Brain Hemorrhages最新文献

{"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":"4 2","pages":"Pages 77-95"},"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":"4 2","pages":"Pages 69-71"},"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}

{"title":"Intra-hematoma Rosiglitazone infusion therapy attenuates blood-brain barrier disruption after intracerebral hemorrhage in rabbits","authors":"Siying Ren ,&nbsp;Likun Wang ,&nbsp;Guofeng Wu ,&nbsp;Lei Huang ,&nbsp;Zhouping Tang","doi":"10.1016/j.hest.2023.01.001","DOIUrl":"https://doi.org/10.1016/j.hest.2023.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>To observe the effect of intra-hematoma Rosiglitazone (RSG) infusion therapy in treating intracerebral hemorrhage (ICH). Specifically, to explore the effects of RSG on tight junction associated proteins Occludin and ZO-1 expression within perihematomal brain tissues as well as the blood–brain barrier (BBB) permeability after ICH in rabbits.</p></div><div><h3>Methods</h3><p>A total of 30 rabbits were randomly assigned to three groups including sham control group (NC group, n = 10), hemorrhage model group (HM group, n = 10), and hemorrhage model with RSG treatment group (RSG group, n = 10). ICH was induced in rabbits of HM group and RSG group, involving an injection of autologous non-anticoagulant artery blood (0.3 mL, similar to basal ganglia hematoma 30 mL in humans) into the left basal ganglia of the rabbits’ brains. The NC group was injected with the same amount of saline into the same area. Six hours later after ICH induction or sham surgery, the RSG group received the intra-hematoma RSG (0.5 mg/0.1 mL) infusion, meanwhile the NC group and the HM group were injected with saline (0.1 mL) into the hematoma area. On day seven, the perihematomal brain tissues were obtained to determine the Occludin and ZO-1 expressions by Western Blot and RT-PCR, and the BBB permeability by the Evan’ s Blue (EB) content.</p></div><div><h3>Results</h3><p>Occludin and ZO-1 expressions and mRNA levels were all significantly decreased in the HM group and RSG group compared with the NC group (<em>P</em> &lt; 0.01). Occludin and ZO-1 expressions and mRNA levels were all significantly increased in the RSG group compared with the HM group (<em>P</em> &lt; 0.01). The EB contents were all significantly increased in the HM group and RSG group compared with the NC group (<em>P</em> &lt; 0.01). The EB content was significantly decreased in the RSG group compared with the HM group (<em>P</em> &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>Intra-hematoma RSG infusion therapy could increase the expressions of tight junction associated proteins Occludin and ZO-1 in the perihematomal brain tissues and decrease the BBB permeability in rabbits after ICH.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"4 2","pages":"Pages 47-52"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49744604","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":"Inflammatory response in sepsis and hemorrhagic stroke","authors":"Matyas Jelinek ,&nbsp;Kamil Duris","doi":"10.1016/j.hest.2022.10.005","DOIUrl":"https://doi.org/10.1016/j.hest.2022.10.005","url":null,"abstract":"<div><p>Exaggerated/deregulated inflammatory response is a major medical problem that is often associated with bad outcomes or even the death of the patient. Sepsis and severe hemorrhagic stroke are two illustrative examples because sepsis represents inflammation that is systemic initially, while stroke is initially a local pathology that in severe cases turns into systemic inflammation. There are clear differences between the two pathological conditions in terms of mechanisms and dynamics of inflammatory response at an early stage, while later the inflammatory response becomes uniform. This article aims to describe side-by-side sepsis and hemorrhagic stroke so that similar features and differences can stand out. We will describe the pathophysiological and clinical aspects of sepsis and hemorrhagic stroke, experimental models, the role of inflammation, and molecular mechanisms of inflammation in both conditions. Comparison of inflammatory response in these two model situations may lead to a better understanding of life-threatening conditions pathophysiology, in which the exaggeration/deregulation of the inflammatory response may occur with potentially severe consequences. This article is kept detailed to provide the reader with in-depth information, which should allow him to find the mechanisms of inflammatory response and to elaborate them by himself in the context of his particular needs.