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Purpose: Cerebral vasospasm occurs frequently after aneurismal subarachnoid haemorrhage (SAH) and is a dangerous complication. Only a few cases of cerebral vasospasm after intracerebral haemorrhage (ICH) have been reported. To determine the incidence of vasospasm, the authors of this study
evaluated the participants’ digital subtraction angiographies (DSA) after these patients had experienced ICH. Materials and methods: Sixty patients with ICH (26 women and 34 men between 20 and 69 years of age, mean age 49.6 years ± 13.9 SD) who underwent cerebral arteriography were included in this study. Cerebral vasospasm was graded as mild (up to 25% of vessel narrowing), moderate (26-50% of vessel narrowing), and severe (more than 50% of vessel narrowing). Results: Vasospasm of the ipsilateral middle cerebral artery (MCA) to the ICH was found in 13 patients (21.6%), the ipsilateral anterior cerebral artery (ACA) in 4 patients, and the posterior cerebral artery (PCA) in one patient. Two patients had a spasm of the contralateral MCA. Severe MCA spasm was found in 3 patients, moderate in 5, and mild in 5. All cases of ACA and PCA spasms were assessed as mild. Conclusions: Cerebral vasospasm is a rather frequent finding in patients who have just experienced ICH. Therefore, practitioners need to assess and monitor the status of the cerebral vasculature in these patients.
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40 adult Wistar rats were divided into two groups depending on the applied anaesthesia. In both groups animals were generally anaesthetized with fentanyl, dehydrobenzperidol administered intraperitoneally and midazolam given intramuscularly. In the second group (SEVO) animals received
sevoflurane of 2.2 vol% end-tidal concentration. Intracerebral haematoma was produced through infusion of 100 µl of autologous blood into the striatum. Each group was divided into five subgroups depending on the length of survival period: 1, 3, 7, 14, 21 days. The astrocytic population was studied by means of anti-GFAP staining. Stereological analysis was applied to estimate the numerical density of immunoreactive cells and the distribution of their types. On 7th day of observation the density of GFAP-immunoreactive astrocytes in SEVO was lower (p<0,05) than that in the control group. In the control group, the increase (p<0.05) of per cent of activated astrocytes between the 1st and 3rd survival day was noted, which remained at this level till the end of observation. In SEVO group, the increase (p<0.05) of per cent of activated astrocytes between the 3rd and 7th day and the decrease (p<0.05) between the 14th and 21st survival day were observed. During days of observation the per cent of activated astrocytes was lower (p<0.05) in the SEVO group than that in the control group. Administration of sevoflurane during anaesthesia to animals with intracerebral haemorrhage has evoked not only the delay of the activation of astrocytes but also decrease in its level.
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Intracerebral haematoma was produced in 25 adult rats by infusion of 100 µl of autologous blood into the striatum. The animals’ brains were removed at 1, 3, 7, 14 and 21 days after production of the haematoma. The TUNEL method was used to detect DNA fragmentation and TUNEL-positive cells were
qualified. TUNEL-positive cells were already found on the first day of observation and were present for three weeks after haematoma production. These results provide evidence that programmed cell death is associated with intracerebral haemorrhage.
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Spontaneous intracerebral haemorrhage carries a high mortality rate and treatment of the disease raises more questions then answers. Mass effect, ischaemia and toxicity of blood components are responsible for brain tissue damage. Initially occurring disturbances of cerebral blood flow have a
temporary character and do not play a key role in the pathology of intracerebral haematoma. Oedema formatting in the 24–48 hours after intracerebral bleeding is the result of multidirectional processes. The pathological mechanism that underlines it is the function of activation of systemic complement and cascade of coagulation. In the light of these findings, further clinical and experimental investigations should be focused on these factors.
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The management of intracerebral hemorrhage (ICH) requires prompt diagnostic assessment and recognition. Accurate localization and categorization of ICH-type is crucial. There are two main categories of ICH: 1) hemorrhagic stroke (HS), which occurs in the deeper or subcortical regions of the
brain, where the arterial network tapers to fine end-arteries, and, 2) cerebral amyloid angiopathy hemorrhage (CAAH), which occurs at the superficial or cortical-subcortical region of the grey and white matter junction. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most used imaging tools in diagnosing ICH. However, availability, time, and cost often prevent emergent MRI use. Therefore, CT remains the primary tool in the diagnosis of ICH. The assessment of imaging studies is time-dependent, and a radiologist should do a detailed diagnostic evaluation. Human error can occur in a pressured clinical setting, even for highly trained medical professionals. Assisted or automated computer-aided analysis of CT/MRI may help to reduce the assessment time, improve the diagnostic accuracy, better differentiate between types of ICH, and reduce the risk of human errors. This review evaluates CT and MRI’s role in distinguishing between the two varieties of ICH-HS and CAAH. It focuses on how CT could be utilized as the preferred diagnostic tool. In addition, we discuss the role of automation using machine learning (ML) and the role or advantages of ML in the automated assessment of CT for the detection and classification of HS and CAAH. We have included our observations for future research and the requirements for further evaluation.
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Human adipose-derived stem cells (huADSC) were generated from fat tissue of a 65-year-old male donor. Flow cytometry and reverse transcription polymerase chain reaction (RT-PCR) analyses indicated that the huADSC express neural cell proteins (MAP2, GFAP, nestin and β-III tubulin),
neurotrophic growth factors (BDNF and GDNF), and the chemotactic factor CXCR4 and its corresponding ligand CXCL12. In addition, huADSC expressed the characteristic mesenchymal stem cell (MSC) markers CD29, CD44, CD73, CD90, CD105 and HLA class I. The huADSC were employed, via a right femoral vein injection, to treat rats inflicted with experimental intracerebral hemorrhage (ICH). Behavioral measurement on the experimental animals, seven days after the huADSC therapy, showed a significant functional improvement in the rats with stem cell therapy in comparison with rats of the control group without the stem cell therapy. The injected huADSC were detectable in the brains of the huADSC treated rats as determined by histochemistry analysis, suggesting a role of the infused huADSC in facilitating functional recovery of the experimental animals with ICH induced stroke.
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