Brain Hemorrhages最新文献

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Impact of strict fluid management on the treatment outcome of clazosentan for cerebral vasospasm 严格输液管理对克拉生坦治疗脑血管痉挛疗效的影响
Brain Hemorrhages Pub Date : 2024-04-01 DOI: 10.1016/j.hest.2023.12.001
Takaaki Itazu, Taichi Ikedo, Takeyoshi Tsutsui, Akihiro Niwa, Yuji Kushi, Saya Ozaki, Naoto Yamada, Koji Shimonaga, Eika Hamano, Kiyofumi Yamada, Hirotoshi Imamura, Hisae Mori, Koji Iihara, Hiroharu Kataoka
{"title":"Impact of strict fluid management on the treatment outcome of clazosentan for cerebral vasospasm","authors":"Takaaki Itazu,&nbsp;Taichi Ikedo,&nbsp;Takeyoshi Tsutsui,&nbsp;Akihiro Niwa,&nbsp;Yuji Kushi,&nbsp;Saya Ozaki,&nbsp;Naoto Yamada,&nbsp;Koji Shimonaga,&nbsp;Eika Hamano,&nbsp;Kiyofumi Yamada,&nbsp;Hirotoshi Imamura,&nbsp;Hisae Mori,&nbsp;Koji Iihara,&nbsp;Hiroharu Kataoka","doi":"10.1016/j.hest.2023.12.001","DOIUrl":"10.1016/j.hest.2023.12.001","url":null,"abstract":"<div><h3>Objective</h3><p>Clazosentan (CLA) reduces cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH). However, adverse events including pulmonary edema were reported. We examined whether the strict management of fluid balance reduces the adverse events and improves patient outcomes.</p></div><div><h3>Methods</h3><p>Patients with aSAH between 2020 and 2023 were included. They were divided into pre-CLA (before CLA approval) and post-CLA (after approval) groups. The patients in the post-CLA group were further divided into the post-CLA1 (before the change in fluid management) and post-CLA2 (after the change) groups. To achieve fluid balance of 0–500 ml/day according to the modified protocol, the infusion volume was restricted.</p></div><div><h3>Results</h3><p>The daily fluid balance increased from the pre-CLA to the post-CLA1 periods (p = 0.01). The protocol changes decreased the pulmonary edema (post-CLA1 vs. post-CLA2, 44 vs. 22 %, p = 0.09) and discontinuation of CLA (44 vs. 9 %, p &lt; 0.01). The incidence of symptomatic spasm (SS) and delayed cerebral infarction (DCI) in the post-CLA2 were slightly reduced without significant differences (SS: 17 vs. 13 %, p = 0.69; DCI: 11 vs. 9 %, p = 1.00).</p></div><div><h3>Conclusion</h3><p>Strict management of fluid balance during CLA treatment reduced the adverse events and discontinuation of CLA administration. Fluid restriction may positively affect the management of cerebral vasospasms.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589238X2300061X/pdfft?md5=3109190f2bfaedbd0b9d40e1fcb24881&pid=1-s2.0-S2589238X2300061X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A high cardiothoracic ratio increases the risk of severe pulmonary complications after early initiation of clazosentan in patients with aneurysmal subarachnoid hemorrhage 动脉瘤性蛛网膜下腔出血患者早期使用克拉索坦后,高心胸比例会增加严重肺部并发症的风险
Brain Hemorrhages Pub Date : 2024-04-01 DOI: 10.1016/j.hest.2023.11.007
Rikuo Nishii, Tsuyoshi Ohta, Nobuyuki Fukui, Masaomi Koyanagi, Masanori Goto, Junichi Takeda, Ryu Fukumitsu, Tadashi Sunohara, Yuki Takano, Kunimasa Teranishi, Kota Nakajima, Yuji Naramoto, Yasuhiro Yamamoto, Satohiro Kawade, Ryo Sakisuka, Takateru Takamatsu, Masanori Tokuda, Hikari Tomita, Mai Yoshimoto, Nobuyuki Sakai
{"title":"A high cardiothoracic ratio increases the risk of severe pulmonary complications after early initiation of clazosentan in patients with aneurysmal subarachnoid hemorrhage","authors":"Rikuo Nishii,&nbsp;Tsuyoshi Ohta,&nbsp;Nobuyuki Fukui,&nbsp;Masaomi Koyanagi,&nbsp;Masanori Goto,&nbsp;Junichi Takeda,&nbsp;Ryu Fukumitsu,&nbsp;Tadashi Sunohara,&nbsp;Yuki Takano,&nbsp;Kunimasa Teranishi,&nbsp;Kota Nakajima,&nbsp;Yuji Naramoto,&nbsp;Yasuhiro Yamamoto,&nbsp;Satohiro Kawade,&nbsp;Ryo Sakisuka,&nbsp;Takateru Takamatsu,&nbsp;Masanori Tokuda,&nbsp;Hikari Tomita,&nbsp;Mai Yoshimoto,&nbsp;Nobuyuki Sakai","doi":"10.1016/j.hest.2023.11.007","DOIUrl":"10.1016/j.hest.2023.11.007","url":null,"abstract":"<div><h3>Objective</h3><p>Pulmonary complications, which are occasionally severe, are common adverse events following the administration of clazosentan. This study aimed to identify factors associated with severe pulmonary adverse events due to clazosentan after aneurysmal subarachnoid hemorrhage (aSAH).