Impact of early surgery on outcome after aneurysmal subarachnoid hemorrhage. A population-based study.

Fogelholm, R; Hernesniemi, Juha; Vapalahti, Matti

doi:10.1161/01.str.24.11.1649

Cited by 217 publications

(130 citation statements)

References 13 publications

Supporting

Mentioning

121

Contrasting

Unclassified

Order By: Relevance

“…1 Even with significant improvements in the medical and surgical management of SAH, case fatality rates remain between 30% and 50%, [2][3][4][5] and those who survive frequently report impaired quality of life (QOL) characterized by disruptive cognitive and emotional symptoms. 3 A recurrent episode of SAH occurs in Ϸ2% to 3% of patients each year after surgical or endovascular aneurysm repair, and this risk increases with time.…”

mentioning

confidence: 99%

Risk Factors for Continued Cigarette Use After Subarachnoid Hemorrhage

Ballard

Kreiter

Claassen

et al. 2003

Stroke

View full text Add to dashboard Cite

Background and Purpose-Cigarette smoking is a risk factor for the formation and rupture of intracranial aneurysms. Few studies have examined predictors of resumption of cigarette smoking after a first episode of subarachnoid hemorrhage (SAH). Methods-Of 620 SAH patients treated between July 1996 and November 2002, we prospectively evaluated continued cigarette use in 152 smokers alive at 3 months. Univariate and multivariate logistic regression analyses were used to identify potential demographic, social, and clinical predictors of continued cigarette use, defined as smoking Ն1 cigarette per week in the month before follow-up. Results-Thirty-seven percent (56 of 152) resumed smoking after their SAH. Patients who continued smoking were younger, were more often black, had begun smoking at an earlier age, and had a higher frequency of prior alcohol or cocaine use and self-reported depression or anxiety than those who quit (all PϽ0.05 Key Words: alcohol drinking Ⅲ cerebral aneurysm Ⅲ cigarette smoking Ⅲ subarachnoid hemorrhage S ubarachnoid hemorrhage (SAH) affects Ϸ21 000 adults in North America each year. 1 Even with significant improvements in the medical and surgical management of SAH, case fatality rates remain between 30% and 50%, 2-5 and those who survive frequently report impaired quality of life (QOL) characterized by disruptive cognitive and emotional symptoms. 3 A recurrent episode of SAH occurs in Ϸ2% to 3% of patients each year after surgical or endovascular aneurysm repair, and this risk increases with time. 6,7 Cigarette smoking is an important modifiable risk factor for SAH. 2,8 -12 Tobacco use is also a risk factor for the formation of multiple 13 and larger 14 aneurysms and therefore may be a risk factor for recurrent SAH after aneurysm repair. 8 Although it is known that up to 60% to 70% of SAH patients smoke cigarettes, 12,13 few studies have examined how many of these patients resume smoking after their hemorrhage or why they return. One study found that the proportion of smokers decreased from 58% before SAH to 30% 4 to 7 years later. 15 To the best of our knowledge, no studies have specifically analyzed risk factors for smoking resumption after SAH.Identification of risk factors for continued cigarette use after SAH may allow more effective substance use interventions while patients are in the hospital and may ultimately decrease the risk of recurrent SAH and other cardiovascular events. For instance, multidisciplinary hospital-based intervention programs increase the frequency of smoking cessation after myocardial infarction, 16,17 which results in reduced long-term mortality. 18 In this study, we sought to determine the frequency of continued cigarette use 3 months after SAH and to identify risk factors for smoking resumption. Patients and Methods Patient Population and Baseline AssessmentSix hundred twenty-six SAH patients admitted consecutively to our Neurological Intensive Care Unit (NICU) between July 1996 and November 2002 were prospectively enrolled in the Columbia University SAH Outc...

show abstract

mentioning

confidence: 99%

Risk Factors for Continued Cigarette Use After Subarachnoid Hemorrhage

Ballard

Kreiter

Claassen

et al. 2003

Stroke

View full text Add to dashboard Cite

show abstract

“…The field of view was 180 ϫ 162 mm, and the prescribed matrix size was 288 ϫ 224. The voxel size was 0.469 mm ϫ 0.804 ϫ 1.4 mm (0.527 mm 3 ) before three-direction zero-filling. The scan time was eight minutes and four seconds.…”

Section: Three-dimensional Tof Mr Angiographymentioning

confidence: 99%

“…The scan time was 51 seconds. Depending on the frequency-encoded matrix, the voxel size was either 0.529 ϫ 0.982 ϫ 1.2 mm (0.62 mm 3 ) or 0.859 ϫ 0.982 ϫ 1.2 mm (1.01 mm 3 ) before threedirection zero-filling. A power injector (Spectris; Medrad, Indianola, PA) delivered 25 mL of gadoteridol (Bracco, Milan, Italy) into the right antecubital vein at a rate of 3 mL/second.…”

