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Extubation timing and risk of extubation failure in aneurysmal subarachnoid hemorrhage patients.
Chin Neurosurg J
November 2024
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
Background: The extubation time is critical during the intensive care unit stay in aneurysmal subarachnoid hemorrhage (aSAH) patients. The current conventional parameters for predicting extubation failure (EF) and extubation time may not be suitable for this population. Here, we aimed to identify factors associated with EF in aSAH patients.
View Article and Find Full Text PDFUltra-Early and Short-Term Tranexamic Acid Treatment in Patients With Good- and Poor-Grade Aneurysmal Subarachnoid Hemorrhage.
Neurology
June 2024
From the Department of Neurosurgery (M.A.T., R.P., V.V., B.A.C., W.P.V., D.V.), Amsterdam UMC, University of Amsterdam; Department of Neurosurgery (M.R.G.), Clinical Neuroscience Centre, University Hospital Zurich, Switzerland; Department of Neurology and Neurosurgery (M.D.I.V., G.J.E.R.), UMC Utrecht Brain Centre, University Medical Centre Utrecht; Departments of Neurology (K.J.) and Neurosurgery (J.F.C.W.), Haaglanden Medical Centre, Den Haag; Departments of Neurosurgery (R.W.K.) and Neurology (N.D.K.), Leiden University Medical Centre; Departments of Neurosurgery (F.C.B., D.N.) and Intensive Care (H.K.), ISALA Hospital, Zwolle; Departments of Neurosurgery (B.P.) and Neurology (G.R.), Elisabeth Tweesteden Ziekenhuis, Tilburg; Department of Neurology (F.B.), Spaarne Gasthuis, Haarlem; Department of Neurology (L.J.A.R.), Ziekenhuisgroep Twente, Almelo; Department of Neurology (P.J.A.M.B.), Medisch Spectrum Twente, Enschede; Department of Neurology (V.I.H.K.), OLVG, Amsterdam; Department of Neurology (T.C.R.), Dijklander Hospital, Hoorn; Department of Neurology (H.P.B.), Gelre Hospital, Apeldoorn; Department of Neurosurgery (H.D.B.); Department of Neurology, Donders Institute for Brain, Cognition and Behaviour (C.J.M.K.), Radboud University Medical Centre, Nijmegen; Departments of Radiology and Nuclear Medicine (R.B., C.B.L.M.M.), Intensive Care (J.H.), and Neurology (Y.B.W.E.M.R.), Amsterdam UMC, University of Amsterdam., the Netherlands.
Background And Objectives: The results of the ULTRA trial showed that ultra-early and short-term treatment with tranexamic acid (TXA) does not improve clinical outcome after aneurysmal subarachnoid hemorrhage (aSAH). Possibly, the lack of a beneficial effect in all patients with aSAH is masked by antagonistic effects of TXA in certain subgroups. In this post hoc subgroup analysis, we investigated the effect of TXA on clinical outcome in patients with good-grade and poor-grade aSAH.
View Article and Find Full Text PDFA Comparison of Perioperative Complications and Outcomes in Patients Undergoing Cerebral Aneurysm Clipping Performed Ultra-Early (≤ 24 hours) versus Late (> 24 hours): A 7-Year Retrospective Study of 302 Patients.
Asian J Neurosurg
March 2024
Department of Anesthesiology, Faculty of Medicine, Mahidol University, Siriraj Hospital, Bangkok, Thailand.
The intracerebral aneurysm with subarachnoid hemorrhage (SAH) has a high morbidity and mortality rate. This study aimed to compare the incidences of perioperative complications in ultra-early surgery (within 24 hours) with those in late surgery (> 24 hours). Retrospective data were reviewed for 302 patients who underwent craniotomies with aneurysm clipping between January 2014 and December 2020.
View Article and Find Full Text PDFImpact of time to start of tranexamic acid treatment on rebleed risk and outcome in aneurysmal subarachnoid hemorrhage.
Eur Stroke J
September 2024
Department of Neurosurgery, Amsterdam University Medical Centers Location University of Amsterdam, Amsterdam, The Netherlands.
Introduction: The ULTRA-trial investigated effectiveness of ultra-early administration of tranexamic acid (TXA) in subarachnoid hemorrhage (SAH) and showed that TXA reduces the risk of rebleeding without concurrent improvement in clinical outcome. Previous trials in bleeding conditions, distinct from SAH, have shown that time to start of antifibrinolytic treatment influences outcome. This post-hoc analysis of the ULTRA-trial investigates whether the interval between hemorrhage and start of TXA impacts the effect of TXA on rebleeding and functional outcome following aneurysmal SAH.
View Article and Find Full Text PDFMR Imaging-based Biomarker Development in Hemorrhagic Stroke Patients Including Brain Iron Quantification, Diffusion Tensor Imaging, and Phenomenon of Ultra-early Erythrolysis.
Neuroimaging Clin N Am
May 2024
Department of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA; Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Otorhinolaryngology, University of Michigan, Ann Arbor, MI 48109, USA. Electronic address:
This review article discusses the role of MR imaging-based biomarkers in understanding and managing hemorrhagic strokes, focusing on intracerebral hemorrhage (ICH) and aneurysmal subarachnoid hemorrhage. ICH is a severe type of stroke with high mortality and morbidity rates, primarily caused by the rupture of small blood vessels in the brain, resulting in hematoma formation. MR imaging-based biomarkers, including brain iron quantification, ultra-early erythrolysis detection, and diffusion tensor imaging, offer valuable insights for hemorrhagic stroke management.
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