Differing Perspectives on Outcome after Subarachnoid Hemorrhage: The Patient, the Relative, the Neurosurgeon

Buchanan, Karin M.; Elias, Lorin; Goplen, Gary B.

doi:10.1097/00006123-200004000-00012

Cited by 55 publications

(46 citation statements)

References 35 publications

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“…Distinct from generally recognized triggers of apoptosis, such as direct tissue trauma, ischemia, inflammation, etc., transsynaptic apoptosis involves the spread of cell death beyond the boundaries of the immediate injury to involve otherwise uninjured neurons that are an axon’s length away. This phenomenon may help to explain the prevalence of cognitive and neuropsychological deficits that commonly afflict humans with “mild-to-moderate” SAH who do not suffer a global insult [6, 10]. …”

Section: Discussionmentioning

confidence: 99%

“…Among the worst cases are those in which the hemorrhage involves the eloquent cortex, a situation frequently encountered with rupture of middle cerebral artery aneurysms [55, 56]. However, even among patients with mild hemorrhages (World Federation of Neurosurgical Societies grade 1) who do not suffer clinical or radiological vasospasm and who do not experience perioperative complications, long-term psychosocial and cognitive difficulties are still very common [6, 10]. …”

Section: Introductionmentioning

confidence: 99%

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Heparin Reduces Neuroinflammation and Transsynaptic Neuronal Apoptosis in a Model of Subarachnoid Hemorrhage

Simard

Tosun

Ivanova

et al. 2012

Transl. Stroke Res.

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Subarachnoid hemorrhage (SAH) can lead to disabling motor, cognitive, and neuropsychological abnormalities. Part of the secondary injury to cerebral tissues associated with SAH is attributable to the neuroinflammatory response induced by blood. Heparin is a pleiotropic compound that reduces inflammatory responses in conditions outside the central nervous system. Using a model of SAH devoid of global insult, we evaluated the effect of delayed intravenous (IV) infusion of heparin, at a dose that does not produce therapeutic anticoagulation, on neuroinflammation, myelin preservation, and apoptosis. Adult male rats underwent bilateral stereotactic injections of autologous blood (50 μL) into the subarachnoid space of the entorhinal cortex. The rats were implanted with mini-osmotic pumps that delivered either vehicle or unfractionated heparin (10 U/kg/h IV) beginning 12 h after SAH. No mechanical or hemorrhagic injury was observed in the hippocampus. In vehicle controls assessed at 48 h, SAH was associated with robust neuroinflammation in the adjacent cortex [neutrophils, activated phagocytic microglia, nuclear factor-kappa B, tumor necrosis factor-alpha, and interleukin-1beta] and neurodegeneration (Fluoro-Jade C staining and loss of NeuN). In the hippocampus, a muted neuroinflammatory response was indicated by Iba1-positive, ED1-negative microglia exhibiting an activated morphology. The perforant pathway showed Fluoro-Jade C staining and demyelination, and granule cells of the dentate gyrus had pyknotic nuclei, labeled with Fluoro-Jade C and showed upregulation of cleaved caspase-3, consistent with transsynaptic apoptosis. Administration of heparin significantly reduced neuroinflammation, demyelination, and transsynaptic apoptosis. We conclude that delayed IV infusion of low-dose unfractionated heparin may attenuate adverse neuroinflammatory effects of SAH.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Heparin Reduces Neuroinflammation and Transsynaptic Neuronal Apoptosis in a Model of Subarachnoid Hemorrhage

Simard

Tosun

Ivanova

et al. 2012

Transl. Stroke Res.

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“…In general, poorer neurological status at admission [24], depression, anxiety and fatigue in the aftermath are known to be related to decreased HRQoL [43]. Furthermore, there is evidence that HRQoL is also reduced in patients with an expected good recovery [2]. …”

