Articles: subarachnoid-hemorrhage.
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Altered levels of cerebrospinal fluid (CSF) glucose and lactate concentrations are associated with poor outcomes in acute brain injury patients. However, no data on changes in such metabolites consequently to therapeutic interventions are available. The aim of the study was to assess CSF glucose-to-lactate ratio (CGLR) changes related to therapies aimed at reducing intracranial pressure (ICP). ⋯ In this study, CGLR significantly changed over time, regardless of the study group. However, these effects were more significant in those patients receiving interventions to reduce ICP.
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Case Reports
Infectious thrombosis of the superior sagittal sinus with subarachnoid hemorrhage: A case report.
Cerebral venous sinus thrombosis (CVST) represents 0.5% to 1% of all strokes. CVST can cause headaches, epilepsy, and subarachnoid hemorrhage (SAH). CVST is easily misdiagnosed because of the variety and non-specificity of symptoms. Herein, we report a case of infectious thrombosis of the superior sagittal sinus with SAH. ⋯ We describe a case of infectious thrombosis of the superior sagittal sinus manifested as SAH, which is easily misdiagnosed, especially when patients present with an infection. Clinicians must therefore take care during the diagnosis and selection of the treatment strategy.
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Curr Pain Headache Rep · Mar 2023
ReviewQuality Improvement in the Management of Subarachnoid Hemorrhage: Current State and Future Directions.
Aneurysmal subarachnoid hemorrhage carries high mortality and morbidity. Quality improvement (QI) efforts in the management of this disease process are growing as the field of neurocritical care matures. This review provides updates in QI in subarachnoid hemorrhage (SAH) and discusses gaps and future directions. ⋯ Literature published on the topic over the past 3 years were evaluated. An assessment of current QI practices pertaining to the acute care of SAH was conducted. These include processes surrounding acute pain management, inter-hospital coordination of care, complications during the initial hospital stay, role of palliative care, and quality metrics collection, reporting, and monitoring. SAH QI initiatives have shown promise by decreasing ICU and hospital lengths of stay, health care costs, and hospital complications. The review reveals substantial heterogeneity, variability, and limitations in SAH QI protocols, measures, and reporting. Uniformity in QI research, implementation, and monitoring will be crucial as disease-specific QI develops in neurological care.
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The study aimed to explore risk factors for cerebral infarction after microsurgical clipping in patients with Hunt-Hess grade 0-2 single intracranial aneurysms. ⋯ Our study identified history of TIA/stroke and IOH as independent risk factors for cerebral infarction after microsurgical clipping.