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BackgroundDelayed cerebral ischemia represents a significant contributor to death and disability following aneurysmal subarachnoid hemorrhage. The lack of standardized experimental setups and outcome assessments, particularly regarding secondary vasospastic/ischemic events, may be partly responsible for the translational failure.
BackgroundThe outcome of diffuse angiogram‐negative subarachnoid hemorrhage (dan‐SAH) compared with aneurysmal SAH (aSAH) remains unclear. Propensity score matching resulted in matching 65 patients with dan‐SAH to 260 patients with aSAH, and clinical outcomes were compared between the groups. versus 0%,P=0.027), death (11.2%
Subarachnoid hemorrhage is a critical neurological condition accounting for about 5% of all strokes, and survivors experience long-term cognitive deterioration and increased risk of dementia. Genetic predispositions have been associated with post-subarachnoid hemorrhage cognitive outcomes and emphasize a role for personalized care strategies.
Neutrophils are reported to be critical mediators of to poor outcome after subarachnoid hemorrhage (SAH). Following SAH, neutrophils cause vascular occlusion via neutrophil extracellular traps (NETs) and NETs have been identified as a therapeutic target to prevent delayed cerebral ischemia in mice (DCI) with SAH.
Neutrophils are reported to be critical mediators of to poor outcome after subarachnoid hemorrhage (SAH). In this study, our hypothesis was that NETs cause vascular occlusion leading to delayed cerebral ischemia (DCI) and worse outcome after SAH. However, degrading NETs only marginally improved outcomes.
Introduction:Oxidative stress plays an important role in both early brain injury and delayed cerebral ischemia after subarachnoid hemorrhage (SAH). In this study, we evaluated the effect of MnP-05 on short-term outcomes of SAH in mice.Methods:We used 12-week-old male C57BL/6J mice. P<0.05, Fig.
IntroductionAcute spinal cord ischemia syndrome (ASCIS) is a rare disease that is thought to comprise roughly only 1.2% The use of recreational cocaine in young adults is well known to be responsible for acute ischemic and hemorrhagic strokes in individuals who lack other vascular risk factors. of all strokes [1, 2].
Background:Several studies have shown that tranexamic acid (TXA), an anti-fibrinolytic agent, may reduce hematoma expansion (HE) in intracerebral hemorrhage (ICH), but its therapeutic time window is unclear. We excluded trials that used TXA for longer than 3 days which causes delayed vasospasm, increasing the risk of cerebral ischemia.
Subarachnoid hemorrhage (SAH), commonly caused by a ruptured aneurysm, carries a high rate of disability and death. Preclinical studies demonstrate SAH induces dysregulation of the cerebrovasculature and increases neuroinflammation, which contributes to early brain injury and delayed cerebral ischemia.
Introduction:Supratentorial intracerebral hemorrhage (ICH) is a devastating stroke subtype with high mortality and morbidity, and hematoma clearance is a critical therapeutic target. The primary outcome was a score of 0-2 on the modified Rankin Scale at 90 days, analyzed in the intention-to-treat population. mL (IQR 10.0-18.0).
Introduction:Subarachnoid hemorrhage (SAH) is the deadliest form of hemorrhagic stroke. Post-SAH vasospasm induces brain tissue hypoxia-ischemia resulting in brain injury and functional impairments. At 48h after SAH, mice were tested for functional outcomes followed by blood collection through cardiac puncture.
Introduction:Delayed cerebral ischemia (DCI) is a leading cause of morbidity and mortality in aneurysmal subarachnoid hemorrhage (aSAH). The primary outcome was DCI, defined as an exclusionary change in GCS or new, none-treatment related infarcts on imaging. Stroke, Volume 55, Issue Suppl_1 , Page A114-A114, February 1, 2024.
Intracerebral Hemorrhagic (ICH) stroke is the second most common type of stroke and its aftermath is often more severe than ischemia. In order to improve post ICH outcome, immediate therapeutic interventions should be administered. Stroke, Volume 56, Issue Suppl_1 , Page AWP213-AWP213, February 1, 2025.
