Brain Hemorrhages最新文献

{"title":"Apropos of menstrual changes and abnormal uterine bleeding after COVID-19 vaccination","authors":"Luca Roncati,&nbsp;Antonio Manenti","doi":"10.1016/j.hest.2022.11.001","DOIUrl":"10.1016/j.hest.2022.11.001","url":null,"abstract":"<div><p>It is news of 28 October 2022 that the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency has recommended to add heavy menstrual bleeding among the side effects of unknown frequency inside the package insert of nucleoside-modified messenger ribonucleic acid vaccines to prevent coronavirus disease 2019 (COVID-19). The decision has been made in the light of the numerous reports of unexpected menstrual changes or abnormal uterine bleeding following COVID-19 vaccination. Here we advance a possible involvement of the particular adenohypophyseal microcirculation in these strange and still unexplained events.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9642033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40698656","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}

{"title":"Establishing causality between SARS-CoV-2 and stroke/bleeding requires a temporal relationship and plausible pathophysiology","authors":"Josef Finsterer ,&nbsp;Fulvio A. Scorza ,&nbsp;Antonio-Carlos G. de Almeida","doi":"10.1016/j.hest.2022.10.004","DOIUrl":"10.1016/j.hest.2022.10.004","url":null,"abstract":"<div><p>Cerebrovascular events are increasingly recognized as a complication of SARS-CoV-2 infections. They can be due to hypercoagulability, vasculopathy, cardiac involvement in the infection, or autonomic dysfunction. However, establishing a causal relationship between cerebrovascular events and viral infection is not always easy and requires thorough investigation and documentation of a close temporal relationship between SARS-CoV-2 infection and the onset of cerebral impairment. Establishing a causal relationship between SARS-CoV-2 infection and cerebrovascular events is desirable as it can guide therapeutic management and determine the outcome.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40653033","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}

{"title":"Telerehabilitation-based exercises with or without transcranial direct current stimulation for pain, motor and cognitive function in older adults with mild cognitive impairments post-stroke: A multi-arm parallel-group randomized controlled trial study protocol","authors":"Tolulope Adeniji ,&nbsp;Thayananthee Nadasan ,&nbsp;Oladapo Michael Olagbegi ,&nbsp;Olumide Dada","doi":"10.1016/j.hest.2023.01.004","DOIUrl":"https://doi.org/10.1016/j.hest.2023.01.004","url":null,"abstract":"<div><h3>Background</h3><p>Cognitive impairments, pain, and motor dysfunction are daunting challenges for stroke survivors, clinicians, and caregivers during rehabilitation programmes. There is a dearth of studies investigating the effectiveness of combining neurodevelopmental technique telerehabilitation-based exercises with transcranial direct current stimulation (tDCS) for stroke survivors with mild cognitive impairments post-stroke.</p></div><div><h3>Objectives</h3><p>The primary aim of this study is to investigate and compare the effects of Telerehabilitation-Based Exercises with or without Transcranial Direct Current Stimulation (tDCS) on pain, motor and cognitive function in older adults with mild cognitive impairments post-stroke.</p></div><div><h3>Methods</h3><p>A multi-arm parallel-group (three groups) randomized controlled trial study involving a minimum of 87 participants (29 per group) will be conducted. Participants will be randomized into either telerehabilitation programmes with tDCS, telerehabilitation programmes alone or conventional physiotherapy programmes. All participants will be treated 3 times weekly for 8 weeks (45 min of intervention per session).</p></div><div><h3>Discussion</h3><p>The findings in this study are expected to guide the provision of effective and affordable rehabilitation for stroke survivors with mild cognitive impairment.