Section: Introductionmentioning

confidence: 99%

Coping strategies, health-related quality of life and psychiatric history in patients with aneurysmal subarachnoid haemorrhage

et al. 2010

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PurposeSubarachnoid haemorrhage (SAH) reduces health-related quality of life (HRQoL) and increases the risk of psychiatric sequels such as depression and posttraumatic stress disorder. Especially those with a psychiatric history and those using maladaptive coping strategies are at risk for such sequels. The extent to which HRQoL after SAH was related to a history of psychiatric morbidity and to the use of various coping strategies was assessed.MethodsPatients admitted to the Uppsala University Hospital with aneurysmal SAH (n = 59) were investigated prospectively. Seven months after SAH, data were collected using the Structured Clinical Interview for DSM-IV axis I disorders, the Short Form-36 (SF-36) Health Survey and the Jalowiec Coping Scale.ResultsPatients with SAH had lower HRQoL than the general Swedish population in all eight domains of the SF-36. The lower HRQoL was almost entirely in the subgroup with a psychiatric history. HRQoL was also strongly correlated to the use of coping. Physical domains of SF-36 were less affected than mental domains. Those with a psychiatric history used more coping than the remainder with respect to all emotional coping scales. Coping and the presence of a psychiatric history were more strongly related to mental than to physical components of HRQoL.ConclusionsA psychiatric history and the use of maladaptive emotional coping were related to worse HRQoL, more to mental than to physical aspects.

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“…Ана-лиз ближайших функциональных исходов свиде-тельствует о наличии когнитивных расстройств разной степени выраженности у 59% больных на момент выписки из стационара [4]. 60-70% больных, состояние которых до операции было 1-3 балла по шкале Hunt-Hess, в послеопераци-онном периоде не имеют тяжелых когнитивных расстройств, нарушавших психосоциальную адаптацию [5].…”

Section: âведениеunclassified

Long-Term Results of the Microsurgical Treatment of the Cerebral Aneurysm Ruptures in Patients at a Compensated State

Шагал¹,

Tkachev²,

Shagal³

et al. 2018

Kuban. nauсh. med. vestnik

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АННОТАЦИЯЦель. Уточнить выраженность когнитивных и психоэмоциональных расстройств в исходе лечения больных с раз-рывами церебральных аневризм, находившихся в компенсированном состоянии. Материалы и методы. В статье анализируются результаты обследования и лечения 57 пациентов, оперирован-ных в остром периоде аневризматического субарахноидального кровоизлияния, тяжесть состояния которых при поступлении составляла 1-3 по шкале Hunt-Hess. В зависимости от результатов лечения больные были разделены на 2 группы: в первую вошли 37 больных с отличными ближайшими результатами лечения по инвертированной шкале исходов Глазго (GOS 1), во вторую 20 пациентов с хорошими и посредственными ближайшими результатами лечения (GOS 2-3). Результаты. Пациенты с хорошими и посредственными ближайшими результатами лечения характеризуются бо-лее низким качеством жизни по сравнению с больными с зафиксированными отличными результатами, что объяс-няется наличием более выраженных тревожно-депрессивных расстройств и цефалгии. Заключение. Снижение качества жизни пациентов с хорошими и посредственными ближайшими результатами лечения разрывов церебральных аневризм требует проведения нейрореабилитационного лечения.Ключевые слова: церебральная аневризма, аневризматическое субарахноидальное кровоизлияние, резуль-таты оперативного лечения Для цитирования: Шагал Л.В., Ткачев В.В., Шагал В.В., Блуменау И.С., Заболотских Н.В., Музлаев Г.Г. Отда-ленные результаты микрохирургического лечения разрывов церебральных аневризм у пациентов, находившихся в компенсированном состоянии. Кубанский научный медицинский вестник. 2018; 25(3): 129-132. DOI: 10.25207 / 1608 25(3): 129-132. DOI: 10.25207 / -6228-2018 For ABSTRACT Aim.To study the severity of cognitive and psychoemotional disorders in the outcome of treatment of the patients with cerebral aneurysms ruptures, who were admitted in a compensated condition. Materials and methods. 57 cases are analyzed in the article. These are the cases of patients who were operated on in

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Differing Perspectives on Outcome after Subarachnoid Hemorrhage: The Patient, the Relative, the Neurosurgeon

Cited by 55 publications

References 35 publications

Heparin Reduces Neuroinflammation and Transsynaptic Neuronal Apoptosis in a Model of Subarachnoid Hemorrhage

Heparin Reduces Neuroinflammation and Transsynaptic Neuronal Apoptosis in a Model of Subarachnoid Hemorrhage

Coping strategies, health-related quality of life and psychiatric history in patients with aneurysmal subarachnoid haemorrhage

Long-Term Results of the Microsurgical Treatment of the Cerebral Aneurysm Ruptures in Patients at a Compensated State

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