Background:We have previously identified that hemoglobin decrements and new-onset anemia during an intracerebral hemorrhage (ICH) hospitalization is frequent, rapid, and associates with poor outcome. Patients who had a brain MRI and serial hemoglobin measurements were included.
Background:We identified that major ABO incompatible platelet transfusions are associated with poor intracerebral hemorrhage (ICH) outcomes, yet the driver for this relationship is unknown and does not appear to be related to impaired hemostasis. Conversely, acute ICH patients are known to develop remote ischemic lesions on brain MRI.
Introduction:Elevated levels of Interleukin-6 (IL-6) levels in cerebrospinal fluid (CSF) have been correlated with delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). Further studies are needed to validate findings and refine MAP management for improved outcomes in aSAH patients.
Introduction:Real-world data showed that less than half of the acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) presenting with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (2-5) achieved favorable outcomes at 90 days after mechanical thrombectomy (MT). was related to 90-day mRS 0-3.
The aim of this study is to provide outcome comparisons between WEB and BAC in a specific cohort of patients with ruptured wide‐necked IAs.MethodsIn this international cohort study, we included consecutive patients treated for ruptured wide‐neck IAs with either WEB or BAC at three neurovascular centers. Of the patients, 60.5%
We aimed to compare the clinical and radiological outcomes between WEB and BAC in a cohort of patients with ruptured wide‐necked intracranial aneurysms.METHODSIn this international multicenter cohort study, we included consecutive patients treated for ruptured wide‐neck intracranial aneurysms with either WEB or BAC at 4 neurovascular centers.
Side note: The differential of sudden persistent loss of consciousness with adequate hemodynamics is relatively short: seizure, intracranial hemorrhage, basilar artery occlusion. We have also shown several cases in which atrial flutter hides true, active ischemia. There was again no intracranial hemorrhage.
We performed this analysis to identify the prevalence of atrial fibrillation and associated outcomes in symptomatic internal carotid artery stenosis patients undergoing CAS or CEA.Methods:We analyzed the data from the National inpatient sample (NIS) between January 2016 to December 2021. versus 18.8% for CAS or CEA, respectively, p=0.50].
This study compared outcomes for patients with DOAC treatment failure who changed or retained their prestroke DOAC.Methods and ResultsThis retrospective cohort study analyzed data from the National Health Insurance Research Database from 2012 to 2020. The primary outcome was a composite of recurrent IS and transient ischemic attack.
Primary outcome was a shift toward better functional outcome on the modified Rankin Scale at 90 days. Although symptomatic intracranial hemorrhages occurred more often in the IVT group (4.8% These studies mainly concerned anterior circulation occlusions. All patients with a posterior circulation occlusion were included.
This ECG is diagnostic of diffuse subendocardial ischemia. Because the patient had asystole, was resuscitated without difficulty, and had no neurologic function, suspected a cerebral hemorrhage was suspected as the etiology of the arrest, specifically subarachnoid hemorrhage. What is the utility of a head CT in cardiac arrest?
In this study, we tested the hypothesis that small extracellular vesicles (sEVs) derived from healthy human VSMCs (VSMC-sEVs) reduce diabetes- and ischemia-neurovascular damage.Methods and Results:VSMC-sEVs were characterized.
Introduction:Despite comparable outcomes for different frontline techniques in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), there are sparse data regarding if and when to switch techniques if the first pass is unsuccessful. 3.86, P = 0.002) and 90-day good clinical outcome (adjusted odds ratio 2.10, 95% CI: 1.15-3.85,
BACKGROUNDSteroids have pleiotropic neuroprotective actions including the regulation of inflammation and apoptosis which may influence the effects of ischemia on neurons, glial cells, and blood vessels. Secondary outcomes include 90‐day functional independence (modified Rankin scale score, 0–2).
MCA tortuosity was calculated using Inflection Count Metric(ICM) by two blinded readers to angiographical/clinical outcomes. The primary efficacy end point was achievement of modified Thrombolysis in Cerebral Ischemia (mTICI) reperfusion scores of ≥2b on first pass. Good functional outcomes was defined as mRS0-2 on 90-day followup.
