The Time Course of Cognitive Deficits in Experimental Subarachnoid Hemorrhage.

Subarachnoid hemorrhage (SAH) is a devastating stroke type. Approximately 50% of survivors suffer from the permanent disability, caused by the cognitive deficits. To enrich the pre-clinical research on the neurological deficits after SAH, we investigate the temporal cognitive deficits and the longitudinal course of cognitive recovery in endovascular perforation SAH murine model. The SAH mice show reproducible body weakness and headache-symbolized moaning symptoms, which is closed to clinical patients. SAH mice exhibit significantly impaired cognitive function in domains of learning ability, short-term and long-term memory. The cognitive deficits occur mostly in the early phase and recover gradually till day 10 after SAH. The systematical assessments of cognitive function after experimental aneurysmal SAH elucidate the time course of cognitive deficits and provide the time window of potential interventions.

Long-term outcomes of ruptured cerebral arteriovenous malformations in the paediatric population: A retrospective review in a regional hospital in Hong Kong.

The objective of the study is to evaluate the management outcomes of ruptured cerebral arteriovenous malformations (bAVMs) in the paediatric population in a regional hospital in Hong Kong. We performed a retrospective review between 1 January 1999 and 31 December 2017 for ruptured bAVM in a regional neurosurgical centre in Hong Kong. All other vascular pathologies and unruptured cases were excluded. Thirty-three eligible patients were included for analysis. The median age at presentation was 12 (3-18), with a slight male preponderance. Presenting complaints included headache (60.6%), motor deficits (24.2%), and seizure (6.1%). Glasgow coma scale (GCS) on presentation (median, IQR) was 15 (13-15). bAVMs were lobar in 57.6%, infratentorial in 27.3%, and basal ganglia in 9.1%. Follow-up was 101 ±â€¯61 months and ranged from 24 to 229 months. 12 (36.4%) patients underwent emergency haematoma evacuation with or without bAVM excision because of neurological deterioration in the acute phase. 7 (21.2%) patients underwent interval excision and 11(33.3%) patients underwent stereotactic radiosurgery (SRS). There was no residual bAVM and no Clavien-Dindo complications greater than grade II in interval surgery group. Those who underwent SRS had a significantly higher Spetzler-Martin grade; bAVM obliteration was achieved at 73.3%, without any major symptomatic post-radiosurgery complications. There was 1 (3%) mortality and 30 (90.9%) patients recovered well with minor non-disabling deficits (GOS 5). For paediatric patients with ruptured bAVM, a satisfactory management outcome can be achieved with careful patient selection for surgery and radiosurgery.

Endovascular Perforation Murine Model of Subarachnoid Hemorrhage.

Subarachnoid hemorrhage (SAH) is a subtype of stroke with disastrous outcomes of high disability and mortality. A variety of endeavors have been developed to explore a SAH animal model for investigation of the disease. Among these models, the endovascular perforation SAH model was considered to be the most simulative to the clinical human SAH because it reproduces several pathophysiology procedures and presents some of the most important post-hemorrhage features. An applicable SAH animal model should have the characteristics of low mortality rate, limited surgical manipulation, and adaptation to many species, which permits reproducibility and standardization. An intensive discussion of how to improve the techniques and refine the procedure has taken place in the last decade. This report describes our experiences with a murine model of SAH. We aim to standardize and optimize the procedures to establish a relatively stable animal model for SAH research.