Association of Quantified Location-Specific Blood Volumes with Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage

Steen, Wessel E. van der; Zijlstra, Ijsbrand A.J.; Verbaan, Dagmar; Boers, Anna M. M.; Gathier, Celine S.; Berg, René van den; Rinkel, Gabriël J.E.; Coert, Bert A.; Roos, Yvo B.W.E.M.; Majoie, Charles B. L. M.; Marquering, Henk A.

doi:10.3174/ajnr.a5626

Cited by 21 publications

(17 citation statements)

References 35 publications

(36 reference statements)

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“…Artificial intelligence (AI) is increasingly used in imaging and, in the future, may minimize or eliminate the need for manual grading of SAH. However, current automated techniques incorporate several manual steps in the evaluation of SAH, and none is yet well accepted in clinical practice [19,20]. To date, no widely generalizable AI program has been developed for medical image analysis [21].…”

Section: Discussionmentioning

confidence: 99%

“…It is not known how long it will be before a reliable AI-dependent SAH scale is established. Further, the influence of the range of blood attenuations in evolving SAH and hematocrit levels, partial volume effects, and streak artifacts on the success of SAH grading with AI software is yet to be seen [20]. Our scale permits the evaluation of all major cisterns linked to common aneurysm rupture sites, including the infratentorial cisterns.…”

Section: Discussionmentioning

confidence: 99%

“…However, studies have demonstrated more consistent associations between the extent of cisternal SAH and vasospasm [22,23]. Research into the influence of IVH on the development of vasospasm has produced inconsistent results [9,19,20,24].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A Quantitative Subarachnoid Hemorrhage Grading System, Including Supratentorial and Infratentorial Cisterns, With Multiplanar Computed Tomography Reformations

Slonimsky¹,

Ouyang²,

Upham³

et al. 2022

Cureus

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Quantitative Subarachnoid Hemorrhage Grading System, Including Supratentorial and Infratentorial Cisterns, With Multiplanar Computed Tomography Reformations

Slonimsky¹,

Ouyang²,

Upham³

et al. 2022

Cureus

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“…[10,15,27,29,30] Acute ischemia from SAH has been attributed to CPP, and this is supported by data from repeat hemorrhages in humans with ICP monitors. [8,12,15,22,30] It is possible that cerebral circulatory arrest caused by high ICP during bleeding results in global ischemic brain injury. It also seems likely that the initial impact, including cytotoxic and vasogenic edema, may increase the cerebral energy demand during the early recovery phase after SAH.…”

Section: Global Cerebral Edemamentioning

confidence: 93%

Acute paraparesis syndrome after ruptured anterior communicating artery aneurysm

Lee

2022

Medicine

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Here, we describe a series of 7 patients who presented with acute paraparesis due to anterior communicating artery aneurysm rupture. This study aimed to assess the clinical and radiological factors associated with acute paraparesis syndrome caused by subarachnoid hemorrhage (SAH).Between June 2005 and December 2012, our institution consecutively treated 210 patients with anterior communicating aneurysm rupture within 24 hours after ictus. We divided the patients into 2 groups based on the presence (n = 7) and absence (n = 203) of acute paraparesis after anterior communicating aneurysm rupture.Diffusion-weighted magnetic resonance imaging revealed high intensity in the medial aspects of the bilateral frontal lobes in 3 patients. The mean third ventricular distance at the time of admission was 9.2 mm (range, 8-12.5 mm), and the mean bicaudate distance was 33.9 mm (range, 24-39 mm). There was a significant difference in the bicaudate distance (P = .001) and third ventricle distance (P = .001) between the 2 groups. Acute hydrocephalus and global cerebral edema (GCE) were confirmed radiologically in all patients in the acute paraparesis group. The presence of acute hydrocephalus (P = .001) and GCE (P = .003) were significantly different between the groups.Acute paraparesis syndrome after SAH is transient and gradually improves if the patient does not develop severe vasospasm. The present study demonstrates that acute paraparesis after SAH is associated with acute hydrocephalus and GCE.Abbreviations: BCI = bicaudate index, CBF = cerebral blood flow, CPP = cerebral perfusion pressure, CT = computed tomography, GCE = global cerebral edema, GCS = Glasgow Coma Scale, GOS = Glasgow Outcome Scale, H-H = Hunt and Hess, ICP = intracranial pressure, MRI = magnetic resonance image, SAH = subarachnoid hemorrhage.

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“…The latter may be diagnosed using clinical assessments, including chest X-ray, brain computed tomography, magnetic resonance imaging, and laboratory examinations [10]. The already-known pathogeneses of DCI include cerebral vasospasm, inflammation, microthrombosis , and cortical spreading ischemia [11], and a measure of intracranial hematoma is one of the strong predictors of DCI [12]. Cerebral vasospasm has been considered as the main player in DCI for a long time, although the drugs targeting cerebral vasospasm have failed to cause any improvement in the neurological outcomes [13].…”

Section: Early Brain Injury (Ebi) and Delayed Cerebral Ischemia (Dci)mentioning

confidence: 99%

The Role of Periostin in Brain Injury Caused by Subarachnoid Hemorrhage

Kanamaru¹,

Kawakita²,

Asada³

et al. 2019

obm neurobiol

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Aneurysmal subarachnoid hemorrhage (aSAH) causes serious brain injury, and its mechanisms have not been completely unraveled so far. The causative factors for the brain injury initiated by an aneurysm rupture, which is referred to as the early brain injury (EBI), include elevated intracranial pressure, cerebral hypoperfusion, and blood contents that are directly exposed to the brain surface. At Day 4-14 post aSAH, delayed cerebral ischemia (DCI) often develops, which may worsen the neurological outcomes critically. DCI may be a consequence of EBI. Understanding the complex mechanisms underlying the post-aSAH brain injury (EBI and DCI) is, therefore, important in order to improve the neurological outcomes. In addition, several biomarkers possibly associated with EBI, DCI, and neurological outcome have been investigated, although none of these has been conclusive. A matricellular protein periostin has emerged as an important potential contributor to EBI and DCI, and may serve as the biomarker and a therapeutic molecular target for EBI and DCI. In the present report, the possible role of periostin in aSAH has been reviewed.

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Association of Quantified Location-Specific Blood Volumes with Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage

Abstract: Our findings suggest that in patients with aneurysmal subarachnoid hemorrhage, the cisternal blood volume has a stronger relation with delayed cerebral ischemia than the blood volumes at other locations in the brain.

Cited by 21 publications

References 35 publications

A Quantitative Subarachnoid Hemorrhage Grading System, Including Supratentorial and Infratentorial Cisterns, With Multiplanar Computed Tomography Reformations

A Quantitative Subarachnoid Hemorrhage Grading System, Including Supratentorial and Infratentorial Cisterns, With Multiplanar Computed Tomography Reformations

Acute paraparesis syndrome after ruptured anterior communicating artery aneurysm

The Role of Periostin in Brain Injury Caused by Subarachnoid Hemorrhage

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