Brain Hemorrhages最新文献

{"title":"Bioinformatics analysis of potential pathogenesis and risk genes of neuroinflammation-promoted brain injury in intracerebral hemorrhage","authors":"Ilgiz Gareev , Ozal Beylerli , Elmar Musaev , Chunlei Wang , Valentin Pavlov","doi":"10.1016/j.hest.2024.07.007","DOIUrl":"10.1016/j.hest.2024.07.007","url":null,"abstract":"<div><h3>Objective</h3><div>Spontaneous (non-traumatic) intracerebral hemorrhage (ICH) is one of the major causes of global death. The purpose of our bioinformatics analysis was to detect viable pathophysiological targets and small-molecule drug candidates and to identify the precise secondary mechanisms of brain injury in ICH.</div></div><div><h3>Methods</h3><div>The GSE24265 dataset, consisting of data from four perihematomal brain tissues and seven contralateral brain tissues, was downloaded from the Gene Expression Omnibus (GEO) database and screened for differentially expressed genes (DEGs) in ICH. Online analysis tool GEO2R and Drug Susceptibility Assessment Module within the ACBI Bioinformation tool was used for data differential expression analysis. TargetScan, miRDB, and RNA22 were used to investigate the miRNAs regulating the DEGs. The functional annotation of DEGs was performed using Gene Ontology (GO) resources, and the cell signaling pathway analysis of DEGs was performed using the Kyoto Encyclopedia of Genes and Genomes (KEGG). DAVID is used to perform GO function enrichment analysis and KEGG pathway analysis of candidate target genes. Enrichment analysis was performed for delving the molecular mechanism of DEGs, and protein–protein interaction (PPI) networks and microRNA (miRNA)-messenger RNA (mRNA) networks were used to reveal the hub nodes and the related interaction relationships. Hub genes and miRNA-mRNA interaction of PPI network were identified by STRING version 12.0 online software and Cytoscape. Next, the DEGs were analyzed using the L1000CDS2 database to identify small-molecule compounds with potential therapeutic effects.</div></div><div><h3>Results</h3><div>A total of 325 upregulated genes and 103 downregulated genes associated with ICH were identified. The biological functions of DEGs associated with ICH are mainly involved in the inflammatory response, chemokine activity, and immune response. The KEGG analysis identified several pathways significantly associated with ICH, including but not limited to cytokine-cytokine receptor interaction and MAPK signaling pathway. A PPI network consisting of 188 nodes and 563 edges was constructed using STRING, and 27 hub genes were identified with Cytoscape software. The miRNA-mRNA network with high connectivity contained key 27 mRNAs (from C-C motif chemokine ligand 5 (CCL5), C-C motif chemokine ligand 8 (CCL8), …., to dishevelled-associated activator of morphogenesis 1 (DAAM1), and FRAT regulator of WNT signaling pathway 1 (FRAT1)) and 135 candidate miRNAs. These genes and miRNAs are closely related to secondary brain injury induced by ICH. In addition, a L1000CDS<sup>2</sup> analysis of six small-molecule compounds revealed their therapeutic potential.</div></div><div><h3>Conclusions</h3><div>Our study explores the pathogenesis of brain tissue injury promoted by neuroinflammation in ICH and extends the clinical utility of its key genes. At the same time, we constructed a miRNA-mR","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 1-13"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of brain surgery: Exploring the impact of continuum robotics","authors":"Shreya Shah ,&nbsp;Pearl Sheth ,&nbsp;Rajvi Shah ,&nbsp;Dhyey Shekhaliya ,&nbsp;Manan Shah","doi":"10.1016/j.hest.2024.11.002","DOIUrl":"10.1016/j.hest.2024.11.002","url":null,"abstract":"<div><div>Brain surgery requires at most accuracy and precision, yet current neurosurgical robots are limited in their ability to reach intracranial regions due to their rigid and inflexible nature. However, Continuum robots have great potential and are currently helping to change the face of neurosurgery as we know it. They overcome the challenges of conventional tools by providing much greater flexibility and control, consequently reducing recovery times and improving patient outcomes. Continuum robots are a class of