Subarachnoid hemorrhage (SAH) is a subtype of hemorrhagic stroke. Cerebral vasospasm that occurs in the aftermath of the bleeding is an important factor determining patient outcome and is therefore frequently taken as a study endpoint. However, in small animal studies on SAH, quantification of cerebral vasospasm is a major challenge. Here, an ex vivo method is presented that allows quantification of volumes of entire vessel segments, which can be used as an objective measure to quantify cerebral vasospasm. In a first step, endovascular casting of the cerebral vasculature is performed using a radiopaque casting agent. Then, cross-sectional imaging data are acquired by micro computed tomography. The final step involves 3-dimensional reconstruction of the virtual vascular tree, followed by an algorithm to calculate center lines and volumes of the selected vessel segments. The method resulted in a highly accurate virtual reconstruction of the cerebrovascular tree shown by a diameter-based comparison of anatomical samples with their virtual reconstructions. Compared with vessel diameters alone, the vessel volumes highlight the differences between vasospastic and non-vasospastic vessels shown in a series of SAH and sham-operated mice.
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http://dx.doi.org/10.3791/57997 | DOI Listing |
Cochrane Database Syst Rev
January 2025
Ageing Clinical and Experimental Research, University of Aberdeen, Aberdeen, UK.
Background: Aneurysmal subarachnoid haemorrhage continues to cause a significant burden of morbidity and mortality despite advances in care. Trials investigating local administration of thrombolytics have reported promising results.
Objectives: - To assess the effect of thrombolysis on improving functional outcome and case fatality following aneurysmal subarachnoid haemorrhage - To determine the effect of thrombolysis on the risk of cerebral artery vasospasm, delayed cerebral ischaemia, and hydrocephalus following subarachnoid haemorrhage - To determine the risk of complications of local thrombolysis in aneurysmal subarachnoid haemorrhage SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (last searched 9 March 2023), MEDLINE Ovid (1946 to 9 March 2023), and Embase Ovid (1974 to 9 March 2023).
J Korean Neurosurg Soc
January 2025
Department of Neurosurgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Objective: Clazosentan is a recently approved endothelin receptor antagonist indicated for the prevention of vasospasm and related complications following aneurysmal subarachnoid hemorrhage (aSAH). To date, no direct, head-to-head comparison between clazosentan and nimodipine has been conducted. In this study, we indirectly assessed the efficacy and safety of these two drugs in preventing vasospasm and its associated outcomes after aSAH.
View Article and Find Full Text PDFJ Neuroimaging
January 2025
Department of Neurology, Georgetown University School of Medicine, Washington, District of Columbia, USA.
Background And Purpose: While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) is not endorsed by current clinical guidelines. Recognizing that arterial pressure gradient (ΔP) can be estimated using PI, we investigated the potential significance of TCD-estimated ΔP.
Methods: In this observational study of 186 SAH patients, we recorded the mean cerebral blood flow velocity (mCBFV) and PI values from the middle cerebral artery, along with corresponding blood pressures.
Med Klin Intensivmed Notfmed
January 2025
Paracelsus Medizinische Privatuniversität, Institut für Pflegewissenschaft und -praxis, Salzburg, Österreich.
Background: Early mobilization of critical ill patients in the intensive care unit (ICU) has a positive effect on outcome. Currently, due to concerns of cerebral vasospasm and rebleeding patients with subarachnoid hemorrhage (SAH) have a prolong bedrest for 12-14 days.
Objective: What effect does early mobilization have on vasospasm, clinical outcome, length of stay and ICU complication rate in patients with SAH compared to standard treatment?
Methods: A systematic literature search was conducted in MEDLINE via the PubMed® (U.
Acta Anaesthesiol Scand
February 2025
Department of Brain and Spinal Cord Injury, Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Background: The harm-benefit balance for early out-of-bed mobilisation of patients with severe acquired brain injury (ABI) in neurointensive care units (neuro-ICUs) is unclear, and there are no clinical guidelines. This study aimed to survey the current clinical practice and perceptions among clinicians involved in first out-of-bed mobilisation in Scandinavian neuro-ICUs.
Methods: This was a cross-sectional, anonymous, web-based survey; the reporting follows the recommended CROSS checklist.
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