Brain Circulation最新文献

{"title":"Considerations for delayed-onset spinal arachnoid web after intracranial subarachnoid hemorrhage.","authors":"Georgia Wong, Gnel Pivazyan, Jeffrey M Breton, Ehsan Dowlati, Daniel R Felbaum","doi":"10.4103/bc.bc_99_23","DOIUrl":"10.4103/bc.bc_99_23","url":null,"abstract":"<p><p>Spinal arachnoid web (AW) is a rare condition causing spinal cord-related issues. Its cause is often idiopathic but can be linked to past trauma or spine surgery. We describe two cases of AWs that developed after subarachnoid hemorrhage (SAH). Case #1 is a 71-year-old male with nonaneurysmal SAH who developed myelopathy 1 year later. Magnetic resonance imaging revealed upper thoracic cord edema and an AW. Case #2 is a 57-year-old female who underwent coiling of a ruptured basilar artery aneurysm and ventriculoperitoneal shunting for hydrocephalus. Twenty months later, she developed mid-thoracic AW requiring surgical resection. Both patients showed symptom improvement postresection avoiding further reoperation. History of SAH is emerging as a risk factor for AW development, emphasizing the importance of monitoring delayed-onset myelopathy and back pain in recent SAH patients.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 2","pages":"89-93"},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of high-altitude and cold environment on brain and heart damage in rats with hemorrhagic shock.","authors":"Jun Xu, Wantong Yu, Ning Li, Sijie Li, Xiaojie Wang, Chen Gao, Feng-Yong Liu, Xunming Ji, Changhong Ren","doi":"10.4103/bc.bc_24_24","DOIUrl":"10.4103/bc.bc_24_24","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhagic shock (HS) causes severe organ damage, worsened by high-altitude conditions with lower oxygen and temperatures. Existing research lacks specific insights on brain and heart damage under these conditions. This study hypothesizes that high-altitude and cold (HAC) environments exacerbate HS-induced damage in the brain and heart, aiming to improve treatment strategies.</p><p><strong>Materials and methods: </strong>Twenty-four male Sprague-Dawley (SD) rats (200-250 g of weight) were randomly assigned into sham, HS + normal, HS + HAC (4,000 m), and HS + HAC (6,000 m). The HS model was established in SD rats (35% loss of total blood volume), and histopathological injuries of the brain and heart were detected using hematoxylin and eosin staining, Sirius red staining, and immunohistochemistry. Apoptosis of the brain and heart tissues was detected by terminal transferase-mediated dUTP nick end labeling (TUNEL) immunofluorescence staining. To determine the levels of tumor necrosis factor-α (TNF-α), interferon-gamma (IFN-γ), monocyte chemoattractant protein-1 (Mcp-1), BCL2-associated X (BAX), and myeloid cell leukemia-1 (Mcl-1) protein, western blotting assay was used.</p><p><strong>Results: </strong>The HAC environment induced pathological damage to the brain and heart and aggravated the degree of cardiac fibrosis in HS rats. However, it did not cause apoptosis of the brain and heart. In addition, it upregulated TNF-α, IFN-γ, Mcp-1, and BAX protein levels, but downregulated Mcl-1 protein levels (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>The HAC environment aggravated the degree of brain and heart damage in HS rats, which may be related to neuron nucleus pyknosis, myocardial fibrosis, and inflammatory and apoptosis activation.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 2","pages":"174-183"},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of the neurocritical care specialty in China based on the analysis of neurocritical care unit volume and quality.","authors":"Yingying Su, Junfang Teng, Suyue Pan, Wen Jiang, Furong Wang, Fei Tian, Jing Jing, Huijin Huang, Jie Cao, Huaiqiang Hu, Liping Liu, Wei Li, Cheng Liang, Liansheng Ma, Xuegang Meng, Linyu Tian, Changqing Wang, Lihua Wang, Yan Wang, Zhenhai Wang, Zhiqiang Wang, Zunchun Xie, Mingyao You, Jun Yuan, Chaosheng Zeng, Li Zeng, Le Zhang, Lei Zhang, Xin Zhang, Yongwei Zhang, Bin Zhao, Saijun Zhou, Zhonghe Zhou","doi":"10.4103/bc.bc_71_23","DOIUrl":"https://doi.org/10.4103/bc.bc_71_23","url":null,"abstract":"<p><strong>Purpose: </strong>Through three neurocritical care unit (NCCU) surveys in China, we tried to understand the development status of neurocritical care and clarify its future development.</p><p><strong>Methods: </strong>Using a cross-sectional survey method and self-report questionnaires, the number and quality of NCCUs were investigated through three steps: administering the questionnaire, sorting the survey data, and analyzing the survey data.