Review
Clinical Neurology
Zachary A. Sorrentino, Dimitri Laurent, Jairo Hernandez, Caroline Davidson, Coulter Small, William Dodd, Brandon Lucke-Wold
Summary: Persistent headache attributed to past non-traumatic subarachnoid hemorrhage (SAH) is a significant complication that can significantly decrease the quality of life of patients. The pathophysiology of these headaches is diverse, and only a few medications have shown efficacy in alleviating the pain. An effective treatment paradigm should include evidence-based therapeutics, reduction of opioid medications if ineffective, and consideration of multi-modal pain control strategies including nerve blocks.
Article
Clinical Neurology
Ben Gaastra, Harry Carmichael, Ian Galea, Diederik Bulters
Summary: This study investigated the long-term frequency and prognosis of persistent headache following aneurysmal subarachnoid hemorrhage (aSAH). The results showed that the prevalence of persistent headache was higher in aSAH patients compared to controls, but decreased over time. Headache frequency was not related to the severity of aSAH, treatment, or hydrocephalus. Additionally, aSAH patients had a higher frequency of migrainous features compared to controls.
Review
Biochemistry & Molecular Biology
Chang-Zhang Chai, Ue-Cheung Ho, Lu-Ting Kuo
Summary: Aneurysmal subarachnoid hemorrhage (aSAH) is a severe neurological disorder with high mortality and severe functional sequelae. Systemic inflammation after hemorrhagic stroke may contribute to intracranial and extracranial tissue damage. Previous studies suggest that systemic inflammatory biomarkers could be useful in predicting clinical outcomes. Anti-inflammatory treatment may hold promise in improving prognosis for patients with aSAH. This review summarizes the intricate interactions between the nervous and immune systems.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Immunology
Sung-Ho Ahn, Angela Burkett, Atzhiry Paz, Jude P. Savarraj, Sarah Hinds, Georgene Hergenroeder, Aaron M. Gusdon, Xuefeng Ren, Jeong-Ho Hong, Huimahn A. Choi
Summary: The study identified serum cytokines at different time points that were independently associated with persistent CE, particularly persistent elevations of Eotaxin were associated with persistent CE after SAH.
JOURNAL OF NEUROINFLAMMATION
(2022)
Article
Clinical Neurology
Alis J. Dicpinigaitis, Syed Faraz Kazim, Fawaz Al-Mufti, Daniel E. Hall, Katherine E. Reitz, Kavelin Rumalla, Matthew K. McIntyre, Adam S. Arthur, Visish M. Srinivasan, Jan-Karl Burkhardt, Meic H. Schmidt, Chirag D. Gandhi, Christian A. Bowers
Summary: This study evaluated frailty in aneurysmal subarachnoid hemorrhage (aSAH) using large-scale data and compared the effectiveness of the risk analysis index (RAI), modified frailty index (mFI), and Hospital Frailty Risk Score (HFRS). The RAI showed the largest effect size and discriminative ability in predicting poor functional outcomes in aSAH patients.
JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Swarna Rajagopalan, Nanda Siva, Andrew Novak, Jeffrey Garavaglia, Casey Jelsema
Summary: This small study found that peripheral nerve blocks (PNBs) can be a safe, feasible, and effective treatment for headache after aneurysmal subarachnoid hemorrhage (HASH). Patients who received PNBs in addition to medication showed significant reduction in pain. Further research with a larger sample size is needed.
FRONTIERS IN NEUROLOGY
(2023)
Article
Clinical Neurology
Marvin Darkwah Oppong, Marcela Jara Bastias, Daniela Pierscianek, Leonie Droste, Thiemo F. Dinger, Yahya Ahmadipour, Laurel Rauschenbach, Carlos Quesada, Mehdi Chihi, Philipp Dammann, Michael Forsting, Karsten H. Wrede, Ulrich Sure, Ramazan Jabbarli
Summary: Seizures at the onset of aneurysmal subarachnoid hemorrhage (aSAH) occur in 9.5% of cases and are associated with younger age, higher WFNS grade, specific aneurysm characteristics, and elevated admission body temperature. These early seizures are related to early brain injury severity and independently predict poor outcomes in younger individuals.
JOURNAL OF NEUROLOGY
(2021)
Review
Clinical Neurology
Michael Veldeman, Walid Albanna, Miriam Weiss, Soojin Park, Anke Hoellig, Hans Clusmann, Raimund Helbok, Yasin Temel, Gerrit Alexander Schubert
Summary: The review summarized the diagnostic value of invasive neuromonitoring in detecting DCI, with data supporting its use in selected patients at high risk for DCI.
