Enlighten-Research publications by members of the University of Glasgow http://eprints.gla.ac.uk Minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label phase 3 trial with blinded endpoint

The overall rate of complications related to cranioplasty after craniectomy is not negligible, and certain factors may be associated with increased risk. Therefore, when evaluating the need to perform a large decompressive craniectomy, the surgeon should also be aware that the patient is not only subject to the risks of the initial operation, but also the risks of subsequent cranioplasty.

Analysis of the data in this study indicates that atorvastatin improves neurological recovery after experimental ICH and may do so in part by increasing neuronal plasticity.

Administration of high-dose MgSO4 following aneurysmal SAH is safe, and steady Mg++ levels in the range of 4 to 5.5 mg/dl are easily maintained. This treatment does not interfere with neurological assessment, administration of anesthesia during surgery, or other aspects of clinical care. We observed a trend in which a higher percentage of patients obtained GOS scores of 4 or 5 in the group treated with MgSO4, but the trend did not reach a statistically significant level. A larger study is needed to evaluate this trend further.

Background and Purpose-This study investigates the effects of statin treatment on experimental intracerebral hemorrhage (ICH) using behavioral, histological, and MRI measures of recovery. Methods-Primary ICH was induced in rats. Simvastatin (2 mg/kg), atorvastatin (2 mg/kg), or phosphate-buffered saline (nϭ6 per group) was given daily for 1 week. MRI studies were performed 2 to 3 days before ICH, and at 1 to 2 hours and 1, 2, 7, 14, and 28 days after ICH. The ICH evolution was assessed via hematoma volume measurements using susceptibility-weighted imaging (SWI) and tissue loss using T 2 maps and hematoxylin and eosin (H&E) histology. Neurobehavioral tests were done before ICH and at various time points post-ICH. Additional histological measures were performed with doublecortin neuronal nuclei and bromodeoxyuridine stainings. Results-Initial ICH volumes determined by SWI were similar across all groups. Simvastatin significantly reduced hematoma volume at 4 weeks (Pϭ0.002 versus control with acute volumes as baseline), whereas that for atorvastatin was marginal (Pϭ0.09). MRI estimates of tissue loss (% of contralateral hemisphere) for treated rats were significantly lower (Pϭ0.0003 and 0.001, respectively) than for control at 4 weeks. Similar results were obtained for H&E histology (Pϭ0.0003 and 0.02, respectively). Tissue loss estimates between MRI and histology were well correlated (R