Outcome after aSAH depends on several factors, including the severity of the initial event, perioperative medical management, surgical variables, and the incidence of complications. Cerebral vasospasm (CV) is ure to consistently respond to treatment, emphasizing the need for further research into the underlying mechanisms of SAH-induced cerebrovascular dysfunction. To this end, our paper reviews the relevant literature on the main therapies employed for CV after aSAH and discusses possible avenues for future investigations. Current management of this condition consists of maximal medical therapy, including triple H regimen and oral administration of calcium antagonists, followed by endovascular balloon angioplasty and/or injection of vasodilatory agents for refractory cases. As the precise pathophysiology of CV is further elucidated, the development of promising investigational therapies will follow.
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http://dx.doi.org/10.1016/j.jns.2007.04.046 | DOI Listing |
Neurocrit Care
December 2024
Department of Neurology, Albany Medical Center, Albany, NY, USA.
Intrathecal nicardipine (ITN) is an investigational therapy for cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). The objective of this scoping review was to characterize the current state of the literature and map the current available evidence, examine research methodology, clarify key concepts and definitions in the literature, report procedural characteristics, identify and analyze knowledge gaps, and serve as a precursor for future systematic reviews, meta-analyses, and randomized controlled trials. An electronic search for studies on ITN for the treatment of CVS and DCI in patients with aSAH was conducted in accordance with published standards.
View Article and Find Full Text PDFInterv Neuroradiol
December 2024
Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
Background: Ruptured intracranial aneurysms lead to significant mortality and morbidity. Recent advancements have suggested staged coiling with subsequent flow diverter stent placement may reduce the risk of hemorrhage with dual antiplatelet therapy (DAPT) or stent thrombosis in the acute inflammatory phase after aneurysm rupture while still appropriately mitigating risk of aneurysmal rehemorrhage.
Materials And Methods: A systematic review and single-arm meta-analysis was conducted.
Interv Neuroradiol
December 2024
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Background And Purpose: Mechanical thrombectomy (MT) has become the standard of care for treatment of acute ischemic stroke secondary to large vessel occlusion up to 24 h from the last known normal time. With ADAPT and SOLUMBRA techniques, classically, a large bore aspiration catheter is delivered over a microcatheter and microwire crossing the clot to perform thrombectomy. Recently, a novel macrowire (Colossus 035 in.
View Article and Find Full Text PDFHeart
December 2024
Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy
Am J Transl Res
November 2024
Department of Radioactive Intervention, Henan No. 3 Provincial People's Hospital Zhengzhou 450006, Henan, China.
ECMO is an advanced technology for extracorporeal respiratory and circulatory support. It involves the extraction of venous blood from the patient's body, which is subsequently oxygenated within an oxygenator (or membrane lung). This oxygen-rich blood is reinfused either into veins or arteries, rapidly compensating for impaired lung and heart functionalities.
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