Articles: subarachnoid-hemorrhage.
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Journal of neurosurgery · Jan 2025
Auricular vagus nerve stimulation for mitigation of inflammation and vasospasm in subarachnoid hemorrhage: a single-institution randomized controlled trial.
Inflammation contributes to morbidity following subarachnoid hemorrhage (SAH). The authors of this study evaluate how applying noninvasive transauricular vagus nerve stimulation (taVNS) can target this deleterious inflammatory response following SAH and reduce the rate of radiographic vasospasm. ⋯ taVNS is a noninvasive method of neuro- and systemic immunomodulation. This trial supports the finding that taVNS following SAH can mitigate the inflammatory response, reduce radiographic vasospasm, and potentially improve functional and neurological outcomes.
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Aneurysmal subarachnoid hemorrhage (SAH) is frequently complicated by permanent shunt-dependent hydrocephalus, but it is difficult to predict which patients are at highest risk. This study seeks to identify novel variables associated with shunt dependency after aneurysmal SAH and to create a predictive algorithm that improves upon existing models. ⋯ Our study suggests that elevated modified Graeb score on initial computed tomography and high cerebrospinal fluid protein levels prior to EVD wean are important prognostic indicators for the development of shunt dependency after aneurysmal SAH. Integrating these findings into clinical practice may aid in earlier and more targeted decision-making.
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Multicenter Study
Interpretable machine learning model for outcome prediction in patients with aneurysmatic subarachnoid hemorrhage.
Aneurysmatic subarachnoid hemorrhage (aSAH) is a critical condition associated with significant mortality rates and complex rehabilitation challenges. Early prediction of functional outcomes is essential for optimizing treatment strategies. ⋯ The novel deep learning model demonstrated strong predictive performance in determining functional outcomes in patients with aSAH, making it a valuable tool for guiding early rehabilitation strategies.
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisThrombolysis for aneurysmal subarachnoid haemorrhage.
Aneurysmal subarachnoid haemorrhage continues to cause a significant burden of morbidity and mortality despite advances in care. Trials investigating local administration of thrombolytics have reported promising results. ⋯ There is some evidence that thrombolysis can probably improve outcomes after aneurysmal subarachnoid haemorrhage, without increasing the risk of haemorrhagic complications. Thrombolysis likely reduces the risk of poor functional outcome and cerebral artery vasospasm, and may reduce the risk of delayed cerebral ischaemia, but it likely makes little to no difference to case fatality or hydrocephalus, and may make little to no difference to the risk of cerebral infarction. However, the current evidence is still uncertain. The uncertainty is primarily due to the small total number of participants and outcome events. Data from further studies are required to confirm the efficacy of thrombolysis for improving outcomes after aneurysmal subarachnoid haemorrhage.