Fifty four patients (33 male and 21 female, mean age 47) with spontaneous aneurysmal subarachnoid hemorrhages have been tested by repeated TCD: 25 of them were systematically administered intravenous Nimodipine when admitted at hospital, the 29 others constituted a reference group. There was no statistically significant difference between the two groups of patients for age, sex, initial clinical status, importance of bleeding at CT scan, localization of aneurysm or existence of an angiospasm, whether clinically symptomatic or not. In 72% of the cases, TCD allowed to prove the existence of an angiospasm when higher flow velocity was registered in cranial basal arteries. There was no significant difference between the two groups. The final clinical status of the patients seemed to be more favourable in the treated group. Yet it did not appear to be directly linked to the existence of a spasm or not. This argued in favour of a non-univocal mechanism of action of Nimodipine.
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Neurocrit Care
January 2025
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Oral nimodipine is the only drug approved in North America for patients with aneurysmal subarachnoid hemorrhage (aSAH). However, bioavailability is variable and frequently poor, leading to fluctuations in peak plasma concentrations that cause dose-limiting hypotension. Furthermore, administration is problematic in patients who cannot swallow.
View Article and Find Full Text PDFJ Intensive Med
January 2025
Department of Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
This review summarizes the current research advances and guideline updates in neurocritical care. For the therapy of ischemic stroke, the extended treatment time window for thrombectomy and the emergence of novel thrombolytic agents and strategies have brought greater hope for patient recovery. Minimally invasive hematoma evacuation and goal-directed bundled management have shown clinical benefits in treating cerebral hemorrhage.
View Article and Find Full Text PDFInt J Surg
January 2025
Department of neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Background: Risk factors and mechanisms of cognitive impairment (CI) after aneurysmal subarachnoid hemorrhage (aSAH) are unclear. This study used a neuropsychological battery, MRI, ERP and CSF and plasma biomarkers to predict long-term cognitive impairment after aSAH.
Materials And Methods: 214 patients hospitalized with aSAH (n = 125) or unruptured intracranial aneurysms (UIA) (n = 89) were included in this prospective cohort study.
Acute Med Surg
January 2025
Department of Emergency and Critical Care Medicine Institute of Medicine, University of Tsukuba Hospital Tsukuba Ibaraki Japan.
Background: Traumatic intracranial aneurysms (TICAs) can be fatal if ruptured. We report a case of a TICA, distant from facial bone fractures, successfully treated with flow diverter (FD) before rupture.
Case Presentation: A 20-year-old woman was admitted following a car accident.
Phys Ther Res
November 2024
Department of Neurosurgery, Tsuchiura Kyodo General Hospital, Japan.
Objective: To investigate the impact of multidisciplinary team (MDT) intervention for early mobilization (EM) of patients with aneurysmal subarachnoid hemorrhage (aSAH) in the intensive care unit (ICU).
Methods: A retrospective uncontrolled before-after observational study was conducted to assess patient outcomes before and after introducing MDT in the stroke care unit (SCU). Participants admitted to the SCU from April 2017 to September 2023 were categorized into conventional (April 2017 to June 2020) and MDT (July 2020 to September 2023) groups.
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