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The British Journal of Ophthalmology Jan 2007Glaucoma: a vascular dysregulation
Glaucoma: a vascular dysregulation
Topics: Glaucoma; Humans; Intraocular Pressure; Ion Channels; Mitochondria; Mitochondrial Proteins; Regional Blood Flow; Retinal Vessels; Uncoupling Agents; Uncoupling Protein 1; Vasospasm, Intracranial
PubMed: 17179119
DOI: 10.1136/bjo.2006.103010 -
Journal of Neurology, Neurosurgery, and... May 2005
Topics: Brain; Brain Infarction; Brain Ischemia; Cerebral Arteries; Cerebrovascular Circulation; Corpus Striatum; Diagnosis, Differential; Endothelium, Vascular; Fibrin; Humans; Hypertension; Magnetic Resonance Imaging; Necrosis; Vasospasm, Intracranial
PubMed: 15834013
DOI: 10.1136/jnnp.2004.039982 -
Neurological Research Mar 2009Delayed cerebral vasospasm has long been recognized as an important cause of poor outcome after an otherwise successful treatment of a ruptured intracranial aneurysm,... (Review)
Review
OBJECTIVE
Delayed cerebral vasospasm has long been recognized as an important cause of poor outcome after an otherwise successful treatment of a ruptured intracranial aneurysm, but it remains a pathophysiological enigma despite intensive research for more than half a century.
METHOD
Summarized in this review are highlights of research from North America, Europe and Asia reflecting recent advances in the understanding of delayed ischemic deficit.
RESULT
It will focus on current accepted mechanisms and on new frontiers in vasospasm research.
CONCLUSION
A key issue is the recognition of events other than arterial narrowing such as early brain injury and cortical spreading depression and of their contribution to overall mortality and morbidity.
Topics: Animals; Cerebral Cortex; Cortical Spreading Depression; Humans; International Cooperation; Subarachnoid Hemorrhage; Vasoconstriction; Vasospasm, Intracranial
PubMed: 19298755
DOI: 10.1179/174313209X393564 -
Brain and Behavior Sep 2017Subarachnoid hemorrhage (SAH)-induced cerebral vasospasm and early brain injury is a fatal clinical syndrome. Cerebral vasospasm and early brain injury are associated...
BACKGROUND AND PURPOSE
Subarachnoid hemorrhage (SAH)-induced cerebral vasospasm and early brain injury is a fatal clinical syndrome. Cerebral vasospasm and early brain injury are associated with inflammatory response and oxidative stress. Whether curcumin, which plays important roles to regulate inflammatory cytokines and inhibit oxidative stress, inhibits SAH-induced inflammation and oxidative stress are largely unknown.
METHODS
Adult male rats underwent autologous blood injection into prechiasmatic cistern to induce SAH. Curcumin (150 mg/kg) was administered at 0.5, 24 and 48 hr post-SAH. Mortality calculation and neurological outcomes as well as morphological vasospasm of anterior cerebral artery were studied. Superoxide dismutase, lipid peroxidation, and inflammatory cytokines (MCP-1 and TNF-α) expression in prefrontal region were quantified. Furthermore, p65 and phosphor-p65 were quantitatively analyzed.
RESULTS
Curcumin remarkedly reduced mortality and ameliorated neurological deficits after SAH induction ( < .05); morphological results showed that cerebral vasospasm in curcumin-treated group was mitigated ( < .05). SAH-induced MCP-1 and TNF-α overexpression were inhibited in curcumin-treated group ( < .05). Importantly, phosphor-p65 was significantly inhibited after curcumin treatment ( < .05).
CONCLUSIONS
Curcumin can inhibit SAH-induced inflammatory response via restricting NF-κB activation to alleviate cerebral vasospasm and early brain injury.
Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Curcumin; Cytokines; Disease Models, Animal; Inflammation; Male; NF-kappa B; Oxidative Stress; Rats; Rats, Sprague-Dawley; Signal Transduction; Subarachnoid Hemorrhage; Vasospasm, Intracranial
PubMed: 28948084
DOI: 10.1002/brb3.790 -
AJNR. American Journal of Neuroradiology Jan 2006To evaluate the utility of perfusion CT (PCT) combined with CT angiography (CTA) for the diagnosis and management of vasospasm, by using conventional digital subtraction...
PURPOSE
To evaluate the utility of perfusion CT (PCT) combined with CT angiography (CTA) for the diagnosis and management of vasospasm, by using conventional digital subtraction angiography (DSA) as the gold standard.
