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Clipping Versus Coiling for Ruptured Intracranial Aneurysms: A Systematic Review and Meta-Analysis Original Contributions
Conclusions— Coiling yields a better clinical outcome, the benefit being greater in those with a good preoperative grade than those with a poor preoperative grade. However, coiling leads to a greater risk of rebleeding. Well-designed randomized trials with special considerations to the aspect are needed.
Source: Stroke - December 24, 2012 Category: Neurology Authors: Li, H., Pan, R., Wang, H., Rong, X., Yin, Z., Milgrom, D. P., Shi, X., Tang, Y., Peng, Y. Tags: Cerebral Aneurysm, AVM, & Subarachnoid hemorrhage, Aneurysm, AVM, hematoma, Other Stroke Treatment - Surgical Original Contributions Source Type: research

Recovery of akinetic mutism and injured prefronto-caudate tract following shunt operation for hydrocephalus and rehabilitation: A case report
Rationale: A 76-year-old female patient was diagnosed with an aneurysmal subarachnoid hemorrhage following rupture of a right posterior communicating artery aneurysm. Patient concerns: She was treated surgically with clipping of the aneurysmal neck. Six months after onset, when starting rehabilitation at our hospital, she showed no spontaneous movement or speech. Diagnoses: aneurysmal subarachnoid hemorrhage following rupture of a right posterior communicating artery aneurysm. Interventions: During 2 months’ rehabilitation, her AM did not improve significantly. As there was no apparent change, she underwent a ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Complete spontaneous thrombosis and recanalization of a ruptured posterior cerebral artery aneurysm.
Abstract Complete spontaneous thrombosis followed by recanalization of non-giant aneurysms is a rare event that can be discovered incidentally on advanced neural images. In this case report, the authors described a woman who presented with subarachnoid hemorrhage (SAH) and left posterior cerebral artery (PCA) territory ischemic stroke. Cerebral angiography revealed a left PCA aneurysm at the P1-P2 junction. The patient received conservative treatment and repeated cerebral angiography 4 weeks later demonstrated the disappeared aneurysm. Subsequent magnetic resonance imaging (MRI) and contrast-enhanced computed tomo...
Source: Turkish Neurosurgery - May 27, 2014 Category: Neurosurgery Authors: Wei D, Jingru Z, Cungang F, Yake X, Dongliang W, Zhengmao W, Xinting W, Qingjun Z Tags: Turk Neurosurg Source Type: research

Spontaneous subarachnoid hemorrhage of unknown origin: hospital course and long-term clinical and angiographic follow-up.
CONCLUSIONS Hydrocephalus and delayed cerebral ischemia, while infrequent, do occur in SAH of unknown origin. Long-term neurological outcomes are generally good. A thorough evaluation to rule out an etiology of hemorrhage is necessary; however, imaging beyond 6 weeks from ictus has little utility, and rebleeding is unexpected. PMID: 25526276 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - December 19, 2014 Category: Neurosurgery Authors: Elhadi AM, Zabramski JM, Almefty KK, Mendes GA, Nakaji P, McDougall CG, Albuquerque FC, Preul MC, Spetzler RF Tags: J Neurosurg Source Type: research

Symptomatic contralateral subdural hygromas after decompressive craniectomy: plausible causes and management protocols.
CONCLUSIONS Arachnoid tears and blockage of arachnoid villi appear to be the underlying causes of a CLSDC. The absence of sufficient fluid pressure required for CSF absorption after a DC further aggravates such fluid collections. Underlying hydrocephalus may appear as subdural collections in some patients after the DC. Bur hole drainage appears to be only a temporary measure and leads to recurrence of a CLSDC. Therefore, cranioplasty is the definitive treatment for such collections and, if performed early, may even avert CLSDC formation. A temporary ventriculostomy or an external lumbar drainage may be added to aid the cra...
Source: Journal of Neurosurgery - December 12, 2014 Category: Neurosurgery Authors: Salunke P, Garg R, Kapoor A, Chhabra R, Mukherjee KK Tags: J Neurosurg Source Type: research

Revisiting secondary normal pressure hydrocephalus: does it exist? A review.
CONCLUSIONS Secondary NPH encompasses a diverse group of clinical manifestations associated with a subset of patients with acquired hydrocephalus. The most common etiologies of sNPH include SAH and traumatic brain injury. Secondary NPH does indeed exist, and should be differentiated from idiopathic NPH based on outcome and on clinical, pathophysiological, and epidemiological characteristics, but should not be considered as a separate entity. PMID: 27581318 [PubMed - in process]
Source: Neurosurgical Focus - August 31, 2016 Category: Neurosurgery Authors: Daou B, Klinge P, Tjoumakaris S, Rosenwasser RH, Jabbour P Tags: Neurosurg Focus Source Type: research

Risk of Shunting After Aneurysmal Subarachnoid Hemorrhage: A Collaborative Study and Initiation of a Consortium Clinical Sciences
Conclusions— Shunt dependency after aSAH is associated with higher morbidity and mortality, and prediction modeling of shunt dependency is feasible with clinically useful yields. It is important to identify and understand the factors that increase risk for shunting and to eliminate or mitigate the reversible factors. The aSAH-PARAS Consortium (Aneurysmal Subarachnoid Hemorrhage Patients’ Risk Assessment for Shunting) has been initiated to pool the collective insights and resources to address key questions in post-aSAH shunt dependency to inform future aSAH treatment guidelines.
Source: Stroke - September 25, 2016 Category: Neurology Authors: Adams, H., Ban, V. S., Leinonen, V., Aoun, S. G., Huttunen, J., Saavalainen, T., Lindgren, A., Frosen, J., Fraunberg, M., Koivisto, T., Hernesniemi, J., Welch, B. G., Jaaskelainen, J. E., Huttunen, T. J. Tags: Epidemiology, Risk Factors, Complications, Quality and Outcomes, Cerebral Aneurysm Clinical Sciences Source Type: research

