Early Brain Injury or Cerebral Vasospasm (eBook)

Chapter : The Role of Apolipoprotein E in the Pathological Events Following Subarachnoid Hemorrhage: A Review 15
Introduction 15
APOE and Outcome After SAH 15
ApoE and Early Brain Injury After SAH 16
ApoE and Cerebral Vasospasm After SAH 16
Conclusion 16
References 16
Chapter : Mechanisms of Statin Treatment in Cerebral Vasospasm 18
Introduction 18
Materials and Methods 19
Results 19
Conclusion 20
References 20
Chapter : The Effect of Phosphodiesterase Inhibitor Tadalafil on Vasospasm Following Subarachnoid Hemorrhage in an Experimental 21
Introduction 21
Methods and Materials 22
Animal Model 22
Induction of Experimental SAH 22
Perfusion-Fixation 22
Embedding, Morphometry, and Statistical Analysis 22
Results 22
Discussion 23
References 24
Chapter : Effect of a Free Radical Scavenger, Edaravone, on Free Radical Reactions: Related Signal Transduction and Cerebral Va 25
Introduction 25
Materials and Methods 26
Production of SAH 26
Intravenous Injection of Edaravone 26
Histological Evaluation 26
Western Blotting 26
Statistical Analysis 26
Results 27
Evaluation of Cerebral Vasospasm (Figs. 1 and 2) 27
Expression of Rho-kinase (Fig. 3) 27
Discussion 28
Conclusion 29
References 29
Chapter : Comparison of Nimodipine Delivery Routes in Cerebral Vasospasm After Subarachnoid Hemorrhage: An Experimental Study i 31
Introduction 31
Materials and Methods 31
Animal Groups 31
Nimodipine Solution 32
SAH Formation 32
Angiography Procedure 32
Perfusion-Fixation 32
Neurological Parameters 32
Embedding, Morphometry, and Statistical Analysis 33
Results 33
Pathological Measurements 33
Mortality and Neurological Parameters 33
Angiographic Measurements 34
Discussion 35
Conclusion 36
References 36
Chapter : Effect of Recombinant Osteopontin on Cerebral Vasospasm After Subarachnoid Hemorrhage in Rats 37
Introduction 37
Materials and Methods 37
Experimental Model of SAH and Study Protocol 37
Neurological Scoring 38
India Ink angiography 38
Severity of SAH 38
Intracerebroventricular Infusion 38
Statistics 39
Results 39
Conclusion 39
References 40
Chapter : The Effect of Intracisternal Zn (II) Protoporphyrin IX on Vasospasm Process in the Experimental Subarachnoid Hemorrha 41
Introduction 41
Methods and Materials 42
Animal Model 42
Induction of Experimental SAH 42
Perfusion-Fixation 42
Embedding, Morphometry, and Statistical Analysis 42
Results 42
Discussion 43
References 44
Chapter : Temporal Profile of the Effects of Intracisternal Injection of Magnesium Sulfate Solution on Vasodilation of Spastic 46
Introduction 46
Materials and Methods 47
Results 47
Temporal Profile of Changes in CSF Mg2+ and Ca2+ Concentrations 47
Temporal Profile of Neuroimaging Changes 48
Conclusion 48
References 49
Chapter : Comparison of Intrathecal Cilostazol and Nimodipine Treatments in Subarachnoid Hemorrhage: An Experimental Study in R 50
Introduction 50
Methods and Materials 51
Induction of SAH 51
Experimental Protocol 51
Statistical Analysis 52
Results 52
Discussion 52
Conclusion 54
References 55
Chapter : Blocking Cerebral Lymphatic Drainage Deteriorates Cerebral Oxidative Injury in Rats with Subarachnoid Hemorrhage 56
Introduction 56
Materials and Methods 56
Animal Preparations 56
Arterial Blood Gas and Blood Pressure Monitoring 57
Serum Lactate Dehydrogenase Activity Detection 57
Detection of Brain Tissue Superoxide Dismutase Activity and Malonaldehyde Content 57
Statistical Analysis 57
Results 58
Behavior Observation and SAH Models Verification 58
Arterial Blood Gas and Blood Pressure 58
Serum Lactate Dehydrogenase Activity 58
Brain Tissue Superoxide Dismutase Activity and Malonaldehyde Content 58
Discussion 58
References 59
Chapter : Comparison of Intrathecal Dotarizine and Nimodipine Treatments in Cerebral Vasospasm After Subarachnoid Hemorrhage: A 61
Introduction 61
Methods and Materials 62
Animal Model 62
Dotarizine Solution and Vehicle 62
SAH Formation 62
Angiography Procedure 62
Perfusion-Fixation 63
Embedding, Morphometry, and Statistical Analysis 63
Results 63
Mortality, Morbidity, and Neurological Parameters 63
Pathological Measurements 63
Angiographic Measurements 64
Discussion 65
References 66
Chapter : Changes of Blood-Brain Barrier Permeability Following Intracerebral Hemorrhage and the Therapeutic Effect of Minocycl 67
Introduction 67
Materials and Methods 68
Experimental Animals 68
Animal Grouping 68
Establishment of Rat ICH Model 68
