A comprehensive prognostic model for delayed cerebral ischemia in rupture intracranial aneurysms after surgical clipping DOI Creative Commons

Hui Zheng,

Hai Zhou,

Yutong Zhao

et al.

Research Square (Research Square), Journal Year: 2023, Volume and Issue: unknown

Published: Dec. 4, 2023

Abstract Background and Objectives : Delayed cerebral ischemia (DCI), one of the most common complications following aneurysmal subarachnoid hemorrhage (SAH), was strongly related to poor patient outcomes. Identifying predictive factors for its occurrence is crucial improving care Our research aimed explore risk delayed in aneurysm patients after surgical clipping developed a prediction model. Methods The datasets used this study are available from corresponding author upon reasonable request. Patients demographics, features, comorbidities, clinical manifestations, imaging blood pressure on admission，incidence DCI, interventions were recorded. SAH randomly assigned training or validation cohort based ratio 7:3, which implemented as internal validations final models. ability assessed by area under receiver operating characteristic (ROC) curve. Results A total 272 included our research. logistic model 7 independent predictors (Age, Smoking, Drinking, WFNS, Fisher, MAP Second postoperative day, Na) simple-to-use nomogram. set model's C-index 0.844 0.766, demonstrating moderate with regard risks DCI. Conclusion We seven predict incidence focused exploring status DCI patients. Elevated second day may indicate early microvascular spasm.

Language: Английский

Leveraging machine learning algorithms to forecast delayed cerebral ischemia following subarachnoid hemorrhage: a systematic review and meta-analysis of 5,115 participants DOI

Ibrahim Mohammadzadeh,

Behnaz Niroomand, Pooya Eini

et al.

Neurosurgical Review, Journal Year: 2025, Volume and Issue: 48(1)

Published: Jan. 7, 2025

Language: Английский

Citations

3
Systemic Metabolic Alterations after Aneurysmal Subarachnoid Hemorrhage: A Plasma Metabolomics Approach DOI Creative Commons
Bosco Seong Kyu Yang, Jude Savarraj, Hua Chen

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 7, 2025

Aneurysmal subarachnoid hemorrhage (aSAH) causes systemic changes that contribute to delayed cerebral ischemia (DCI) and morbidity. Circulating metabolites reflecting underlying pathophysiological mechanisms warrant investigation as biomarker candidates. Blood samples, prospectively collected within 24 hours (T1) of admission 7-days (T2) post ictus, from patients with acute aSAH two tertiary care centers were retrospectively analyzed. Samples healthy subjects non-neurologic critical illness served controls. A validated external analysis platform was used perform untargeted metabolomics. Bioinformatics analyses conducted identify metabolomic profiles defining each group delineate metabolic pathways altered in group. Machine learning (ML) models developed incorporating key improve DCI prediction. Among 70 aSAH, 30 control, 17 sick control subjects, a total 1,117 detected. Groups matched among clinical variables. occurred 36% poor functional outcome observed 70% at discharge. Metabolomic readily discriminated the groups. demonstrated robust mobilization lipid metabolites, increased levels free fatty acids (FFAs), mono- diacylglycerols (MAG, DAG) compared both also had decreased circulating amino acid derived consistent catabolism. associated sphingolipids (sphingosine sphinganine) acylcarnitines S- adenosylhomocysteine T1. Decreased lysophospholipids outcomes. Incorporating into ML improved prediction variables alone. Profound shifts occur after characteristic increases decreases metabolites. Key outcomes (sphingolipids, lysophospholipids, acylcarnitines) provide insight driving secondary complications. These may prove be useful biomarkers prognostication personalize care.

Language: Английский

Citations

0
Systematic review and meta-analysis of transcranial doppler biomarkers for the prediction of delayed cerebral ischemia following subarachnoid hemorrhage DOI Creative Commons
Hanna Schenck,

Céline van Craenenbroeck,

Sander M. J. van Kuijk

et al.

Journal of Cerebral Blood Flow & Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: March 20, 2025

Delayed cerebral ischemia (DCI) following an aneurysmal subarachnoid hemorrhage (aSAH) significantly impacts mortality, morbidity, and healthcare costs. This study assessed the diagnostic accuracy of Transcranial Doppler (TCD)-derived biomarkers for predicting DCI via a systematic review meta-analysis. Included studies had to correctly define report data on sensitivity, specificity, positive predictive value, negative value. Univariate or bivariate analyses with random effects model were used, risk bias was evaluated Quality Assessment Diagnostic Accuracy Studies. From 23 eligible articles (n = 2371 patients), three biomarker categories identified: blood flow velocities (CBFV), autoregulation, microembolic signals (MES). The highest sensitivity (0.86, 95% CI 0.71–0.94) specificity (0.75, 0.52–0.94) prediction achieved mean CBFV 120 cm/s combined Lindegaard ratio. transient hyperemic response test showed best performance among autoregulatory 0.88, (95% 0.54–0.98) 0.82 0.52–0.94). MES less effective predictors. Combining enhanced TCD’s High heterogeneity noted, indicating need standardized TCD approach improved evaluation.

