The AVICH Score: A Novel Grading System to Predict Clinical Outcome in Arteriovenous Malformation–Related Intracerebral Hemorrhage

2016 ◽  
Vol 92 ◽  
pp. 292-297 ◽  
Author(s):  
Marian C. Neidert ◽  
Michael T. Lawton ◽  
Marius Mader ◽  
Burkhardt Seifert ◽  
Antonios Valavanis ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Intracerebral Hemorrhage ◽  
Arteriovenous Malformation ◽  
Grading System

scholarly journals Postoperative ‘STEMI’ in Intracerebral Hemorrhage due to Arteriovenous Malformation: A Case Report and Review of Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Ravinder Datt Bhanot ◽  
Jasleen Kaur ◽  
Shitiz Sriwastawa ◽  
Kendall Bell ◽  
Kushak Suchdev
Keyword(s):  
Myocardial Infarction ◽  
Intracerebral Hemorrhage ◽  
Arteriovenous Malformation ◽  
Cardiac Biomarkers ◽  
Review Of Literature ◽  
Fibrinolytic Agents ◽  
Intraparenchymal Hemorrhage ◽  
Ecg Changes ◽  
St Segment ◽  
Electrocardiogram Ecg

Electrocardiogram (ECG) changes suggestive of cardiac ischemia are frequently demonstrated in patients with ischemic stroke and subarachnoid hemorrhage. However, little is known of such changes particularly acute ST segment myocardial infarction (STEMI) in patients with intracerebral hemorrhage (ICH), especially after neurosurgery. We present a patient with intraparenchymal hemorrhage due to cerebral arteriovenous malformation (AVM) who exhibited acute STEMI after neurosurgery. Serial cardiac biomarkers and echocardiograms were performed which did not reveal any evidence of acute myocardial infarction. The patient was managed conservatively from cardiac stand point with no employment of anticoagulants, antiplatelet therapy, fibrinolytic agents, or angioplasty and recovered well with minimal neurological deficit. This case highlights that diffuse cardiac ischemic signs on the ECG can occur in the setting of an ICH after neurosurgery, potentially posing a difficult diagnostic and management conundrum.

scholarly journals Association of Molecular Markers With Perihematomal Edema and Clinical Outcome in Intracerebral Hemorrhage

Stroke ◽  
2013 ◽  
Vol 44 (3) ◽  
pp. 658-663 ◽  
Author(s):  
Na Li ◽  
Yan Fang Liu ◽  
Li Ma ◽  
Hans Worthmann ◽  
Yi Long Wang ◽  
...  
Keyword(s):  
Molecular Markers ◽  
Clinical Outcome ◽  
Intracerebral Hemorrhage ◽  
Perihematomal Edema

Serum Procalcitonin Levels are Associated with Clinical Outcome in Intracerebral Hemorrhage

2017 ◽  
Vol 38 (3) ◽  
pp. 727-733 ◽  
Author(s):  
Dingxiu He ◽  
Yun Zhang ◽  
Biao Zhang ◽  
Wei Jian ◽  
Xiaojian Deng ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Intracerebral Hemorrhage

Association between Apolipoprotein E Polymorphism and Clinical Outcome after Ischemic Stroke, Intracerebral Hemorrhage, and Subarachnoid Hemorrhage

2021 ◽  
pp. 1-10
Author(s):  
Wen Pan ◽  
Min Zhang ◽  
Zhenping Guo ◽  
Wenfeng Xiao ◽  
Chao You ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Clinical Outcome ◽  
Intracerebral Hemorrhage ◽  
Apolipoprotein E ◽  
Functional Outcomes ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Fixed Effects Models ◽  
Increased Risk

