scholarly journals Тhe contribution of computed tomography to the diagnosis of multiple aneurysm in the acute period of aneurysmal intracranial hemorrhage

2021 ◽  
Vol 12 (3) ◽  
pp. 35-42
Author(s):  
E. I. Zyablova ◽  
D. O. Kardailskaya ◽  
V. A. Pоrkhanov ◽  
V. V. Tkachev
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Emergency Room ◽  
Ct Angiography ◽  
Diagnostic Algorithm ◽  
Diagnostic Efficiency ◽  
Acute Period ◽  
Multiple Aneurysms ◽  
Enhanced Ct ◽  
Traumatic Subarachnoid Hemorrhage ◽  
The Brain

Introduction. Multiple aneurysms are detected in patients with non-traumatic subarachnoid hemorrhage (nSAH) in 14–45% of cases. The diagnostic algorithm for this pathology can be shortened by performing the non-enhanced CT of head, CT-angiography, and if the localization of hemorrhage according to non-enhanced CT data matches, there is enough evidence to perform direct surgery without obtaining preoperative DCA.Objective. Determination of the diagnostic efficiency of CT and CTA of brachiocephalic arteries (CTA BCA) for planning the surgical treatment in the case of multiple aneurysms of intracranial arteries in the acute period of non-traumatic ICH in an emergency room.Material and methods. Retrospective analysis of the records of radiological examinations in the preoperative period in patients in an acute period of non-traumatic subarachnoid hemorrhage in the acute period performed in an emergency room of the Research Institute — Ochapovsky Regional Hospital no. 1. in the period from September 2017 to July 2018 (cerebral angiography, non-enhanced CT of the brain, CTA BCA).Results. According to the CTA BCA, 60 aneurysms were found: 21 patients had 2 aneurysms each one, 2 patients had 3 aneurysms, one patient had 8 aneurysms, and 4 patients had one aneurysm each. In comparison with DCA, which was performed in 10 patients, additionally there were found 3 miliary aneurysms, one aneurysm was excluded. For patients who did not obtain DCA, CTA scans were compared with intraoperative data on the side of surgical intervention (n=18). According to the CTA BCA, 18 aneurysms were found, according to the intraoperative record were found 17 aneurysms, while in one case a large bilobulated aneurysm was defined by a radiologist as two oppositely directed. The rest of the data was consistent.Conclusion. The presence of nICH on the non-contrast CT of the brain, and the correspondence of the localization of hemorrhage according to the results of CT-angiography, is sufficient for direct surgery without obtaining preoperative DCA, which is especially important in difficult patients. The use of DCA in patients with multiple aneurysms is recommended only in controversial and difficult cases.

scholarly journals Results of revascularizing operations performed in the acute period of subarachnoid hemorrhage

2021 ◽  
Vol 23 (2) ◽  
pp. 14-24
Author(s):  
V. A. Lukyanchikov ◽  
I. M. Shetova ◽  
V. D. Shtadler ◽  
N. E. Kudryashova ◽  
G. K. Guseynova ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Long Term Results ◽  
Emission Computed Tomography ◽  
Acute Period ◽  
The Brain

The study objective is an assessment of long-term results of cerebral revascularization performed in the acute period of subarachnoid hemorrhage due to rupture of cerebral aneurysms.Materials and methods. This cross-sectional study includes 74 patients, operated in N.V. Sklifosovsky Research Institute for Emergency Medicine in the acute period of aneurysmal subarachnoid hemorrhage. Patients were divided into two groups. The first group contained patients with EC—IC bypass performed in the acute period of aneurysmal subarachnoid hemorrhage. The Control group contained patients without bypass. In the long-term period, 11 patients were examined. Computed tomography of cerebral vessels, duplex ultrasound examination of the aortic arch, brachiocephalic arteries and intracranial vessels, transcranial Doppler ultrasonography with a breathing function test, single-photon emission computed tomography of the brain followed by stress test with acetazolamide, Modified Renkin Scale, Mini-Mental State Examination, Montreal Cognitive Assessment, Index Bartel, The Hospital Anxiety and Depression Scale, Holms-Rahe were performed. For descriptive results, a mathematical model was used.Results. The best treatment outcomes in severe patients with subarachnoid hemorrhage and cerebral ischemia were observed when performing simultaneous clipping of the aneurysm and EC-IC bypass (57.1 % versus 41.0 %) there was no statistically significant difference in outcomes. EC-IC bypass functioned in 37.5 % of cases. The rate and acceleration of the fall in volumetric blood flow and the passage of blood from the aortic bulb to the cerebral arterioles affect the perfusion values in the region of the brain concerned. Evaluation of long-term results of simultaneous interventions revealed persistent disturbances in the regulation of cerebral blood flow at the microcirculatory level. Patients with EC-IC bypass had a higher level of cognitive function and stress potential.Conclusion. The results of this study showed us the necessity for a comprehensive exploration of cerebral blood flow.

