Abstract:
BACKGROUND:The effects of induced hypertension (IH) on cerebral perfusion after subarachnoid hemorrhage (SAH) are unclear. The objectives of this investigation are to: (1) determine whether there are differences in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) measured with computed tomography perfusion (CTP) before and after IH; (2) evaluate differences in the presence of infarction and clinical outcome between patients with and without IH. METHODS:We performed a retrospective cohort analysis of 25 aneurysmal SAH patients. IH was initiated as per the standard institutional protocol when patients showed clinical symptoms of delayed cerebral ischemia (DCI). Differences in CBF, CBV, and MTT between early (<72 h after aneurysm rupture) and late (7-10 days after aneurysm rupture) CTP were quantified in patients with (n = 13) and without IH (n = 12). Outcome measures included cerebral infarction and clinical outcome at 3 months. RESULTS:Early MTT was significantly greater in the IH group compared to the no-IH group. There was no difference in early or late CBV or CBF between the two groups. In patients that received IH, there was a significant decrease in MTT between the early (7.0 ± 1.2 s) and late scans (5.8 ± 1.6 s; p = 0.005). There was no difference in the incidence of infarction (5/13 vs. 2/11) or poor outcome (3/11 vs. 6/13) between the IH and no-IH groups, respectively (p > 0.05). CONCLUSIONS:Elevated MTT is a significant factor for the development of DCI in patients eventually requiring IH therapy and is improved by IH treatment. Therapies to prevent DCI and improve clinical outcome may need to be initiated earlier, when cerebral perfusion abnormalities are first identified.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Murphy A,de Oliveira Manoel AL,Macdonald RL,Baker A,Lee TY,Marotta T,Montanera W,Aviv R,Bharatha Adoi
10.1007/s12028-017-0379-6subject
Has Abstractpub_date
2017-08-01 00:00:00pages
3-10issue
1eissn
1541-6933issn
1556-0961pii
10.1007/s12028-017-0379-6journal_volume
27pub_type
杂志文章abstract:BACKGROUND:Oral anticoagulants have been associated with greater hematoma expansion in patients with intracerebral hemorrhage (ICH). The purpose of this study was to determine whether the reported use of antiplatelet agents also results in greater hematoma expansion. METHODS:Retrospective review of patients with spont...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-009-9290-0
更新日期:2010-02-01 00:00:00
abstract::Drug shortages have become all too familiar in the health care environment, with over 200 drugs currently on shortage. In the wake of Hurricane Maria in September 2017, hospitals across the USA had to quickly and creatively adjust medication preparation and administration techniques in light of decreased availability ...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-019-00730-7
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Stroke is common after aneurysmal subarachnoid hemorrhage (aSAH). Transcranial Doppler ultrasound (TCD) monitoring is often employed to identify vasospasm and allow intervention to avoid infarction. The required duration of monitoring has not been established. We aim to determine if 10 days of TCD monitoring...
journal_title:Neurocritical care
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更新日期:2011-12-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9389-3
更新日期:2011-08-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-9038-7
更新日期:2008-01-01 00:00:00
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doi:10.1007/s12028-013-9934-y
更新日期:2014-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-014-9989-4
更新日期:2014-12-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0054-4
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:There is some evidence that hyperglycemia increases the rate of poor outcomes in patients with intracerebral hemorrhage (ICH). We explored the relationship between various parameters of serum glucose concentrations measured during acute hospitalization and hematoma expansion, perihematomal edema, and three m...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9541-8
更新日期:2011-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2010-08-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-014-9962-2
更新日期:2014-06-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-9045-8
更新日期:2008-01-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2015-04-01 00:00:00
abstract::Diagnosis of an intracranial aneurysm during pregnancy is a rare event requiring multidisciplinary care for successful management. The knowledge base for the anesthesiologist involves principles of both obstetric and neuroanesthesia, as well as critical care. This article reports such a case and discusses the relevant...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:4:1:018
更新日期:2006-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-018-0560-6
更新日期:2018-12-01 00:00:00
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更新日期:2020-04-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:2:3:300
更新日期:2005-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0040-x
更新日期:2007-01-01 00:00:00
abstract::Stroke in pregnant women has a mortality rate of 1.4 deaths per 100,000 deliveries. Vascular malformations are the most common cause of hemorrhagic stroke in this population; preeclampsia and other risk factors have been identified. However, nearly a quarter of strokes have an undeterminable cause. Spontaneous intracr...
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pub_type: 杂志文章
doi:10.1007/s12028-018-0501-4
更新日期:2019-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2015-06-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0577-x
更新日期:2019-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-014-9957-z
更新日期:2014-08-01 00:00:00
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doi:10.1007/s12028-020-01185-x
更新日期:2021-01-25 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-016-0274-6
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Cerebral edema, which is associated with increased intracranial fluid, is often a complication of many acute neurological conditions. There is currently no accepted method for real-time monitoring of intracranial fluid volume at the bedside. We evaluated a novel noninvasive technique called "Volumetric Integ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-017-0409-4
更新日期:2018-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9552-5
更新日期:2011-12-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0653-2
更新日期:2019-06-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
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更新日期:2008-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
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更新日期:2017-08-01 00:00:00