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Fever Burden in Patients With Subarachnoid Hemorrhage and the Increased Use of Antibiotics
Background: Fever occurs in the majority of subarachnoid hemorrhage (SAH) patients. Nearly 50% of SAH patients have noninfectious fevers. Data are lacking describing the effects of fever burden in the SAH patient population. Methods: This was a single-center, retrospective observational cohort study in patients more or equal to 18 years of age with a diagnosis of nontraumatic SAH admitted to an ICU between January 1, 2010 and September 1, 2015. Exclusion criteria were SAH secondary to trauma or admission for more than 48 hours.
Source: Journal of Stroke and Cerebrovascular Diseases - August 8, 2019 Category: Neurology Authors: Carolyn A Magee, Melissa L. Thompson Bastin, Katelyn Graves, Donna Burgess, Melissa Nestor, John R. Lamm, Aaron M. Cook Source Type: research

Propofol Reduces Inflammatory Brain Injury after Subarachnoid Hemorrhage: Involvement of PI3K/Akt Pathway
Background: Our previous study showed that propofol, one of the widely used anesthetic agents, can attenuate subarachnoid hemorrhage (SAH)-induced early brain injury (EBI) via inhibiting inflammatory and oxidative reaction. However, it is perplexing whether propofol attenuates inflammatory and oxidative reaction through modulating PI3K/Akt pathway. The present study investigated whether PI3K/Akt pathway is involved in propofol's anti-inflammation, antioxidation, and neuroprotection against SAH-induced EBI.
Source: Journal of Stroke and Cerebrovascular Diseases - October 3, 2019 Category: Neurology Authors: Hua-bin Zhang, Xian-kun Tu, Quan Chen, Song-sheng Shi Source Type: research

Incidence of Convexal Subarachnoid Hemorrhage in the Elderly: The Mayo Clinic Study of Aging
Nontraumatic convexal subarachnoid hemorrhages in the elderly can be a manifestation of cerebral amyloid angiopathy associated with a high risk of future intracerebral hemorrhage. The incidence in the elderly population is unknown. Our objectives were to: 1) determine the incidence of convexal subarachnoid hemorrhage in a population-based study, and, 2) to compare apopolipoprotein-E genotype and amyloid positron emission tomographic (PET) imaging for those with versus without hemorrhage.
Source: Journal of Stroke and Cerebrovascular Diseases - October 23, 2019 Category: Neurology Authors: Micah Yost, Catherine Arnold Fiebelkorn, Alejandro A. Rabinstein, James Klaas, Jeremiah A. Aakre, Robert D. Brown, Michelle M. Mielke, David S. Knopman, Val Lowe, Ronald C. Petersen, Clifford R. Jack, Prashanthi Vemuri, Jonathan Graff-Radford Source Type: research

Successful Cesarean Section Deliveries in a Patient with a History of Developmental Venous Anomaly-Induced Hemorrhage
While hemorrhage can occur because of developmental venous anomalies (DVAs), there is no established opinion concerning their association with pregnancy and childbirth. In the present report, we discuss the case of a now 39-year-old woman with DVA in whom pregnancy and childbirth were successful. When she was 28, she experienced disturbance of consciousness and paralysis on the left side of the body, and brain computed tomography revealed cerebral hemorrhage coupled with subarachnoid hemorrhage.
Source: Journal of Stroke and Cerebrovascular Diseases - October 25, 2019 Category: Neurology Authors: Yuko Nonaka, Shoji Yasuda, Nobutoshi Kumagai, Yoshinori Kakino, Jiro Nakagawa, Katsunobu Takenaka Tags: Case Report Source Type: research

