المؤلفون: Jiahao Su, Yichun Xing, Sitao Liang, Qichang Lin, Huijiao Liu

المصدر: Medicine

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Observational Study, Glasgow Outcome Scale, Blood volume, intraventricular hemorrhage, Neurosurgical Procedures, Cerebral Ventricles, Hematoma, Postoperative Complications, medicine, Humans, extraventricular drainage, Aged, Cerebral Hemorrhage, Retrospective Studies, business.industry, Incidence (epidemiology), Therapeutic effect, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Prognosis, transcortical approach surgery, Hydrocephalus, Surgery, Intraventricular hemorrhage, Drainage, Female, business, Research Article

الوصف: Intraventricular hemorrhage is a serious intracerebral hemorrhagic disease with high mortality and poor prognosis. This retrospective study designed to investigate the therapeutic effect of transcortical approach surgery versus extraventricular drainage (EVD) on patients with intraventricular hemorrhage. Patients with intraventricular hemorrhage in Zhongshan City People's Hospital from January 01, 2014 to June 01, 2019 were retrospectively examined. They were divided into transcortical approach surgery groups and EVD groups to analyze the clinical characteristics and prognosis. A total of 96 patients were enrolled in the study (24 in the transcortical approach surgery group and 72 in the EVD group). The efficiency of postoperative operation was 15/19 in the transcortical approach surgery group and 24/48 in the EVD group (P = .012). The Glasgow Outcome Scale was 3.63 ± 1.27 in the transcortical approach surgery group and 2.80 ± 1.87 in the EVD group (P = .049). The postoperative residual blood volume was 9.62 ± 3.64 mL in the transcortical approach surgery group and 33.60 ± 3.53 mL in the EVD group (P

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1b52d61a8b3c12bf59794fe5614300f6Test
http://europepmc.org/articles/PMC8542114Test

المؤلفون: Gen Hamanaka, Jong Woo Lee, Xiaoying Wang, Estefania Reyes-Bricio, Josephine Lok, Mohammad Rashedul Islam, MingMing Ning, Liangge Hsu, Sherry Hsiang Yi Chou, Hajime Takase, Justin Mathew, Eng H. Lo, Ryo Ohtomo, Ken Arai, Kazuhide Hayakawa, Changhong Xing

المصدر: Neurology

مصطلحات موضوعية: 0301 basic medicine, Adult, Male, medicine.medical_specialty, Subarachnoid hemorrhage, Endothelium, Adolescent, Gastroenterology, Article, Proinflammatory cytokine, 03 medical and health sciences, Mice, Young Adult, 0302 clinical medicine, Modified Rankin Scale, Antigens, CD, Internal medicine, medicine, Animals, Humans, cardiovascular diseases, Neuroinflammation, Aged, Aged, 80 and over, Microglia, business.industry, Recovery of Function, Middle Aged, Subarachnoid Hemorrhage, medicine.disease, Cadherins, Prognosis, Hydrocephalus, nervous system diseases, Mice, Inbred C57BL, 030104 developmental biology, medicine.anatomical_structure, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, Biomarkers, External ventricular drain

الوصف: ObjectiveTo determine if CSF and plasma levels of soluble vascular endothelial (sVE)-cadherin are associated with functional outcome after subarachnoid hemorrhage (SAH) and to investigate sVE-cadherin effects on microglia.MethodsSerial CSF and plasma were collected from prospectively enrolled patients with nontraumatic SAH from a ruptured aneurysm in the anterior circulation and who required an external ventricular drain for clinical indications. Patients with normal-pressure hydrocephalus without SAH served as controls. For prospective assessment of long-term outcomes at 3 and 6 months after SAH, modified Rankin Scale scores (mRS) were obtained and dichotomized into good (mRS ≤ 2) vs poor (mRS > 2) outcome groups. For SAH severity, Hunt and Hess grade was assessed. Association of CSF sVE-cadherin levels with long-term outcomes, HH grade, and CSF tumor necrosis factor (TNF)-α levels were evaluated. sVE-cadherin effects on microglia were also studied.ResultssVE-cadherin levels in CSF, but not in plasma, were higher in patients with SAH and were associated with higher clinical severity and higher CSF TNF-α levels. Patients with SAH with higher CSF sVE-cadherin levels over time were more likely to develop worse functional outcome at 3 months after SAH. Incubation of cultured microglia with sVE-cadherin resulted in increased inducible nitric oxide synthase, interleukin-1β, reactive oxygen species, cell soma size, and metabolic activity, consistent with microglia activation. Microinjection of sVE-cadherin fragments into mouse brain results in an increased number of microglia surrounding the injection site, compared to injection of denatured vascular endothelial–cadherin fragments.ConclusionsThese results support the existence of a novel pathway by which sVE-cadherin, released from injured endothelium after SAH, can shift microglia into a more proinflammatory phenotype and contribute to neuroinflammation and poor outcome in SAH.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d990b0c48ffa925adb30e0a63b2d8f4eTest
https://europepmc.org/articles/PMC7274931Test/

