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Background: Subarachnoid hemorrhage (SAH) may be a cause of neurogenic pulmonary edema (NPE). It is well known that lymphatic fluid draining by thoracic duct to lungs consists of many dangerous metabolites, degraded tissue particles, and microbiologic pathogens. However, not enough studies have investigated whether NPE causes septicemia or not. In this study, we retrospectively examined our experimental materials to determine whether there is a meaningful relationship between NPE and cerebral abscess formation., Methods: Forty-two rabbits were divided into 3 groups: Control (n = 5), SHAM (n = 7), and SAH (n = 30) with severe neurogenic lung edema detected in rabbits. The SHAM and SAH groups received 1 mL saline and 1 mL autologous arterial blood into the Sylvian cisterna, respectively. Weight, heartbeat, respiration rate, and blood pressure were recorded by routinely using monitoring devices. All multilevel lungs and brain tissue microsections were examined by stereologic and Cavalier methods. For statistical analysis, NPE criteria and the numbers of abscess or abscess resembling cores in the brains were estimated in all groups and compared. The Mann Whitney-U test was used to analyze the results statistically., Results: All rabbits were around 4 years old; body weight was between 3.94 and 4.5 kg; normal heart rhythm rate was found between 251 ± 39/minutes and 281 ± 30/minutes; and respiration rate was between 24 ± 5/minutes and 36 ± 7/minutes. Histopathologic examinations showed that abscess formations frequently spread in middle cerebral arterial territories of all animals in the NPE-detected rabbits. While average abscess numbers were estimated as 3 ± 1 in 7 animals (n = 7; P < 0.005) in severe NPE-detected rabbits, only 1 ± 1 abscess core was detected in a less severe NPE that developed in 3 (n = 3; P < 0.05) animals. The vasospasm index values of pulmonary arteries (PAs) of all animals were 1.233 ± 0.065 in the control group; 1.567 ± 0.0430 in the SHAM group, and 2.890 ± 0.0453 in the SAH group (P < 0.05)., Conclusions: This experimental study showed that NPE is a relatively common pathology following experimental SAH in rabbits. The NPE is frequently complicated with brain abscess as shown in this study. The pathophysiologic mechanism was concluded, as NPE may be responsible for cerebral abscess development via bacteria/cytotoxic particles conveyed by thoracic duct to lungs and transferred from the ruptured alveoli-capillary membrane to the brain by way of systemic circulation., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The cervical segment of an internal carotid artery (cICA) usually has a straight vertical course without any branching. In the present study, variations of the cICA were evaluated based on the three-dimensional volume-rendered neurovascular images. The computed tomography angiography images of 56 patients diagnosed with subarachnoid hemorrhage (SAH) were evaluated retrospectively. Two separate researchers, blinded to each other and clinical information of the patients, evaluated the courses of cICA bilaterally. The variations were classified as tortuosity, kinking, and coiling. A total of 112 cICA segments of 56 patients were evaluated. The cICA variations were present in 21.4% of patients and 17.9% of segments. There was tortuosity in 5 (8.9%) patients, kinking in 4 (7.1%) patients, and coiling in 6 (10.7%) patients. Of 41 patients with aneurysmal SAH, there were a cICA variation in 8 (19.5%) patients. A cICA variation was detected in 4 (26.7%) of 15 patients with idiopathic SAH. The cICA variation ratio in SAH patients was concordant with studies performed in different patient groups. Although the ratio was slightly higher in idiopathic SAH patients, there was no statistical significance between the aneurysmal and idiopathic SAH groups. The coiling was more frequent in SAH patients compared to previous studies. The cICA variations tend to be bilateral in SAH patients. [ABSTRACT FROM AUTHOR]

Background/aim: Cerebral vasospasm is a term that refers to prolonged, slowly progressing but reversible pathological narrowing of cerebral arteries occurring several days after subarachnoid hemorrhage (SAH), usually accompanied by a decrease in perfusion distal to the affected artery. Leptin is an endogenous polypeptide hormone that can be carried freely and bound to protein in the blood. Materials and methods: We investigated the superiority of topical application of leptin that may make a contribution to the development of new treatment modalities for unconscious patients in brain injury intensive care units and its preventive effect, which is considered to have multifactorial pathogenesis on cerebral vasospasm occurring after SAH via stereological studies of the basilar artery. Results: When mean serum leptin levels of the groups were compared, statistically significant differences were observed between the control and topical leptin-treated groups in favor of the treated groups with respect to serum leptin levels (P < 0.05). In the topical leptin-applied group, a significant difference in favor of vasodilatation was observed in the measurements of the basilar artery luminal area (P < 0.05). Conclusion: In accordance with the results, the topical administration of leptin can be used in the prevention of vasospasm, especially in unconscious patients with subarachnoid hemorrhage. [ABSTRACT FROM AUTHOR]

Introduction: We present a rare clinical condition of concomitant spinal subdural hematoma and cranial subarachnoid hemorrhage (SAH) related to oral anticoagulant therapy. Case Report: In this report, we present the case of a 78 -year- old female who was brought by an ambulance to the emergency department with sudden onset neurological deficit, which was eventually diagnosed as a simultaneous spinal subdural hematoma and SAH. Conclusion: The coagulation profile of patients should be screened in the context of anticoagulant therapy in appropriate or short time periods; an early clinical intervention will result in a greater likelihood of the patient's recovery. [ABSTRACT FROM AUTHOR]