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"4 2","pages":"Pages 96-107"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49744803","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":"Intracerebral hemorrhage associated COVID-19 patient with normal coagulation profile after ECMO treatment: A case report","authors":"Wael Osman Amer ,&nbsp;Hussein Awad El gharieb ,&nbsp;Hossam Ibrahim ,&nbsp;Ahmed Alanazi ,&nbsp;Mostafa Meshref","doi":"10.1016/j.hest.2022.08.002","DOIUrl":"10.1016/j.hest.2022.08.002","url":null,"abstract":"<div><h3>Objective</h3><p>Coronavirus disease 2019 (COVID-19) is a novel coronavirus-caused infectious acute respiratory disease that can progress to severe acute respiratory distress syndrome (ARDS). For severe cases, extracorporeal membrane oxygenation (ECMO) is an excellent treatment option. ECMO had a number of side effects, including bleeding. Intracerebral hemorrhage can occur in COVID patients due to a variety of mechanisms, including covid's effect on ACE-2 receptors and subsequent hypertension, coagulopathy, DIC, or medication, such as anticoagulant use.</p></div><div><h3>Case presentation</h3><p>We present a case of a 53-year-old male COVID-19 patient who developed multiple, massive, severe intracerebral hemorrhages (ICH) despite a normal coagulation profile after ECMO treatment.</p></div><div><h3>Conclusion</h3><p>COVID-19 can progress to severe acute respiratory distress syndrome (ARDS), necessitating the use of extracorporeal membrane oxygenation (ECMO). Although ICH is not a common complication in patients with COVID-19 disease, it is unknown why this patient had a lower threshold of ICH despite having a normal coagulation profile.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"4 2","pages":"Pages 65-68"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9373471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9565313","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":"SARS-CoV-2 may underlie NMDA-related autoimmune encephalitis and venous sinus thrombosis","authors":"Josef Finsterer","doi":"10.1016/j.hest.2022.10.008","DOIUrl":"10.1016/j.hest.2022.10.008","url":null,"abstract":"","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"4 2","pages":"Pages 108-109"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9625848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9618832","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":"The effect of atorvastatin on the blood-brain barrier biomarkers in acute intracerebral hemorrhage, a pilot clinical trial","authors":"Leila Simani ,&nbsp;Mahtab Ramezani ,&nbsp;Nasrin Ahmadi ,&nbsp;Fatima Abazari ,&nbsp;Samira Raminfard ,&nbsp;Maziyar Shojaei ,&nbsp;Anahita Zoghi ,&nbsp;Ehsan Karimialavijeh ,&nbsp;Seyed Hossein Aghamiri ,&nbsp;Hossein Pakdaman","doi":"10.1016/j.hest.2022.07.004","DOIUrl":"https://doi.org/10.1016/j.hest.2022.07.004","url":null,"abstract":"<div><h3>Objective</h3><p>Prior studies have shown statins provide neuroprotection by targeting secondary brain injury pathways and regulating cytokine production. We aimed to evaluate the association between statin administration and molecular outcomes in acute Intracranial hemorrhages (ICHs).</p></div><div><h3>Methods</h3><p>Adult patients with acute spontaneous ICH were recruited and randomly allocated into two groups: group A received atorvastatin (40 mg/day) orally in addition to routine antihypertensive medications, while group B only received routine antihypertensives. Serum levels of matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor (VEGF), as primary outcomes, were measured at baseline, and after 45 days.</p></div><div><h3>Results</h3><p>Thirty-nine ICH patients (group A: 20; group B: 19) were analyzed. A notable elevation in VEGF and a reduction in MMP-9 levels were detected in group A compared to those in group B (P-value = 0.024 and 0.008, respectively).</p></div><div><h3>Conclusion</h3><p>Our data suggest that atorvastatin in the acute phase of ICH could improve the serum levels of neuroprotective molecular biomarkers.