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49746186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy as a treatment for Stroke: Utilizing regulatory T cells","authors":"Yuanwei Li ,&nbsp;Devin W. McBride ,&nbsp;Yingxin Tang ,&nbsp;Desislava Doycheva ,&nbsp;John H. Zhang ,&nbsp;Zhouping Tang","doi":"10.1016/j.hest.2023.02.003","DOIUrl":"https://doi.org/10.1016/j.hest.2023.02.003","url":null,"abstract":"<div><p>Stroke, a cerebrovascular disease with a high mortality rate, is categorized as either ischemic or hemorrhagic. Current existing therapies have limitations, including a narrow time window for treatment. As stroke induces a rapid and large immune response, immune cells and inflammatory mediators have become promising therapeutic targets for both ischemic and hemorrhagic strokes. In recent years, T cells have been investigated for their role in the pathogenesis of secondary injury and their therapeutic potential after stroke. And regulatory T cells, as one of the subpopulations of T cells, have been proved neuroprotective at both acute and recovery stages. In this review, we summarize the existing roles of Tregs in stroke and the various methods available for Treg intervention, and then provide a perspective for the future of immunotherapy in stroke.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49746800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematological indices as predictors of intracerebral hematoma expansion detected on serial computed tomography","authors":"K. Suprasanna ,&nbsp;H.B. Sridevi ,&nbsp;S.R. Ravikiran ,&nbsp;Ishank Jain ,&nbsp;Varun Holla","doi":"10.1016/j.hest.2023.02.004","DOIUrl":"https://doi.org/10.1016/j.hest.2023.02.004","url":null,"abstract":"<div><h3>Objective</h3><p>Hematoma expansion is associated with unfavourable neurological outcomes in intracranial haemorrhage. We aimed to study association of red blood cell (RBC) indices, platelet indices, and their ratios with hematoma expansion, detected by serial computed tomography (CT).</p></div><div><h3>Methods</h3><p>Hospital-based observational study of 88 patients with intracerebral hematoma referred for serial CT head with patients grouped as having progression/ no change/ resolution of hematoma. Baseline hematological indices and ratios were analysed.</p></div><div><h3>Results</h3><p>40 patients (45.5 %) had resolution, 20 patients (22.7 %) had no change and 28 patients (31.8 %) had progression of hematoma. RBC distribution width (RDW) (p value 0.001) and Plateletcrit (p-value 0.009) showed statistically significant difference among the groups. RBC distribution width (RDW) to PC ratio (RPR)<!--> <!-->showed statistically significant increase (p &lt; 0.001) in patients with progression.<!--> <!-->Receiver operating characteristic curve with RPR as test variable in predicting progression of hematoma showed cut-off value as 0.0615 (64.3 % sensitivity, 63.3 % specificity). Patients with RPR &gt; 0.0615 had greater chances of hematoma progression {OR 3.1 (95 % CI 1.22 to 7.91); p = 0.0174}</p></div><div><h3>Conclusion</h3><p>Raised RPR was most significant parameter with higher RDW, lower plateletcrit values in patients with progression of intra-parenchymal hematoma. These readily available indices can aid in prompt prognostication of intracerebral haemorrhage cases.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49746901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of telerehabilitation-based exercises plus transcranial direct current stimulation for stroke rehabilitation among older adults: A scoping review","authors":"Tolulope Adeniji ,&nbsp;Oladapo M. Olagbegi ,&nbsp;Thayananthee Nadasan ,&nbsp;Olumide Dada","doi":"10.1016/j.hest.2022.11.002","DOIUrl":"https://doi.org/10.1016/j.hest.2022.11.002","url":null,"abstract":"<div><h3>Objective</h3><p>Physiotherapy rehabilitation of patients with stroke is challenging for the patient, their informal caregivers and the therapist involved. A telerehabilitation programme combined with transcranial direct current stimulation (tDCS) may be the more appealing approach that may save rehabilitation time and improve treatment outcomes. This study performs a scoping review on the effect of telerehabilitation-based exercises plus tDCS among older adults with stroke.</p></div><div><h3>Methods</h3><p>This scoping adopts the Joana Briggs Institute guidelines for conducting a scoping review. Using Keywords and related MeSH terms to telerehabilitation-based exercises and tDCS among older adults with stroke, the following databases were searched: Cochrane, PubMed, Scopus, and Web of Science. Additional seven other databases (Academic Search Complete; PsycInfo; Health Source-Consumer Edition; Health Source: Nursing/Academic Edition; MEDLINE with Full Text; Academic Search Ultimate) were searched via EBSCOhost. The articles identified were imported to Mendeley for deduplication and then to Rayyan for further deduplication, title and abstract screening.