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Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. What can we do in the ED to prevent rebleeding in patients with subarachnoid hemorrhage?
(MedPage Today) -- In patients with acute intracerebral hemorrhage who had surgery within 24 hours, minimally invasive evacuation surgery combined with guideline-based medical management care yielded better functional outcomes at 180 days than.
After 30 years of disappointment, 2 randomized controlled trials investigating the effect of neurosurgical treatment on functional outcome in patients with intracerebral hemorrhage were published in 2024. In this critique article, we will discuss the main findings of these trials, their implications and future perspectives.
Recovery trajectories in intracerebral hemorrhage (ICH) are recognized as distinct from those observed in ischemic stroke. This narrative review aims to clarify the pathophysiology underlying ICH recovery patterns, highlighting the unique timeline and nature of functional improvements seen in ICH survivors.
Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. What can we do in the ED to prevent rebleeding in patients with subarachnoid hemorrhage?
Starting with the good news, GLP-1s lowered risks for 42 health outcomes while increasing risks for 19 outcomes. As expected, GLP-1s reduced MI risk by 9%, cardiac arrest by 22%, incident HF by 11%, ischemic stroke by 7%, and hemorrhagic stroke by 14%. year follow-up.
BACKGROUND:Although lower hemoglobin levels associate with worse intracerebral hemorrhage (ICH) outcomes, causal drivers for this relationship remain unclear. Similar relationships were seen with poor 6- and 12-month outcomes. Additional studies are required to clarify whether correcting anemia can improve these outcomes.
BACKGROUND:Stroke-induced opposite T-cell responses in the peri-lesion area and periphery worsen stroke outcomes by aggravating brain injury or increasing infectious complications, respectively. In this study, we investigated the causal link between TCRs and the opposite T-cell responses observed in intracerebral hemorrhage (ICH).METHODS:We
BACKGROUND:Prior studies on the clinical impact of intracerebral hemorrhage (ICH) location have used visual localization of hematomas to neuroanatomical structures. In a voxel-wise analysis, ICH presence in deep white matter, thalami, caudate, midbrain, and pons was associated with worse outcomes. Stroke, Ahead of Print.
Introduction:Patients who have had hemorrhagic strokes experience psychological and functional deficits after hospital discharge. Social Determinants of Health (SDoH) can also impact outcomes. Conclusion:Psychological and functional outcomes for patients with hemorrhagic strokes are associated with SDoH.
Introduction:Managing post-acute hemorrhagic stroke care is complex and necessitates close follow-up and coordination. Primary outcome evaluated variables contributing to attendance of a neuroscience appointment post-discharge and secondary outcome: examined 90-day all cause readmission using binomial logistic regressions.
Introduction:Intracerebral Hemorrhage (ICH) leads to high rates of morbidity and mortality. Malnutrition is common in stroke patients and leads to worse outcomes. Body mass index (BMI) is a widely available marker of nutrition status, however studies on BMI and post-ICH outcomes are limited and have conflicting results.
Our study aims to describe the trends and outcomes of patients with Subarachnoid Hemorrhage (SAH) using a Nationwide Inpatient Sample (NIS) database.Methods:We examined the 2016-2020 NIS database, focusing on patients aged 18 years and older with a primary SAH discharge diagnosis. years with 72,650 (61.0%) being female.
Background:The prognostic significance of the affected hemisphere in hemorrhagic stroke remains uncertain. We aimed to determine the relationship between the affected hemisphere (right or left) and differences in non-motor outcomes (pain, mood) in patients with acute intracerebral hemorrhage (ICH).
The results showed that giving blood thinners in addition to clot-busting medications to people with ischemic strokes (clot-caused strokes) did not improve their outcomes 90 days later. The study was looking for improvement in functional outcomes at 90 days. those receiving argatroban averaged 5.2,
Clinical characteristics, technical considerations associated with thrombectomy, severity and subtypes of HT (Heidelberg) and clinical outcomes were analyzed.Results:HT was adjudicated present in 70 out of 149 (47.0%) consecutive thrombectomy patients. Coexisting subtypes were present in 27.1 % of HT cases. of all patients and 11.4%
Introduction:Alzheimers Disease (AD), characterized by extracellular deposition of amyloid beta (A) plaques in brain tissue, is often comorbid with cerebral amyloid angiopathy, which carries an elevated risk of intracranial hemorrhage. Secondary outcomes were ICH, SAH, and SDH assessed separately. andICD-10-CMcode G30.x.
In stroke, it has been associated with infarct growth, hemorrhagic transformation, and poor outcomes. We hypothesized that severe WMD in large vessel occlusion (LVO) stroke patients would correlate with worse 90-day functional outcomes, measured by the modified Rankin Scale (mRS).Methods:We
Introduction:Intracerebral hemorrhage (ICH) volume and expansion are important predictors of clinical outcome. Recent results show volumetric thresholds for prediction of poor outcome differ based on the anatomic location (lobar vs deep) of the ICH. Poor outcome was defined as modified Rankin Scale 4-6.
Background and Issues:Timely identification and intervention are critical for positive outcomes in acute intracerebral hemorrhage (ICH) patients. Outcomes were measured using data for when the goals were being met versus not being met.Results:Outcomes were measured from 111 ICH patients from 2022-2023.
The exposure was an incident diagnosis of non-traumatic intracranial hemorrhage, defined as a composite of intracerebral hemorrhage, subarachnoid hemorrhage, or subdural hemorrhage. The outcome was an incident diagnosis of dementia. million patients, 14,775 had a diagnosis of intracranial hemorrhage.