Determination of BBB Permeability 68
Sampling and Preparation 68
Expressions of VEGF, NGF and HPS70 Detected by Immunohistochemistry 68
Statistical Analyses 69
Results 69
Changes of EB Content in Rat Brain Tissue Following ICH 69
VEGF Expression in Brain Tissue Detected by Immunohistochemistry 69
NGF and HSP70 Expressions in Brain Tissue Detected by Immunohistochemistry 69
Discussion 70
References 72
Chapter : Comparison of Intrathecal Flunarizine and Nimodipine Treatments in Cerebral Vasospasm After Experimental Subarachnoid 74
Introduction 74
Methods and Materials 75
Animal Model 75
SAH Formation 75
Perfusion-Fixation 75
Neurological Parameters 75
Embedding, Morphometry, and Statistical Analysis 75
Results 76
Discussion 76
References 78
Chapter : Treatment with Ginsenoside Rb1, A Component of Panax Ginseng, Provides Neuroprotection in Rats Subjected to Subarachn 79
Introduction 79
Materials and Methods 80
Randomized Grouping and SAH Model 80
Calculating Mortality 80
Spontaneous Activity Scores 80
Brain Water Content 80
Histological Examination 81
Statistical Analysis 81
Results 81
Mortality 81
Spontaneous Activity Scores 81
Brain Water Content 81
Histological Examination 81
Conclusion 83
References 83
Chapter : The Effects of Intrathecal Nicergoline and Nimodipine in Cerebral Vasospasm: An Experimental Study in Rabbits 84
Introduction 84
Methods and Materials 85
Animal Model 85
SAH Formation 85
Perfusion-fixation 85
Neurological Parameters 85
Embedding, Morphometry, and Statistical Analysis 85
Results 85
Discussion 87
References 87
Chapter : Metabolic Reflow as a Therapy for Ischemic Brain Injury 89
Introduction 89
Materials and Methods 90
Results 91
Effect of TSC on Cerebral Infarction After Permanent Focal Ischemia 91
Effect of TSC on Cerebral Infarction After Temporary Focal Ischemia 91
Effect of TSC on Oxygenation in the Ischemic Penumbra 91
Discussion 91
References 92
Chapter : The Influence of Cisternal and Ventricular Lavage on Cerebral Vasospasm in Patients Suffering from Subarachnoid Hemor 95
Introduction 95
Materials and Methods 95
Results 96
Discussion 96
Conclusion 97
References 97
Chapter : Dural Arteriovenous Fistulae at the Craniocervical Junction: The Relation Between Clinical Symptom and Pattern of Ven 99
Introduction 99
Clinical Material and Methods 99
Results 100
Selected Cases 101
Discussion 102
Conclusion 104
References 104
Chapter : Surgical Procedure and Results of Cisternal Washing Therapy for the Prevention of Cerebral Vasospasm Following SAH 105
Introduction 105
Surgical Procedure and Postoperative Management 105
Materials and Methods 106
Results 107
Discussion 107
Conclusion 108
References 109
Chapter : Objective Evaluation of the Treatment Methods of Intracranial Aneurysm Surgery 110
Introduction 110
Materials and Methods 110
Patient Population 110
Surgical Methods 111
Results 111
Discussion 111
Conclusion 114
References 114
Chapter : Recurrent Vasospasm After Endovascular Treatment in Subarachnoid Hemorrhage 115
Introduction 115
Methods 116
Patient Population 116
Definitions of Vasospasm 116
Medical Management 116
Endovascular Management 116
Clinical and Radiographic Assessment 116
Outcome Measures 117
Statistical Analysis 117
Results 117
Discussion 119
Conclusion 120
References 120
Chapter : Endovascular Embolization for Intracranial Aneurysms: Report of 162 Cases 121
Subjects and Methods 121
General Information 121
Preoperative Treatment 121
Embolization Materials 122
Postoperative Treatment 122
Results 122
Discussion 122
References 123
Chapter : Treatment of Post-hemorrhagic Cerebral Vasospasm: Role of Endovascular Therapy 124
Clinical Significance 124
Pathophysiology 124
Diagnosis 125
Medical Management 125
Interventional Treatment of Vasospasm 125
Clinical Indications and Efficacy 125
Techniques and Devices 127
Complication Avoidance and Management 127
Conclusion 128
References 128
Chapter : Delayed Intracranial Hemorrhage Associated with Antiplatelet Therapy in Stent-Assisted Coil Embolized Cerebral Aneury 130
Introduction 130
Patients and Methods 130
Patient Population 130
Drug Regimens 132
Result Comparison 132
Statistical Analysis 132
Results 132
Discussion 133
Conclusion 135
References 135
Chapter : Microsurgical Treatment of Ruptured Intracranial Aneurysm: A 120-Case Analysis 137
Subjects and Methods 137
General Information 137
Preoperative Treatment 137
Surgical Procedures 138