</p></div><div><h3>Results</h3><p>Out of 216 total articles retrieved, 6 met the study’s inclusion criteria and were extracted for this study. The evidence shows that the telerehabilitation-based exercise intervention with tDCS improves upper limb motor function among older adult patients with stroke.</p></div><div><h3>Discussion &amp; conclusion</h3><p>Most of the evidence found focused on a combination of virtual reality-based exercises plus tDCS, and none of the telerehabilitation exercise interventions follows the neurorehabilitation techniques such as the Brunnstrom approach and Bobath technique. While it can be concluded that the evidence points towards improving upper limb motor functions with virtual reality and tDCS for stroke rehabilitation among older adults, there is no evidence of its effect on non-motor symptoms such as pain and cognitive functions possibly due to unavailability of relevant studies. There is also a dearth of evidence for t he telerehabilitation programme that uses neurodevelopmental techniques such as Brunnstrom and Bobath approaches with tDCS. This is paramount in providing effective care to older adult patients with stroke.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49758537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial hemorrhage and Covid-19: A retrospective analysis of 1675 hospitalized Covid-19 Brazilian patients","authors":"Artur Eduardo Martio,&nbsp;Pedro de Moraes Rêgo Soares,&nbsp;Octávio Ruschel Karam,&nbsp;Wagner Lazaretto Padua,&nbsp;Luciano Bambini Manzato,&nbsp;Paulo Moacir Mesquita Filho","doi":"10.1016/j.hest.2023.01.002","DOIUrl":"10.1016/j.hest.2023.01.002","url":null,"abstract":"<div><h3>Objective</h3><p>The present study seeks to overcome the lack of data on Covid-19 associated intracranial hemorrhage (ICH) in Brazil.</p></div><div><h3>Methods</h3><p>This is a retrospective, single-center case series of consecutive patients. It is a subanalysis of a larger study still in progress, which covers all neurological manifestations that occurred in patients admitted between March 1st, 2020 and June 1st, 2022, with active SARS-CoV-2 infection confirmed by polymerase chain reaction test. All patients with non-traumatic ICH were included.</p></div><div><h3>Results</h3><p>A total of 1675 patients were evaluated: 917 (54.75 %) had one or more neurological symptoms and 19 had non-traumatic ICH, comprising an incidence of 1.13 %. All patients had one or more risk factors for ICH. The presence of neurological manifestations before the ICH and ICU admission showed a statistically significant relationship with the occurrence of ICH (X² = 6.734, <em>p</em> = 0.0095; OR = 4.47; CI = 1.3–15.4; and FET = 9.13; <em>p</em> = &lt;0.001; OR = 9.15; CI = 3.27–25.5 respectively).</p></div><div><h3>Conclusion</h3><p>Our findings were largely congruent with the world literature. We believe that the assessment of risk factors can accurately predict the subgroup of patients at increased risk of ICH, but further studies are needed to confirm these hypotheses.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9569839","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}

{"title":"Complete basilar artery occlusion following ventriculoperitoneal shunt placement for giant aneurysm complicated by concurrent obstructive hydrocephalus: A case report","authors":"Molly Monsour ,&nbsp;Elliot Neal ,&nbsp;Davide Marco Croci ,&nbsp;Maxim Mokin ,&nbsp;Waldo Guerrero ,&nbsp;Kunal Vakharia ,&nbsp;Siviero Agazzi ,&nbsp;Harry Van Loveren","doi":"10.1016/j.hest.2022.10.003","DOIUrl":"https://doi.org/10.1016/j.hest.2022.10.003","url":null,"abstract":"<div><h3>Objective</h3><p>Giant aneurysms are infrequently complicated with obstructive hydrocephalus (HC), however, when concurrent, effective treatments are unestablished. There are incredibly few reports of HC due to basilar artery giant aneurysms and fewer reports regarding ventriculoperitoneal (VP) shunt complications in these patients.</p></div><div><h3>Case presentation</h3><p>We report the case of a gentleman in his 70 s who presented with a fusiform aneurysm of the entire basilar artery and mild intra-aneurysmal thrombosis. HC, secondary to the aneurysm, indicated VP shunt placement. Within 12 h following shunt placement, however, the patient deteriorated rapidly due to complete basilar artery occlusion and widespread brainstem ischemia. Endovascular intervention was unsuccessful due to extremely high clot burden. He unfortunately expired 2 days afterwards.