</p></div><div><h3>Methods</h3><p>We conducted a retrospective study of 59 patients transported to our hospital and diagnosed with aSAH between April 2022 and May 2023.</p></div><div><h3>Results</h3><p>The analysis included 33 patients who were treated with clazosentan. Pulmonary complications occurred in 20 patients (61 %) and clazosentan administration was discontinued due to severe pulmonary complications in 7 patients (21 %). The cardiothoracic ratio on admission was significantly higher (57 % vs. 49 %, <em>p</em> = 0.0081) and clazosentan was initiated earlier after aSAH onset (42 vs. 66 h, <em>p</em> = 0.047) in patients who discontinued clazosentan compared with patients who completed administration of clazosentan. The median duration of clazosentan administration was 3.2 days in the discontinuation group. No significant associations were found between the time of clazosentan initiation and the incidence of angiographic vasospasm, delayed cerebral ischemia, or 90-day modified Rankin scale.</p></div><div><h3>Conclusions</h3><p>The risk of severe pulmonary complications is higher in patients with high cardiothoracic ratios on admission, and delaying clazosentan initiation may prevent pulmonary complications even in high-risk cases.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589238X23000517/pdfft?md5=e325369c7d66c8909b709c2192fa359b&pid=1-s2.0-S2589238X23000517-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135510272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Could clazosentan, first approved in Japan, improve neurological prognosis after subarachnoid hemorrhage in combination with modified water-electrolyte management? 在日本首次获批的克拉索坦能否改善蛛网膜下腔出血后神经系统的预后?
Brain Hemorrhages Pub Date : 2024-04-01 DOI: 10.1016/j.hest.2023.10.005
Eiji Shikata , Izumi Yamaguchi , Masaaki Korai , Takeshi Miyamoto , Tadashi Yamaguchi , Hiroshi Kagusa , Kenji Shimada , Yoshiteru Tada , Keiko T. Kitazato , Yasuhisa Kanematsu , Yasushi Takagi
{"title":"Could clazosentan, first approved in Japan, improve neurological prognosis after subarachnoid hemorrhage in combination with modified water-electrolyte management?","authors":"Eiji Shikata ,&nbsp;Izumi Yamaguchi ,&nbsp;Masaaki Korai ,&nbsp;Takeshi Miyamoto ,&nbsp;Tadashi Yamaguchi ,&nbsp;Hiroshi Kagusa ,&nbsp;Kenji Shimada ,&nbsp;Yoshiteru Tada ,&nbsp;Keiko T. Kitazato ,&nbsp;Yasuhisa Kanematsu ,&nbsp;Yasushi Takagi","doi":"10.1016/j.hest.2023.10.005","DOIUrl":"10.1016/j.hest.2023.10.005","url":null,"abstract":"<div><p>An aneurysmal subarachnoid hemorrhage (aSAH) is a devastating event associated with a high mortality and morbidity rate. Though numerous medications are used to prevent cerebral vasospasm and vasospasm-related cerebral infarction after aSAH, no effective pharmacological treatment has been established. Clazosentan, a highly selective endothelin receptor type A antagonist, was approved for use in Japan in April 2022 based on results of two pivotal randomized, placebo-controlled phase 3 studies (JapicCTI-163369, JapicCTI-163368). These studies indicated that clazosentan significantly reduced the incidence of vasospasm-related morbidity and all-cause mortality after aneurysm coiling and clipping. Clazosentan is thus expected to become a “game changer” for improving the neurological prognosis after aSAH. However, other reports indicate that even when clazosentan or nimodipine are administered for prophylaxis against delayed neurological decline, patients treated with increased colloid administration or hypertonic saline (3% sodium chloride) load exhibit poor functional outcome and higher mortality, suggesting that extra fluid and sodium derived from prophylactic colloid administration contribute to negative outcomes after aSAH. Pharmacological treatments such as clazosentan in addition to perioperative management involving delivery of less water and sodium might be crucial for achieving better outcomes than conventional therapy. Based on a literature review, we present here the future perspectives regarding clazosentan and the necessity for modifying management of the water-electrolyte balance by focusing on endothelin-1 and blood–brain barrier disruption.