robots characterized by their higher number of degrees of freedom. This flexibility and maneuverability lead to the possibility of minimally invasive procedures which were not possible with conventional methods. This paper profoundly reviews the major research done in the field of continuum robots in neurosurgery and to provide a comparative analysis along with a discussion of the same. The review discusses the state of neurosurgery before continuum robots, the limitations of conventional tools, and why continuum robots are looking so promising for the future of neurosurgery. A detailed comparative analysis of existing research is tabulated to highlight the current challenges and future scope in the development and application of continuum robots in brain surgery.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 38-56"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed-reality head-mounted display in cranial neurosurgery: A proof-of-concept study","authors":"Lukas Andereggen ,&nbsp;Gwendoline Boillat ,&nbsp;Joshua Haegler ,&nbsp;Philipp Gruber ,&nbsp;Basil Erwin Grüter ,&nbsp;Stefan Wanderer ,&nbsp;Angelo Tortora ,&nbsp;Gerrit A. Schubert ,&nbsp;Hans-Jakob Steiger ,&nbsp;Serge Marbacher","doi":"10.1016/j.hest.2024.07.003","DOIUrl":"10.1016/j.hest.2024.07.003","url":null,"abstract":"<div><h3>Objective</h3><div>Mixed-reality (MR) head-mounted displays (HMD) offer virtual augmentations registered with real objects, allowing for direct patient-centered lesion visualization. In contrast to other surgical subspecialties, however, the application of MR in neurosurgery remains poor. In this proof-of-concept study, we aimed at evaluating the applicability, educational value, and accuracy of HMD as compared to standard neuronavigation (SN) in the planning of treatment for patients undergoing neurovascular and tumor surgeries.</div></div><div><h3>Methods</h3><div>A 3D hologram of the patient’s anatomy was generated from conventional CT scan, MRI, and/or 3D rotational angiography (3D-RA), and integrated into the HMD. The participating surgeons completed a standardized questionnaire, which evaluated the application of HMD compared to SN, to detail the visualization benefits and limitations of the 3D hologram.</div></div><div><h3>Results</h3><div>Eight consecutive patients with neurovascular (n = 4) or tumor pathologies (n = 4) were selected for MR. The mean (±SD) setup time was significantly longer for HMD than SN (8.3 ± 1.5 min vs. 4.8 ± 1.3 min; <em>p</em> &lt; 0.001), independent of the pathology applied (i.e., tumor: 8.0 ± 2.0 vs. 4.3 ± 1.3, <em>p</em> = 0.02, and vascular: 8.7 ± 0.9 vs. 5.4 ± 1.1; <em>p</em> &lt; 0.001). Surgeons wearing the HMD succeeded in moving the 3D hologram from respective operators’ angles and identifying the shape and configuration of the lesion. The MR device was superior to SN with regard to treatment planning on account of its improved spatial awareness. The current method is however limited in its representation of small perforators in neurovascular pathologies and bony involvement in tumors.</div></div><div><h3>Conclusions</h3><div>MR may become a valuable tool in the preoperative treatment planning, education and guidance of complex procedures in selected patients, yet further development is necessary to improve the clinical applicability of the MR HMD.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 24-29"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side?","authors":"Masanori Tsuji ,&nbsp;Fujimaro Ishida ,&nbsp;Ryuta Yasuda ,&nbsp;Tomonori Ichikawa ,&nbsp;Takenori Sato ,&nbsp;Kazuhiro Furukawa ,&nbsp;Yoichi Miura ,&nbsp;Yasuyuki Umeda ,&nbsp;Naoki Toma ,&nbsp;Hidenori Suzuki","doi":"10.1016/j.hest.2024.04.006","DOIUrl":"10.1016/j.hest.2024.04.006","url":null,"abstract":"<div><div><em>Background:</em> Saccular aneurysms (SAs) have been long studied in hemodynamics using computational fluid dynamics (CFD), while dissecting aneurysms (DAs) remain unclear. To estimate which side of the aneurysm ruptured, we evaluated the hemodynamics of the bilateral vertebral artery DAs (VADAs).