Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2011
Treatment with ginsenoside rb1, a component of panax ginseng, provides neuroprotection in rats subjected to subarachnoid hemorrhage-induced brain injury.
recent trials have shown Ginsenoside Rb1 (GRb1), an active component of a well known Chinese medicine Panax Ginseng, plays a significant role in improving the complications seen after an ischemic brain event. In the present study, we investigated the use of GRb1 as a treatment modality to reduce brain edema, reduce arterial vasospasm, and improve neurobehavioral function after subarachnoid hemorrhage-induced brain injury (SAH) in rats. ⋯ the results of the study suggest that GRb1 treatment reduces brain edema, improves neurobehavioral function, and blocks vasculature thickening and spasm after SAH in rats. Given the novelty of the study, further research will be needed to confirm the benefits of treatment and mechanisms behind neuroprotection.
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Acta Neurochir. Suppl. · Jan 2011
Review Randomized Controlled TrialIntravenous magnesium sulfate after aneurysmal subarachnoid hemorrhage: current status.
Delayed ischemic neurological deficit or clinical vasospasm remained a major cause for delayed neurological morbidity and mortality for patients with aneurysmal subarachnoid hemorrhage (SAH). Magnesium is a cerebral vasodilator. In experimental model of drug or SAH-induced vasospasm, magnesium blocks voltage-dependent calcium channels and reverses cerebral vasoconstriction. ⋯ Using random effects model (Mantel-Haenszel, Robins-Breslow-Greenland), the pooled odds ratio for symptomatic vasospasm or delayed cerebral ischemia is, 0.620, 95% CI 0.389-0.987, statistically significant. Similarly, the pooled odds ratio for favorable outcome is 1.598, 95% CI 1.074-2.377, statistically significant. There are two multi-center phase III studies (IMASH and MASH2) being carried out to assess the clinical effects, in which IMASH has finished data collection on 30th June 2009.
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Acta Neurochir. Suppl. · Jan 2011
ReviewMonitoring of the inflammatory response after aneurysmal subarachnoid haemorrhage in the clinical setting: review of literature and report of preliminary clinical experience.
Clinical and experimental studies showed a marked inflammatory response in aneurysmal subarachnoid haemorrhage (SAH), and it has been proposed to play a key role in the development of cerebral vasospasm (CVS). Inflammatory response and occurrence of CVS may represent a common pathogenic pathway allowing point of care diagnostics of CVS. Therefore, monitoring of the inflammatory response might be useful in the daily clinical setting of an ICU. The aim of the current report is to give a summary about factors contributing to the complex pathophysiology of inflammatory response in SAH and to discuss possible monitoring modalities. ⋯ Monitoring of the inflammatory response, in particular IL-6, might be a useful tool for the daily clinical management of patients with SAH and CVS.
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Acta Neurochir. Suppl. · Jan 2011
ReviewTreatment of post-hemorrhagic cerebral vasospasm: role of endovascular therapy.
In this review, the current role of intracranial angioplasty and intra-arterial vasodilators for post-hemorrhagic vasospasm is described with an emphasis on the rationale for its use and the supporting data from published scientific and clinical studies. Current clinical indications and specific techniques are highlighted. Special attention is given to the evolution of these techniques over time. A discussion of acute and chronic complications, short and long-term treatment results, device specific trends and controversies are outlined.
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Acta Neurochir. Suppl. · Jan 2011
ReviewComparison of different preclinical models of intracerebral hemorrhage.
Intracerebral hemorrhage (ICH) is the most devastating type of stroke. It is characterized by spontaneous bleeding in brain parenchyma and is associated with a high rate of morbidity and mortality. Presently, there is neither an effective therapy to increase survival after intracerebral hemorrhage nor a treatment to improve the quality of life for survivors. ⋯ The "balloon" method has also been used to mimic ICH for study. In this summary, we intend to provide a comparative overview of the technical methods, aspects, and pathologic findings of these types of ICH models. We will also focus on the similarities and differences among these rodent models, achievements in technical aspects of the ICH model, and discuss important aspects in selecting relevant models for study.