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589238X23000438/pdfft?md5=007dbb3fa62e5593cb4cd48a58198c33&pid=1-s2.0-S2589238X23000438-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136127697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evolving approaches in the management of patients with subarachnoid hemorrhage from 2002 to 2022: The impact of clazosentan and treatment modalities on outcomes 2002年至2022年蛛网膜下腔出血患者治疗方法的演变:克拉索坦和治疗模式对疗效的影响
Brain Hemorrhages Pub Date : 2024-04-01 DOI: 10.1016/j.hest.2023.11.006
Hajime Maeda , Tsuyoshi Izumo , Kazuaki Okamura , Susumu Yamaguchi , Yoichi Morofuji , Takayuki Matsuo
{"title":"Evolving approaches in the management of patients with subarachnoid hemorrhage from 2002 to 2022: The impact of clazosentan and treatment modalities on outcomes","authors":"Hajime Maeda ,&nbsp;Tsuyoshi Izumo ,&nbsp;Kazuaki Okamura ,&nbsp;Susumu Yamaguchi ,&nbsp;Yoichi Morofuji ,&nbsp;Takayuki Matsuo","doi":"10.1016/j.hest.2023.11.006","DOIUrl":"10.1016/j.hest.2023.11.006","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to assess the changes in patient demographics, aneurysm characteristics, and treatment modalities for subarachnoid hemorrhage (SAH) over the past two decades.</p></div><div><h3>Methods</h3><p>We analyzed SAH 6,446 patients between 2002 and 2022, which was divided into three periods: 2002–2011 (FP), 2012–2021 (SP), and post-clazosentan 2022 (PC). The final cohort included 2878, 2016, and 152 patients in FP, SP, and PC groups, respectively. We examined patient demographics, surgical procedures, spasm prevention therapy, and delayed ischemic neurological deficits (DIND).</p></div><div><h3>Results</h3><p>The mean age of the patients increased over the study period (64, 66, and 68 years in FP, SP, and PC groups, respectively). Clipping was the predominant method during FP (79 %); however, coiling surpassed clipping in 2022 (coiling vs. clipping, 47 % vs. 46.3 %). Before clazosentan introduction, fasudil was the primary spasm prevention treatment (&gt;80 %); however, its use decreased (63.9 %) after clazosentan introduction. DIND varied across FP, SP, and PC groups (37.4 %, 24.2 %, and 16.7 % respectively). Age and generation were significantly associated with DIND and irreversibility.</p></div><div><h3>Conclusion</h3><p>Regarding the management of patients with SAH, shift from clipping to coiling, and the introduction of new spasm prevention treatments such as clazosentan were observed, led to a decrease in DIND.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589238X23000505/pdfft?md5=832725d93f0fd4ffbe7b31cbe971bf53&pid=1-s2.0-S2589238X23000505-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135510273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Initial results of clazosentan with multiple-drug management for the prevention of cerebral vasospasm after aneurysmal subarachnoid hemorrhage 动脉瘤性蛛网膜下腔出血后使用克拉生坦配合多种药物治疗预防脑血管痉挛的初步结果
Brain Hemorrhages Pub Date : 2024-04-01 DOI: 10.1016/j.hest.2024.01.004
Tatsuki Kimura, Kaima Suzuki, Hiroki Sato, Aoto Shibata, Yushiro Take, Hidetoshi Ooigawa, Masataka Yoshimura, Shinya Kohyama, Hiroki Kurita
{"title":"Initial results of clazosentan with multiple-drug management for the prevention of cerebral vasospasm after aneurysmal subarachnoid hemorrhage","authors":"Tatsuki Kimura,&nbsp;Kaima Suzuki,&nbsp;Hiroki Sato,&nbsp;Aoto Shibata,&nbsp;Yushiro Take,&nbsp;Hidetoshi Ooigawa,&nbsp;Masataka Yoshimura,&nbsp;Shinya Kohyama,&nbsp;Hiroki Kurita","doi":"10.1016/j.hest.2024.01.004","DOIUrl":"10.1016/j.hest.2024.01.004","url":null,"abstract":"<div><h3>Objective</h3><p>Cerebral vasospasm is an unelucidated complication of subarachnoid hemorrhage. Various treatments exist against cerebral vasospasms however, consensus on the optimal treatment is lacking. We use clazosentan, which is used to prevent cerebral vasospasm, with multidrug combinations. In this study, we aimed to clarify the initial results of using clazosentan in multidrug combinations in the real world.