المؤلفون: Bo Carlberg, Jan Malm, Katarina Laurell, Hanna Israelsson, Göran Leijon, Anders Eklund, Carsten Wikkelsö, Babar Kahlon

مصطلحات موضوعية: Male, Pediatrics, medicine.medical_specialty, Crash, Vascular risk, Article, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, Obesity, Prospective Studies, Vascular Diseases, Prospective cohort study, Aged, Aged, 80 and over, Sweden, business.industry, Case-control study, Middle Aged, medicine.disease, Hydrocephalus normal pressure, Hydrocephalus, Normal Pressure, Large sample, Hydrocephalus, Case-Control Studies, (Idiopathic) normal pressure hydrocephalus, Physical therapy, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, Biomarkers

الوصف: Objective:To assess the complete vascular risk factor (VRF) profile of idiopathic normal pressure hydrocephalus (INPH) using a large sample of representative patients with INPH and population-based controls to determine the extent to which vascular disease influences INPH pathophysiology.Methods:All patients with INPH who underwent shunting in Sweden in 2008–2010 were compared to age- and sex-matched population-based controls. Inclusion criteria were age 60–85 years and no dementia. The 10 most important VRFs and cerebrovascular and peripheral vascular disease were prospectively assessed using blood samples, clinical examinations, and standardized questionnaires. Assessed VRFs were hypertension, hyperlipidemia, diabetes, obesity, psychosocial factors, smoking habits, diet, alcohol intake, cardiac disease, and physical activity.Results:In total, 176 patients with INPH and 368 controls participated. Multivariable logistic regression analysis indicated that hyperlipidemia (odds ratio [OR] 2.380; 95% confidence interval [CI] 1.434–3.950), diabetes (OR 2.169; 95% CI 1.195–3.938), obesity (OR 5.428; 95% CI 2.502–11.772), and psychosocial factors (OR 5.343; 95% CI 3.219–8.868) were independently associated with INPH. Hypertension, physical inactivity, and cerebrovascular and peripheral vascular disease were also overrepresented in INPH. Moderate alcohol intake and physical activity were overrepresented among the controls. The population-attributable risk percentage was 24%.Conclusions:Our findings confirm that patients with INPH have more VRFs and lack the protective factors present in the general population. Almost 25% of cases of INPH may be explained by VRFs. This suggests that INPH may be a subtype of vascular dementia. Targeted interventions against modifiable VRFs are likely to have beneficial effects on INPH.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7f6cb84c481ee9dfb122c543d40cc7c1Test
https://europepmc.org/articles/PMC5304464Test/

المؤلفون: M. Pluderi, Sergio M. Gaini, Susanna Bacigaluppi, Lucia Innocenti, Giustino Tomei, Diego Spagnoli, Lorenzo Bello

مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, Programmable value shunt, cerebrospinal fluid pressure monitoring test, cerebrovascular disease, idiopathic normal pressure hydrocephalus, programmable value shunt, Central nervous system disease, Quality of life, Idiopathic normal pressure hydrocephalus, Risk Factors, Medicine, Humans, Prospective Studies, Cerebrovascular disease, Stroke, Aged, Aged, 80 and over, business.industry, Vascular disease, Settore MED/27 - Neurochirurgia, Middle Aged, medicine.disease, Survival Analysis, Cerebrospinal fluid pressure monitoring test, Hydrocephalus, Normal Pressure, Surgery, Hydrocephalus, Shunting, Cerebrovascular Disorders, Intracranial pressure monitoring, Female, Neurology (clinical), business, Shunt (electrical), Follow-Up Studies