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"4 2","pages":"Pages 53-56"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49744842","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":"Computational fluid dynamics using dual-layer porous media modeling to evaluate the hemodynamics of cerebral aneurysm treated with FRED: A technical note","authors":"Masanori Tsuji ,&nbsp;Fujimaro Ishida ,&nbsp;Takenori Sato ,&nbsp;Kazuhiro Furukawa ,&nbsp;Yoichi Miura ,&nbsp;Ryuta Yasuda ,&nbsp;Yasuyuki Umeda ,&nbsp;Naoki Toma ,&nbsp;Hidenori Suzuki","doi":"10.1016/j.hest.2022.05.007","DOIUrl":"https://doi.org/10.1016/j.hest.2022.05.007","url":null,"abstract":"<div><p>Flow diverter (FD) implantation is increasingly performed for aneurysms that are difficult to treat with conventional endovascular therapy and direct surgery. Now, a new FD stent, the Flow-Redirection Endoluminal Device (FRED), enters into clinical practice and is expected to have higher therapeutic efficacy. To predict whether an aneurysm is completely occluded by FRED, we have developed a novel computational fluid dynamics (CFD) technique using dual-layer porous media modeling that simulates its characteristic stent strut. This technique may be useful to evaluate hemodynamic changes in an aneurysm after FRED implantation using the preoperative patient-specific aneurysm geometry. The authors describe the novel CFD technique with a dual-layer porous media and report the potential usefulness of the technique to predict the aneurysm-occlusion status after FRED implantation preoperatively using an illustrative case of an unruptured internal carotid artery anterior wall aneurysm.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"4 1","pages":"Pages 39-43"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49744415","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":"Pediatric hemorrhagic stroke: A retrospective case series in Hong Kong","authors":"Jacqueline Fung Chak Lam,&nbsp;Eric Yuk Hong Cheung,&nbsp;Emily Kit Ying Chan,&nbsp;Xian Lun Zhu,&nbsp;Rebecca Yuen Ting Ng,&nbsp;George Kwok Chu Wong","doi":"10.1016/j.hest.2022.05.006","DOIUrl":"https://doi.org/10.1016/j.hest.2022.05.006","url":null,"abstract":"<div><h3>Background</h3><p>Non-traumatic paediatric haemorrhagic stroke (PHS) is a common cause of death in children. We aimed to delineate the aetiologies of PHS and compare the outcomes of various management approaches to improve the treatment for children with PHS.</p></div><div><h3>Methods</h3><p>A retrospective analysis of PHS patients from a tertiary neurosurgical centre was conducted. Outcomes were evaluated based on the 30-day complication rate, rebleeding rate and functional outcome using the Modified Rankin Scale.</p></div><div><h3>Results</h3><p>39 patients were identified. The most common presentation for older children was severe headache, whereas symptoms were non-specific in younger children. Structural vascular lesions are the most common cause of PHS and 46% had arteriovenous malformation. 56% of patients received acute surgical intervention. 47% of patients were treated conservatively in the acute setting requiring interval definitive surgeries. Surgically managed patients experienced a higher 30-day complication rate but lower rebleeding rate. Functional outcome is good for PHS and most patients had full recovery.</p></div><div><h3>Conclusions</h3><p>Ruptured cerebral arteriovenous malformation was the most common cause of PHS and sudden onset of severe headache was the key presenting symptom. Prompt surgical intervention for PHS reduced the rebleeding rate.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"4 1","pages":"Pages 6-12"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49744844","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":"Emerging regenerative medicine for hemorrhagic stroke: An update on stem cell therapies","authors":"Molly Monsour ,&nbsp;Cesario V. Borlongan","doi":"10.1016/j.hest.2022.07.001","DOIUrl":"https://doi.org/10.1016/j.hest.2022.07.001","url":null,"abstract":"<div><p>Hemorrhagic stroke (HS) is a disastrous occurrence with high mortality rates, however, there are no established treatments for this pathology. Given recent advances in stem cell therapies, concerted research efforts have elucidated the therapeutic potential of stem cells in treating HS. In 2020, our group reviewed the use of SCs in regulating the neuroinflammatory reactions which occur after HS.¹ This review will build on that work, highlighting more recent advancements in the field of SC treatments for HS. Ultimately, with greater focus in this area of research, innovative SC therapies can be optimized in preclinical studies and soon be transferred to clinical applications for HS therapeutics.</p></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"4 1","pages":"Pages 22-26"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49744526","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}