</p></div><div><h3>Methods</h3><p>We retrospectively investigated 54 patients who were treated for subarachnoid hemorrhage and received clazosentan. We compared the results of these patients on the basis of two groups: those with good outcomes (modified Rankin scale score: 0–3) and poor outcomes (4–6) at discharge.</p></div><div><h3>Results</h3><p>Among the patients, poor outcome was observed in 19 patients (35.2 %). Angiographic vasospasms occurred in 10 patients (good outcome [n = 6] vs. poor outcome [n = 4]; p = 0.73), and symptomatic vasospasms occurred in 4 patients (n = 2 vs. n = 2, p = 0.61). The incidence of pleural effusion (28.6 % vs. 73.7 %, p &lt; 0.01) and the mean daily fluid balance (303.5 mL/day vs. 785.4 mL/day, p &lt; 0.01) were higher in the poor outcome group.</p></div><div><h3>Conclusion</h3><p>Pleural effusion and high positive balance may be associated with poor outcome. However, the number of cases examined was small; therefore, further large-scale studies with a bigger sample size are needed.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589238X24000135/pdfft?md5=4299f1a83ece989eff9004b4f29c1b6e&pid=1-s2.0-S2589238X24000135-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139639241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Special considerations and pitfalls for intracerebral bleeding followed COVID-19 case treated by ECMO 通过 ECMO 治疗 COVID-19 病例后脑内出血的特别注意事项和陷阱
Brain Hemorrhages Pub Date : 2024-02-01 DOI: 10.1016/j.hest.2023.06.001
Wael Osman Amer , Hussein Awad El Gharieb , Zakaria Ahmed , Hossam Ibrahim , Ahmed Alanazi , Mostafa Meshref
{"title":"Special considerations and pitfalls for intracerebral bleeding followed COVID-19 case treated by ECMO","authors":"Wael Osman Amer ,&nbsp;Hussein Awad El Gharieb ,&nbsp;Zakaria Ahmed ,&nbsp;Hossam Ibrahim ,&nbsp;Ahmed Alanazi ,&nbsp;Mostafa Meshref","doi":"10.1016/j.hest.2023.06.001","DOIUrl":"10.1016/j.hest.2023.06.001","url":null,"abstract":"<div><p>COVID-19, or coronavirus infection, is an acute respiratory illness caused by the corona virus that can develop into a life-threatening form of ARDS. Extracorporeal membrane oxygenation (ECMO) is a highly effective treatment for life-threatening instances. One of the many complications associated with ECMO was bleeding. COVID patients are at risk for intracerebral bleeding due to several factors, including the drug's action on ACE2 receptors, leading to hypertension, as well as hypercoagulability, dysregulated immune response, DIC, and the use of anticoagulants.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10257510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10091343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Falx interhemispheric subdural hematoma in a hypertensive patient with urticaria: A case report 一名患有荨麻疹的高血压患者的大脑镰间硬膜下血肿:病例报告
Brain Hemorrhages Pub Date : 2024-02-01 DOI: 10.1016/j.hest.2023.08.003
Umut Ocak, Mustafa Tolga Özdal
{"title":"Falx interhemispheric subdural hematoma in a hypertensive patient with urticaria: A case report","authors":"Umut Ocak,&nbsp;Mustafa Tolga Özdal","doi":"10.1016/j.hest.2023.08.003","DOIUrl":"10.1016/j.hest.2023.08.003","url":null,"abstract":"<div><p>Falx interhemispheric subdural hematoma (FISH) is a rare subtype of subdural hematoma that occurs between the cerebral hemispheres along with falx cerebri. It represents less than 0.5% of all subdural hematomas and is frequently misdiagnosed due to its rarity and nonspecific clinical presentation. We present a case of 59-year-old female with a history of urticaria and hypertension who developed FISH following minor head trauma. The patient experienced presyncope, nausea, dizziness, and headache. A non-contrast computed tomography (CT) scan of the head revealed FISH, and the patient was managed conservatively without surgical intervention. This case report highlights the importance of considering FISH in the differential diagnosis of patients presenting with headache, dizziness, and presyncope, particularly in the setting of minor head trauma. We discuss the potential relationship between FISH, urticaria, and hypertension, as well as the possible causes of presyncope in this case, including orthostatic hypotension probably due to vagal nerve stimulation. Indeed, further studies are needed to explore these associations and to better understand the underlying mechanisms.