Does Pre-existing Anticoagulation or Antiplatelet Therapy Increase the Risk of Traumatic Subarachnoid Hemorrhage Progression?

Background: In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity. Objective: This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage. Methodology: This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study. Result: Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm. Conclusion: From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81

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Effects of post-interventional antiplatelet therapy on angiographic vasospasm, delayed cerebral ischemia, and clinical outcome after aneurysmal subarachnoid hemorrhage: a single-center experience

Neurosurgical Review ◽

10.1007/s10143-021-01477-6 ◽

2021 ◽

Author(s):

Claudia Ditz ◽

Björn Machner ◽

Hannes Schacht ◽

Alexander Neumann ◽

Peter Schramm ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Cerebral Ischemia ◽

Functional Outcome ◽

Antiplatelet Therapy ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Delayed Cerebral Ischemia ◽

Control Group ◽

Lesion Volume ◽

Single Center ◽

Single Center Experience

AbstractPlatelet activation has been postulated to be involved in the pathogenesis of delayed cerebral ischemia (DCI) and cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to investigate potentially beneficial effects of antiplatelet therapy (APT) on angiographic CVS, DCI-related infarction and functional outcome in endovascularly treated aSAH patients. Retrospective single-center analysis of aSAH patients treated by endovascular aneurysm obliteration. Based on the post-interventional medical regime, patients were assigned to either an APT group or a control group not receiving APT. A subgroup analysis separately investigated those APT patients with aspirin monotherapy (MAPT) and those receiving dual treatment (aspirin plus clopidogrel, DAPT). Clinical and radiological characteristics were compared between groups. Possible predictors for angiographic CVS, DCI-related infarction, and an unfavorable functional outcome (modified Rankin scale ≥ 3) were analyzed. Of 160 patients, 85 (53%) had received APT (n = 29 MAPT, n = 56 DAPT). APT was independently associated with a lower incidence of an unfavorable functional outcome (OR 0.40 [0.19–0.87], P = 0.021) after 3 months. APT did not reduce the incidence of angiographic CVS or DCI-related infarction. The pattern of angiographic CVS or DCI-related infarction as well as the rate of intracranial hemorrhage did not differ between groups. However, the lesion volume of DCI-related infarctions was significantly reduced in the DAPT subgroup (P = 0.011). Post-interventional APT in endovascularly treated aSAH patients is associated with better functional outcome at 3 months. The beneficial effect of APT might be mediated by reduction of the size of DCI-related infarctions.

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Does 16-Detector Computed Tomography Improve Detection of Non-traumatic Subarachnoid Hemorrhage in the Emergency Department?

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2007.10.066 ◽

2009 ◽

Vol 36 (2) ◽

pp. 171-175 ◽

Cited By ~ 11

Author(s):

Ana P. Lourenco ◽

William W. Mayo-Smith ◽

Robert J. Tubbs ◽

Robert Sidman

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Subarachnoid Hemorrhage ◽

Traumatic Subarachnoid Hemorrhage

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What are the effects of antiplatelet therapy for people with aneurysmal subarachnoid hemorrhage who undergo surgery?

Cochrane Clinical Answers ◽

10.1002/cca.2177 ◽

2018 ◽

Author(s):

Jane Burch

Keyword(s):

Subarachnoid Hemorrhage ◽

Antiplatelet Therapy ◽

Aneurysmal Subarachnoid Hemorrhage

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Hypertrophic Olivary Degeneration after Traumatic Subarachnoid Hemorrhage

Internal Medicine ◽

10.2169/internalmedicine.53.2436 ◽

2014 ◽

Vol 53 (13) ◽

pp. 1453-1454 ◽

Cited By ~ 3

Author(s):

Takeshi Hayashi ◽

Hiroshi Kigawa ◽

Norio Tanahashi

Keyword(s):

Subarachnoid Hemorrhage ◽

Hypertrophic Olivary Degeneration ◽

Traumatic Subarachnoid Hemorrhage

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Comparative evaluation of the effectiveness of the transdermal therapeutic system with fentanil and gabapentine in head pain therapy

Regional Anesthesia and Acute Pain Management ◽

10.17816/1993-6508-2019-13-1-4-5-9 ◽

2019 ◽

Vol 13 (1-4) ◽

pp. 5-9

Author(s):

A. Zh. Bayalieva ◽

R. Ya. Shpaner ◽

I. R. Ganeeva

Keyword(s):

Subarachnoid Hemorrhage ◽

Comparative Evaluation ◽

Severe Pain ◽

Pain Therapy ◽

Therapeutic System ◽

Transdermal Fentanyl ◽

Head Pain ◽

Transdermal Therapeutic System ◽

Endovascular Occlusion ◽

Traumatic Subarachnoid Hemorrhage

The study was conducted to comparatively evaluate the effectiveness a transdermal therapeutic system with fentanyl and gabapentin in the treatment of headache in patients with non-traumatic subarachnoid hemorrhage. When assessing the intensity of headache in patients, it was found that with severe pain immediately after endovascular occlusion, the use of transdermal fentanyl with dexketoprofen or paracetamol is most acceptable, and the combination of gabapentin with dexketoprofen / paracetamol is better in case of headache in a more delayed period.

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