Background and objectives:Remote ischemic conditioning during cerebral ischemia ( PerRIC ) represents a new protection paradigm. The primary outcome was a modified Rankin Scale ( mRS ) score <=2 at 90 days. Stroke, Volume 56, Issue Suppl_1 , Page AWMP7-AWMP7, February 1, 2025. The mean age was 74.0
His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Anything more on history?
intraluminal floating thrombus, intracardiac thrombus, acute coronary syndrome, acute limb ischemia, DVT and PE) within 3 days of symptom onset. The primary outcome was the incidence of intracranial hemorrhage (ICH) between both groups. The primary outcome was the incidence of intracranial hemorrhage (ICH) between both groups.
The protective effect of NO donors has been shown to prevent ischemia-reperfusion injury through reduction of reactive oxygen species formation in cardiovascular studies. Eligible patients were randomized to receive 800μg GTN or same volume of normal saline through the catheter after recanalization.
The primary outcome was the presence of perfusion scotoma defined as ICuV 10mL. Introduction:CT perfusion maps (CTP) can estimate the ischemic core in acute ischemic stroke based on distinctive cerebral blood flow (CBF) thresholds.
2,3The SAMMPRIS trial reported that percutaneous transluminal angioplasty and stenting (PTAS) was associated with inferior outcomes compared to aggressive medical management alone but it is unclear whether these findings are generalizable to LVO strokes.4 However, these rescue treatments are associated with their own risks.2,3The
IntroductionPituitary apoplexy is a serious, emergent, and potentially dangerous condition of the pituitary in which the gland is affected by hemorrhage and/or ischemia typically in the setting of an underlying adenoma. Rutkowski’s 2017 study was the only to assess outcomes prior to versus after intervention at the 72 hours timepoint.
The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated. Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). Chest trauma was suspected on initial exam.
Post by Smith and Meyers Sam Ghali ( [link] ) just asked me (Smith): "Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR?" That said, complete LM occlusion would be expected to have subepicardial ischemia (STE) in these myocardial territories: STE vector 1.
Opioids associate with worse outcomes in myocardial infarction , probably because they eliminate the pain signal that informs the clinician of the urgency of revascularization. below) Other examples of AIVR: Young man with Gunshot wound to right chest with hemorrhagic shock, but bullet path not near heart. Do not treat AIVR.
The primary outcome was successful reperfusion defined as a Modified Treatment in Cerebral Ischemia (mTICI) score of 2b or greater at the end of the procedure. Secondary outcomes included NIH Stroke Scale (NIHSS) at 24 hours, NIHSS at discharge, median modified Rankin Scale (mRS) score at discharge and at 90‐day follow‐up.
Background:Ischemia on diffusion weighted imaging (DWI) after intracerebral hemorrhage (ICH) increases the risk of future ischemic stroke. Though cortical superficial siderosis (cSS) is also a hemorrhagic small vessel disease subtype, it is unclear if cSS similarly relates to DWI lesions. and cSS in 10.6%.
Introduction:Aneurysmal subarachnoid hemorrhage (aSAH) survivors suffer cognitive and behavioral challenges preventing their return to work and social activities. The factors that may affect neuropsychological outcomes after aSAH are not well characterized. Stroke, Volume 56, Issue Suppl_1 , Page AWP26-AWP26, February 1, 2025.
Introduction:Subarachnoid hemorrhage (SAH) following mechanical thrombectomy (MT) is not uncommon. Additionally, non-diffuse SAH group were significantly associated with significantly improved 90-day good functional outcomes defined as mRS 0-2 in unadjusted analysis (80% vs. 30%, OR 9.33, 95% CI 1.99-72.99, 102.05, p = 0.02).
Background:Ischemic lesions on diffusion weighted imaging (DWI) occur in one-third of intracerebral hemorrhage (ICH). Patients with severe, chronic hypertension may be more vulnerable to the development of ischemia after ICH due to altered cerebral autoregulatory limits. and LVH was seen in 23.5%.
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