</p></div><div><h3>Conclusion</h3><p>Hydrocephalus due to aneurysms is not uncommon, and VP shunt placement should be optimized to avoid unforeseen complications like the one described. We suspect that the shunt placement aggravated the already aberrant flow within the aneurysm, propagating a pro-thrombotic environment. With further reports of this complication, a standardized method to place VP shunts for patients with giant aneurysms while minimizing the risk of thrombotic occlusion could be established.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49744528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of blood component transfusions, tranexamic acid and fluids on subarachnoid hemorrhage outcomes","authors":"Ali Solhpour ,&nbsp;Siddharth Kumar ,&nbsp;Matthew J. Koch ,&nbsp;Sylvain Doré","doi":"10.1016/j.hest.2022.10.002","DOIUrl":"https://doi.org/10.1016/j.hest.2022.10.002","url":null,"abstract":"<div><p>For years, there have been many discussions about the optimal/beneficial threshold for transfusion of blood products in subarachnoid hemorrhage (SAH), and it remains to be established. Over the period spent by patients who are recuperating from such acute intracranial bleeding, they often become anemic. This is a rationale why these patients are considered candidates for transfusion to restore normal hemoglobin levels and optimal arterial oxygen content. After a comprehensive review of multidisciplinary studies, it becomes evident that the benefits of blood transfusion may vary greatly depending on the situation. The objective here is to summarize the reported outcomes following administration of blood products, i.e., platelets, tranexamic acid, prothrombin complex concentrate, red blood cells, and colloids/crystalloids for optimal oxygenation and to minimize rebleeding. These treatments are reviewed in the context of how they interact with the brain during the early brain injury, the vasospasm, microthrombus formation, inflammation, brain edema, and the delayed cerebral ischemic phases. In severe SAH, cardiac dysfunction and hyponatremia are not uncommon, and the transfusion-associated circulatory overload should be monitored. Thus, continuous hemodynamic monitoring is necessary to prevent pulmonary edema, along with the maintenance of euvolemia. The paper also highlights conditions when transfusion is contraindicated. Patient blood management programs should be promoted to develop clearer hospital transfusion guidelines to strive for optimization of patient hemoglobin and iron stores, and to train for more restrictive RBC policy. The results reported thus far need to be critically reviewed by a panel of experts, along with the need to design novel rigorous prospective parallel-group studies to establish SAH-specific guidelines.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49744801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal subarachnoid hemorrhage after ventriculoperitoneal shunt placement to manage communicating hydrocephalus due to melanoma leptomeningeal disease","authors":"Jonah Gordon ,&nbsp;Gavin Lockard ,&nbsp;Adam Alayli ,&nbsp;Nam D. Tran","doi":"10.1016/j.hest.2022.06.003","DOIUrl":"https://doi.org/10.1016/j.hest.2022.06.003","url":null,"abstract":"<div><p>Leptomeningeal disease (LMD) is a rare, late complication of malignant cancers. In addition to causing significant neurosurgical morbidity, LMD can cause communicating hydrocephalus by disrupting the cerebrospinal fluid (CSF) outflow. We report an 18-year old female with a metastatic melanoma presenting with headaches, altered mental status, nausea, and vomiting three months following a craniotomy for a temporal melanoma brain metastasis that had extended into the lateral ventricle. A diagnosis of communicating hydrocephalus was made after brain MRI demonstrated ventriculomegaly, thus necessitating placement of a ventriculoperitoneal shunt. Despite an initial improvement in symptoms, the patient quickly deteriorated within six hours following shunt placement and expired following a diffuse subarachnoid hemorrhage. This represents an important complication to consider in patients with leptomeningeal metastases and warrants future exploration to determine incidence and etiology.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49757864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}