</div><div><em>Case presentation:</em> A 44-year-old male was diagnosed with subarachnoid hemorrhage by the rupture of either side of bilateral VADAs. The rupture side could not be determined on admission (Day 0). CFD was performed using a patient-specific geometry model obtained from 3-demensional (3D) rotational angiography (RA) on day 1. We predicted that the right DA had ruptured based on the hemodynamics, associated with flow stagnation and complexity in the ruptured SAs by a transient analysis with the patient-specific blood flow velocity waveforms. After careful observation, gadolinium-enhanced MRI on day 16 showed a contrast effect in the right wall and a change in the right shape was confirmed on the second 3D RA on day 17. According to both imaging evaluations and CFD, the right was presumed to be ruptured, and a flow-diverter stent was placed at the right VA. The right VADA did not re-rupture for 12 months.</div><div><em>Conclusion:</em> Our results indicated that hemodynamics of ruptured DAs would be similar to that of ruptured SAs.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 57-60"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between NT-pro-BNP and other serological indicators and the prognosis of spontaneous intracerebral hemorrhage","authors":"Jingxuan Wang ,&nbsp;Danyang Chen ,&nbsp;Yingxin Tang ,&nbsp;Prativa Sherchan ,&nbsp;Jiahui Wang ,&nbsp;Ping Zhang ,&nbsp;Zhouping Tang","doi":"10.1016/j.hest.2024.05.004","DOIUrl":"10.1016/j.hest.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>Acute spontaneous intracerebral hemorrhage (ICH) is a life-threatening condition, and certain serological indicators may be associated with the prognosis after ICH. This study investigated the relationship between N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and other serological indicators with prognosis 90 days after the onset of acute ICH.</div></div><div><h3>Methods</h3><div>The general information, clinical, and follow-up data of patients with ICH who were admitted to the Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2019 to September 2022 were retrospectively collected. Based on the modified Rankin Scale (mRS) at 90 days of onset, the patients were divided into poor prognosis group (mRS &gt; 3) and good prognosis group (mRS ≤ 3), and the differences in various indicators between these two groups were compared. Serological indicators related to prognosis were determined by univariate and multivariate logistic regression analysis, and the predictive value was evaluated by receiver operating characteristic (ROC) analysis and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>A total of 121 patients with ICH were included in the study with 49 patients having a good prognosis and 72 patients having a poor prognosis. Multivariate logistic regression analysis showed that NT-pro-BNP at admission was associated with prognosis at 90 days after ICH onset (<em>P</em> &lt; 0.05). ROC and DCA analyses demonstrated that NT-pro-BNP had a certain predictive ability for ICH prognosis.</div></div><div><h3>Conclusions</h3><div>The level of NT-pro-BNP at admission may be an independent risk factor for predicting prognosis at 90 days after the onset of ICH. The higher the level, the worse the prognosis may be.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 14-18"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrovascular disorders in patients with malignant tumors","authors":"Ozal Beylerli ,&nbsp;Rustam Talybov ,&nbsp;Elmar Musaev ,&nbsp;Tatyana Trofimova ,&nbsp;Huaizhang Shi ,&nbsp;Tatiana Ilyasova ,&nbsp;Valentin Pavlov","doi":"10.1016/j.hest.2024.08.003","DOIUrl":"10.1016/j.hest.2024.08.003","url":null,"abstract":"<div><div>Patients with malignant tumors face an elevated risk of cerebrovascular complications, such as intratumoral hemorrhage, tumor invasion into arterial and venous sinuses, leptomeningeal infiltration, and tumor embolism. This review examines the significant role and implications of cisplatin and radiation therapy in the development of these cerebrovascular complications, which can occur at various stages: before, during, or long after the completion of cancer treatment. Detailed clinical case studies of CNS involvement during oncological therapy are presented to illustrate these complications. The mechanisms by which cisplatin and radiation therapy contribute to cerebrovascular disorders are