Introduction:Intraventricular hemorrhage (IVH), a common complication of intracerebral hemorrhage (ICH), can occur with little or no associated ICH (mostly IVH, mIVH). mIVH is reported to have better outcomes than IVH associated with substantial ICH. Age and IVH volume were final model independent predictors of good outcome.
Findings from the first international randomized controlled trial to compare patient outcomes following treatment with large-bore mechanical thrombectomy (LBMT) versus catheter-directed thrombolysis (CDT) for intermediate-risk pulmonary embolism (PE) show that LBMT is superior with respect to the hierarchically-tested aggregated outcome of all-cause (..)
The exposure was a new diagnosis of non-traumatic intracranial hemorrhage, defined as a composite of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and subdural hemorrhage (SDH). The outcome was a first-ever diagnosis of dementia. million patients, 14,775 had a diagnosis of intracranial hemorrhage.
A database analysis linked semaglutide use to notable reductions in the rates of diabetic macular edema and vitreous hemorrhage in diabetic retinopathy.
Background:Subarachnoid Hemorrhage (SAH) accounts for 2-7% of strokes and has high mortality and morbidity. We generated the co-expression networks using the Weighted Gene Co-Expression Network Analysis (WGCNA) package to determine modules (groups of co-expressed genes) associated with 90-day SAH outcome.
Introduction:Delirium associates with poor outcome after intracerebral hemorrhage (ICH), yet its incidence and contributing factors are poorly characterized. The median hemorrhage volume was 8.0 [1.6-24.7] 1.10]), top-quartile hemorrhage volume (2.89 [1.08-7.75]), female) with an ethno-racial distribution of 57.6%
Racial and ethnic disparities in risk factors and outcomes for young patients with ischemic stroke (AIS) are well described. Less is known about disparities in risk and outcomes for young patients presenting with intracerebral hemorrhage (ICH), which is associated with higher short-term and long-term mortality. Asian, and 5.1%
the 2023 calendar year, our comprehensive stroke metric for hemorrhagic stroke scoring was at 64%, below the 'Get with the Guidelines' benchmark of 87%.To the 2023 calendar year, our comprehensive stroke metric for hemorrhagic stroke scoring was at 64%, below the 'Get with the Guidelines' benchmark of 87%.To
Purpose:We previously reported that activated T cells accumulate in the perihematomal regions after Intracerebral hemorrhage (ICH) and aggravate hemorrhagic brain injury. Inhibiting TCR activation through AX-024 proves beneficial for improving neurological outcomes after ICH.
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.
Background:Injury location is an established outcome predictor in intracerebral hemorrhage (ICH), with most studies focusing on outcomes relating to motor deficits. Data were analyzed by one-way ANOVA and Tukey post-hoc tests.Results:ICH location had differential effects on behavioral outcomes.
BACKGROUNDThe rate of underlying ruptured aneurysms, complications, and their relevance to outcomes in “benign” perimesencephalic subarachnoid hemorrhage are not well known and underreported.METHODSRetrospective analysis of patients with perimesencephalic subarachnoid hemorrhage from a large tertiary care center (2007–2022).RESULTSEighty‐one
Background:A novel inflammatory score has been validated for hematoma expansion and poor outcomes in patients with intracerebral hemorrhage. Logistic regression models were used for exploring the association between inflammatory score and hemorrhagic transformation and poor 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.
Introduction:Viscoelastic hemostatic assays can detect coagulopathy relevant for intracerebral hemorrhage (ICH) patients at risk for hematoma expansion. However, it is unclear whether these assays associate with long term ICH outcomes. Poor 6-month neurological outcome was defined as modified Rankin Scale (mRS) 4-6.
Background:Intracerebral hemorrhage (ICH) is a critical neurological condition with high rates of mortality and morbidity. Accurate prediction of the clinical outcomes in ICH patients is essential for effective clinical management. Spot sign was consistently identified as a robust predictor of outcomes across multiple studies.
Hemorrhagic strokes (HS) are increasingly significant causes of disability and mortality worldwide, making the use of blood biomarkers for their diagnosis and prognosis critical. The study found that GFAP levels were significantly higher in HS patients, particularly among those with fatal outcomes. Survivors had GFAP levels of 1.35
The primary outcome was functional status measured by the modified Rankin Scale at 90 to 180 days. Earlier SBP control was associated with better functional outcomes (modified Rankin Scale score, 3–6; odds ratio, 0.98 [95% CI, 0.97–0.99]) Stroke, Ahead of Print. SD, 13.0], 2120 [36.8%] females) were included in analyses.
The primary outcome was good functional outcome at 3 months. The secondary outcomes included excellent functional outcome at 3 months and early neurological improvement. The odds ratio (OR) of good functional outcome at 3 months was 0.93 (95% CI, 0.68–1.28) The OR of excellent functional outcome (OR 1.23; 95% CI 0.92–1.64)
Background and Purpose:The role of surgical evacuation using craniotomy or endoscopic procedure in patients with intracerebral hemorrhage (ICH) associated with oral anticoagulants is not well described. We compared the outcomes between patients with ICH associated with oral anticoagulants to those with spontaneous ICH.
Intracerebral hemorrhage is the most serious type of stroke, leading to high rates of severe disability and mortality. Hematoma expansion is an independent predictor of poor functional outcome and is a compelling target for intervention. Stroke, Ahead of Print.
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