Significance of contrast enhancement in cranial computerized tomography after subarachnoid hemorrhage

Dóczi, T; Ambrose, James; O'Laoire, Seán A.

doi:10.3171/jns.1984.60.2.0335

Cited by 41 publications

(11 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…33,54,57 It is well known that leukocyte trafficking increases in SAH due to a breakdown of the blood-brain barrier. 5,[8][9][10][11]14,23,52,66 Increased levels of various soluble adhesion molecules (such as E-selectin, intercellular adhesion molecule-1, and vascular adhesion molecule-1) and cytokines (such as IL-6 and IL-1) have been noted in the plasma and CSF of patients with SAH.…”

Section: Discussionmentioning

confidence: 99%

Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage

Fountas¹,

Τάσιου²,

Kapsalaki

et al. 2009

FOC

View full text Add to dashboard Cite

Object Cerebral vasospasm is a common and potentially devastating complication of aneurysmal subarachnoid hemorrhage (aSAH). Inflammatory processes seem to play a major role in the pathogenesis of vasospasm. The Creactive protein (CRP) constitutes a highly sensitive inflammatory marker. The association of elevated systemic CRP and coronary vasospasm has been well established. Additionally, elevation of the serum CRP levels has been demonstrated in patients with aSAH. The purpose of the current study was to evaluate the possible relationship between elevated CRP levels in the serum and CSF and the development of vasospasm in patients with aSAH. Methods . A total of 41 adult patients in whom aSAH was diagnosed were included in the study. Their demographics, the admitting Glasgow Coma Scale (GCS) score, Hunt and Hess grade, Fisher grade, CT scans, digital subtraction angiography studies, and daily neurological examinations were recorded. Serial serum and CSF CRP measurements were obtained on Days 0, 1, 2, 3, 5, 7, and 9. All patients underwent either surgical or endovascular treatment within 48 hours of their admission. The outcome was evaluated using the Glasgow Outcome Scale and the modified Rankin Scale. Results The CRP levels in serum and CSF peaked on the 3rd postadmission day, and the CRP levels in CSF were always higher than the serum levels. Patients with lower admission GCS scores and higher Hunt and Hess and Fisher grades had statistically significantly higher levels of CRP in serum and CSF. Patients with angiographic vasospasm had higher CRP measurements in serum and CSF, in a statistically significant fashion (p < 0.0001). Additionally, patients with higher CRP levels in serum and CSF had less favorable outcome in this cohort. Conclusions Patients with aSAH who had high Hunt and Hess and Fisher grades and low GCS scores showed elevated CRP levels in their CSF and serum. Furthermore, patients developing angiographically proven vasospasm demonstrated significantly elevated CRP levels in serum and CSF, and increased CRP measurements were strongly associated with poor clinical outcome in this cohort.

show abstract

Section: Discussionmentioning

confidence: 99%

Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage

Fountas¹,

Τάσιου²,

Kapsalaki

et al. 2009

FOC

View full text Add to dashboard Cite

show abstract

“…2223 The clinical significance of BBB breakdown after SAH has been stressed, and a correlation between BBB opening, poor neurologic grade, and outcome has been reported. 7 In an attempt to elucidate the pathochemical mechanism of BBB dysfunction after SAH, we tested the hypothesis that BBB opening is induced by the action of lipid hydroperoxides generated from free radical reactions catalyzed by iron and by hemoglobin degradation products and by the oxidative catabolism of arachidonic acid. Lipid hydrolysis with subsequent eicosanoid production may also be a pathochemical event occurring early after SAH.…”

Section: Discussionmentioning

confidence: 99%

“…6 An increase in the permeability of major cerebral vessels and microvessels following subarachnoid hemorrhage (SAH) has been reported in both humans and experimental animals and has been correlated with a poor clinical outcome. 7 Although increased intracranial pressure (ICP), changes in cerebral blood flow (CBF), and loss of CBF autoregulation contribute to the breakdown of the BBB, 1 vasoactive substances originating from the breakdown products of extravasated blood also contribute to the opening of the BBB by directly affecting the brain vessels.…”

Section: Protective Effect Of a 21-aminosteroid On The Blood-brain Bamentioning

confidence: 99%

Protective effect of a 21-aminosteroid on the blood-brain barrier following subarachnoid hemorrhage in rats.