The Spectrum of Nontraumatic Convexity Subarachnoid Hemorrhage
Background: Nontraumatic convexity subarachnoid hemorrhage (cSAH) is a nonaneurysmal variant that is associated with diverse etiologies. Methods: With IRB approval, we retrospectively reviewed consecutive nontraumatic cSAH from July 1, 2006 to July 1, 2016. Data were abstracted on demographics, medical history, neuroimaging, etiology, and clinical presentation. Results: We identified 94 cases of cSAH. The cases were classified according to the following etiologies: reversible cerebral vasoconstriction syndrome (RCVS) 17 (18%), cerebral amyloid angiopathy (CAA) 15 (16%), posterior reversible encephalopathy syndrome 16 (17%)...
Source: Journal of Stroke and Cerebrovascular Diseases - October 30, 2019 Category: Neurology Authors: Rachel Forman, James J. Conners, Sarah Y. Song, Sayona John, Rajeev Garg, Jennifer Harris, Vivien H. Lee Source Type: research

Silencing of Tenascin-C Inhibited Inflammation and Apoptosis Via PI3K/Akt/NF- κB Signaling Pathway in Subarachnoid Hemorrhage Cell Model
Tenascin-C (TNC) is upregulated in serum and cerebrospinal fluid after subarachnoid hemorrhage (SAH) and the deficiency of TNC could alleviate neuronal apoptosis and neuroinflammation after SAH. However, the specific mechanism of TNC regulating neuronal apoptosis and neuroinflammation after SAH is not well recognized. The aim of this study was to investigate whether PI3K/Akt/ NF- κB signaling pathway is involved in the regulation of TNC on early brain injury after SAH.
Source: Journal of Stroke and Cerebrovascular Diseases - November 5, 2019 Category: Neurology Authors: Xiaopeng Tong, Jinjing Zhang, Miaoxin Shen, Junyang Zhang Source Type: research

Recombinant Human Milk Fat Globule-Epidermal Growth Factor 8 Attenuates Microthrombosis after Subarachnoid Hemorrhage in Rats
This study investigated the effects of recombinant human milk fat globule-epidermal growth factor 8 on microthrombosis and neurological function after subarachnoid hemorrhage.
Source: Journal of Stroke and Cerebrovascular Diseases - December 24, 2019 Category: Neurology Authors: Jikai Wang, Yuchun Zuo, Kai Zhuang, Kui Luo, Xiaoxin Yan, Jianming Li, John H. Zhang, Fei Liu Source Type: research

Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage – Serum D-dimer and C-reactive Protein as Early Markers
Identifying patients at risk for delayed cerebral ischemia after an aneurysmal subarachnoid hemorrhage remains challenging and both delayed treatment and over-treatment are reasonable concerns.
Source: Journal of Stroke and Cerebrovascular Diseases - December 26, 2019 Category: Neurology Authors: Helene Hurth, Ulrich Birkenhauer, Jochen Steiner, Dennis Schlak, Florian Hennersdorf, Florian H. Ebner Source Type: research

Elevated Cerebrospinal Fluid Protein Is Associated with Unfavorable Functional Outcome in Spontaneous Subarachnoid Hemorrhage
Background/objective: Subarachnoid hemorrhage (SAH) is a devastating neurologic event for which markers to assess poor outcome are needed. Elevated cerebrospinal fluid (CSF) protein may result from inflammation and blood-brain barrier (BBB) disruption that occurs during SAH. We sought to determine if CSF protein level is associated with functional outcome after SAH. Methods: We prospectively collected single-center demographic and clinical data for consecutive patients admitted with spontaneous SAH.
Source: Journal of Stroke and Cerebrovascular Diseases - January 12, 2020 Category: Neurology Authors: Neil A. Nadkarni, Matthew B. Maas, Ayush Batra, Minjee Kim, Edward M. Manno, Farzaneh A. Sorond, Shyam Prabhakaran, Andrew M. Naidech, Eric M. Liotta Source Type: research

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 - January 17, 2020 Category: Neurology Authors: Sheheryar A. Jamali, Marion T. Turnbull, Takahisa Kanekiyo, Prakash Vishnu, Abba C. Zubair, Carol C. Raper, Rabih G. Tawk, William D. Freeman Source Type: research

