The network topology of aneurysmal subarachnoid haemorrhage

Ibrahim, George M.; Macdonald, R. Loch

doi:10.1136/jnnp-2014-308992

Cited by 7 publications

(5 citation statements)

References 35 publications

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“…Such standards of monitoring brain pathology may complement alternate representations of complex data sets 88 with the ultimate ambitious goal of a wholesystem approach to neurocritical care. Such an approach removes some obstacles by replacing a ''black box'' that only shows outputs devoid of context, with information about the evolution of disease process, the homeostatic responses, and therapeutic interventions, along with means to tease apart the effects of these interactions.…”

Section: Neurocritical Care As a Systems Processmentioning

confidence: 99%

Recording, analysis, and interpretation of spreading depolarizations in neurointensive care: Review and recommendations of the COSBID research group

Dreier

Fabricius

Ayata

et al. 2016

J Cereb Blood Flow Metab

284

402

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Spreading depolarizations (SD) are waves of abrupt, near-complete breakdown of neuronal transmembrane ion gradients, are the largest possible pathophysiologic disruption of viable cerebral gray matter, and are a crucial mechanism of lesion development. Spreading depolarizations are increasingly recorded during multimodal neuromonitoring in neurocritical care as a causal biomarker providing a diagnostic summary measure of metabolic failure and excitotoxic injury. Focal ischemia causes spreading depolarization within minutes. Further spreading depolarizations arise for hours to days due to energy supply-demand mismatch in viable tissue. Spreading depolarizations exacerbate neuronal injury through prolonged ionic breakdown and spreading depolarization-related hypoperfusion (spreading ischemia). Local duration of the depolarization indicates local tissue energy status and risk of injury. Regional electrocorticographic monitoring affords even remote detection of injury because spreading depolarizations propagate widely from ischemic or metabolically stressed zones; characteristic patterns, including temporal clusters of spreading depolarizations and persistent depression of spontaneous cortical activity, can be recognized and quantified. Here, we describe the experimental basis for interpreting these patterns and illustrate their translation to human disease. We further provide consensus recommendations for electrocorticographic methods to record, classify, and score spreading depolarizations and associated spreading depressions. These methods offer distinct advantages over other neuromonitoring modalities and allow for future refinement through less invasive and more automated approaches.

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Section: Neurocritical Care As a Systems Processmentioning

confidence: 99%

Recording, analysis, and interpretation of spreading depolarizations in neurointensive care: Review and recommendations of the COSBID research group

Dreier

Fabricius

Ayata

et al. 2016

J Cereb Blood Flow Metab

284

402

View full text Add to dashboard Cite

show abstract

“…[2][3][4] In acute ischemic stroke, hypoalbuminemia is associated with poor outcome, [5][6][7][8] and is a strong predictor of early death in subarachnoid hemorrhage. [9,10] Little is known about the significance of serum albumin levels as a prognostic factor in spontaneous intracerebral hemorrhage (ICH). [11] ICH induces an acute-phase inflammatory response (APR).…”

Section: Accepted Manuscript Introductionmentioning

confidence: 99%

Hypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage

Napoli¹,

Behrouz

Topel

et al. 2017

Journal of Critical Care

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“…These physiological variables consistently accompanied poor performance in previously published studies [60][61][62][63]. Earlier studies reported that low albumin levels are associated with increased morbidity and mortality in aSAH patients [64][65][66]. Hypoalbuminemia can occur due to reduced synthesis, increased loss, or altered distribution in extracellular and intracellular spaces.…”

Section: Discussionmentioning

confidence: 66%

The Role of Early Serum Biomarkers and Clinical Rating Scales in the Prediction of Delayed Cerebral Ischaemia and Short-Term Outcome after Aneurysmal Subarachnoid Haemorrhage: Single Centre Experience

Burzyńska,

Uryga,

Woźniak

et al. 2023

JCM

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Considering the variety of complications that arise after aneurysmal subarachnoid haemorrhage (aSAH) and the complex pathomechanism of delayed cerebral ischaemia (DCI), the task of predicting the outcome assumes a profound complexity. Therefore, there is a need to develop early predictive and decision-making models. This study explores the effect of serum biomarkers and clinical scales on patients’ outcomes and their interrelationship with DCI and systemic complications in aSAH. This was a retrospective analysis including aSAH patients admitted to the Wroclaw University Hospital (Wrocław, Poland) from 2011 to 2020. A good outcome was defined as a modified Rankin Scale (mRS) score of 0–2. The prediction of the development of DCI and poor outcome was conducted using logistic regression as a standard model (SM) and random forest as a machine learning method (ML). A cohort of 174 aSAH patients were included in the analysis. DCI was diagnosed in 79 (45%) patients. Significant differences between patients with poor vs. good outcome were determined from their levels of albumin (31 ± 7 vs. 35 ± 5 (g/L); p < 0.001), D-dimer (3.0 ± 4.5 vs. 1.5 ± 2.8 (ng/mL); p < 0.001), procalcitonin (0.2 ± 0.4 vs. 0.1 ± 0.1 (ng/mL); p < 0.001), and glucose (169 ± 69 vs. 137 ± 48 (nmol/L); p < 0.001). SM for DCI prediction included the Apache II scale (odds ratio [OD] 1.05; 95% confidence interval [CI] 1.00–1.09) and albumin level (OD 0.88; CI 0.82–0.95). ML demonstrated that low albumin level, high Apache II scale, increased D-dimer and procalcitonin levels had the highest predictive values for DCI. The integration of clinical parameters and scales with a panel of biomarkers may effectively facilitate the stratification of aSAH patients, identifying those at high risk of secondary complications and poor outcome.

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The network topology of aneurysmal subarachnoid haemorrhage

Abstract: URL: http://www.clinicaltrials.gov; Identifier: NCT00111085.

Cited by 7 publications

References 35 publications

Recording, analysis, and interpretation of spreading depolarizations in neurointensive care: Review and recommendations of the COSBID research group

Recording, analysis, and interpretation of spreading depolarizations in neurointensive care: Review and recommendations of the COSBID research group

Hypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage

The Role of Early Serum Biomarkers and Clinical Rating Scales in the Prediction of Delayed Cerebral Ischaemia and Short-Term Outcome after Aneurysmal Subarachnoid Haemorrhage: Single Centre Experience

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