Acta neurochirurgica. Supplement
-
Acta Neurochir. Suppl. · Jan 2011
Predictors analysis of symptomatic cerebral vasospasm after subarachnoid hemorrhage.
symptomatic cerebral vasospasm (SCVS) is still lacking in reliable early warning methods and often diagnosed after clinical deterioration of neurological function, making prevention and treatment extremely passive. This study investigates the risk factors relevant to SCVS after subarachnoid hemorrhage (SAH) in order to provide useful information for clinical work. ⋯ SCVS is the final result of multiple factors acting together. Age and modified Fisher grades are independent risk factors to SCVS.
-
Acta Neurochir. Suppl. · Jan 2011
Clinical study of changes of cerebral microcirculation in cerebral vasospasm after SAH.
Aim to investigate the changes of cerebral microcirculation after subarachnoid hemorrhage (SAH) and its association with cerebral vasospasm (CVS) after SAH. CTP was performed in 85 patients with SAH and 35 controls. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were recorded for final analysis. ⋯ In 46 CVS patients, sCVS group presented significantly lower CBF and more prolonged MTT than asCVS patients (P<0.05). Seven cases with MTT between 6.31 and 12.72 s showed delayed ischemic neurological deficit (DIND), two of whom had hemiplegia, and one died. Our findings suggest that CTP examination contributes to uncover the changes of cerebral microcirculation after SAH, and the changes of cerebral microcirculation are associated with CVS post SAH.
-
Acta Neurochir. Suppl. · Jan 2011
Evidenced Based Guidelines for the Management of Good Grade Subarachnoid Haemorrhage Patients in Leeds, UK.
Aneurysmal Subarachnoid Haemorrhage (SAH) is a common neurosurgical condition with high morbidity and mortality, with our trust treating over 120 patients annually. Although there are recommendations for the management of some aspects of subarachnoid haemorrhage, a comprehensive guideline document has not been produced. Our guidelines seek to address all aspects of acute patient care in our neurosurgical unit, using evidence based medicine with a multi-disciplinary team to produce care pathways establishing a standard of care for our patients.
-
The lack of radiation, high soft tissue contrast and capacity for multiplanar and three-dimensional imaging have made magnetic resonance imaging (MRI) the imaging modality of choice for evaluating spinal cord diseases. In diagnostic imaging of the spine, MRI is clearly superior to both conventional radiography (CR) and computed tomography (CT) and it should be preferred as first diagnostic examination when degenerative spine pathologies are suspected. ⋯ Both "container" and "contents" of the spine should be primly evaluated. Finally, a correlation between clinical and radiological features seems to be mandatory for selecting the correct therapeutic choice, since the reliability of the MRI as potential prognostic indicator has been demonstrated.
-
Acta Neurochir. Suppl. · Jan 2011
Post-treatment with SR49059 improves outcomes following an intracerebral hemorrhagic stroke in mice.
Intracerebral hemorrhage (ICH) is a devastating stroke subtype characterized by severe brain edema formation leading to cerebral blood flow compromise and parenchymal damage. Arginine vasopressin (AVP), a non-peptide antidiuretic hormone, has recently been implicated as a modulator of brain edema following injury. In this study, we investigated the effects of SR49059, a highly specific AVP V1a receptor antagonist, on brain injury outcomes following ICH, specifically assessing the ability of SR49059 in reducing brain edema and improving neurobehavioral deficits. ⋯ The study found that SR49059 significantly reduced cerebral edema at 24 and 72 h post-ICH injury and improved neurobehavioral deficits at 72 h. Our study suggests that blockage of the AVP V1a receptor is a promising treatment target for improving ICH-induced brain injury. Further studies will be needed to confirm this relationship and determine future clinical direction.