Endovascular and Surgical Treatment Is Predictive of Readmission Risk After Aneurysmal Subarachnoid Hemorrhage

2020 ◽  
Vol 142 ◽  
pp. e494-e501
Author(s):  
Ajay Chatrath ◽  
Sauson Soldozy ◽  
Jennifer D. Sokolowski ◽  
Rebecca M. Burke ◽  
Julianne G. Schultz ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Readmission Risk

scholarly journals Surgical treatment of intracranial aneurysms: six-year experience in Belo Horizonte, MG, Brazil

2004 ◽  
Vol 62 (2a) ◽  
pp. 245-249 ◽  
Author(s):  
Leodante Batista da Costa Jr ◽  
Josaphat Vilela de Morais ◽  
Agustinho de Andrade ◽  
Marcelo Duarte Vilela ◽  
Renato P. Campolina Pontes ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Intracranial Aneurysms ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
The United States ◽  
Anterior Circulation ◽  
Common Location ◽  
Belo Horizonte ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Anterior Circulation Aneurysms

Spontaneous subarachnoid hemorrhage accounts for 5 to 10 % of all strokes, with a worldwide incidence of 10.5 / 100000 person/year, varying in individual reports from 1.1 to 96 /100000 person/year. Angiographic and autopsy studies suggest that between 0.5% and 5% of the population have intracranial aneurysms. Approximately 30000 people suffer aneurysmal subarachnoid hemorrhage in the United States each year, and 60% die or are left permanently disabled. We report our experience in the surgical treatment of intracranial aneurysms in a six year period, in Belo Horizonte, Minas Gerais, Brazil. We reviewed the hospital files, surgical and out-patient notes of all patients operated on for the treatment of intracranial aneurysms from January 1997 to January 2003. Four hundred and seventy-seven patients were submitted to 525 craniotomies for treatment of 630 intracranial aneurysms. The majority of patients were female (72.1%) in the fourth or fifth decade of life. Anterior circulation aneurysms were more common (94.4%). The most common location for the aneurysm was the middle cerebral artery bifurcation. The patients were followed by a period from 1 month to 5 years. The outcome was measured by the Glasgow Outcome Scale (GOS). At discharge, 62.1% of the patients were classified as GOS 5, 13.9% as GOS 4, 8.7% as GOS 3, 1.7% as GOS 2 and 14.8% as GOS 1.

The burden of pediatric subarachnoid hemorrhage healthcare disparities in Senegal: A retrospective cohort study

2021 ◽  
Author(s):  
Thioub Mbaye ◽  
Maguette Mbaye ◽  
Yvan Zolo ◽  
Manal Sghiouar ◽  
Sagar Diop ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Population Attributable Fraction ◽  
Surgical Care ◽  
Health Systems Strengthening ◽  
Rank Test ◽  
Signed Rank ◽  
Fisher Grade ◽  
Signed Rank Test

Introduction Pediatric aneurysms are uncommon but potentially deadly clinical conditions with varied etiology and outcomes. In low-resource countries, numerous barriers prevent the timely diagnosis and management of pediatric aneurysmal subarachnoid hemorrhage (aSAH). Thus, this study aimed to assess the mortality of pediatric aSAH stemming from limited access to pediatric neurological surgery care in Senegal. Methods Pediatric aSAH patients admitted at the authors’ institution from 2012 and 2020 were recruited. Spearman Rho’s correlation, McNemar’s test, and Wilcoxon signed-rank test were used. Odds ratios and their 95% confidence intervals were calculated, and the population attributable fraction (PAF) was used to quantify aSAH mortality attributable to lack of surgical care. Results Twenty-four pediatric patients (12 females and 12 males) aged 12.2 (95% CI=10.0-14.3) years presented with aSAH. They had 1 median aneurysm (range [1, 2]) measuring 12.6 (6.1-19.0) mm. The median WFNS grade was 3 (range [1, 4]), and the mean Fisher grade was 4 (range [1, 4]). Fifteen patients (62.5%) had surgical treatment on day 15.0 (IQR=23.0) of hospitalization. The overall mortality rate was 20.8%, and the PAF of mortality for lack of surgical treatment during hospitalization was 0.08. Conclusion Eight percent of deaths among pediatric aSAH patients who do not receive surgical treatment are attributable to lack of access to surgical treatment. Health systems strengthening policies should be implemented to address this health inequity.

Abstract P453: Histamine 2 Blockers and Nimodipine in Aneurysmal Subarachnoid Hemorrhage Patients

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
Wei Huang ◽  
Iryna Lobanova ◽  
Fawad Ishfaq ◽  
Nitish Kumar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Significant Interaction ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Mortality Rates ◽  
Relative Bioavailability ◽  
Discharge Destination ◽  
H2 Blockers ◽  
Clinically Significant

Background: Histamine (H) 2 blockers led to a significant increase of the relative bioavailability of nimodipine and therefore may change tolerability of nimodipine in patients with aneurysmal subarachnoid hemorrhage (SAH). Objective: To determine the effect of H2 blockers on outcome of SAH patients being treated with nimodipine on outcomes. Methods: We analyzed data from Cerner Health Facts® which collected data from participating facilities from January 1st, 2000 to July 1st, 2018. We identified SAH patients who underwent endovascular or surgical treatment for intracranial aneurysm and received nimodipine with or without H2 blockers. Outcome was defined by discharge destination and classified into none to minimal disability, moderate to severe disability, or death. Results: A total of 815 (54.8%) of 1488 SAH patients received H2 blockers in addition to nimodipine. There were no differences in rates of cerebral ischemia (8.8% versus 9.8%) or performance of angioplasty (3.8% versus 3.7%) between patients who did or did not receive H2 blockers. There were no differences in rates of intubation/mechanical ventilation (26.0% versus 29.3%) or intra-procedural cerebral infarction (3.4% versus 2.8%) between the two groups. There was no difference in in hospital mortality rates (10.9% versus 10.2%) or none to minimal disability (41.8% versus 38.2%) between patients who did or did not receive H2 blockers. Conclusions: H2 blockers are frequently used with nimodipine in SAH patients and did not appear to adversely affect rates of death or disability. The finding does not support any clinically significant interaction between H2 blockers and nimodipine in SAH patients.