Hydrocephalus associated with childhood nonaccidental head trauma.
CONCLUSIONS PTV presents early after NAHT, particularly after a DC has been performed. However, the authors found that only a few PTV/NAHT patients developed shunt-dependent hydrocephalus. PMID: 27798981 [PubMed - in process]
Source: Neurosurgical Focus - October 31, 2016 Category: Neurosurgery Authors: Vadivelu S, Rekate HL, Esernio-Jenssen D, Mittler MA, Schneider SJ Tags: Neurosurg Focus Source Type: research

Increased Plasma Galectin-3 Preceding the Development of Delayed Cerebral Infarction and Eventual Poor Outcome in Non-Severe Aneurysmal Subarachnoid Hemorrhage
This study included 83 consecutive patients diagnosed with aneurysmal SAH of resuscitated World Federation of Neurological Surgeons (WFNS) grades 1 –3. Plasma galectin-3 levels were once measured on days 1–3 (the day after clipping or coiling). Fifteen patients had poor outcomes, which were associated with increasing age, female, pre-onset morbidity, worse WFNS grade, modified Fisher computed tomography scale, acute hydrocephalus, and highe r galectin-3 levels compared with good outcomes. Multivariate analyses revealed that plasma galectin-3 was an independent determinant for poor outcome (odds ratio, 3.08; 95% confide...
Source: Translational Stroke Research - August 22, 2017 Category: Neurology Source Type: research

Effect of choice of treatment modality on the incidence of shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage.
CONCLUSIONS SDHC after aSAH occurred significantly more frequently in patients who underwent surgical clipping. Strategies for treatment of ruptured aneurysms should be used to mitigate SDHC and minimize poor outcomes. PMID: 29521594 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - March 9, 2018 Category: Neurosurgery Authors: Koyanagi M, Fukuda H, Saiki M, Tsuji Y, Lo B, Kawasaki T, Ioroi Y, Fukumitsu R, Ishibashi R, Oda M, Narumi O, Chin M, Yamagata S, Miyamoto S Tags: J Neurosurg Source Type: research

Change of Ascending Reticular Activating System Following Shunt Operation for Hydrocephalus in a Subarachnoid Hemorrhage Patient
Conclusions A patient with subarachnoid and intraventricular hemorrhage showed recovery of an injured ARAS and consciousness after a shunt operation for hydrocephalus. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - July 16, 2018 Category: Neurosurgery Authors: Jang, SungHo Lee, HanDo Tags: Case Report Source Type: research

Higher Plasma Osteopontin Concentrations Associated with Subsequent Development of Chronic Shunt-Dependent Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage
AbstractA matricellular protein osteopontin (OPN) is considered to exert neuroprotective and healing effects on neurovascular injuries in an acute phase of aneurysmal subarachnoid hemorrhage (SAH). However, the relationships between OPN expression and chronic shunt-dependent hydrocephalus (SDHC) have never been investigated. In 166 SAH patients (derivation and validation cohorts, 110 and 56, respectively), plasma OPN levels were serially measured at days1 −3, 4−6, 7−9, and 10−12 after aneurysmal obliteration. The OPN levels and clinical factors were compared between patients with and without subsequent development ...
Source: Translational Stroke Research - January 9, 2021 Category: Neurology Source Type: research

Clinical presentation and assessment of older patients presenting with headache to emergency departments: A multicentre observational study
CONCLUSION: Older patients with headache had different clinical features to the younger cohort and were more likely to have a serious secondary cause of headache than younger adults. There should be a low threshold for investigation in older patients attending ED with non-traumatic headache.PMID:34570422 | DOI:10.1111/ajag.12999
Source: Australasian Journal on Ageing - September 27, 2021 Category: Geriatrics Authors: Sierra Beck Frances B Kinnear Anne Maree Kelly Kevin H Chu Win Sen Kuan Gerben Keijzers Richard Body Mehmet A Karamercan Sharon Klim Tissa Wijeratne Sinan Kamona Colin A Graham Tom Roberts Daniel Horner Said Laribi HEAD Study Group Source Type: research

Successful weaning versus permanent cerebrospinal fluid diversion after aneurysmal subarachnoid hemorrhage: post hoc analysis of a Swiss multicenter study
CONCLUSIONS: These results show a temporary but clinically meaningful cognitive benefit in the first weeks after aSAH in successfully weaned patients. The resolution of this difference over time may be due to the positive effects of permanent CSF diversion and underlines its importance. Patients who do not show progressive neuropsychological improvement after weaning should be considered for repeat CT imaging to rule out chronic (untreated) hydrocephalus.PMID:37004134 | DOI:10.3171/2023.1.FOCUS22638
Source: Neurosurgical Focus - April 2, 2023 Category: Neurosurgery Authors: Ahmed El-Garci Olivia Zindel-Geisseler Noemi Dannecker Yannick Rothacher Ladina Schlosser Anna Zeitlberger Julia Velz Martina Seb ök Noemi Eggenberger Adrien May Philippe Bijlenga Ursula Guerra-Lopez Rodolfo Maduri Val érie Beaud Daniele Starnoni Alessi Source Type: research

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