METHODS
We retrospectively identified 27 patients with acute subarachnoid hemorrhage who had undergone CTA/PCT, DSA, and transcranial Doppler (TCD) ultrasonography within a time interval of 12 hours of one another. The patients' charts were reviewed for treatment of vasospasm. CTA, PCT, TCD, and DSA examinations were independently reviewed and quantified for vasospasm. PCT thresholds, CTA findings, noncontrast CT (NCT) hypodensities, and TCD thresholds were evaluated for accuracy, sensitivity, and specificity, as well as for negative (NPV) and positive predictive values (PPV) in the prediction of angiographic vasospasm and endovascular treatment, considering DSA as the gold standard.
RESULTS
Thirty-five CTA/PCT, TCD, and DSA examinations were performed on these 27 patients. A total of 123 arterial territories in 11 patients demonstrated angiographic vasospasm. Six patients underwent endovascular therapy. CTA qualitative assessment and PCT-derived mean transit time (MTT) with a threshold at 6.4 seconds represented the most accurate (93%) combination for the diagnosis of vasospasm, whereas MTT considered alone represented the most sensitive parameter (NPV, 98.7%). A cortical regional cerebral blood flow value =39.3 (mL x 100 g(-1)x min(-1)) represented the most accurate (94.8%) indicator for endovascular therapy. PCT had significantly higher PPV (89.9%) than TCD (62.9%).
CONCLUSIONS
A CT survey combining CTA and PCT represents an accurate screening test in patients with suspected vasospasm. However promising, the value of PCT for selecting the best management strategy in such patients will need to be further investigated.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Angiography, Digital Subtraction; Brain; Cerebral Angiography; Cerebrovascular Circulation; Contrast Media; Female; Humans; Intracranial Aneurysm; Iohexol; Male; Middle Aged; Predictive Value of Tests; Sensitivity and Specificity; Subarachnoid Hemorrhage; Tomography, X-Ray Computed; Ultrasonography, Doppler, Transcranial; Vasospasm, Intracranial
PubMed: 16418351
DOI: No ID Found -
Internal Medicine (Tokyo, Japan) Mar 2021The legalization of recreational marijuana in some countries has been accompanied by an increased number of case reports of serious cardiovascular and cerebrovascular...
The legalization of recreational marijuana in some countries has been accompanied by an increased number of case reports of serious cardiovascular and cerebrovascular complications. However, there have been few studies describing the detailed clinical course of reversible cerebral vasospasm syndrome (RCVS) associated with marijuana use. We herein report a unique case of recurrent bi-fronto-parietal subcortical (watershed) infarction in the setting of chronic daily marijuana use for several years, with evidence of bilateral anterior cerebral artery vasoconstriction. The quick resolution of symptoms with treatment and the normalization of cerebral vasoconstriction on follow-up imaging lend high certainty to the diagnosis of RCVS.
Topics: Cannabis; Cerebrovascular Disorders; Humans; Syndrome; Vasoconstriction; Vasospasm, Intracranial
PubMed: 33028773
DOI: 10.2169/internalmedicine.5687-20 -
Turkish Neurosurgery 2021To analyze Chromogranin A levels on vasospasm in an experimental subarachnoid heamorrhage (SAH) model.
AIM
To analyze Chromogranin A levels on vasospasm in an experimental subarachnoid heamorrhage (SAH) model.
MATERIAL AND METHODS
Sixteen Wistar Albino male rats were used in study. Two groups are formed; first was consisting of 8 rats that experimental SAH was performed on them, second group was control group that nothing was done. Animals were sacrified fourtyeight hours later subarachnoid heamorrhage was occured. Peripheral venous blood samples were taken from the experimental group before SAH formation, 15 minutes, 75 minutes after experimental SAH formation and 48 hours as peak of vasospasm. Simultaneous peripheral venous blood samples were also collected from the control group. Blood samples were biochemically evaluated after centrifugation and serum Chromogranin A levels were studied.
RESULTS
Serum chromogranin A levels increased statistically significant (p < 0.05) at the 15th minute after SAH, as the samples obtained from the experimental and control groups were anticipated as a result of the statistical analysis of the data after the biochemical examinations.
CONCLUSION
In all these findings, we concluded that Chromogranin A could be used as a marker for the investigation of endocrine stress in the early period of post-SAH vasospasm and it could be proved by more studies.
Topics: Animals; Biomarkers; Chromogranin A; Disease Models, Animal; Male; Rats; Rats, Wistar; Subarachnoid Hemorrhage; Vasospasm, Intracranial
PubMed: 33216329
DOI: 10.5137/1019-5149.JTN.28235-19.5 -
Frontiers in Neurology 2020Computed tomography angiography (CTA) is frequently used with computed tomography perfusion imaging (CTP) to evaluate whether endovascular vasospasm treatment is...