Zuccarello

Anderson

1989

Stroke

View full text Add to dashboard Cite

The effects of subarachnoid injection of blood on blood-brain barrier permeability to albumin was assessed in a rat model. Subarachnoid injection of blood caused a significant sixfold increase in Evans blue extravasation, whereas sham operation or NaCl injection had no effect. In addition, subarachnoid injections of arachidonic acid or FeCl 2 increased blood-brain barrier permeability to Evans blue 16-and 10-fold, respectively. The capillary permeability after subarachnoid injection of blood was normalized by pretreatment with a novel 21-aminosteroid, U-74006F, that has antioxidant and antilipolytic activity. Pretreatment with U-74006F also reduced the vascular leakage induced by subarachnoid injection of arachidonic acid or FeClj by 50% and 45%, respectively. We conclude that damage to membrane lipids by peroxidative and/ or lipolytic processes is involved hi the subarachnoid hemorrhage-induced blood-brain barrier opening and that U-74006F protects the blood-brain barrier against the effects of subarachnoid hemorrhage by preventing or limiting these pathologic membrane lipid changes. 6 An increase in the permeability of major cerebral vessels and microvessels following subarachnoid hemorrhage (SAH) has been reported in both humans and experimental animals and has been correlated with a poor clinical outcome. 7Although increased intracranial pressure (ICP), changes in cerebral blood flow (CBF), and loss of CBF autoregulation contribute to the breakdown of the BBB, 1 vasoactive substances originating from the breakdown products of extravasated blood also contribute to the opening of the BBB by directly affecting the brain vessels.8 -14 Sano et al 15 proposed that blood in the subarachnoid spaces generates lipid peroxides from free radical reactions catalyzed by iron and by hemoglobin degradation products and by the oxidative catabolism of arachidonic Received June 28, 1988; accepted August 22, 1988. acid. It has been hypothesized that this progressive lipid peroxidation also leads to endothelial damage and opening of the BBB. We establish the magnitude of BBB damage following SAH in rats and assess the capacity of a novel 21-aminosteroid with antioxidant properties 1617 to prevent BBB breakdown after subarachnoid administration of blood, arachidonic acid, or FeCl 2 . Materials and MethodsWe used 51 male albino Sprague-Dawley rats weighing approximately 250-350 g. All rats were anesthetized with 60 mg/kg i.p. pentobarbital sodium, and a femoral vein and artery were catheterized. A burr hole was drilled over the left cerebral convexity, 4 mm caudally from the coronal suture and 3 mm laterally from the sagittal suture. The dura mater was pierced with a 30-gauge needle, and a PE-10 polyethylene catheter was inserted 3-4 mm anteriorly and inferiorly over the cortical surface. Penetration of the subarachnoid space was demonstrated by flow of cerebrospinal fluid (CSF) through the catheter. The burr hole was sealed with bone wax and cyanoacrylate to prevent leakage of CSF. The catheter was connected to a pressure tran...

show abstract

“…In this case, as it appeared that the brain metastasis might have followed the SAH, we speculated that the SAH might have been involved. Under experimental conditions, previous studies have found that SAH causes marked damage to the blood-brain barrier (BBB) in cat and rat models, and that it induces disruption of the BBB (11)(12)(13)(14)(15)(16)(17). For example, Trojanowski used Evans blue to detect discrete, diffuse spots in the cerebral cortex an hour after the occurrence of an SAH.…”

Section: Discussionmentioning

confidence: 99%

Brain Metastasis of Pleural Mesothelioma after a Subarachnoid Hemorrhage

et al. 2016

View full text Add to dashboard Cite

show abstract

Significance of contrast enhancement in cranial computerized tomography after subarachnoid hemorrhage

Cited by 41 publications

References 38 publications

Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage

Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage

Protective effect of a 21-aminosteroid on the blood-brain barrier following subarachnoid hemorrhage in rats.

Brain Metastasis of Pleural Mesothelioma after a Subarachnoid Hemorrhage

Contact Info

Product

Resources

About