Language: Английский

Citations

0
MiR-34c Is Predictive of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage DOI
Bosco Seong Kyu Yang, Sidra Tabassum,

Sarah Hinds

et al.

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

Introduction Delayed cerebral ischemia (DCI) is a potentially preventable complication from an aneurysmal subarachnoid hemorrhage (SAH). The micro-RNAs (miR) 34 family has shown its ability to disrupt the blood-brain barrier and redox metabolism might contribute complex pathophysiology of DCI. This study aimsto evaluate association between serum levels miR-34c occurrence Methods retrospective observational based on 72 subjects with acute SAH who were admitted single tertiary center December 2017 July 2021. Subjects prospectively adjudicated for clinical outcomes, including delayed ischemia.Levels measured in plasma collected within 48 hours ictus. Patients median-dichotomized into having higher or lower level miR-34c. miR34c compared DCI no groups using Wilcoxon rank sum tests. A multivariable logistic regression model Cox proportional hazard used effect levels. Results median age was 54 years, 76% females, 21% developed Early significantly progressed have Cohen's d 0.75 (p<0.05). Even after adjusting age, sex, histories diabetes, hypertension, Hunt-Hess grade, modified Graeb scores, associated 5.7-fold increased odds (p<0.05; 95% CI: 1.35-32.22). Survival analysis known predictors also revealeda 5.4-fold patients (p < 0.05; CI 1.22-25.43). Conclusion present demonstrates potential importance circulating predicting patients. Given miR-34 vascular physiology, it may be important target future studies.

Language: Английский

Citations

0
Effects of metformin use on aneurysmal subarachnoid hemorrhage outcomes DOI Creative Commons

A Calleja Bueno,

Andrea Becerril‐Gaitan, Collins Mokua

et al.

Acta Neurochirurgica, Journal Year: 2025, Volume and Issue: 167(1)

Published: April 10, 2025

Abstract Background Metformin is widely prescribed and has neuroprotective effects in animals, but its impact on brain injury after aneurysmal subarachnoid hemorrhage (aSAH) humans unclear. Methods This single-center retrospective review assessed patients with aSAH from 2009 to 2023, categorizing them based pre-admission metformin use. The primary outcome was delayed cerebral ischemia (DCI), while secondary outcomes included in-hospital mortality, rebleeding, angiographic vasospasm (CVS), favorable modified Rankin Scale (mRS) scores at discharge the 3-month follow-up. Outcomes were analyzed using logistic regression. Sensitivity analysis performed excluding receiving comfort care. Results A total of 900 (47 853 non-metformin). DCI rates similar between groups (38.3% vs. 29.3%, aOR = 1.06 [0.49–2.28]). Rebleeding 4.3% for users 5.6% non-users (aOR 0.47 [0.09–2.51]). In-hospital mortality 9.7% [0.08–2.84]). Angiographic CVS 38.3% 52.8% 0.49 [0.23–1.05]), 7 days, 29.8% 47.6% 0.46 [0.21–1.01]). showed (39.1% 30.9%, 0.98 [0.45–2.15]) lower days 0.44 [0.20–0.98]). Conclusion use before did not significantly affect risk or CVS. However, care patients, findings are highly speculative reduced post-aSAH. across groups. Future research larger, multi-institutional datasets needed better understand metformin's impact, particularly during aSAH.

Language: Английский

Citations

0
Acute Neurovascular Inflammatory Profile in Patients with Aneurysmal Subarachnoid Hemorrhage DOI Creative Commons

Ruby R. Taylor,

Robert W. Keane,

Begoña Guardiola

et al.

Biomolecules, Journal Year: 2025, Volume and Issue: 15(5), P. 613 - 613

Published: April 23, 2025

Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition that results from intracranial aneurysm rupture, leading to the accumulation of blood between arachnoid and pia mater. The breakdown products damage-associated molecule patterns (DAMPs), which are released as result vascular cellular compromise following elicit local endothelial reactions narrowing cerebral arteries ischemia. In addition, inflammation, characterized by activated cells, perpetuates disruption neurovascular unit blood–brain barrier. uncertain prognosis aSAH patients contributes necessity fluid biomarker can serve valuable adjunct radiological clinical evaluation. Limited studies have investigated inflammation angiogenic protein expression aSAH. Reliable markers inflammatory response associated with may allow for earlier detection at risk complications aid in identification novel pharmacologic targets. We whether angiogenesis signaling proteins potential biomarkers Serum cerebrospinal (CSF) fifteen subjects healthy age-matched controls well hydrocephalus no-aneurysm were evaluated levels proteins. Protein measurement was carried out using electrochemiluminescence. area under curve (AUC) calculated receiver operating characteristics (ROC) obtain information on reliability, specificity, sensitivity, cut-off points, likelihood ratio. grouped Glasgow Outcome Score—Extended 3 months post-injury determine correlation outcome measures. demonstrated elevated serum CSF when compared controls. Certain injury found be promising serum. particular, amyloid-alpha (SAA) correlated unfavorable outcomes Determination these utilized reliable used clinically monitor patient outcomes.