</p><p><strong>Results: </strong>At the second and third surveys, the number of NCCUs (76/112/206) increased by 47% and 84%, respectively. The NCCUs were located in tertiary grade A hospitals or teaching hospitals (65/100/181) in most provinces (24/28/29). The numbers of full-time doctors (359/668/1337) and full-time nurses (904/1623/207) in the NCCUs increased, but the doctor-bed ratio and nurse-bed ratio were still insufficient (0.4:1 and 1.3:1).</p><p><strong>Conclusion: </strong>In the past 20 years, the growth rate of NCCUs in China has accelerated, while the allocation of medical staff has been insufficient. Although most NCCU hospital bed facilities and instruments and equipment tend to be adequate, there are obvious defects in some aspects of NCCUs.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"67-76"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overt nickel and cobalt hypersensitivity after pipeline embolization device placement: A case report.","authors":"Artur Eduardo Martio, Daniel Marchi Kieling, Luciano Bambini Manzato, José Ricardo Vanzin","doi":"10.4103/bc.bc_85_23","DOIUrl":"https://doi.org/10.4103/bc.bc_85_23","url":null,"abstract":"<p><p>Nickel and cobalt are frequently found in metallic alloys used in the manufacture of aneurysm clips and endovascular prostheses, such as the pipeline embolization device (PED). Nickel hypersensitivity can affect up to 15% of the population, however, it is very rarely overt in patients who undergo endovascular stent placement. Here, we present the case of a 35-year-old woman who developed allergic symptoms after PED placement and was later confirmed to be allergic to both nickel and cobalt by patch testing. Fortunately, she responded well to pharmacologic treatment, rendering surgical intervention unnecessary. To the best of our knowledge, this is the first report of symptomatic nickel hypersensitivity, and the second report of symptomatic cobalt allergy caused by the PED. Despite its low prevalence, we believe that surgeons should actively inquire patients in the postoperative period about allergic symptoms, to facilitate early diagnosis and treatment.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"85-88"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endogenous defense mechanism-based neuroprotection in large-vessel acute ischemic stroke: A hope for future.","authors":"Deepak Goel, Sushant Shangari, Manish Mittal, Ashwani Bhat","doi":"10.4103/bc.bc_56_23","DOIUrl":"https://doi.org/10.4103/bc.bc_56_23","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of morbidity and mortality worldwide and a leading cause of disability. None of the neuroprotective agents have been approved internationally except edaravone in Japanese guidelines in acute ischemic stroke. We here discuss that there are two types of endogenous defense mechanisms (EDMs) after acute stroke for neuromodulation and neuroregeneration, and if both can be activated simultaneously, then we can have better recovery in stroke.</p><p><strong>Aims and objectives: </strong>We aimed to study the effect of combination of neuroprotection therapies acting on the two wings of EDM in acute large-vessel middle cerebral artery (LMCA) ischemic stroke.</p><p><strong>Methods: </strong>Sixty patients of LMCA stroke were enrolled and randomized within 72 h into two groups of 30 patients each. The control group received standard medical care without any neuroprotective agents while the intervention group received standard medical care combined with oral citicoline with vinpocetine for 3 months with initial 1 week intravenous and edaravone and cerebrolysin injection, started within 72 h of onset of stroke. Patients were assessed on the basis of the National Institutes of Health Stroke Scale, Fugl-Meyer Assessment Score, Glasgow Coma Scale, and Mini-Mental Status Examination at admission, discharge, and after 90 days.</p><p><strong>Results: </strong>The intervention group showed significant and early improvements in motor as well as cognitive recovery.</p><p><strong>Conclusion: </strong>Combination therapy for neuroprotection which is acting on two pathways of EDM can be useful in functional recovery after acute ischemic stroke.