Article
Critical Care Medicine
Cody L. Nesvick, Soliman Oushy, Krishnan Ravindran, Lorenzo Rinaldo, Panagiotis Kerezoudis, Eelco F. Wijdicks, Giuseppe Lanzino, Alejandro A. Rabinstein
Summary: Around 10% of patients with aneurysmal-pattern subarachnoid hemorrhage have an occult ruptured aneurysm, highlighting the importance of considering a second-look DSA in these cases. Meta-analysis of previous studies showed a pooled rate of positive second angiogram at 10.4%, indicating variability in aneurysm detection across different studies. Substantial inter-study heterogeneity was observed in the meta-analysis, emphasizing the need for further research in this area.
NEUROCRITICAL CARE
(2022)
Review
Biochemistry & Molecular Biology
Judith Weiland, Alexandra Beez, Thomas Westermaier, Ekkehard Kunze, Anna-Leena Siren, Nadine Lilla
Summary: This article reviews the role of neuroinflammation, thromboinflammation, and metabolism in aneurysmal subarachnoid hemorrhage (aSAH), and suggests potential neuroprotective strategies targeting these mechanisms to prevent secondary brain injury.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Clinical Neurology
Ian Galea, Andrew Durnford, James Glazier, Sophie Mitchell, Suraj Kohli, Lesley Foulkes, Jeanette Norman, Angela Darekar, Seth Love, Diederik O. Bulters, James A. R. Nicoll, Delphine Boche
Summary: Iron deposits in the cortical gray matter after aneurysmal subarachnoid hemorrhage (SAH) and is associated with cognitive outcome. These findings support therapeutic approaches to prevent the permeation of hemoglobin into the cortex after SAH.
Article
Clinical Neurology
Jack Henry, Michael Amoo, Mohamed O. Dablouk, Paula Corr, Deirdre Nolan, Deirdre Coffey, Mohsen Javadpour
Summary: The study examined the incidence and risk factors of spontaneous subarachnoid hemorrhage (SAH) in a nationally representative sample. Smoking, hypertension, increasing age, and female sex were identified as risk factors. Smoking had the strongest association with SAH, and there was a synergistic interaction between smoking and hypertension in increasing the risk of SAH.
ACTA NEUROCHIRURGICA
(2023)
Review
Clinical Neurology
Saif Salman, Qiangqiang Gu, Rohan Sharma, Yujia Wei, Benoit Dherin, Sanjana Reddy, Rabih Tawk, W. David Freeman
Summary: This review synthesizes the current state of the art of AI and ML tools for the management of SAH patients. The results show that these technologies have the potential to improve mortality prediction, complications prediction, and reduce latency until intervention.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Marvin Darkwah Oppong, Lasse Lohrer, Karsten H. Wrede, Mehdi Chihi, Alejandro N. Santos, Philipp Dammann, Anna Michel, Laurel Rauschenbach, Maryam Said, Yan Li, Benedikt Frank, Ulrich Sure, Ramazan Jabbarli
Summary: This study aimed to identify the risk factors leading to post-SAH epilepsy. It found that thyroid dysfunction, decompressive craniectomy and shunt placement, prolonged tachycardia, as well as anemia signs were independently associated with symptomatic epilepsy after aSAH.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2023)
Article
Neurosciences
Robert S. Eisinger, Zachary A. Sorrentino, Brandon Lucke-Wold, Sonya Zhou, Brooke Barlow, Brian Hoh, Carolina B. Maciel, Katharina M. Busl
Summary: This retrospective study aimed to investigate the trajectory of post-aSAH headaches and their associations with clinical features. Two distinct headache pain trajectory cohorts were identified, with the moderate-severe pain group being younger, receiving more opioid analgesia, and having lower serum sodium concentrations compared to the mild-moderate pain group.
Article
Neurosciences
Sheheryar A. Jamali, Marion T. Turnbull, Takahisa Kanekiyo, Prakash Vishnu, Abba C. Zubair, Carol C. Raper, Rabih G. Tawk, William D. Freeman
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2020)
Article
Health Care Sciences & Services
William P. Cheshire, Kevin M. Barrett, Benjamin H. Eidelman, Elizabeth A. Mauricio, Josephine F. Huang, William D. Freeman, Maisha T. Robinson, Gary R. Salomon, Colleen T. Ball, Dale M. Gamble, Vickie S. Melton, James F. Meschia
Summary: This study found no significant difference in patient perceptions of physician empathy between telemedicine and in-person consultations for acute stroke care, indicating that empathy can be effectively conveyed through telemedicine encounters without physical touch or proximity.