Language: Английский

Citations

0
Eighteen-Year Trends in Subarachnoid Hemorrhage Management and Outcomes: A Single-Center Experience DOI
Marie Renaudier, Vincent Degos, Gianluca Pisanu

et al.

Neurocritical Care, Journal Year: 2025, Volume and Issue: unknown

Published: April 28, 2025

Language: Английский

Citations

0
Angiographic Response to Endovascular Treatment of Post-Hemorrhage Cerebral Vasospasm Is Not Associated with Clinical Outcome DOI
Faraz Behzadi, John T. Tsiang, Ronak Jani

et al.

Clinical Neurology and Neurosurgery, Journal Year: 2025, Volume and Issue: unknown, P. 108927 - 108927

Published: April 1, 2025

Language: Английский

Citations

0
Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis DOI Creative Commons
Riva Satya Radiansyah, Yuri Pamungkas, Ilham Ikhtiar

et al.

Journal of Yeungnam Medical Science, Journal Year: 2025, Volume and Issue: 42, P. 26 - 26

Published: Feb. 2, 2025

Background: Subarachnoid hemorrhage (SAH) is a devastating neurological condition with high morbidity and mortality rates. Although nimodipine widely used in the management of SAH, potential benefits magnesium as adjunct therapy remain unclear. This meta-analysis aimed to evaluate efficacy safety combining for SAH.Methods: A comprehensive literature search was conducted using PubMed, ScienceDirect, Google Scholar, Cochrane Library. Randomized controlled trials prospective cohort studies comparing plus versus alone patients SAH were included. Key outcomes included cerebral vasospasm (CV), delayed ischemia (DCI), functional outcomes, mortality, adverse events.Results: Twelve involving 2,338 The combination significantly reduced incidence CV (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.29–0.95; <i>p</i>=0.03) DCI (OR, 0.52; CI, 0.31–0.87; <i>p</i>=0.01) compared alone. However, no significant differences found (modified Rankin Scale: OR, 0.97; <i>p</i>=0.75; Glasgow Outcome 0.81; p=0.24), <i>p</i>=0.83), or secondary infarction 0.38; <i>p</i>=0.12). events higher group; however, this difference not statistically 3.14; <i>p</i>=0.33).Conclusion: Adding may help reduce but does improve mortality. Further large-scale are needed optimize dosing regimens confirm these findings.

Language: Английский

Citations

0
Effectiveness of human albumin for clinical outcome in aneurysmal subarachnoid hemorrhages: a protocol for randomized controlled (HASH) trial DOI Creative Commons
Arshad Ali, Muhammad Mohsin Khan, Nissar Shaikh

et al.

Trials, Journal Year: 2025, Volume and Issue: 26(1)

Published: Feb. 14, 2025

Aneurysmal subarachnoid hemorrhage (aSAH) is a dreadful acute neurological condition with an overwhelmingly high rate of associated morbidities and mortality. Despite leaping advancement in neurosurgical techniques imaging modalities, there no substantiative improvement the overall prognosis for aSAH. Cerebral vasospasm remains predominant cause morbidities. Human albumin has been used different conditions, including head trauma, intracerebral hemorrhages, ischemic strokes, favorable outcomes. However, its beneficial use aSAH not sufficiently explored until recently published systematic review by our team. In view scarcity data lack robust evidence, group designed first-ever RCT to compare human albumin-enhanced fluid management versus standard therapy crystalloids patients This single-center open-label, prospective, parallel randomized control trial will be conducted at Hamad General Hospital, Doha, Qatar, from August 2024 July 2027. A sample size 84 (42 each arm) calculated sufficient detect clinically significant difference modified Rankin scale good score between two groups (human-albumin induced volume expansion crystalloid only) aneurysmal patients. The primary outcome based on dichotomized [good grades (0–2) poor (3–6)], while secondary include symptomatic vasospasm, transcranial Doppler velocities, Pulse index Contour Cardiac Output (PiCCO) parameters. aims provide firsthand evidence achieve optimal regime explore potential role improving clinical outcomes ClinicalTrials.gov NCT06548477. Registered 9, 2024. https://clinicaltrials.gov/search?term=NCT06548477 .

Language: Английский

Citations

0