Articles: subarachnoid-hemorrhage.
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To investigate the acute effects on intracerebral pressure, intracranial reserve capacity and CSF absorption resistance, a subarachnoidal haemorrhage was induced experimentally in a cat by bolus injection or continuous infusion of autologous blood into the cisterna magna. Intracisternal bolus injection resulted in a brief steep increase in intracranial pressure. 30 or 60 minutes after the haemorrhage the median intracranial pressure is slightly increased, the reserve capacity markedly reduced and the CSF absorption resistance considerably enhanced. During intracisternal blood infusion there is a continuous intracerebral pressure rise that persists to the end of the infusion and decrease again within a short time. This intracranial pressure behaviour is due to the simultaneous reduction of intracranial reserve capacity and the increase in CSF absorption resistance during the blood infusion.
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J Neurosurg Anesthesiol · Mar 1990
Perioperative monitoring of the electrocardiogram during cerebral aneurysm surgery.
Electrocardiographic (ECG) abnormalities occur frequently following a subarachnoid hemorrhage and may also occur intraoperatively and postoperatively in patients undergoing neurovascular procedures. The aim of this study was to assess the relationship between ECG changes and the neurological status of the patient, the size and the location of the aneurysm, and the influence of these changes on the cardiac and neurological outcome. The preoperative ECG was analyzed in 270 patients. ⋯ Intraoperative and postoperative changes occurred in 35 and 65% of the patients, respectively, and were independent of the studied factors. There were no documented cardiac events. The presence of an abnormal preoperative ECG did not influence the neurological outcome of the patient, but fluctuating postoperative changes were associated with a worse outcome.
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Am. J. Clin. Pathol. · Mar 1990
Comparative StudyRapid differentiation of subarachnoid hemorrhage from traumatic lumbar puncture using the D-dimer assay.
The D-dimer assay of 40 cerebral spinal fluid (CSF) samples accurately differentiated subarachnoid hemorrhage (SAH) from traumatic lumbar puncture. The D-dimer assay was positive in all six patients with subarachnoid hemorrhage. Negative D-dimer values were obtained in control groups of 14 patients with hemorrhagic CSF secondary to traumatic lumbar puncture (LP) and in 20 patients with normal CSF. The D-dimer assay proved to be a better test than xanthochromia or the decline in erythrocyte count in sequentially collected tubes in differentiating subarachnoid hemorrhage from traumatic LP.
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We studied the ex vivo production of prostaglandin D2, prostaglandin E2, 6-ketoprostaglandin F1 alpha, and leukotriene C4 in the brain tissue of rats subjected to experimental subarachnoid hemorrhage. The ex vivo method allows the study of arachidonic acid metabolites released from brain slices at different times after subarachnoid hemorrhage induction and reflects the residual capacity for arachidonic acid metabolism after the pathologic event. The rats were sacrificed 30 minutes, 1 and 6 hours, and 2 days after subarachnoid hemorrhage was induced by the injection of 0.30 ml autologous arterial blood into the cisterna magna. ⋯ The concentration of prostaglandin E2 was increased significantly 6 hours after induction, while ex vivo production of leukotriene C4 was increased significantly at 1 and 6 hours and 2 days. The correlation between these results and the occurrence of vasospasm after subarachnoid hemorrhage is discussed. The results obtained from the ex vivo incubation of brain tissue slices after experimental subarachnoid hemorrhage suggest that after the hemorrhage there is a significant modification of brain eicosanoid metabolism, which could be of great importance in interpreting the pathogenesis of subarachnoid hemorrhage-related neuronal impairment.