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"51-59"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of intravascular catheters in therapeutic hypothermia.","authors":"Yuan Gao, Ming Li, Miaowen Jiang, Yang Zhang, Xunming Ji","doi":"10.4103/bc.bc_32_23","DOIUrl":"https://doi.org/10.4103/bc.bc_32_23","url":null,"abstract":"<p><p>Therapeutic hypothermia (TH) has been regarded as a promising neuroprotective method for acute ischemic stroke (AIS) for decades. During the development of TH, most researchers focused on improving hypothermic benefits by optimizing treatment processes and conditions. Intravenous thrombolysis and endovascular thrombectomy, for instance, have been introduced into AIS treatment. However, the lack of specialized intervention consumables, especially intervention catheter, led to inaccurate and uncontrolled hypothermic temperature, limited the efficacy of TH. In this review, intervention catheters as well as accessory equipment utilized in TH treatment has been summarized. Hopefully, this review may inspire the future development of TH specialized intervention catheter, enhance the outcome of TH, and neuroprotective efficacy in AIS.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"11-20"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for intraprocedural hypoxemia in patients with acute cerebral ischemia treated with vascular intervention and its impact on prognosis: A retrospective cohort study.","authors":"Zhiwei Gu, Aiqin Yin, Li Lu, Yi Lu, Bei Jiang, Limin Yin","doi":"10.4103/bc.bc_50_23","DOIUrl":"https://doi.org/10.4103/bc.bc_50_23","url":null,"abstract":"<p><strong>Background: </strong>Acute cerebral infarction (ACI) is one of the most common ischemic cerebrovascular diseases in neurology, with high morbidity, mortality, and disability. Early thrombolytic treatment of ACI has significant efficacy, but intraprocedural complications of hypoxemia can significantly reduce the efficacy. This study aims to analyze the risk factors for intraprocedural hypoxemia in patients with ACI, so as to take effective measures in advance to reduce the likelihood of adverse patient outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed a total of 238 patients with ACI treated with vascular interventions from May 2017 to May 2022. To assess and collate the patients' characteristics, factors associated with the development of intraprocedural hypoxemia. The independent risk factors for the development of intraprocedural hypoxemia were analyzed by binary logistic regression.</p><p><strong>Results: </strong>A total of 238 patients were included in this study. Of these, intraprocedural hypoxemia occurred in 89 (37.4%). The results showed that old age (odds ratio [OR] = 2.666, <i>P</i> = 0.009), obesity (OR = 3.029, <i>P</i> = 0.003), smoking history (OR = 2.655, <i>P</i> = 0.010), preoperative oxygen saturation (SpO₂) (OR = 0.001, <i>P</i> = 0.042), preoperative C-reactive protein (OR = 1.216, <i>P</i> = 0.002), and time from puncture to vascular recanalization (OR = 1.135, <i>P</i> = 0.000) were independent risk factors for intraprocedural hypoxemia in patients. The prognosis of the patients was assessed according to the modified Rankin scale, and the prognosis of the nonhypoxemia group was significantly better than that of the hypoxemia group. Regression analysis showed that intraprocedural hypoxemia (OR = 0.360, <i>P</i> = 0.001), postoperative lower extremity vein thrombosis (OR = 0.187, <i>P</i> = 0.018), hydrocephalus (OR = 0.069, <i>P</i> = 0.015), intracranial hemorrhage (OR = 0.116, <i>P</i> = 0.002), and reocclusion (OR = 0.217, <i>P</i> = 0.036) were independent risk factors for poor prognosis.</p><p><strong>Conclusions: </strong>Currently, intravascular hypoxemia in patients with ACI has a serious impact on prognosis. Clinical work should attach great importance to the clinical characteristics of patients, identify relevant risk factors, and aggressively take personalized therapeutic actions to improve patients' prognosis.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"42-50"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Featured minimally invasive therapeutic approach for chronic subdural hematoma: Embolization of middle meningeal artery - A narrative review.","authors":"Rasit Dinc","doi":"10.4103/bc.bc_65_23","DOIUrl":"https://doi.org/10.4103/bc.bc_65_23","url":null,"abstract":"<p><p>Chronic subdural hematoma (c-SDH) is a frequent and serious neurological disease. It develops due to hemorrhage to the subdural space, mainly caused by head trauma. The middle meningeal artery (MMA) plays a critical role in the supply of blood to c-SDH. The decision on the type of treatment for c-SDH depends mainly on clinical and imaging evaluation. In cases in which patients are critically ill, the hematoma must be evacuated immediately. For