Cerebral Infarction Risk Post-Anterior Circulation Aneurysm Rupture

| Posted in: Science

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Risk Prediction of Cerebral Infarction after Anterior Circulation Aneurysm Rupture in an Under-Equipped Centre
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Vayara Perumall VINODH, Abdul Rahman Izaini GHANI, Regunath KANDASAMY, Pulivendhan SELLAMUTHU, Mohd Sofan ZENIAN, Thamron KEOWMANI


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Risk Prediction of Cerebral Infarction after Anterior Circulation Aneurysm Rupture in an Under-Equipped Centre

Year: 2022 | Doi: 10.21315/mjms2022.29.2.5

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

Aneurysmal subarachnoid hemorrhage (SAH) poses significant risks, including high morbidity and mortality rates stemming from complications such as cerebral infarction (CI) and vasospasm. Although prediction tools exist for assessing high-risk patients, many are complex, limiting their routine application in neurosurgical centers. This highlights the necessity for a simpler, more accessible predictive model that can help identify patients at elevated risk for CI to initiate early preventive treatment.

Development of the VINODH Score

The study presented the VINODH score (VS), a new predictive model specifically designed to identify patients at high risk for cerebral infarction following aneurysmal SAH. In a single-center retrospective analysis involving 200 patients, four significant predictors were identified: female gender, presence of hydrocephalus requiring cerebrospinal fluid diversion, poor Fisher's exact test grade, and poor World Federation of Neurosurgical Societies (WFNS) score. The VS demonstrated high sensitivity (79%) and specificity (83%) for predicting the onset of CI, making it a reliable tool for clinical use. The model's effectiveness was further validated through an area under the receiver operating characteristic curve (ROC) of 0.902, indicating its robustness in risk stratification.

Conclusion

The VINODH score serves as a valuable and straightforward instrument for early identification of patients at risk of developing cerebral infarction after aneurysmal SAH. Its implementation could significantly enhance preventive strategies within under-resourced neurosurgical centers, ultimately improving patient outcomes. Future studies are needed to validate this score across diverse settings and patient populations, increasing its applicability and reliability in clinical practice.

FAQ section (important questions/answers):

What are the common complications after an aneurysm rupture?

After an aneurysm rupture, common complications include vasospasm and cerebral infarction (CI). These complications result in high morbidity and mortality rates, even among those who survive the initial rupture.

What is the VINODH score and its purpose?

The VINODH score (VS) is a simple predictive model designed to identify high-risk patients for developing cerebral infarction after aneurysmal subarachnoid hemorrhage, aiming to facilitate early preventive treatment.

How many patients were included in the study for the VINODH score?

The study included a total of 200 patients who had anterior circulation aneurysm ruptures and underwent surgical clipping. This sample provided enough data to develop the predictive model effectively.

What factors were identified as significant predictors for CI?

Significant predictors for cerebral infarction (CI) included female gender, presence of hydrocephalus requiring drainage, poor Fisher's exact test grade, and poor WFNS score, which were crucial for the development of the VINODH score.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Cerebral Infarction Risk Post-Anterior Circulation Aneurysm Rupture”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
Table serves as a systematic organization of data, presenting it in rows and columns for easy reference. In the context of the provided text, tables summarize research findings, allow for quick comparisons and enhance the understanding of complex statistical relationships, which are crucial in medical research presentations.

2) Study (Studying):
Study refers to the detailed investigation and analysis of a particular subject or issue. In medical research, it encompasses the methods and results derived from experiments or observations. The integrity of a study directly impacts the validity of findings, contributing to advancements in healthcare practices and theories.

3) Pur:
Poor signifies a lack of quality, effectiveness, or desirability. In medical contexts, it is often used to describe unfavorable outcomes, health conditions, or prognoses. Recognizing poor states helps healthcare professionals identify high-risk patients, as seen in scoring and assessments related to cerebral infarction post-subarachnoid hemorrhage.

4) Developing:
Developing refers to the process of growth, evolution, or progression toward a more advanced state. In research contexts, it often signifies the formulation of new models or methodologies. For instance, developing a predictive score aids in identifying high-risk patients, enhancing targeted treatments and improving patient outcomes.

5) Blood:
Blood is a vital bodily fluid containing cells, nutrients, hormones, and waste products. In medical literature, its characteristics and behavior can significantly affect health conditions, treatments, and prognosis. Understanding blood dynamics is crucial, particularly in conditions resulting from aneurysms or hemorrhages, as it relates to cerebral perfusion.