Section: Ce Mr Angiographymentioning

confidence: 99%

See 1 more Smart Citation

3.0‐Tesla MR angiography of intracranial aneurysms: Comparison of time‐of‐flight and contrast‐enhanced techniques

Gibbs

Huston

Bernstein

et al. 2005

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose: To determine whether 3.0-T elliptical-centric contrast-enhanced (CE) magnetic resonance (MR) angiography is superior to 3.0-T elliptical-centric time-of-flight (TOF) MR angiography in the detection and characterization of intracranial aneurysms, and to determine whether increasing the acquisition matrix size in 3.0-T CE MR angiography improves image quality. Materials and Methods:A total of 50 consecutive patients referred for MR angiographic evaluation of a known or suspected intracranial aneurysm underwent MR angiography, including three-dimensional TOF and elliptical-centric CE techniques at 3.0 T. The 3.0-T three-dimensional TOF and 3.0-T CE examinations were graded for image quality. A blind review identified the presence and location of aneurysms.Results: A total of 28 aneurysms were identified in 23 of the 50 patients. The 3.0-T TOF MR angiography had a higher mean score for image quality than the 3.0-T elliptical-centric CE MR angiography (P Ͻ 0.0001). A total of 14 patients with aneurysms had conventional angiography for comparison. The 3.0-T TOF showed all the aneurysms, whereas 3.0-T CE MR angiography did not show 1 of 19 aneurysms when conventional angiography was the reference standard. Conclusion:For imaging intracranial aneurysms, 3.0-T TOF MR angiography offers better image quality than 3.0-T CE MR angiography using the elliptical-centric technique.

show abstract

“…The recent studies estimate a significantly low annual aneurysm rupture risk of 0.1% to 0.2% for the asymptomatic unruptured intracranial aneurysms [2,3]. Although aneurysmal subarachnoid hemorrhage carries a mortality rate of 40% to 50% and a morbidity rate of 10% to 20% [4,5], preventive Corresponding author: Vania Bozhidarova Georgieva, Ph.D., research fields: neurosurgery, vascular neurosurgery and neuroradiology.…”

Section: Introductionmentioning

confidence: 99%

Morphometric Features of Ruptured and Unruptured Aneurysms in Surgically Treated Patients with Multiple Intracranial Aneurysms

Georgieva¹,

Krastev²,

Byulbyuleva³

et al. 2017

UCMS

View full text Add to dashboard Cite

OBJECTIVE: The purpose of the present research was to evaluate the morphometric characteristics of ruptured and unruptured aneurysms in series of surgically treated patients with multiple intracranial aneurysms. According to the findings the differences between ruptured and unruptured aneurysms were analyzed in patients with subarachnoid hemorrhage and multiple intracranial aneurysms. METHODS: Sixty eight patients with 174 multiple aneurysms and clinical presentation of aneurismal subarachnoid hemorrhage were treated in two hospitals in Sofia, Bulgaria between 1991 and 2010. The ruptured aneurysm was identified from preoperative studies (head computed tomography, digital subtraction angiography, computed tomography angiography) and it was proved during the surgical procedure. The preoperative angiograms were used to perform measurements of morphometric characteristics of ruptured and unruptured cerebral aneurysms. We used univariable logistic regression analysis to obtain odds ratios. Cochran-Mantel-Haenszel test for dependence was performed to obtain adjusted odds ratio and P value for dependence. RESULTS: In 16 (23.53%) patients, the ruptured aneurysm was not the largest one. The calculated odds ratios with 95% confidence intervals revealed strong association with rupture for the aneurysm size ≥ 7.5 mm, aneurysm location at anterior communicating-anterior cerebral artery complex, irregular aneurysm shape and angle of inclination. The average value of the angle of inclination was 153.06° ± 21.16 for the ruptured aneurysms and 106.78° ± 29.50. After performing a test for dependence and adjustment for aneurysm size and location, size ratio, irregular shape, terminal aneurysm type and aneurysm inclination angle were strongly associated with aneurysm rupture. CONCLUSION: The only independent significant determinant for aneurysm rupture besides aneurysm size and location was aneurysm inclination angle (P < 0.05).

show abstract

Impact of early surgery on outcome after aneurysmal subarachnoid hemorrhage. A population-based study.

Cited by 217 publications

References 13 publications

Risk Factors for Continued Cigarette Use After Subarachnoid Hemorrhage

Risk Factors for Continued Cigarette Use After Subarachnoid Hemorrhage

3.0‐Tesla MR angiography of intracranial aneurysms: Comparison of time‐of‐flight and contrast‐enhanced techniques

Morphometric Features of Ruptured and Unruptured Aneurysms in Surgically Treated Patients with Multiple Intracranial Aneurysms

Contact Info

Product

Resources

About