الوصف: OBJECTIVE: The influence of cerebrovascular disease (CVD) on the short- and long-term results of surgery was evaluated in a series of consecutive patients with idiopathic normal-pressure hydrocephalus (iNPH). METHODS: Patients with suspected iNPH admitted to our department between June 1996 and June 2003 were evaluated with four clinical and handicap scales. CVD and risk factors for vascular disease were rated. All patients underwent intracranial pressure monitoring via a spinal catheter. Sixty-six patients received a ventriculoperitoneal shunt with a programmable valve. Prospective assessments were programmed at 2 weeks and 3 months after surgery (short-term follow-up). Long-term follow-up evaluations were arranged in June 2004 with patients and/or relatives and health/home care assistants. RESULTS: At the short-term follow-up examination, a significant clinical improvement was globally present in 89% of the patients (P < 0.05). CVD, such as leucoaraiosis or previous strokes, were present in 71% of the patients. Patients both with and without CVD and/or risk factors for vascular disease presented a significant improvement (P < 0.05) after shunting; 85 and 100% of the patients with and without CVD, respectively. At the long-term follow-up examination (mean, 52 ± 24.8 mo), 24% of the patients were dead and 8% had experienced stroke. Globally, 60% of the patients were still improved (P < 0.05); 52 and 79% of the patients with and without CVD, respectively. CONCLUSION: A high success rate in treatment of iNPH is possible in patients with and without CVD. Despite poorer short- and long-term treatment outcome of iNPH patients with CVD, a long-lasting improvement in their quality of life favors surgery.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9e5aa290baf1f6d9b929a70b00eb9ec7Test
http://hdl.handle.net/2434/32102Test

المؤلفون: Kiwon Lee, J. M. Schmidt, L. Fernandez, Jan Claassen, A.S. Lord, Edward Sander Connolly, Stephan A. Mayer, Neeraj Badjatia

مصطلحات موضوعية: Male, Subarachnoid hemorrhage, Time Factors, Brain Ischemia, Aneurysm, Secondary Prevention, Medicine, Humans, Vasospasm, Intracranial, Aged, Retrospective Studies, business.industry, Incidence (epidemiology), Incidence, Retrospective cohort study, Vasospasm, Intracranial Aneurysm, Articles, Middle Aged, Subarachnoid Hemorrhage, medicine.disease, Hydrocephalus, Respiratory failure, Anesthesia, Case-Control Studies, Female, Neurology (clinical), business, Hyponatremia

الوصف: Objective: Rebleeding of an aneurysm is a leading cause of morbidity and mortality after subarachnoid hemorrhage (SAH). Whereas numerous studies have demonstrated the risk factors associated with rebleeding, few data on complications of rebleeding, including its effect on the development of delayed cerebral ischemia (DCI), are available. Methods: A nested case-control study was performed on patients with rebleeding and control subjects matched for modified Fisher scale, Hunt-Hess grade, age, and sex previously entered into a prospective database. Rebleeding was defined as new hemorrhage apparent on repeat CT with or without new symptoms. Incidence and time course of DCI and hospital complications were compared. A secondary analysis of DCI and hospital complications was also performed on subjects surviving to postbleed day 7. Results: We identified 120 patients with rebleeding and 359 control subjects from 1996 to 2011. The rebleeding rate was 8.6%. In both the primary and secondary analyses, there was no difference in the incidence of DCI or its time course (29% vs 27%, p = 0.6; 7 ± 5 vs 7 ± 6 days, p = 0.9 for primary analysis; 39% vs 31%, p = 0.1, 7 ± 5 vs 7 ± 6 days, p = 0.6 for the secondary analysis). In a multivariate logistic regression model, rebleeding was associated with the complications of hyponatremia, respiratory failure, and hydrocephalus. Patients with rebleeding had higher rates of mortality, brain death, and poor outcomes. Conclusions: Rebleeding after SAH is associated with multiple medical and neurologic complications, resulting in higher morbidity and mortality, but is not associated with change of incidence or timing of DCI.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e06eb54c6b25205d8c51fce3d418f837Test
https://europepmc.org/articles/PMC3466499Test/