6) Gupta:
Gupta is a surname, often associated with individuals contributing to scientific research or literature. In the context of the article, it likely references a co-author involved in studying aneurysmal subarachnoid hemorrhage. The contributions of specific researchers enhance credibility and enrich academic discourse within a field.

7) Rules:
Rules denote guidelines or established norms that govern behavior or practices. In medical research, rules can dictate procedures for patient assessments, treatments, and data analysis. Adhering to these rules ensures consistency, reproducibility, and ethical standards, which are critical to advancing medical knowledge and patient safety.

8) Post:
Post refers to the period after an event or intervention. In healthcare, post often relates to follow-up assessments or evaluations after surgical procedures or treatments. Understanding post-operative or post-event conditions is essential for monitoring patient recovery, optimizing therapeutic strategies, and preventing complications, thereby improving overall care.

9) Male:
Male signifies biological sex, typically characterized by XY chromosomes and associated with certain physiological traits. In research contexts, differentiating between male and female patients is vital for understanding disease prevalence, risk factors, and treatment responses, as evident in studies examining outcomes related to aneurysmal subarachnoid hemorrhage.

10) Education:
Education encompasses the systemic process of acquiring knowledge, skills, and competencies. In medical fields, continuous education is vital for clinicians to stay updated with the latest practices and emerging research findings. Enhanced education contributes to improved patient care and effective application of new models or scoring systems.

11) Repair:
Repair refers to the restoration of structures or functions following damage or injury. In surgical contexts, repairing can involve techniques such as clipping an aneurysm to prevent further bleeding. Understanding repair processes is essential for improving surgical outcomes and reducing complications associated with cerebrovascular conditions.

12) Edema (Oedema):
Oedema is the medical term for swelling caused by excess fluid trapped in the body's tissues. In the context of cerebral conditions, especially after hemorrhage, it can significantly affect neurological functions. Proper identification and management of oedema are crucial to alleviate pressure and improve patient outcomes.

13) Sharman (Sarma, Sharma, Sarman):
Sharma is a common surname, potentially referring to an author or researcher involved in the study of aneurysmal subarachnoid hemorrhage. Individual scholars' work contributes significantly to advancing medical knowledge, emphasizing the collaborative nature of research in identifying risk factors and developing predictive models for better patient management.

14) Pluta:
Pluta is another surname, likely referring to a co-author of research related to cerebrovascular issues. The inclusion of various authors signifies the collaborative efforts required in medical research to multilaterally address complex conditions, ensuring diverse expertise is leveraged for comprehensive understanding and innovation in treatment practices.

15) India:
India refers to a country known for its diverse population and complex healthcare challenges. In research contexts, it may highlight regional studies or clinical practices. Understanding unique demographic characteristics, social determinants, and healthcare infrastructure in India can inform targeted interventions like those involving aneurysms and subarachnoid hemorrhages.

16) Field:
Field denotes a specific area of study or profession. In medicine, various fields can encompass specialties like neurosurgery, which focuses on treating conditions such as aneurysms and cerebrovascular issues. Understanding distinct fields allows for specialization in addressing unique challenges, ultimately leading to better patient outcomes and advancements.

17) Dabu:
Dabu likely refers to a researcher involved in the study of cerebral vasospasm and aneurysmal hemorrhage. Individual researchers like Dabu contribute crucial insights that help shape understanding and management strategies in neurosurgery, emphasizing the importance of collaborative work to advance medical knowledge and improve patient care.

18) Sah:
Shah is a surname representing a researcher or author within the clinical study. Contributions from individuals like Shah in the investigation of aneurysms and their associated conditions enhance the understanding of risk factors and enable the development of effective predictive models, which can improve treatment protocols in healthcare.

19) Sign:
Sign refers to an indicator or observable phenomenon related to a medical condition. In neurosurgery, recognizing specific signs post-rupture is crucial for early intervention and management. Understanding signs associated with conditions like cerebral infarction can lead to timely and appropriate preventive measures to mitigate risks among patients.

20) Horn:
Horn can refer to anatomical structures, such as the frontal horns in brain imaging, or be a term used to describe a specific area of study. In neurological assessments, recognizing the significance of horn structures can guide diagnostic evaluations, treatment decisions, and help predict complications post-surgery.

21) Road:
Road metaphorically represents the path taken in research or medical interventions. Following a clear roadmap in the study allows researchers to identify obstacles, solutions, and the potential for advancements. Establishing a structured approach is vital for meaningful outcomes in neurological studies, leading to improved patient risk assessments.

22) Pain:
Pain is a subjective experience of discomfort arising from injury or illness. In medical contexts, understanding pain mechanisms is crucial for patient management. Effective pain assessment and management strategies can directly affect treatment outcomes in patients recovering from conditions like aneurysms and post-operative complications.

