RESUMEN

Introduction: Apathy is a frequent and debilitating condition among subarachnoid hemorrhage (SAH) survivors. Few studies have evaluated apathy in SAH, and none have examined the course of the condition, predictors of persistent apathy, or its impact on functional outcomes. The proposed study will examine, for the first time, the 12-month course of apathy and its impact on functional outcomes in the largest cohort of SAH survivors to date. Methods and analysis: The current study is designed as a prospective cohort study with a duration of 36 months. We will recruit 240 participants. A trained research assistant will assess apathy using the Apathy Evaluation Scale 3 months after SAH. Patients' level of functioning, comorbidity, global cognitive functioning, and depressive symptoms will be assessed. All SAH patients will participate in follow-up assessments of apathy and functioning at 9 (T2) and 15 months (T3) post-SAH or at 6 and 12 months after the first assessment. Predictors of persistent apathy and the impact of apathy on functional outcomes will be examined. Discussion: This will be the first large-scale 1-year follow-up study of apathy in SAH survivors. The findings will provide valuable data to advance our understanding of the clinical course of apathy in this population. Moreover, the results will have clinical relevance by providing essential information to patients, caregivers, and clinicians; promoting the evaluation of apathy; and facilitating the development of prevention strategies, rehabilitation programs, and therapeutic options. Ethics and dissemination: Ethical approval for this study was obtained from the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CREC Ref. No.: 2023.339) on 3 October 2023. The findings of this study will be shared through publication in a peer-reviewed journal, presentations at relevant conferences, and dissemination through social media platforms.

Asunto(s)

RESUMEN

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.

Asunto(s)

RESUMEN

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.

Asunto(s)

RESUMEN

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.

Asunto(s)