CT angiography in non-traumatic subarachnoid hemorrhage: the importance of arterial attenuation for the detection of intracranial aneurysms

2015 ◽  
Vol 56 (10) ◽  
pp. 1248-1255 ◽  
Author(s):  
Birgitta Ramgren ◽  
Roger Siemund ◽  
Ola G Nilsson ◽  
Peter Höglund ◽  
Elna-Marie Larsson ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Ct Angiography ◽  
Intracranial Aneurysms ◽  
Traumatic Subarachnoid Hemorrhage

Computed Tomography Angiography (CTA) Evaluation of Spontaneous Subarachnoid Hemorrhage

2020 ◽  
Vol 6 (2) ◽  
pp. 78-81
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Chowdhury ◽  
Mohammad Sadekur Rahman Sarkar ◽  
KM Ahasan Ahmed ◽  
Md Nazmul Kabir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Computed Tomography Angiography ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multiple Aneurysm ◽  
Traumatic Subarachnoid Hemorrhage ◽  
One Year ◽  
Spontaneous Subarachnoid Hemorrhage

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

Superficial siderosis of the brain following unexplained subarachnoid hemorrhage: MRI diagnosis and clinical significance

1992 ◽  
Vol 34 (5) ◽  
pp. 407-410 ◽  
Author(s):  
P. M. Bourgouin ◽  
D. Tampieri ◽  
D. Melancon ◽  
R. del Carpio ◽  
R. Ethier
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Significance ◽  
Superficial Siderosis ◽  
Mri Diagnosis ◽  
The Brain

Diagnostic Efficiency of the Trail Making Test as a Function of Cut-off Score, Diagnosis, and Age

1978 ◽  
Vol 47 (1) ◽  
pp. 191-195 ◽  
Author(s):  
Norman G. Gordon
Keyword(s):  
Analysis Of Covariance ◽  
Veterans Administration ◽  
Trail Making Test ◽  
Diagnostic Efficiency ◽  
Male Veterans ◽  
Significant Difference ◽  
Trail Making ◽  
Administration Hospital ◽  
Cutoff Scores ◽  
The Brain

This study is a reinvestigation of the effectiveness of the Trail Making Test in discriminating between brain-damaged ( n = 51) and pseudoneurologic ( n = 72) subjects. All subjects were hospitalized male veterans at the Allen Park Veterans Administration Hospital. An analysis of covariance showed that the pseudoneurologic subjects performed at a significantly higher level than the brain-damaged subjects. Further analysis with two different cutoff scores exhibited unequal discriminatory power throughout the whole range of Trail Making Test scores. These results suggested diagnosing only when the scores were 9 or lower and 13 or higher. This use of extreme scores resulted in an over-all hit rate of 87% in the study. Comparisons with five major subgroupings of the pseudoneurologic subjects yielded only one significant difference: more accurate discrimination with the 12 cut-off score between 10 general-medical and peripheral nerve-damaged subjects (100% correct) and 18 psychotic subjects (39% accuracy).

scholarly journals A Hypothesis: Hydrogen Sulfide Might Be Neuroprotective against Subarachnoid Hemorrhage Induced Brain Injury

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Yong-Peng Yu ◽  
Xiang-Lin Chi ◽  
Li-Jun Liu
Keyword(s):  
Oxidative Stress ◽  
Nitric Oxide ◽  
Hydrogen Sulfide ◽  
Subarachnoid Hemorrhage ◽  
Brain Injury ◽  
Inflammatory Responses ◽  
Ischemia Reperfusion Injury ◽  
Leukocyte Adhesion ◽  
Ischemia Reperfusion ◽  
The Brain

Gases such as nitric oxide (NO) and carbon monoxide (CO) play important roles both in normal physiology and in disease. Recent studies have shown that hydrogen sulfide (H2S) protects neurons against oxidative stress and ischemia-reperfusion injury and attenuates lipopolysaccharides (LPS) induced neuroinflammation in microglia, exhibiting anti-inflammatory and antiapoptotic activities. The gas H2S is emerging as a novel regulator of important physiologic functions such as arterial diameter, blood flow, and leukocyte adhesion. It has been known that multiple factors, including oxidative stress, free radicals, and neuronal nitric oxide synthesis as well as abnormal inflammatory responses, are involved in the mechanism underlying the brain injury after subarachnoid hemorrhage (SAH). Based on the multiple physiologic functions of H2S, we speculate that it might be a promising, effective, and specific therapy for brain injury after SAH.

Sign in / Sign up

Export Citation Format

Share Document