim to highlight evidence describing CA changes and the impact of CA monitoring in patients with cerebrovascular disease, including ischemic stroke, intracerebral hemorrhage (ICH), and aneurysmal subarachnoid hemorrhage (aSAH). The study was preformed according to the Preferred Reporting Items for Systematic Reviews ...
Source: Neurocritical Care - April 5, 2022 Category: Neurology Source Type: research

Hemorrhage or Ischemia? The Importance of ‘Spotting’ it Right
Conclusion In this case of embolic ischemic stroke with reperfusion hemorrhage, contrast extravasation “spot sign” was associated with hematoma expansion.
Source: Neurocritical Care - February 4, 2015 Category: Neurology Source Type: research

Dynamic Autoregulatory Response After Aneurysmal Subarachnoid Hemorrhage and Its Relation to Angiographic Vasospasm and Clinical Outcome
Conclusions Early deterioration of CA significantly correlates with unfavorable clinical outcome and severity of angiographic vasospasm. Dynamic CA measurements might represent an important tool in stratifying therapy guidelines in patients after SAH.
Source: Neurocritical Care - November 6, 2015 Category: Neurology Source Type: research

A Propensity Score-Matched Study of the Use of Non-steroidal Anti-inflammatory Agents Following Aneurysmal Subarachnoid Hemorrhage
Conclusions Inflammation may play a crucial role in the poor outcomes after SAH, and that NSAIDs may be a useful therapeutic option, once validated by larger prospective studies.
Source: Neurocritical Care - March 20, 2016 Category: Neurology Source Type: research

The Role of Serum Calcium Level in Intracerebral Hemorrhage Hematoma Expansion: Is There Any?
AbstractSpontaneous intracerebral hemorrhage (ICH) is a devastating form of stroke, with a high rate of mortality and morbidity. Even with the best current medical or surgical interventions, outcomes remain poor. The location and initial hematoma volume are strong predictors of mortality. Hematoma expansion (HE) is a further marker of poor prognosis that may be at least partly preventable. Several risk factors for HE have been identified, including baseline ICH volume, anticoagulation, and computed tomography angiography spot signs. Recent studies have shown the correlation of serum calcium (Ca++) levels on admission with ...
Source: Neurocritical Care - June 27, 2018 Category: Neurology Source Type: research

External Validation of Hematoma Expansion Scores in Spontaneous Intracerebral Hemorrhage in an Asian Patient Cohort
ConclusionsTo our knowledge, this is the first study to validate HE scores, namely PREDICT, 9-Point and BRAIN, in a multi-ethnic Asian ICH patient population. The PREDICT score was the best performing model in our study cohort, based on the performance metrics employed in this study. Our findings also showed support for CT angiography spot sign as a predictor of outcome after ICH. Although the models assessed are sufficient for risk stratification, the discrimination and calibration are at best moderate and could be improved.
Source: Neurocritical Care - October 30, 2018 Category: Neurology Source Type: research

Serum Alkaline Phosphatase Level is Associated with Angiographic Vasospasm, Delayed Cerebral Ischemia-Caused Clinical Deterioration, and Functional Outcome After Aneurysmal Subarachnoid Hemorrhage
ConclusionsElevated serum ALP level is associated with vasospasm, DCI-caused clinical deterioration, and functional outcome after aSAH. Further studies are required to examine the potential role of serum ALP as an outcome predictor for aSAH patients.
Source: Neurocritical Care - April 22, 2019 Category: Neurology Source Type: research

Effect of Race –Ethnicity and CT Angiography on Renal Injury During Blood Pressure Treatment for Intracerebral Hemorrhage
ConclusionWe found no association between race –ethnicity or CTA and AKI during the acute management of ICH in a real-life stroke population. Our findings suggest that CTA can be safely obtained in acute ICH, even in populations of diverse race–ethnicity who may be more prone to adverse kidney events. CTA did not contribute to developing AKI .
Source: Neurocritical Care - March 5, 2021 Category: Neurology Source Type: research

The Spot Sign and Intraventricular Hemorrhage are Associated with Baseline Coagulopathy and Outcome in Intracerebral Hemorrhage
ConclusionsThe spot sign and IVH are associated with specific hematoma characteristics, such as size and location, but are related differently to coagulation status and clinical course. A combined analysis of the spot sign and IVH can improve the understanding of pathophysiology and risk stratification after ICH.
Source: Neurocritical Care - June 28, 2022 Category: Neurology Source Type: research