scholarly journals A Controlled Study of Continuous Lumbar Drainage of Fluid and Lumbar Puncture Drainage for Aneurysmal SAH after Intracranial Aneurysm Clipping

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Fei Duan ◽  
Guofei Wang ◽  
Xiaohu Ma ◽  
Yue Zhao ◽  
Xuanle Xu ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Intracranial Aneurysm ◽  
Lumbar Puncture ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Effective Rate ◽  
Neurological Deficits ◽  
Controlled Study ◽  
Lumbar Drainage ◽  
Aneurysm Clipping ◽  
Continuous Drainage

Objective. To analyze the different effects of Continuous Lumbar Drainage of fluid and lumbar puncture drainage for aneurysmal subarachnoid hemorrhage (SAH) after intracranial aneurysm clipping. Method. Seventy-five patients with aneurysmal SAH who underwent aneurysm clipping were retrospectively analyzed and were divided into two groups according to the different postoperative drainage methods. The lumbar spine group received lumbar puncture drainage, and the lumbar cistern group received lumbar pool continuous drainage to compare the efficacy. Result. The time to normalize intracranial pressure and headache relief after drainage treatment in the lumbar cistern group was shorter than that in the lumbar spine group. The GOS score was higher than that in the lumbar spine group, and the cerebral artery flow velocity and NIHSS score were significantly lower than those in the lumbar spine group ( P < 0.05 ). The total effective rate of drainage treatment was 76.32% in the lumbar cistern group, which was higher than that in the lumbar spine group (54.05%) ( P < 0.05 ). The total complication rate was 18.42% in the lumbar cistern group, which was lower than that in the lumbar spine group (40.54%) ( P < 0.05 ). Conclusion. Continuous Lumbar Drainage of fluid after intracranial aneurysm clipping for aneurysmal SAH can control symptoms more rapidly, reduce neurological deficits, and improve prognosis than lumbar puncture. Also, the drainage is safer and more widely used.

scholarly journals Effect of hemorrhagic cerebrospinal fluid drainage on cognitive function after intracranial aneurysm clipping

2019 ◽  
Vol 5 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Chaoqun Lin ◽  
Lukui Chen
Keyword(s):  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Cognitive Function ◽  
Lumbar Puncture ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Cerebrospinal Fluid Drainage ◽  
Aneurysm Clipping ◽  
Significant Difference ◽  
Drainage Group

Objective: The effects of repeated lumbar puncture and continuous lumbar cistern drainage on the cognitive function of patients with aneurysmal subarachnoid hemorrhage were compared and analyzed. Methods: Retrospective analysis was performed on 59 patients with aneurysmal subarachnoid hemorrhage treated at our Neurosurgery Department between October 2017 and October 2018. According to the hemorrhagic cerebrospinal fluid drainage mode after aneurysm clipping, the patients were divided into the following two groups: the repeated lumbar puncture drainage (Group A, n = 28) and continuous lumbar cistern drainage (Group B, n = 31). Before and 1 month after surgery, the cognitive function of the patients was scored using the Montreal Cognitive Assessment Scale. Scores of 27~30 were defined as normal, and scores of < 27 as cognitive impairment. Results: The incidences of cognitive impairment were 46% (13/28) and 32% (10/31) for Groups A and B, respectively, before surgery, but the difference was not significant ( P > 0.05). The incidences of cognitive impairment were 35% (10/28) and 12% (4/31) for Groups A and B, respectively, at 1 month after surgery, with significant difference ( P < 0.05). Conclusion: Compared with repeated lumbar puncture, continuous lumbar cistern drainage for aneurysmal subarachnoid hemorrhage significantly reduced the incidence of cognitive impairment after aneurysm clipping.

Cardiac arrest after intracisternal papaverine instillation during intracranial aneurysm surgery

2010 ◽  
Vol 113 (4) ◽  
pp. 760-762 ◽  
Author(s):  
Bulent Baltaci ◽  
Hulya Basar ◽  
Ayse Ozcan ◽  
Yusuf Gulhan ◽  
Cihan Sedat Aytunur
Keyword(s):  
Cardiac Arrest ◽  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysm ◽  
Cerebral Vasospasm ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Aneurysm Surgery ◽  
Sinus Arrest ◽  
Aneurysm Clipping

Cerebral vasospasm induced by aneurysmal subarachnoid hemorrhage is still a leading cause of morbidity and death. This 50-year-old man underwent surgery for aneurysm clipping. After the aneurysm was clipped, papaverine was instilled into the surgical area. Bradycardia, hypotension, and sinus arrest developed in the first minute after applying the papaverine. Thus, the authors concluded that the application of papaverine to the surgical area can result in fatal bradycardia and hypotension.

scholarly journals Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant

2021 ◽  
Vol 11 (4) ◽  
pp. 445
Author(s):  
Hye-Mee Kwon ◽  
In-Gu Jun ◽  
Kyoung-Sun Kim ◽  
Young-Jin Moon ◽  
In Young Huh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracranial Aneurysm ◽  
Hemorrhagic Stroke ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Hazard Analysis ◽  
Related Data ◽  
Incidence And Mortality ◽  
Before And After ◽  
History Of ◽  
Cirrhotic Patients