23) Chan:
Chan is typically a surname linked to contributors in medical research. The work by individuals such as Chan adds depth to studies on cerebrovascular issues, emphasizing the collaborative efforts that enrich the scientific community's understanding, foster innovation, and improve clinical practices in managing complex health conditions.

24) Life:
Life represents the biological and experiential existence of individuals. In medicine, life expectancy, quality of life, and life-altering conditions are significant considerations. Understanding how conditions such as aneurysmal SAH impact life is key for developing treatment plans that prioritize both survival and quality outcomes for patients.

25) Controversy:
Controversy refers to disputes or disagreements surrounding a specific subject. In medical research, controversies often arise regarding treatment efficacy or diagnostic approaches, such as those dealing with aneurysms. Engaging with these controversies can stimulate advancements by challenging existing views and promoting better evidence-based practices.

26) Observation:
Observation is the act of monitoring or examining subjects for data collection. In clinical research, careful observation is essential for diagnosing conditions, assessing treatment outcomes, and informing patient care strategies. Effective observations lead to better understanding of disease mechanisms and improvement in healthcare practices.

27) Discussion:
Discussion involves the exchange of ideas or analysis of findings, crucial in academic writing. In research contexts, discussions help contextualize results, draw conclusions, and suggest implications for clinical practice. Engaging discussions enhance scientific dialogue, ultimately leading to further innovation and refinement of treatment guidelines in healthcare.

28) Dividing:
Dividing refers to the act of separating or categorizing items based on specific criteria. In medical research, it can involve categorizing patients by risk levels or health outcomes. Proper dividing techniques ensure tailored interventions, advancing personalized care approaches, especially in conditions like subarachnoid hemorrhage.

29) Channel:
Channel can refer to a pathway through which something flows, such as blood through vessels. Understanding the channels of blood flow is vital in neurology for managing conditions like vasospasm or cerebral infarction. Disruptions in normal channels can significantly affect patient care and treatment outcomes.

30) Queen:
Queen may refer to a specific institution, possibly linked to a hospital or healthcare center involved in the study. Hospitals named after queens often hold historical significance and serve as critical healthcare providers, impacting community health outcomes by leading advancements in medical research and practices.

31) Beta:
Beta can refer to a variant of a variable typically used in statistical analysis. In medical research, beta values often pertain to coefficients in regression models that indicate variable influence. Understanding the significance and implications of beta values helps refine forecasting and predictive tools in healthcare.

32) Mash (Mas):
Mash typically refers to a process in brewing, but in medical contexts like the acronym MASH, it could represent specific treatment protocols or studies. Understanding such terms enhances clarity in discussing methodologies or therapeutic approaches that contribute to improving management strategies in various clinical situations.

33) Coma:
Coma signifies a state of prolonged unconsciousness, often resulting from severe brain injury or issues such as subarachnoid hemorrhage. Understanding different states of coma is vital in determining prognosis and treatment options. Identifying potential outcomes of comatose states informs critical care practices and decision-making processes.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Cerebral Infarction Risk Post-Anterior Circulation Aneurysm Rupture’. Further sources in the context of Science might help you critically compare this page with similair documents:

Blood flow, Mortality, Statistical analysis, External validation, Inclusion criteria, Exclusion criteria, Study population, Multivariate analysis, Demographic Data, Blood brain barrier, Preventive treatment, Morbidity and Mortality, Research design, Neurological Deficit, Non-invasive method, Apoptosis, Early intervention, Diagnostic accuracy, Inflammatory processes, Cerebral blood flow, Magnesium sulfate, Preventive management, Haematocrit, Glasgow Coma Scale, Hyponatremia, Hypervolemia, Metabolic issues, Vasospasm, Cerebral infarction, Subarachnoid hemorrhage, Clinical outcome, Cerebrospinal Fluid (CSF), Modified Rankin Scale, Hydrocephalus, Cerebral vasospasm, Fresh frozen plasma, Predictive Model, Clinical parameter, Risk score, Magnesium, Subarachnoid haemorrhage, Transcranial Doppler, Binary Logistic Regression, Cerebral infarct, Clinical symptom, Intracranial aneurysm, Neurosurgeon, Cerebral perfusion, Retrospective data collection, Hypoperfusion, Pulmonary oedema, High risk patient, Risk predictors, Receiver Operating Characteristic, Intracerebral haemorrhage, Surgical problem, Vasopressors, Phenylephrine, Cerebral ischaemia.

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