Prognosis for patients with nonsurgically-treated aneurysms

1971 ◽  
Vol 35 (4) ◽  
pp. 438-443 ◽  
Author(s):  
Carl J. Graf
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Clinical Review ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Nonsurgical Treatment ◽  
Autopsy Study ◽  
Content Type ◽  
Unruptured Aneurysms ◽  
Fine Print ◽  
Better Than

✓ The clinical review of this large series of patients with aneurysmal subarachnoid hemorrhage has revealed that the prognosis, with surgical or nonsurgical treatment, is related to several factors, but most significantly to the condition of the patient 1 day after hemorrhage. Autopsy study indicates that the prognosis for patients with unsuspected or “incidental” unruptured aneurysms is better than could be expected with surgical treatment.

scholarly journals Surgical Treatment of Patients with Aneurysmal Subarachnoid Hemorrhage associated with Main Artery Occlusion

1988 ◽  
Vol 28 (2) ◽  
pp. 148-156 ◽  
Author(s):  
Shingo KAWAMURA ◽  
Ichiro SAYAMA ◽  
Akifumi SUZUKI ◽  
Hidenori OHTA ◽  
Masahito NEMOTO ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Artery Occlusion ◽  
Main Artery

Surgical Treatment for Aneurysmal Subarachnoid Hemorrhage in the 8th and 9th Decades of Life

Neurosurgery ◽  
2005 ◽  
Vol 56 (3) ◽  
pp. 469-475 ◽  
Author(s):  
Tetsuyoshi Horiuchi ◽  
Yuichiro Tanaka ◽  
Kazuhiro Hongo
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Elderly Patients ◽  
Surgical Repair ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Ruptured Aneurysm ◽  
Industrialized Countries ◽  
Aneurysmal Rupture ◽  
Patients Âgés ◽  
Computed Tomographic

Abstract OBJECTIVE: Industrialized countries are facing a rapid increase of their senior populations. Consequently, the number of elderly patients with aneurysmal subarachnoid hemorrhage is increasing. The purpose of this study was to assess the results of surgical repair for ruptured aneurysm in elderly patients. METHODS: We retrospectively investigated elderly patients (ages 70–89 yr) who were undergoing surgical treatment for ruptured aneurysm during the 15-year period 1988 to 2002 and compared patients in the 8th and 9th decades of life. Generally, patients were treated surgically within 72 hours after ictus. RESULTS: Of the total of 2835 patients, there were 509 patients (18.0% of total patients) in the 8th decade and 99 patients (3.5%) in the 9th decade of life. Because data were incomplete and patients who received ventricular drainage or ventriculoperitoneal shunt without aneurysmal repair were excluded, 449 and 89 patients in the 8th and 9th decades of life, respectively, were analyzed. No differences in sex, preoperative grade, preoperative computed tomographic findings, location of aneurysm, and aneurysm size were observed between the two decades. Preoperative grade and computed tomographic findings were predictors of favorable outcomes in the 8th and 9th decades. Patient age was a significant predictor of outcome in the 8th but not in the 9th decade. CONCLUSION: To the best of our knowledge, this study is the largest series of its kind to date. Advanced age alone does not exclude adequate surgical repair in patients with aneurysmal rupture in the 9th decade of life.

scholarly journals Comparison of Aggressive Surgical Treatment and Palliative Treatment in Elderly Patients with Poor-Grade Intracranial Aneurysmal Subarachnoid Hemorrhage

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Kuang Zheng ◽  
Bing Zhao ◽  
Xian-Xi Tan ◽  
Ze-Qun Li ◽  
Ye Xiong ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Elderly Patients ◽  
Palliative Treatment ◽  
Treatment Approach ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Poor Grade ◽  
Fisher Grade

Objective. To compare the current treatment approach in elderly patients with poor-grade aneurysmal subarachnoid hemorrhage (SAH) and identify the independent predictors of the outcome after aggressive surgical treatment. Method. This prospective, multicenter cohort study included 104 poor-grade aneurysmal SAH elderly patients, 60 years or older, treated in our institution from October 2010 to March 2013. Patients were grouped according to three treatment arms. Neurological outcome was assessed using the Glasgow Outcome Scale (GOS) at baseline and at a 12-month follow-up. Univariate and multivariate analysis were performed using the following factors: sex, age, smoking history, breathing ability, alcohol consumption, cerebral hernia, aneurysm location, aneurysm diameter, WFNS grade, CT Fisher grade, treatment approach, and the timing of the aneurysm surgery. Results. At the 12-month follow-up, patients in the coiling group and clipping group had better prognosis than patients in the palliative treatment group. Univariate analysis confirmed that the treatment approach, WFNS grade, CT Fisher grade, and age are critical factors for neurological outcomes in poor-grade SAH. Multivariate analysis indicated that WFNS grade V, CT Fisher grades 3–5, and palliative treatment were independent predictors of poor prognoses. Conclusion. Aggressive surgical treatment improves the prognoses in poor-grade aneurysm elderly patients with SAH. Elderly Patients of WFNS grade IV and CT Fisher grades 1-2 are more likely to have a better outcome.

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