multifaceted. Cisplatin, a widely used chemotherapeutic agent, is associated with endothelial damage and thromboembolic events, while radiation therapy can cause vascular injury, leading to long-term changes in cerebral vasculature. These treatments, though effective in managing malignancies, pose significant risks to cerebrovascular health. The review underscores the diverse types and mechanisms of stroke encountered in cancer patients, influenced by tumor stage and pathological characteristics. These include ischemic stroke, hemorrhagic stroke, and transient ischemic attacks, each requiring specific diagnostic and therapeutic strategies. The interaction between cancer pathology and cerebrovascular health necessitates a multidisciplinary approach, integrating oncology, neurology, radiology, and vascular surgery. Such an approach is crucial for effective management and prognosis evaluation in this patient population. Early recognition and intervention are paramount to mitigating risks and improving outcomes. By understanding these complex interactions, healthcare providers can better anticipate and manage cerebrovascular risks in patients undergoing cancer treatment. This comprehensive understanding helps in formulating personalized treatment plans, optimizing both oncological and neurological care, and ultimately enhancing patient quality of life and survival rates.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 284-292"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of PARP in secondary brain injury following intracerebral haemorrhage","authors":"Yan Zhang ,&nbsp;Qiuyang Su ,&nbsp;Guofeng Wu ,&nbsp;Nathanael Matei ,&nbsp;Shengling Zeng","doi":"10.1016/j.hest.2024.08.004","DOIUrl":"10.1016/j.hest.2024.08.004","url":null,"abstract":"<div><div>Intracerebral hemorrhage (ICH) represents a significant health challenge due to its high mortality and severe outcomes. Poly (ADP-ribose) polymerase (PARP) is a chromatin-associated nuclear protease, which would be activated by ROS derived from hematoma metabolites after ICH, and lead to parthanatos, a form of caspase-independent programmed cell necrosis. Recent evidence indicates that PARP activation plays a pivotal role in various human diseases, particularly neurodegenerative disorders, cerebral ischemia–reperfusion injury, and hemorrhagic transformation. However, the link between PARP activation and secondary brain injury (SBI) following ICH remains underexplored. This review delves into the pathological mechanisms of PARP activation in cell injury, with a focus on parthanatos, mitochondrial dysfunction, neuroinflammation, and blood–brain barrier (BBB) disruption after ICH. Understanding these processes may offer new insights into the role of PARP activation in ICH and pave the way for developing more effective therapeutic strategies.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 293-298"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quadriparesis with bilateral anterior cerebral artery infarction following subarachnoid haemorrhage due to rupture of an anterior communicating artery aneurysm: A case report with literature review","authors":"Zain Saleh,&nbsp;Farhat Abbas,&nbsp;Ahtesham Khizar,&nbsp;Bakht Nawaz","doi":"10.1016/j.hest.2024.04.001","DOIUrl":"10.1016/j.hest.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cerebral artery (ACA) territory infarctions are relatively rare, accounting for 0.3 % to 4.4 % of stroke cases, with bilateral occurrences being even rarer. These infarctions can lead to quadriplegia/paresis. Bilateral ACA territory infarctions are possibly caused by vasospasm due to subarachnoid haemorrhage (SAH) from ruptured anterior communicating artery (ACoA) aneurysms or thrombosis in the presence of a rudimentary contralateral artery. ACoA aneurysm with quadriparesis is extremely unusual, with this being only the second recorded occurrence and the youngest reported. Overall, understanding the mechanisms and consequences of ACA territory infarctions, especially bilateral occurrences, remains crucial for effective diagnosis and management of such rare but serious neurological events.