JOURNAL OF TELEMEDICINE AND TELECARE
(2021)
Editorial Material
Clinical Neurology
W. David Freeman, Peter L. Carlen
CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES
(2021)
Article
Medicine, General & Internal
Johan L. Heemskerk, Ricardo A. Domingo, Rabih G. Tawk, Tito G. Vivas-Buitrago, Josephine F. Huang, Ashley Rogers, Alfredo Quinones-Hinojosa, Kingsley Abode-Iyamah, William D. Freeman
Summary: This study analyzed prehospital time for patients with suspected stroke transported to treatment centers in Florida in 2018, finding that dispatch notification and stroke assessment scales can reduce EMS time. Adoption of these interventions may improve stroke systems of care.
MAYO CLINIC PROCEEDINGS
(2021)
Review
Medicine, General & Internal
Cumara B. O'Carroll, Benjamin L. Brown, W. David Freeman
Summary: Spontaneous intracerebral hemorrhage is a medical emergency associated with chronic hypertension and vessel rupture, with treatment strategies focusing on timely diagnosis, aggressive blood pressure control, correction of coagulopathy defects, treatment of cerebral edema, and assessment for surgical intervention.
MAYO CLINIC PROCEEDINGS
(2021)
Review
Medicine, General & Internal
Rabih G. Tawk, Tasneem F. Hasan, Caitlin E. D'Souza, Jeffrey B. Peel, William D. Freeman
Summary: Unruptured intracranial aneurysms are common vascular lesions that can lead to severe consequences. While previous consensus indicated that small aneurysms (<7 mm) are less likely to rupture, current research highlights the importance of considering other risk factors.
MAYO CLINIC PROCEEDINGS
(2021)
Article
Health Care Sciences & Services
Stephen W. English, Kevin M. Barrett, Willam D. Freeman, Bart M. Demaerschalk
Summary: The recognition and management of stroke in the prehospital setting has become more important, with strategies like the mobile stroke unit and telemedicine-enabled ambulance being developed. These strategies differ in costs, scalability, integration, and interoperability, aiming to guide prehospital leaders to find the most suitable solutions for their communities.
JOURNAL OF TELEMEDICINE AND TELECARE
(2022)
Article
Clinical Neurology
W. David Freeman, Ashley Rogers, Alejandro Rabinstein
Summary: This review summarizes the current state, emerging research, and new technologies of TeleNeuroICU, and discusses the value and future development of TeleNeuroICU in healthcare systems.
SEMINARS IN NEUROLOGY
(2022)
Editorial Material
Critical Care Medicine
W. David Freeman
NEUROCRITICAL CARE
(2022)
Article
Clinical Neurology
Stephen W. English, Kevin M. Barrett, William D. Freeman, Bart M. Demaerschalk, Oana M. Dumitrascu
Summary: This article discusses the importance of diagnosing and managing acute vision loss, highlighting the limitations of remote healthcare services and the impact of the COVID-19 pandemic on ophthalmological diagnosis. The authors propose new approaches to improve remote ophthalmological evaluation and enhance acute ophthalmological care.
Editorial Material
Immunology
Amra Sakusic, Baibing Chen, Kimberly McPhearson, Mohammed Badi, William D. Freeman, Josephine F. Huang, Jason L. Siegel, Mark E. Jentoft, Justin M. Oring, Jorge Verdecia, James F. Meschia
Summary: This case presents a 61-year-old woman with a history of orthotopic heart transplant who was hospitalized with new-onset headache. MRI of the brain revealed left occipital lobe involvement and mild vasogenic edema. The patient developed neurological symptoms and was found to have a rare amoeba infection, Balamuthia mandrillaris, leading to her death despite treatment efforts.
OPEN FORUM INFECTIOUS DISEASES
(2023)
Article
Health Care Sciences & Services
Kaneez Zahra, Ricardo A. Domingo, Marion T. Turnbull, Christan D. Santos, Sarah H. Peacock, Daniel A. Jackson, Rabih G. Tawk, Jason L. Siegel, William David Freeman
Summary: This study reports the preliminary safety, tolerability, and utility of concentrated intraventricular nicardipine (IVN) injections in the treatment of aneurysmal subarachnoid hemorrhage (aSAH). The results suggest that concentrated IVN injection is relatively safe, tolerable, and a potential option for treating refractory vasospasm in poor-grade SAH.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Medicine, General & Internal
Ricardo Diaz Milian, Pablo Moreno Franco, William D. Freeman, John D. Halamka
MAYO CLINIC PROCEEDINGS
(2023)
Article
Clinical Neurology
Mariam Tsikvadze, Baltazar Machado De Villafane, Mariah Rose, Sarah Peacock, Jeffrey Brent Peel, Lauren Ng, Christopher Kramer, William D. Freeman
Summary: This article describes a severe case of Susac Syndrome complicated by rapid progression of cerebral edema and eventual brain death, in order to increase awareness of this rare and catastrophic complication.