Computed tomography angiography (CTA) is frequently used with computed tomography perfusion imaging (CTP) to evaluate whether endovascular vasospasm treatment is indicated for subarachnoid hemorrhage patients with delayed cerebral ischemia. However, objective parameters for CTA evaluation are lacking. In this study, we used an automated, investigator-independent, digital method to detect vasospasm, and we evaluated whether the method could predict the need for subsequent endovascular vasospasm treatment. We retrospectively reviewed the charts and analyzed imaging data for 40 consecutive patients with subarachnoid hemorrhages. The cerebrovascular trees were digitally reconstructed from CTA data, and vessel volume and the length of the arteries of the circle of Willis and their peripheral branches were determined. Receiver operating characteristic curve analysis based on a comparison with digital subtraction angiographies was used to determine volumetric thresholds that indicated severe vasospasm for each vessel segment. The automated threshold-based volumetric evaluation of CTA data was able to detect severe vasospasm with high sensitivity and negative predictive value for predicting cerebral hypoperfusion on CTP, although the specificity and positive predictive value were low. Combining the automated detection of vasospasm on CTA and cerebral hypoperfusion on CTP was superior to CTP or CTA alone in predicting endovascular vasospasm treatment within 24 h after the examination. This digital volumetric analysis of the cerebrovascular tree allowed the objective, investigator-independent detection and quantification of vasospasms. This method could be used to standardize diagnostics and the selection of subarachnoid hemorrhage patients with delayed cerebral ischemia for endovascular diagnostics and possible interventions.
PubMed: 32082241
DOI: 10.3389/fneur.2020.00013 -
Molecular Neurobiology Feb 2011Delayed vasospasm that develops 3-7 days after aneurysmal subarachnoid hemorrhage (SAH) has traditionally been considered the most important determinant of delayed... (Review)
Review
Delayed vasospasm that develops 3-7 days after aneurysmal subarachnoid hemorrhage (SAH) has traditionally been considered the most important determinant of delayed ischemic injury and poor outcome. Consequently, most therapies against delayed ischemic injury are directed towards reducing the incidence of vasospasm. The clinical trials based on this strategy, however, have so far claimed limited success; the incidence of vasospasm is reduced without reduction in delayed ischemic injury or improvement in the long-term outcome. This fact has shifted research interest to the early brain injury (first 72 h) evoked by SAH. In recent years, several pathological mechanisms that activate within minutes after the initial bleed and lead to early brain injury are identified. In addition, it is found that many of these mechanisms evolve with time and participate in the pathogenesis of delayed ischemic injury and poor outcome. Therefore, a therapy or therapies focused on these early mechanisms may not only prevent the early brain injury but may also help reduce the intensity of later developing neurological complications. This manuscript reviews the pathological mechanisms of early brain injury after SAH and summarizes the status of current therapies.
Topics: Animals; Brain Injuries; Cell Death; Cerebrovascular Circulation; Clinical Trials as Topic; Humans; Regional Blood Flow; Stroke; Subarachnoid Hemorrhage; Time Factors; Treatment Outcome; Vasospasm, Intracranial
PubMed: 21161614
DOI: 10.1007/s12035-010-8155-z -
Journal of Neurosurgery. Case Lessons Mar 2022Symptomatic cerebral vasospasm following posterior fossa intra-axial tumor resection is a rare phenomenon with only seven cases previously reported in the literature....
BACKGROUND
Symptomatic cerebral vasospasm following posterior fossa intra-axial tumor resection is a rare phenomenon with only seven cases previously reported in the literature. The condition appears distinct to vasospasm following supratentorial tumor resection and extra-axial tumor resection of the posterior fossa. It shares, however, similarities with vasospasm following aneurysmal subarachnoid hemorrhage.
OBSERVATIONS
The authors describe their experience with a 23-year-old female who developed delayed symptomatic vasospasm following resection of a left parapontine cerebellar hemangioblastoma. Tumor resection was complicated by rupture of a fragile arterialized vein, resulting in significant hemorrhage. The patient developed several episodes of focal and variably reversible neurological deficit. These clinical signs corresponded with angiographically confirmed vasospasm, which responded to standard therapies for vasospasm post aneurysmal subarachnoid hemorrhage.
LESSONS
This case and literature review highlight that symptomatic vasospasm is a rare, potentially highly morbid complication of posterior fossa intra-axial tumor resection. This phenomenon may be related to significant intraoperative or postoperative hemorrhage. Postoperative radiological findings such as high risk modified Fisher scale hemorrhage could alert clinicians to this condition.
PubMed: 36273857
DOI: 10.3171/CASE21492