Cortical Blood Flow Insufficiency Scores with Computed Tomography Perfusion can Predict Outcomes in Aneurysmal Subarachnoid Hemorrhage Patients: A Cohort Study

Tanabe, Jun; Nakahara, Ichirō; Matsumoto, Shoji; Suyama, Yoshio; Morioka, Jun; Oda, Jumpei; Hasebe, Akiko; Suzuki, Takeya; Watanabe, Sadayoshi; Suyama, Kenichiro; Ohta, Tsuyoshi; Murayama, Kazuhiro; Hirose, Yuichi

doi:10.1007/s12028-020-01108-w

Cited by 9 publications

(2 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Brain edema has been described as an accurate predictor of EBI and an independent risk factor for unsatisfactory outcomes in patients with SAH (43). Edema increases the mass and ICP following SAH, which may lead to direct brain tissue damage and ultimately, herniation.…”

Section: Discussionmentioning

confidence: 99%

Role of cyclin‑dependent kinase 5 in early brain injury following experimental subarachnoid hemorrhage

et al. 2021

View full text Add to dashboard Cite

Increasing evidence indicates that early brain injury (EBI) can contribute to poor outcomes following subarachnoid hemorrhage (SAH), and is associated with apoptosis. Cyclin-dependent kinase 5 (Cdk5) is a key mediator of neuronal viability. The role of Cdk5 in several neurological disorders has been elucidated; however, its role in EBI after SAH remains unclear. The present study aimed to explore the involvement of Cdk5 in EBI after SAH. The expression levels of Cdk5, Cdk5 phosphorylated at Tyr15 (Cdk5-pTyr15) and p25 (a Cdk5 activator) were assessed by western blotting, and the cell distribution of Cdk5 was demonstrated by double immunofluorescence. The expression levels of caspase-3 and cytochrome c were evaluated by western blotting to assess the severity of neuronal apoptosis. Nissl and TUNEL staining experiments were performed to observe the effects of roscovitine, a Cdk5 inhibitor, on EBI following SAH. The results indicated that the expression levels of Cdk5, p25 and Cdk5-pTyr15 significantly increased in the rat temporal cortex following SAH. Immunofluorescence staining indicated that Cdk5 was expressed in the neurons and astrocytes of the rat cortex after SAH and that Cdk5 underwent nuclear translocation in neurons. Roscovitine administration effectively inhibited Cdk5 activation. In conclusion, roscovitine treatment significantly mitigated EBI and alleviated cerebral edema following SAH. These findings suggest that Cdk5 is an important target in SAH therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of cyclin‑dependent kinase 5 in early brain injury following experimental subarachnoid hemorrhage

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Several previously published studies reported on the early prediction of functional outcome after aSAH by CTP, which allowed the possibility of influencing the outcome by initiating further measures for preventing permanent neurologic disability. [14][15][16] Delayed infarction is one of the strongest contributors to permanent disability after aSAH, which was earlier shown to be predictable by early CTP. [17][18][19][20][21] Although the incidence of delayed infarction in our study was higher in the patient group treated without a predefined protocol, the difference was not statistically significant.…”

Section: Ischemic Complications and Functional Outcome With And Witho...mentioning

confidence: 99%

Impact of Implementing an Elaborated CT Perfusion Protocol for Aneurysmal SAH on Functional Outcome: CTP Protocol for SAH

Malinova¹,

Döring

Psychogios

et al. 2021

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE:The acute phase of aneurysmal SAH is characterized by a plethora of impending complications with the potential to worsen patients' outcomes. The aim of this study was to evaluate whether an elaborated CTP-based imaging protocol during the acute aneurysmal SAH phase is able to prevent delayed infarctions and contribute to a better outcome. MATERIALS AND METHODS:In 2012, an elaborated CTP-based protocol was implemented for the management of patients with aneurysmal SAH. Retrospective analysis of patients with aneurysmal SAH treated from 2010 to 2013 was performed, comparing the patients treated before (group one, 2010-2011) with those treated after the protocol implementation (group two, 2012-2013) with regard to delayed infarctions and outcome according to the mRS at 3-months' follow-up.RESULTS: A total of 133 patients were enrolled, of whom 57 were included in group 1, and 76, in group 2. There were no significant differences between the groups concerning baseline characteristics. In the multivariate analysis, independent predictors of a good outcome (mRS # 2) were younger age (P , .001), lower World Federation of Neurosurgical Societies grade (P , .001), absence of delayed infarction (P ¼ .01), and management according to the CTP protocol (P ¼ .01). Larger or multiple infarctions occurred significantly more often in group 1 compared with group 2 (88% versus 33% of all delayed infarctions, P ¼ .03). The outcome in group 2 was significantly better compared with group 1 (P ¼ .005). CONCLUSIONS:The findings suggest that implementation of an elaborated CTP protocol is associated with a better outcome. An earlier initiation of further diagnostics and treatment with prevention of large territorial and/or multiple infarctions might have led to this finding.ABBREVIATIONS: aSAH ¼ aneurysmal subarachnoid hemorrhage; DCI ¼ delayed cerebral ischemia; DIND ¼ delayed ischemic neurologic deficits; ERT ¼ endovascular rescue therapy; TCD ¼ transcranial Doppler sonography; WFNS ¼ World Federation of Neurosurgical Societies A neurysmal SAH (aSAH) is a potentially lethal cerebrovascular disease due to primary and secondary brain function disturbances requiring elaborated treatment protocols in cerebrovascular centers with a thorough expertise in this field. 1 In particular, the first 2 weeks after aneurysm rupture represent the most critical phase of aSAH, associated with impending complications with the risk of substantially worsening the functional outcome. 2,3 The focus of most diagnostic and therapeutic measures in the acute phase after aSAH is preservation of sufficient cerebral perfusion with the aim of prevention of secondary brain injury. CTP has been increasingly implemented in

show abstract

The impact of perfusion computed tomography on the diagnosis and outcome of delayed cerebral ischemia after subarachnoid hemorrhage

Seyour,

Salvagno,

Rozenblum

et al. 2023

Neurol Sci

View full text Add to dashboard Cite

Cortical Blood Flow Insufficiency Scores with Computed Tomography Perfusion can Predict Outcomes in Aneurysmal Subarachnoid Hemorrhage Patients: A Cohort Study

Cited by 9 publications

References 25 publications

Role of cyclin‑dependent kinase 5 in early brain injury following experimental subarachnoid hemorrhage

Role of cyclin‑dependent kinase 5 in early brain injury following experimental subarachnoid hemorrhage

Impact of Implementing an Elaborated CT Perfusion Protocol for Aneurysmal SAH on Functional Outcome: CTP Protocol for SAH

The impact of perfusion computed tomography on the diagnosis and outcome of delayed cerebral ischemia after subarachnoid hemorrhage

Contact Info

Product

Resources

About