Aneurysmal subarachnoid hemorrhage during pregnancy: a comprehensive and systematic review of the literature

Beighley, Adam; Glynn, Ryan; Scullen, Tyler; Mathkour, Mansour; Werner, Cassidy; Berry, John F.; Carr, Christopher; Abou‐Al‐Shaar, Hussam; Aysenne, Aimee; Nerva, John D.; Dumont, Aaron S.

doi:10.1007/s10143-020-01457-2

Cited by 9 publications

(16 citation statements)

References 61 publications

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“…The food intake score and neurological dysfunction score of the experimental group showed a decreasing trend. The possible reason was acute vasospasm caused by surgical modeling, which did not cause long-term serious neurological symptoms and excluded delayed vasospasm but also did not exclude the existence of cerebral circulation compensation [ 12 ]. At 1 h, 6 h, 24 h, and 72 h after SAH, the CBV and CBF values of the experimental group were lower than those of the sham operation group, and the MTT value was higher than that of the sham operation group, indicating that the rabbit SAH model caused reversible and irreversible ischemic injury, which was consistent with the experimental requirements.…”

Section: Experimental Data Analysismentioning

confidence: 99%

The Role of ET-1 in Early Cerebral Microcirculation Changes after Subarachnoid Hemorrhage

Qin

Wang

Xie

et al. 2022

Journal of Healthcare Engineering

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Subarachnoid hemorrhage (SAH), especially aneurysmal subarachnoid hemorrhage, is a serious cerebrovascular disease with high mortality and morbidity. However, there is no effective treatment in clinics. In recent years, more and more studies have shown that early brain injury (EBI) may be an important reason for poor prognosis of SAH. Explore the mechanism of early brain injury after subarachnoid hemorrhage (SAH). In this study, 20 male New Zealand white rabbits were selected and divided into the experimental group and sham operation group, with 10 rabbits in each group. The neurobehavioral scores, food intake, and cerebral perfusion parameters, cerebral blood volume (CBV), cerebral blood flow velocity (CBF), ET-1, IL-1, and IL-6, in rabbit plasma were compared. The food intake scores and neurological dysfunction scores of the experimental group at 1 h, 6 h, 24 h, and 72 h after modeling were higher than those of the sham operation group, which had a statistical significance ( P < 0.05 ). The dysfunction scores all showed a gradual decrease; the CBV and CBF values of the experimental group at 1 h, 6 h, 24 h, and 72 h after modeling were all lower than those of the sham operation group, which had a statistical significance ( P < 0.05 ), and the MTT values were all higher than that of the sham operation group, which had a statistical significance ( P < 0.05 ). The TTP values of rats in the experimental group were higher than those in the sham operation group at 6 h, 24 h, and 72 h after modeling ( P < 0.05 ), the experimental group was in the modeling. The levels of serum ET-1, IL-1, and IL-6 at 1 h, 6 h, 24 h, and 72 h were higher than those in the sham operation group, which had a statistical significance ( P < 0.05 ). New Zealand white rabbits can have brain perfusion volume disorder, inflammatory reaction, and cerebral vasospasm in the early stage after SAH, and brain injury can appear in the early stage.

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Section: Experimental Data Analysismentioning

confidence: 99%

The Role of ET-1 in Early Cerebral Microcirculation Changes after Subarachnoid Hemorrhage

Qin

Wang

Xie

et al. 2022

Journal of Healthcare Engineering

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“…100 Hemorrhagic maternal stroke can occur secondary to rupture of pre-existing vascular lesions such as AVMs and cerebral aneurysms. 78,79 Various vasculopathies can cause maternal stroke. Reversible cerebral vasoconstriction syndrome (RCVS) is a common etiology of maternal stroke, and most commonly occurs postpartum.…”