<b><i>Backgrounds:</i></b> Previous studies reported inconsistent results regarding associations between apolipoprotein E (<i>APOE</i>) polymorphism and clinical outcomes after ischemic stroke (IS), intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH). Thus, the study was designed to make a systematic review and meta-analysis regarding the association between <i>APOE</i> polymorphism and clinical outcome after IS, ICH, and SAH. <b><i>Methods:</i></b> To identify studies eligible for this meta-analysis, we searched for articles published before August 2021 in the databases (PubMed, Web of Science, and Google Scholar). We used STATA 12.0 software to compute hazard ratios (HRs) and their 95% confidence intervals (CIs) regarding <i>APOE</i> polymorphism and clinical outcome after IS, ICH, and SAH. <b><i>Results:</i></b> Meta-analysis showed no significant association between <i>APOE</i> polymorphism and functional outcome after IS with fixed effects models (ε4 carrier vs. non-ε4 carrier: HR, 1.00; 95% CI: 0.83–1.21, <i>I</i><sup>2</sup> = 29.4%, <i>p</i> = 0.183; ε2 carrier vs. non-ε2 carrier: HR, 0.92; 95% CI: 0.72–1.16, <i>I</i><sup>2</sup> = 15.6%, <i>p</i> = 0.307). Meta-analysis showed that ICH patients carrying ε4 allele have increased risk of poor outcome in Caucasian population with fixed effects models (ε4 carrier vs. non-ε4 carrier: HR, 1.75; 95% CI: 1.19–2.57, <i>I</i><sup>2</sup> = 0.0%, <i>p</i> = 0.543). Meta-analysis showed no significant association between <i>APOE</i> polymorphism and functional outcomes after SAH with random effects models (ε4 carrier vs. non-ε4 carrier: HR, 1.51; 95% CI: 0.80–2.84, <i>I</i><sup>2</sup> = 57.1%, <i>p</i> = 0.022). <b><i>Conclusions:</i></b> In conclusion, the present study demonstrated <i>APOE</i> ε4 carriers show worse functional outcomes after ICH, but not after IS or SAH. More large-scale studies were critical to explore the association between <i>APOE</i> polymorphism and clinical outcome after IS, ICH, and SAH.

The Ruptured Arteriovenous Malformation Grading Scale (RAGS): An Extension of the Hunt and Hess Scale to Predict Clinical Outcome for Patients With Ruptured Brain Arteriovenous Malformations

Neurosurgery ◽  
2019 ◽  
Vol 87 (2) ◽  
pp. 193-199 ◽  
Author(s):  
Michael A Silva ◽  
Pui Man Rosalind Lai ◽  
Rose Du ◽  
Mohammad A Aziz-Sultan ◽  
Nirav J Patel
Keyword(s):  
Clinical Outcome ◽  
Arteriovenous Malformation ◽  
Venous Drainage ◽  
Receiver Operating Curve ◽  
Simple Extension ◽  
Grading Systems ◽  
Ruptured Avm ◽  
Grading Scale ◽  
Ordinal Logistic Regression Model

Abstract BACKGROUND Arteriovenous malformation (AVM) rupture is highly morbid. Outcomes after AVM rupture differ from other types of brain hemorrhage. There are no specific widely used grading systems designed to predict clinical outcome after AVM rupture. OBJECTIVE To develop an all-comers scoring system to grade patients with AVM rupture and predict clinical outcome more accurately than grading systems currently in use. METHODS We retrospectively reviewed patients who presented to our institution with a ruptured AVM. Using change in modified Rankin Score (mRS) as our response variable, we generated an ordinal logistic regression model to test for significant predictor variables. The full model was sequentially condensed until the simplest model with the highest area under the receiver operating curve (AUROC) was achieved. RESULTS A total of 115 patients who presented with ruptured AVMs were included in the study, with a mean follow-up time of 4 yr. The Ruptured AVM Grading Scale (RAGS) consists of the Hunt and Hess (HH) score (1-5), patient age (&lt;35 = 0, 35-70 = 1, and &gt;70 = 2), deep venous drainage (1), and eloquence (1). The RAGS score outperformed other neurosurgical grading scales in predicting change in mRS, with an AUROC greater than 0.80 across all follow-up periods. CONCLUSION The RAGS score is a simple extension of the HH scale that predicts clinical outcome after AVM rupture more accurately than other grading systems.

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