this purpose, surgery is generally accepted as the mainstay of treatment. Among surgical techniques, twist-drill craniotomy, burr-hole craniotomy, and craniotomy are the three most used. The recurrence rate of c-SDH after surgery is an important problem with a rate of up to 30%. The technical success classification embolization of MMA (EMMA) has emerged as an effective and safe option for the treatment of c-SDH, especially those that recur. EMMA is commonly used as an adjunct to surgery or less frequently alone. The technical success of EMMA has been a promising minimal invasive strategy as an alternative or adjunctive therapy to surgical methods. Polyvinyl alcohol is the most widely used among various embolizing agents, including n-butyl cyanoacrylate, coil, and gelatin sponge. EMMA has been shown to prevent the formation or recurrence of c-SDH by eliminating blood flow to the subdural space. Complication rates are low. The large-scale comparative prospective will ensure efficacy and safety. This article aims to highlight the current information about EMMA in patients with c-SDH.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"28-34"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the clinical value of single-phase computed tomography angiography in the assessment of collateral circulation in acute ischemic stroke: A narrative review.","authors":"Yunqiu Yang, Zhen Wang, Qingmao Hu, Libo Liu, Guorui Ma, Chen Yang","doi":"10.4103/bc.bc_54_23","DOIUrl":"https://doi.org/10.4103/bc.bc_54_23","url":null,"abstract":"<p><p>Acute ischemic stroke (AIS) condition assessment and clinical prognosis are significantly influenced by the compensatory state of cerebral collateral circulation. A standard clinical test known as single-phase computed tomography angiography (sCTA) is useful for quickly and accurately assessing the creation or opening of cerebral collateral circulation, which is crucial for the diagnosis and treatment of AIS. To improve the clinical application of sCTA in the clinical assessment of collateral circulation, we examine the present use of sCTA in AIS in this work.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"35-41"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periprocedural management of patients presenting for neurointerventional procedures using flow diverters for complex intracranial aneurysms: An anesthetist's perspective - A narrative review.","authors":"Anjane Sree, Ajay Prasad Hrishi, Ranganatha Praveen, Manikandan Sethuraman","doi":"10.4103/bc.bc_77_23","DOIUrl":"https://doi.org/10.4103/bc.bc_77_23","url":null,"abstract":"<p><p>Complex intracranial aneurysms pose significant challenges in the realm of neurointervention, necessitating meticulous planning and execution. This article highlights the crucial roles played by anesthetists in these procedures, including patient assessment, anesthesia planning, and continuous monitoring and maintaining hemodynamic stability, which are pivotal in optimizing patient safety. Understanding these complex procedures and their complications will aid the anesthetist in delivering optimal care and in foreseeing and managing the potential associated complications. The anesthetist's responsibility extends beyond the procedure itself to postprocedure care, ensuring a smooth transition to the recovery phase. Successful periprocedural anesthetic management in flow diverter interventions for complex intracranial aneurysms hinges on carefully orchestrating these elements. Moreover, effective communication and collaboration with the interventional neuroradiologist and the procedural team are emphasized, as they contribute significantly to procedural success. This article underscores the essential requirement for a multidisciplinary team approach when managing patients undergoing neurointerventions. In this collaborative framework, the expertise of the anesthetist harmoniously complements the skills and knowledge of other team members, contributing to the overall success and safety of these procedures. By providing a high level of care throughout the periprocedural period, anesthetists play a pivotal role in enhancing patient outcomes and minimizing the risks associated with these intricate procedures. In conclusion, the periprocedural anesthetic management of neurointervention using flow diverters for complex intracranial aneurysms is a multifaceted process that requires expertise, communication, and collaboration.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"21-27"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}