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589238X2300027X/pdfft?md5=6be5bdbe0e53c6fce0bcf8229931a31a&pid=1-s2.0-S2589238X2300027X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87599163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of Microsurgical Resection of Low-Grade Cerebral Arteriovenous Malformations: A Prospective Observational Multicenter Study from a Low-Middle-Income Country 低级别脑动静脉畸形显微手术切除术的结果:一项来自中低收入国家的前瞻性多中心观察研究
Brain Hemorrhages Pub Date : 2024-02-01 DOI: 10.1016/j.hest.2023.06.002
Adnan Khaliq , Ahtesham Khizar , Muhammad Hassan Raza , Muhammad Idris Khan , Nayab Gul
{"title":"Outcomes of Microsurgical Resection of Low-Grade Cerebral Arteriovenous Malformations: A Prospective Observational Multicenter Study from a Low-Middle-Income Country","authors":"Adnan Khaliq ,&nbsp;Ahtesham Khizar ,&nbsp;Muhammad Hassan Raza ,&nbsp;Muhammad Idris Khan ,&nbsp;Nayab Gul","doi":"10.1016/j.hest.2023.06.002","DOIUrl":"10.1016/j.hest.2023.06.002","url":null,"abstract":"<div><h3>Objective</h3><p>To appraise the overall outcomes of microsurgical resection of low-grade arteriovenous malformations (AVMs) in a low-middle-income country.</p></div><div><h3>Methods</h3><p>Data was collected prospectively from three different neurosurgical centres in Pakistan for this study and it lasted for two years. According to the Spetzler-Martin (S-M) grading system, patients diagnosed with cerebral AVMs were divided into three classes A, B, and C. AVMs of grade 1 and 2 were included in Class A. Class B contained grade 3 AVMs, while Class C contained grade 4 and 5 AVMs. All male and female patients in Class A were eligible for this study. Patients were evaluated postoperatively for seizures, haemorrhage, focal neurological deficits, and AVM cure rates. Morbidity, mortality, and functional recovery were used to evaluate the outcome. Functional recovery and cure rate were observed after 6 months of follow-up.</p></div><div><h3>Results</h3><p>There were a total of 22 patients. Mean age was 36.41 ± 14.32 SD years. There were 12 (54.5 %) male patients and 10 (45.5 %) female patients. 13 patients (59.1 %) presented with spontaneous intracerebral haemorrhage, while 9 patients (40.9 %) presented with seizures. 14 patients (63.6 %) had S-M grade 1 and 8 patients (36.4 %) had S-M grade 2. All patients underwent microsurgical resection. We discovered 4.5 % morbidity in our study. There was no postoperative mortality. At 6 months, an excellent functional outcome of 95.5 % (according to the Glasgow outcome scale) and 100 % cure rate was observed.</p></div><div><h3>Conclusion</h3><p>Microsurgery is a safe and effective treatment for low-grade AVMs in terms of morbidity, mortality, functional outcome and cure rates in our country.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589238X23000244/pdfft?md5=3d1e32344b8224fdc038c404047e253d&pid=1-s2.0-S2589238X23000244-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90418937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of SARS-CoV-2 Omicron variant infection on the outcomes of patients with spontaneous intracerebral hemorrhage: A prospective cohort study SARS-CoV-2 Omicron变异型感染对自发性脑出血患者预后的影响:前瞻性队列研究
Brain Hemorrhages Pub Date : 2024-02-01 DOI: 10.1016/j.hest.2023.12.002
Sai Du , Zhitao Zhang , Chuhua Fu , Liang Tan , Liansheng Mou , Yi Huang , Jianfei Feng , Haijun Zhang , Yincai Xu , Xinzhen Ye , Rongrui Tang