A Propensity Score-Matched Comparison of Readmission Rates Associated With Microsurgical Clipping and Endovascular Treatment of Ruptured Intracranial Aneurysms
Background: In the treatment of aneurysmal subarachnoid hemorrhage (aSAH), microsurgical clipping, and endovascular therapy (EVT) with coiling are modalities for securing the ruptured aneurysm. Little data is available regarding associated readmission rates. We sought to determine whether readmission rates differed according to treatment modality for ruptured intracranial aneurysms. Methods: The Nationwide Readmissions Database (NRD) was used to identify adults who experienced aSAH and underwent clipping or EVT.
Source: Journal of Stroke and Cerebrovascular Diseases - February 20, 2020 Category: Neurology Authors: Haydn Hoffman, Muhammad S. Jalal, Lawrence S. Chin Source Type: research

Lactate and Lactate Dehydrogenase in Cistern as Biomarkers of Early Brain Injury and Delayed Cerebral Ischemia of Subarachnoid Hemorrhage
Objective: The pathophysiology of delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) has not been fully evaluated. The aim of this study was to evaluate the dynamics of lactate and lactate dehydrogenase (LDH) in carotid cisternal cerebrospinal fluid (CSF), and to discuss their effectiveness as markers of early brain injury (EBI) and DCI following aSAH. Patients and Methods: Among 91 consecutive aSAH patients treated between January 2012 and March 2019 at National Hospital Organization Beppu Medical Center, 19 patients (20.9%) were eligible for this retrospective study.
Source: Journal of Stroke and Cerebrovascular Diseases - March 11, 2020 Category: Neurology Authors: Mitsuhiro Anan, Yasuyuki Nagai, Hirotaka Fudaba, Minoru Fujiki Source Type: research

Early Serum Calprotectin (S100A8/A9) Predicts Delayed Cerebral Ischemia and Outcomes after Aneurysmal Subarachnoid Hemorrhage
Aneurysmal subarachnoid hemorrhage (aSAH) not only has a high early mortality, but also leads to serious long-term neurological dysfunction. Looking for biomarkers that can predict the prognosis of patients will contribute to the decision-making of early treatment. Current clinical scores, such as Glasgow Coma Scale (GCS) score, Hunt and Hess scale, and Fisher grade, can determine the clinical neurological status of patients. However, because of sedation or disturbance of consciousness, the neurological status of patient is sometimes difficult to assess.
Source: Journal of Stroke and Cerebrovascular Diseases - March 12, 2020 Category: Neurology Authors: Chenchen Wang, Yun Kou, Yuwei Han, Xiaoming Li Source Type: research

Temporal Relationship between Hyponatremia and Development of Cerebral Vasospasm in Aneurysmal Subarachnoid Hemorrhage Patients: A Retrospective Observational Study
Background: Hyponatremia is a common complication after aneurysmal subarachnoid hemorrhage (aSAH). Previous studies have reported an association between hyponatremia and vasospasm, however whether hyponatremia directly contributes to the pathogenesis of cerebral vasospasm (CVS), or is a by-product is still unclear. The aim of this study was to explore an association between hyponatremia and CVS after aSAH, and evaluating the temporality of these 2 events. Methods: A retrospective study of consecutive patients with aSAH admitted to the Baylor St.
Source: Journal of Stroke and Cerebrovascular Diseases - March 19, 2020 Category: Neurology Authors: C ésar E. Escamilla-Ocañas, Chethan P. Venkatasubba Rao, Eric Bershad, Rahul Damani Source Type: research

Outcomes in Elderly Japanese Patients Treated for Aneurysmal Subarachnoid Hemorrhage: A Retrospective Nationwide Study
Objective: Japan has the largest elderly population in the world. As data on the clinical outcomes in elderly patients with aneurysmal subarachnoid hemorrhage (aSAH), including those older than 80 years, are lacking, we analyzed the characteristics of 54,805 aSAH patients and recorded their treatments and clinical outcomes using a Japanese nationwide inpatient database. Methods: Using the Japanese Diagnostic Procedure Combination database, we identified aSAH patients aged 18 years or older who were hospitalized between July 1, 2010 and March 31, 2016.
Source: Journal of Stroke and Cerebrovascular Diseases - March 24, 2020 Category: Neurology Authors: Kohei Hironaka, Shotaro Aso, Masanori Suzuki, Fumihiro Matano, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Akio Morita Source Type: research

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