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Subarachnoid Hemorrhage
Published in Stephen M. Cohn, Alan Lisbon, Stephen Heard, 50 Landmark Papers, 2021
Dominic A. Harris, Ajith J. Thomas
Intracranial aneurysms typically occur in 1–2% of the population and aneurysmal subarachnoid hemorrhage (aSAH) remains a morbid and lethal condition [1]. Atraumatic subarachnoid hemorrhage is caused by the rupture of an intracranial aneurysm in 80% of cases. Other causes include vascular malformations such as arteriovenous malformations and vasculopathies including vasculitis. Even though the earliest description of subarachnoid hemorrhage dates back over 2400 years, successful treatment and management of these patients were not achieved until the advances in neurosurgery significantly improved morbidity and mortality throughout the 20th century [2].
Neurologic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Robert Burger, Terry Rolan, David Lardizabal, Upinder Dhand, Aarti Sarwal, Pradeep Sahota
Subarachnoid hemorrhage usually presents with a sudden onset, severe headache that patients frequently describe as the “worst of their life.” Pregnancy does appear to increase the risk of aneurysmal and arteriovenous malformation (AVM) rupture with the greatest risk later in pregnancy, at the time of delivery, and in the puerperium (9). Most subarachnoid hemorrhages can be diagnosed with the use of MRI or CT scanning. A small percentage however may have negative cranial imaging and require analysis of CSF for detection of the hemorrhage. The risk of subarachnoid hemorrhage is estimated at 1 to 2per 10,000 pregnancies.
Subarachnoid haemorrhage and cerebrovascular traumatic pathology
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Daniel du Plessis, Paul Johnson
Potential mechanisms of death pertaining to severe traumatic basal subarachnoid haemorrhage as discussed above also pertain to basal subarachnoid haemorrhage of natural causes. Fatal complications (some acting in a contributory rather than primary manner) of subarachnoid haemorrhage include obstructive hydrocephalus and severe brain swelling. The latter can assume the form of very rapid, dramatic perfusion swelling (so-called malignant brain swelling). Neurogenic pulmonary oedema, cardiac dysrhythmias or myocardial injury may also contribute to or cause death (Schievink et al. 1995). Acute neurogenic pulmonary oedema may be found in as many as 90 per cent of those who die suddenly from spontaneous subarachnoid haemorrhage (Walder et al. 2002). Morbidity related to neurogenic pulmonary oedema though is more within the range of 40–50 per cent and the reported mortality of neurogenic pulmonary oedema is approximately 7 per cent. Patient outcome in cases of neurogenic pulmonary oedema is usually determined by the underlying neurological insult that led to neurogenic pulmonary oedema and not by the pulmonary oedema per se.
The rare manifestations in tuberculous meningoencephalitis: a review of available literature
Published in Annals of Medicine, 2023
Rong li He, Yun Liu, Quanhui Tan, Lan Wang
Subarachnoid haemorrhage refers to the blood flowing into the subarachnoid space after the blood vessels at the bottom of the brain or on the surface of the brain break, leading to the corresponding clinical symptoms. Subarachnoid haemorrhage is rare in tuberculous meningoencephalitis. Only a few literatures have reported this phenomenon. The main clinical manifestation is sudden severe headache, with or without nausea, vomiting and other symptoms [14]. At present, the aetiology of TBM with SAH is still unclear. At present, its pathogenesis is considered to be related to TBM vasculitis and late inflammatory reaction, which may lead to subarachnoid haemorrhage [15]. Pathological examination also showed that subarachnoid haemorrhage may be related to the rupture of inflammatory tuberculoma or fungal aneurysm [16]. The diagnosis of subarachnoid haemorrhage mainly depends on the clinical manifestations. Cranial CT is the first choice for imaging diagnosis, and the positive rate is about 85%. Head CT shows diffuse high-density images of basal cistern, ventricular system and convexity of brain. Intracranial arterial lesions can also be detected by digital subtraction DSA of the whole cranial artery and MRA of the intracranial artery magnetic resonance angiography. The main causes of subarachnoid haemorrhage are aneurysm rupture and haemorrhage [17]. The clinical manifestations of patients with nodular encephalopathy suddenly appear in the course of the disease, which can be diagnosed in combination with the corresponding changes of head CT.
Subarachnoid hemorrhage in C57BL/6J mice increases motor stereotypies and compulsive-like behaviors
Published in Neurological Research, 2021
Danop Nanegrungsunk, Michael E. Ragozzino, Hao-Liang Xu, Kyle J. Haselton, Chanannait Paisansathan
Subarachnoid hemorrhage (SAH) results from the rupture of a vessel at the surface of the brain and subsequent flow of blood into the subarachnoid space. In humans, there are several etiologies of SAH; but approximately 85% result from the rupture of a cerebral aneurysm [1]. Annually SAH occurs in 5 − 10 per 100,000 people mostly in individuals under the age of 55 years [1–3]. For the majority of individuals experiencing SAH, there is a modest long-term neurological outcome with a minimum of symptoms [1,3]. However, multiple reports indicate that over 30% of individuals experiencing SAH will exhibit long-term changes in cognition, motor function, and mood [4,5]. Neurocognitive tests in patients 6 months following SAH revealed an impairment in memory, attention, executive function and language function [6,7]. Other testing has revealed SAH can increase depression, anxiety, increased emotional liability, increased irritability, and fatigue, which is strongly related to their decreased quality of life and psychosocial functioning [6,8,9]. Taken together, there is substantial evidence that a broad range of motor, cognitive, and emotional impairments can occur within a subpopulation of individuals who experience SAH.
Influence of neurovascular embolic coil primary wind diameter on aneurysm packing density and case costs
Published in Journal of Medical Economics, 2021
Ramesh Grandhi, Emilie Kottenmeier, Heather L. Cameron, Sarah T. Kane, Philipp Taussky
Intracranial aneurysms occur in up to 2% of the general population1, with an estimated 9 million Americans having unruptured intracranial aneurysms2. Approximately 65,000 unruptured intracranial aneurysms are treated annually in the U.S.3,4, with the primary goals of preventing aneurysm rupture and consequent morbidity and mortality to patients5. Aneurysm rupture results in roughly 27,000 new cases of subarachnoid hemorrhage each year6. The devastating effects of subarachnoid hemorrhage include a mortality rate of 25–50% and permanent disability in nearly 50% of survivors, underscoring the importance of interventions to prevent hemorrhage recurrence6 or to prevent aneurysm rupture in the first place.