Long-Term Functional Effects of Aneurysmal Subarachnoid Haemorrhage with Special Emphasis on the Patient's View

1999 ◽  
Vol 141 (6) ◽  
pp. 571-577 ◽  
Author(s):  
E. Fertl ◽  
M. Killer ◽  
H. Eder ◽  
L. Linzmayer ◽  
B. Richling ◽  
...  
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
The Patient’S View

Delayed cerebral ischaemia in patients with aneurysmal subarachnoid haemorrhage: Functional outcome and long‐term mortality

2019 ◽  
Vol 63 (9) ◽  
pp. 1191-1199 ◽  
Author(s):  
Markus Harboe Olsen ◽  
Matias Orre ◽  
Anna Cold Winge Leisner ◽  
Rune Rasmussen ◽  
Søren Bache ◽  
...  
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Functional Outcome ◽  
Cerebral Ischaemia ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Delayed Cerebral Ischaemia ◽  
Long Term Mortality

scholarly journals Haptoglobin genotype and outcome after aneurysmal subarachnoid haemorrhage

2020 ◽  
Vol 91 (3) ◽  
pp. 305-313 ◽  
Author(s):  
Matthew J Morton ◽  
Isabel C Hostettler ◽  
Nabila Kazmi ◽  
Varinder S Alg ◽  
Stephen Bonner ◽  
...  
Keyword(s):  
Subarachnoid Haemorrhage ◽  
High Volume ◽  
Expression Level ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Fisher Grade ◽  
Haptoglobin Genotype ◽  
Low Volume

ObjectiveAfter aneurysmal subarachnoid haemorrhage (aSAH), extracellular haemoglobin (Hb) in the subarachnoid space is bound by haptoglobin, neutralising Hb toxicity and helping its clearance. Two exons in the HP gene (encoding haptoglobin) exhibit copy number variation (CNV), giving rise to HP1 and HP2 alleles, which influence haptoglobin expression level and possibly haptoglobin function. We hypothesised that the HP CNV associates with long-term outcome beyond the first year after aSAH.MethodsThe HP CNV was typed using quantitative PCR in 1299 aSAH survivors in the Genetics and Observational Subarachnoid Haemorrhage (GOSH) Study, a retrospective multicentre cohort study with a median follow-up of 18 months. To investigate mediation of the HP CNV effect by haptoglobin expression level, as opposed to functional differences, we used rs2000999, a single nucleotide polymorphism associated with haptoglobin expression independent of the HP CNV. Outcome was assessed using modified Rankin and Glasgow Outcome Scores. SAH volume was dichotomised on the Fisher grade. Haemoglobin-haptoglobin complexes were measured in cerebrospinal fluid (CSF) of 44 patients with aSAH and related to the HP CNV.ResultsThe HP2 allele associated with a favourable long-term outcome after high-volume but not low-volume aSAH (multivariable logistic regression). However rs2000999 did not predict outcome. The HP2 allele associated with lower CSF haemoglobin-haptoglobin complex levels. The CSF Hb concentration after high-volume and low-volume aSAH was, respectively, higher and lower than the Hb-binding capacity of CSF haptoglobin.ConclusionThe HP2 allele carries a favourable long-term prognosis after high-volume aSAH. Haptoglobin and the Hb clearance pathway are therapeutic targets after aSAH.

scholarly journals Efficacy and safety of cilostazol-nimodipine combined therapy on delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage: a prospective, randomised, double-blinded, placebo-controlled trial protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036217
Author(s):  
Troy Dawley ◽  
Chad F Claus ◽  
Doris Tong ◽  
Sina Rajamand ◽  
Diana Sigler ◽  
...  
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Cerebral Ischaemia ◽  
Controlled Trial ◽  
Combined Therapy ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Delayed Cerebral Ischaemia ◽  
Symptomatic Vasospasm ◽  
Institutional Review ◽  
Double Blinded

IntroductionDelayed cerebral ischaemia (DCI) due to cerebral vasospasm (cVS) remains the foremost contributor to morbidity and mortality following aneurysmal subarachnoid haemorrhage (aSAH). Past efforts in preventing and treating DCI have failed to make any significant progress. To date, our most effective treatment involves the use of nimodipine, a calcium channel blocker. Recent studies have suggested that cilostazol, a platelet aggregation inhibitor, may prevent cVS. Thus far, no study has evaluated the effect of cilostazol plus nimodipine on the rate of DCI following aSAH.Methods and analysisThis is a multicentre, double-blinded, randomised, placebo-controlled superiority trial investigating the effect of cilostazol on DCI. Data concerning rates of DCI, symptomatic and radiographic vasospasm, length of intensive care unit stay, and long-term functional and quality-of-life (QoL) outcomes will be recorded. All data will be collected with the aim of demonstrating that the use of cilostazol plus nimodipine will safely decrease the incidence of DCI, and decrease the rates of both radiographic and symptomatic vasospasm with subsequent improvement in long-term functional and QoL outcomes when compared with nimodipine alone.Ethics and disseminationEthical approval was obtained from all participating hospitals by the Ascension Providence Hospital Institutional Review Board. The results of this study will be submitted for publication in peer-reviewed journals.Trial registration numberNCT04148105

Long-Term Cognitive Outcome following Aneurysmal Subarachnoid Haemorrhage

2022 ◽  
Vol 31 (1) ◽  
pp. 106184
Author(s):  
Ben Gaastra ◽  
Frederick Ewbank ◽  
William Tapper ◽  
Diederik Bulters ◽  
Ian Galea
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Cognitive Outcome ◽  
Aneurysmal Subarachnoid Haemorrhage
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