Section: Pregnancymentioning

confidence: 99%

“…The increase in intravascular volume and cardiac output during pregnancy may worsen the condition of patients with pre-existing heart disease, contributing to increased risk of cardioembolic events including stroke [ 77 ]. These hemodynamic changes can also lead to increased hemodynamic stress on the arterial wall, and although controversial, it may affect the enlargement and increased rupture risk of arteriovenous malformations (AVMs) and cerebral aneurysms [ 78 , 79 ] or the development of dissection [ 80 ]. The major vascular change during pregnancy is vasodilation of the systemic vasculature, which causes a decrease in systemic vascular resistance and promotes venous stasis [ 76 ].…”

Section: Risk Factors ( Figure 1 )mentioning

confidence: 99%

“…In a recent cohort study, of the women who experienced ICH during pregnancy and the postpartum period, approximately one-third (35.3%) had preeclampsia/eclampsia, and 9.2% had coagulopathy [ 100 ]. Hemorrhagic maternal stroke can occur secondary to rupture of pre-existing vascular lesions such as AVMs and cerebral aneurysms [ 78 , 79 ].…”

Section: Risk Factors ( Figure 1 )mentioning

confidence: 99%

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Stroke in Women: A Review Focused on Epidemiology, Risk Factors, and Outcomes

Yoon

Bushnell

2023

J Stroke

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Stroke is a particularly important issue for women. Women account for over half of all persons who experienced a stroke. The lifetime risk of stroke is higher in women than in men. In addition, women have worse stroke outcomes than men. Several risk factors have a higher association with stroke in women than in men, and women-specific risk factors that men do not have should be considered. This focused review highlights recent findings in stroke epidemiology, risk factors, and outcomes in women.

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“…In the nonpregnant population, subarachnoid hemorrhage (SAH) is most commonly due to rupture of intracranial aneurysms and can result in severe disability or death, depending on the severity of the initial bleed. 54 Pregnancyassociated SAH is more often seen in the setting of RCVS, as discussed below, and tends to occur over the cerebral convexities, with a substantially better prognosis compared to aneurysmal SAH. 55,56 Reversible Cerebral Vasoconstriction Syndrome RCVS is a syndrome of transient, multifocal, segmental nonvasculitic vasospasm of the large and medium-sized cerebral arteries, typically presenting with recurrent thunderclap headaches with or without associated neurologic deficits.…”

Section: Subarachnoid Hemorrhagementioning

confidence: 99%

Maternal Stroke Associated With Pregnancy

Miller¹

2022

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW: This article summarizes current knowledge of the epidemiology, pathophysiology, prevention, and treatment of cerebrovascular disease in pregnant and postpartum women.RECENT FINDINGS: Stroke is a leading cause of maternal morbidity and mortality, and most fatal strokes are preventable. Adaptive physiologic changes of pregnancy, including hemodynamic changes, venous stasis, hypercoagulability, and immunomodulation, contribute to increased maternal stroke risk. The highest-risk time period for maternal stroke is the immediate postpartum period. Migraine and hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, are major risk factors for maternal stroke. Adverse pregnancy outcomes, including gestational hypertension, preeclampsia, preterm delivery, and fetal growth restriction, are important risk factors for cerebrovascular disease later in life.SUMMARY: Many catastrophic maternal strokes could be avoided with targeted prevention efforts, early recognition of warning signs, and rapid evaluation of neurologic symptoms. Neurologists play a central role in the care of pregnant patients with cerebrovascular disease, whether acute or chronic, and should be familiar with the unique and complex physiology of pregnancy and its complications, particularly hypertensive disorders of pregnancy.

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Aneurysmal subarachnoid hemorrhage during pregnancy: a comprehensive and systematic review of the literature

Cited by 9 publications

References 61 publications

The Role of ET-1 in Early Cerebral Microcirculation Changes after Subarachnoid Hemorrhage

The Role of ET-1 in Early Cerebral Microcirculation Changes after Subarachnoid Hemorrhage

Stroke in Women: A Review Focused on Epidemiology, Risk Factors, and Outcomes

Maternal Stroke Associated With Pregnancy

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