Postoperative Treatment 138
Results 138
Discussion 138
References 139
Chapter : Clazosentan: Prevention of Cerebral Vasospasm and the Potential to Overcome Infarction 141
Introduction 141
Materials and Methods 142
Results 142
Discussion 142
Conclusion 144
References 144
Chapter : Current Management of Subarachnoid Hemorrhage in Advanced Age 145
Introduction 145
Material and Methods 145
Illustrative Cases 146
Results 146
Discussion 146
Conclusions 148
References 149
Chapter : A Numerical Approach to Patient-Specific Cerebral Vasospasm Research 150
Introduction 150
Methods 151
Results 151
Discussion 151
Conclusion 151
References 153
Chapter : Evidenced Based Guidelines for the Management of Good Grade Subarachnoid Haemorrhage Patients in Leeds, UK 154
Introduction 154
Methods 154
Results 154
Nursing and Physiotherapy 154
Surgery 155
Critical Care 155
Interventional Neuro-radiology 156
Discussion 156
References 157
Chapter : Clinical Trial of Nicardipine Prolonged-Release Implants for Preventing Cerebral Vasospasm: Multicenter Cooperative S 158
Introduction 158
Methods and Materials 158
Development of NP 158
Patient Population and Management 159
Results 159
Discussion 160
References 160
Chapter : Intravenous Magnesium Sulfate After Aneurysmal Subarachnoid Hemorrhage: Current Status 161
Introduction 161
Materials and Methods 161
Results 162
Discussion 164
References 164
Chapter : Predictors Analysis of Symptomatic Cerebral Vasospasm After Subarachnoid Hemorrhage 166
Introduction 166
Materials and Methods 166
Results 167
Discussion 167
Conclusion 169
References 169
Chapter : Intra-arterial Administration of Fasudil Hydrochloride for Vasospasm Following Subarachnoid Haemorrhage: Experience o 170
Introduction 170
Materials and Methods 170
Results 170
Discussion 172
References 172
Role of Controlled Lumbar CSF Drainage for ICP Control in Aneurysmal SAH 173
Introduction 173
Methods 174
Results 174
Discussion 175
Conclusion 176
References 176
Chronic Hydrocephalus After Aneurysmal Subarachnoid Space Hemorrhage 178
Introduction 178
Clinical Data and Method 178
General Information 178
Clinical Manifestation 178
Imaging Examination 178
Treatment 179
Prognosis 179
Statistical Treatment 179
Result 179
Discussion 179
Conclusion 179
References 180
Statins in the Management of Aneurysmal Subarachnoid Hemorrhage: An Overview of Animal Research, Observational Studies, Random 182
Introduction 182
Literature Review 183
Search Strategy 183
Experimental Studies in Animals 183
Biological Effects in Humans 185
Physiological Effects in Humans 185
Randomized Controlled Trials and Meta-Analyses 185
Observational Studies 187
Conclusions 188
References 189
New Modalities to Assess Efficacy of Triple-H Therapy: Early Experience 191
Introduction 191
Materials and Methods 191
Results 192
Discussion 194
Conclusions 195
References 195
Nicardipine Pellets for the Prevention of Cerebral Vasospasm 196
Introduction 196
Material and Methods 196
Results 197
Discussion 198
Conclusion 198
References 198
Neuromonitoring in Intensive Care: A New Brain Tissue Probe for Combined Monitoring of Intracranial Pressure (ICP) Cerebral Bl 201
Introduction 201
Methods 201
Results 202
Discussion 203
Conclusion 204
Disclosures 204
References 204
Vasospasm After Subarachnoid Hemorrhage: A 3D Rotational Angiography Study 205
Introduction 205
Materials and Methods 206
Results 206
Discussion 208
Conclusion 208
References 209
Value of Noninvasive Imaging in Follow-Up of Intracranial Aneurysm 210
Introduction 210
Clinical Materials and Methods 210
Patients 210
Image Acquisition 211
Image Interpretation 211
Result 211
Discussion 212
Conclusion 214
References 214
Neuroimaging Research on Cerebrovascular Spasm and Its Current Progress 216
Introduction 216
Transcranial Doppler (TCD) 216
Digital Subtraction Angiography (DSA) 217
Perfusion Computed Tomography (PCT) and Computed Tomography Angiography (CTA) 217
Diffusion-Weighted Magnetic Resonance Imaging (DWI) and Perfusion-weighted Magnetic Resonance Imaging (PWI) 218
Conclusion 219
References 219
Detection and Characterization of Intracranial Aneurysms with Dual-Energy Subtraction CTA: Comparison with DSA 221
Introduction 221
Materials and Methods 222
Patients 222
Subtraction CTA Protocol 222
DSA Protocol 222
Image Analysis 222
Statistical Analysis 223
Results 223
Discussion 223
Conclusion 226
References 226
Author_Index_o.pdf 228
Subject_Index_o.pdf 231