{"title":"Impact of SARS-CoV-2 Omicron variant infection on the outcomes of patients with spontaneous intracerebral hemorrhage: A prospective cohort study","authors":"Sai Du ,&nbsp;Zhitao Zhang ,&nbsp;Chuhua Fu ,&nbsp;Liang Tan ,&nbsp;Liansheng Mou ,&nbsp;Yi Huang ,&nbsp;Jianfei Feng ,&nbsp;Haijun Zhang ,&nbsp;Yincai Xu ,&nbsp;Xinzhen Ye ,&nbsp;Rongrui Tang","doi":"10.1016/j.hest.2023.12.002","DOIUrl":"10.1016/j.hest.2023.12.002","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to investigate the impact of the infection with the novel coronavirus Omicron variant on the outcomes of patients with severe spontaneous intracerebral hemorrhage.</p></div><div><h3>Methods</h3><p>We conducted a multicenter prospective non-randomized cohort study during the peak of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) Omicron strain epidemic. Clinical data were collected from nine centers in China between December 1, 2022, and February 28, 2023. Patients were categorized into good and poor outcomes groups based on modified Rankin Scale scores at discharge. Clinical characteristics were compared, and univariate and multivariate logistic regression analyses were performed. Additionally, coagulation function was compared between SARS-CoV-2 Omicron positive and negative patients.</p></div><div><h3>Results</h3><p>Among 86 included patients, 30 (35 %) had a favorable outcome, while 56 (65 %) had an unfavorable outcome. Of these, 32 (37 %) tested positive for SARS-CoV-2 Omicron, while 54 (63 %) tested negative. Multivariate analysis identified Glasgow Coma Scale score and hypertension as independent risk factors affecting outcomes (P &lt; 0.05). Surprisingly, SARS-CoV-2 Omicron infection emerged as a protective factor for patient outcomes (P &lt; 0.05). Additionally, SARS-CoV-2 Omicron-positive patients exhibited significantly elevated fibrinogen levels upon admission (P &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>In comparison to patients without SARS-CoV-2 Omicron infection, patients with severe spontaneous intracerebral hemorrhage who were co-infected with SARS-CoV-2 Omicron exhibited a more favorable short-term outcome.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589238X23000621/pdfft?md5=03e415e0f2dc76523387876fc5e5bc05&pid=1-s2.0-S2589238X23000621-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139023076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Managing Mental Disorders in Intracranial Hemorrhage (ICH) Patients: A Case Study on The Importance of Early Recognition and Intervention 处理颅内出血(ICH)患者的精神障碍:关于早期识别和干预重要性的案例研究
Brain Hemorrhages Pub Date : 2024-02-01 DOI: 10.1016/j.hest.2023.02.005
Irma Suswati, Rahayu, Anisa Putri Maulida, Aan Dwi Prasetio
{"title":"Managing Mental Disorders in Intracranial Hemorrhage (ICH) Patients: A Case Study on The Importance of Early Recognition and Intervention","authors":"Irma Suswati,&nbsp;Rahayu,&nbsp;Anisa Putri Maulida,&nbsp;Aan Dwi Prasetio","doi":"10.1016/j.hest.2023.02.005","DOIUrl":"10.1016/j.hest.2023.02.005","url":null,"abstract":"<div><p>Intracranial Hemorrhage (ICH) can lead to various clinical manifestations and complications. These include mental disorders that range from impaired cognitive function to disturbances in the sensorium, perception, thought content, and emotions. One of the most common outcomes of ICH is mood disturbances and cognitive dysfunction. Therefore, this study presents the case of a 50-year-old patient who came to the emergency room with a stroke and was diagnosed with ICH and a mental organic disorder after radiographic and laboratory examinations. The management of mental disorders must be given special attention in the care of ICH patients. This is because complications of Neurobehavioral after ICH are often recognized too late and lead to poor long-term patient outcomes. An increase in patient mortality can also occur, with decreased outcomes and quality of life, leading to sequelae.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589238X23000098/pdfft?md5=922a6b89261daf7786b01e1daec0bd81&pid=1-s2.0-S2589238X23000098-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84612287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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