Journal of the neurological sciences
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Observational Study
Prognostic value of the 2010 consensus definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.
Delayed cerebral ischemia (DCI) complicates the recovery of approximately 30% of patients with aneurysmal subarachnoid hemorrhage (aSAH). The definition of DCI widely varies, even though a consensus definition has been recommended since 2010. This study aimed to evaluate the prognostic value of the 2010 consensus definition of DCI in a cohort of patients with aSAH. ⋯ The incidence of DCI after aSAH is high and its occurrence is strongly associated with an unfavorable neurological outcome. This finding adds to the previous literature, which has shown that DCI appears to be a major contributor affecting the functional ability of survivors of aSAH. To further advance reliable knowledge of DCI, future studies should adhere to the consensus definition of DCI.
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To investigate the role of brain natriuretic peptide (BNP) in predicting long-term functional outcome and develop a new predictive score of poor functional outcome after surgery for chronic subdural hematoma (cSDH). ⋯ Preoperative plasma BNP is an independent predictor of functional outcome at follow-up. Using the FLOP-score, the risk of experiencing a poor outcome could accurately be predicted.
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Observational Study
Age differences in utilization and outcomes of tissue-plasminogen activator and mechanical thrombectomy in acute ischemic stroke.
U.S. demographics is shifting towards older population. Older stroke patients likely receive less tissue-plasminogen activator (t-PA) and mechanical thrombectomy (MT) compared to younger patients. The objective of this study is to evaluate extent of difference in utilization of t-PA and MT and outcomes of stroke between three age groups -18-45 (young adults), 46-80 (middle/old), and > 80 (oldest old) years. ⋯ Oldest old receive one-fourth less t-PA and half less MT compared to young adults. Oldest old patients who received t-PA alone or MT alone had remarkably worse outcomes for in-hospital mortality and discharge to home than young adults did.
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Multicenter Study Observational Study
Cerebral venous sinus thrombosis associated with SARS-CoV-2; a multinational case series.
SARS-CoV-2 induced coagulopathy can lead to thrombotic complications such as stroke. Cerebral venous sinus thrombosis (CVST) is a less common type of stroke which might be triggered by COVID-19. We present a series of CVST cases with SARS-CoV-2 infection. ⋯ CVST should be considered as potential comorbidity in SARS-CoV-2 infected patients presenting with neurological symptoms. Our data suggest that compared to non-SARS-CoV-2 infected patients, CVST occurs in older patients, with lower rates of known CVST risk factors and might lead to a poorer outcome in the SARS-CoV-2 infected group.
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Randomized Controlled Trial Multicenter Study Observational Study
Association between critical care admission and 6-month functional outcome after spontaneous intracerebral haemorrhage.
There is uncertainty about the clinical benefit of admission to critical care after spontaneous intracerebral haemorrhage (ICH). ⋯ Admission to critical care is associated with poor 6-month functional outcome after spontaneous ICH but not with death. Patients admitted to critical care were a priori more severely affected. Although adjusted for main known predictors of poor outcome, our findings could still be confounded by unmeasured factors. Establishing the true effectiveness of critical care after ICH requires a randomised trial with clinical outcomes and quality of life assessments.