</div></div><div><h3>Case Presentation</h3><div>A 35-year-old male, previously healthy, presented with quadriparesis and an ACoA aneurysm. Initially experiencing a headache and brief loss of consciousness, he later developed right foot drop and progressive right-sided weakness, leading to altered consciousness. Subsequent imaging revealed SAH consistent with the aneurysm and also bilateral ACA territory infractions. Upon referral for further management, he presented with intact higher mental functions but motor deficits in the upper and lower limbs. Imaging and assessments confirmed the diagnosis, prompting a decision for craniotomy and clipping. Postoperatively, the patient showed improvement, with enhanced power in both upper limbs at one-month follow-up.</div></div><div><h3>Conclusion</h3><div>Bilateral ACA territory infarction is unusual, and the symptoms are not yet well understood. ACoA aneurysm with quadriparesis is extremely unusual. Understanding the mechanics and clinical consequences of bilateral ACA territory infarctions is critical for early detection and management.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 299-302"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain Hemorrhages has specially appointed Professor Wang Yongjun from Beijing Tiantan Hospital as Honorary Editor-in-Chief","authors":"Yingxin Tang","doi":"10.1016/j.hest.2024.07.009","DOIUrl":"10.1016/j.hest.2024.07.009","url":null,"abstract":"","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 303-304"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-term outcomes in stent-assisted coil embolization for ruptured cerebral aneurysms in the acute period: A single institution retrospective review","authors":"Hannaly Cheuk Hang Lui ,&nbsp;Yuen Ting Ng ,&nbsp;Simon Chun Ho Yu ,&nbsp;James Tin Fong Zhuang ,&nbsp;George Kwok Chu Wong","doi":"10.1016/j.hest.2024.06.002","DOIUrl":"10.1016/j.hest.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>The purposes of this study were to retrospectively review mid-term outcomes of stent-assisted coil embolization for acutely ruptured cerebral aneurysms, and to identify risk factors.</div></div><div><h3>Methods</h3><div>Between April 2013 and October 2018, thirty-four consecutive patients had stent-assisted coil embolization for treatment of acutely ruptured cerebral aneurysms that were not amendable by simple coiling. Hospital subarachnoid hemorrhage registry and notes on hospital electronic medical systems were retrospectively reviewed. All patients had a dose of intravenous abciximab 10 mg and heparin 2000 units before stenting and started dual antiplatelet therapy after procedure.</div></div><div><h3>Results</h3><div>Of the thirty-four consecutive patients, twenty-six (76 %) were treated with braided stents and eight (24 %) were treated with laser-cut stents. There was no rebleeding in thirty-two patients who achieved total aneurysmal occlusion or residual neck only. Rebleeding occurred in two patients who only achieved partial embolization, resulting in mortality. There were three (9 %) thromboembolic complications, in which two were ADL-independent upon hospital discharge and the one with WFNS Grade V succumbed. Twenty (59 %) patients achieved clinical favorable outcomes (mRS 0–2) at follow-up (mean+/-SD: 17+/-15 months). The need of EVD insertion was a statistically significant risk factor for procedure-related cerebral infarction, intracerebral hemorrhage and 30-day mortality. The GOS and mRS were closely related to the need of EVD insertion and sidewall location of aneurysm.</div></div><div><h3>Conclusions</h3><div>The study established the efficacy and safety profile of stent-assisted embolization for treatment acutely ruptured cerebral aneurysms. The embolization goal should be total aneurysmal occlusion or with minimal residual neck to prevent rebleeding and reduce mortality. The use of such technique should be considered when simple coiling or microsurgical clipping is not feasible or suitable. The need of EVD insertion is an independent risk factor for intracerebral hematoma and 30-day mortality. When needed, EVD insertion shall be considered before antiplatelet agents, and require exceptionally meticulous hemostasis intraoperatively.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 267-273"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}