Postoperative hemorrhagic stroke (HS) is a rare yet devastating complication after liver transplantation (LT). Unruptured intracranial aneurysm (UIA) may contribute to HS; however, related data are limited. We investigated UIA prevalence and aneurysmal subarachnoid hemorrhage (SAH) and HS incidence post-LT. We identified risk factors for 1-year HS and constructed a prediction model. This study included 3544 patients who underwent LT from January 2008 to February 2019. Primary outcomes were incidence of SAH, HS, and mortality within 1-year post-LT. Propensity score matching (PSM) analysis and Cox proportional hazard analysis were performed. The prevalence of UIAs was 4.63% (n = 164; 95% confidence interval (CI), 3.95–5.39%). The 1-year SAH incidence was 0.68% (95% CI, 0.02–3.79%) in patients with UIA. SAH and HS incidence and mortality were not different between those with and without UIA before and after PSM. Cirrhosis severity, thrombocytopenia, inflammation, and history of SAH were identified as risk factors for 1-year HS. UIA presence was not a risk factor for SAH, HS, or mortality in cirrhotic patients post-LT. Given the fatal impact of HS, a simple scoring system was constructed to predict 1-year HS risk. These results enable clinical risk stratification of LT recipients with UIA and help assess perioperative HS risk before LT.

scholarly journals Endovascular options in the treatment of delayed ischemic neurological deficits due to cerebral vasospasm

2009 ◽  
Vol 26 (3) ◽  
pp. E6 ◽  
Author(s):  
Christopher S. Eddleman ◽  
Michael C. Hurley ◽  
Andrew M. Naidech ◽  
H. Hunt Batjer ◽  
Bernard R. Bendok
Keyword(s):  
Cerebral Vasospasm ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Mortality Rates ◽  
Neurological Deficits ◽  
Acute Management ◽  
Treatment Algorithms ◽  
Angiographic Evidence ◽  
Intraarterial Therapy ◽  
Clinical Changes

The second leading cause of death and disability in patients with aneurysmal subarachnoid hemorrhage (SAH) is delayed cerebral ischemia due to vasospasm. Although up to 70% of patients have been shown to have angiographic evidence of vasospasm, only 20–30% will present with clinical changes, including mental status changes and neurological deficits that necessitate acute management. Endovascular capabilities have progressed to become viable options in the treatment of cerebral vasospasm. The rationale for intraarterial therapy includes the fact that morbidity and mortality rates have not changed in recent years despite optimized noninvasive medical care. In this report, the authors discuss the most common endovascular options—namely intraarterial vasodilators and transluminal balloon angioplasty—from the standpoint of mechanism, efficacy, limitations, and complications as well as the treatment algorithms for cerebral vasospasm used at our institution.

scholarly journals Effect and Mechanism of Lidocaine Pretreatment Combined with Dexmedetomidine on Oxidative Stress in Patients with Intracranial Aneurysm Clipping

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Junting Zhang ◽  
Hongwei Zhang ◽  
Liang Zhao ◽  
Zhanqi Zhao ◽  
Ying Liu
Keyword(s):  
Oxidative Stress ◽  
Intracranial Aneurysm ◽  
Brain Tissue ◽  
Sham Group ◽  
Drug Group ◽  
Sham Operation ◽  
Lidocaine Group ◽  
Aneurysm Clipping ◽  
Single Drug ◽  
Lidocaine Pretreatment

This study aimed to explore the effect and mechanism of lidocaine pretreatment combined with dexmedetomidine on oxidative stress in patients with intracranial aneurysm clipping. Many studies have used various drugs such as lidocaine to explore the effect and mechanism of lidocaine pretreatment. A total of 80 patients with intracranial aneurysm clipping surgery were randomly divided into 4 groups: the single lidocaine group, single dexmedetomidine group, lidocaine combined with dexmedetomidine group, and control group. The thread embolism method was used to establish a stable intracranial aneurysm model of Hashimoto rats. Fifty adult rats were randomly divided into a sham operation group, ligation of the left common carotid artery and bilateral posterior branch of renal artery, lidocaine group, dexmedetomidine group, and lidocaine combined with dexmedetomidine group. The colorimetric method was used to determine the oxidative stress indicators in brain tissue: MDA content, SOD activity, and T-AOC content. The western blot method characterized the protein levels related to oxidative stress: nNOS, iNOS, and NADPH oxidase subunits p22phox, gp91phox, and p47phox. The differences in each index between the groups were statistically significant ( P < 0.05 ). Animal experiment results revealed that the content of MDA in the brain tissue of rats in the LD group was significantly lower than that in the single-drug group and sham group. The T-AOC and SOD concentrations in the LD group were significantly higher than those in the single-drug group and sham group, and the differences between the groups were statistically significant ( P < 0.05 ). The protein expression of the LD group was significantly lower than that of the drug-alone group and model group, and the difference between groups was statistically significant ( P < 0.05 ). To sum up, lidocaine pretreatment combined with dexmedetomidine can effectively maintain the hemodynamic stability of patients with intracranial aneurysm clipping and reduce postoperative oxidative stress response. Its mechanism of action may be related to the inhibition of oxidative stress damage mediated by nNOS, iNOS, and p22phox, gp91phox, and p47phox in the hippocampus. Our study has significant and applicable medical aspects in lidocaine pretreatment combined with dexmedetomidine on oxidative stress in patients.

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