Citations 4
A Rat Model of Second Impact Syndrome in Diffuse Traumatic Brain Injury: Evidence of Facial Hypersensitivity, Neurological and Other Behavioral Alterations, and Immunological and Histopathological Tissue Changes
Aragão, Ana Carolina A., Santos, Vito Thayson dos, Alencar, Denise, Mendes, Gabriel Cury Batista, Pontes, Lucca de, Sanchez-Garavito, Emiliano, Wilding, Hannah , Lima, Roberto C.A., Nobre, Lívia Maria Soares , Melo, Juliana, Oliveira, Denise Nunes , Rolim, Adriana, Filho, Leonardo de Macêdo , Mendes, Gabrielle, Bhanja, Debarati , Lima, Roberto Cesar, Melo, Juliana, Shlobin, Nathan A. , Sessle, Barry J. , Hawryluk, Gregory W. J.
No container title available | August 21, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Traumatic brain injury (TBI) can lead to chronic complications, including headache and facial hypersensitivity. Second-impact syndrome (SIS), occurring when a second TBI precedes recovery from an initial injury, often causes severe long-term symptoms. Neuroinflammation is implicated, but the comprehensive pathophysiology of SIS remains unclear. This study characterized neurological/behavioral outcomes, facial nociception, plasma inflammatory markers, and central nervous system (CNS) histopathology in rat models of SIS and single mild TBI. Female Wistar rats (n = 6/group) were assigned to naïve control, sham surgery, single impact (TBI), or double impact (SIS; intervals: 1h, 24h, 3d, 7d, 14d). Mild TBI was induced using a modified Marmarou weight-drop model. Assessments (facial mechanical sensitivity via von Frey, Neurological Severity Scale (NSS), Neurobehavioral Scale (NBS)) were performed pre-injury and on days 1,3,5,7 post-injury. Plasma IL-6 and TNF-α were measured by ELISA. Histopathology (H&E) assessed CNS inflammation. All impact groups developed transient facial mechanical allodynia and acute neurobehavioral deficits (impaired NSS/NBS at day 1). SIS groups, particularly with longer intervals (≥ 24h), exhibited more prolonged facial allodynia and significant neurological deficits compared to single TBI at specific timepoints. Plasma cytokines showed minimal changes. Histopathology revealed significantly elevated CNS inflammation in both TBI and SIS groups versus controls, with SIS groups (intervals 24h-14d) showing robust responses. Repeated TBI, especially with longer recovery intervals between injuries, results in more severe and prolonged facial allodynia, neurological deficits, and CNS neuroinflammation than a single mild TBI. These findings illuminate SIS pathophysiology and underscore the critical need for protection post-concussion.
Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage
Collaborators, GBD 2021 Global Subarachnoid Hemorrhage Risk Factors, Rautalin, Ilari, Stark, Benjamin, Johnson, Catherine O., Kaprio, Jaakko , Korja, Miikka, Krishnamurthi, Rita , Nair, Balakrishnan , Vergouwen, Mervyn D. I. , Abdelkader, Atef , Abdullahi, Auwal , Abualruz, Hasan , Abukhadijah, Hana J , Adamu, Lawan Hassan, Adegboye, Oyelola A. , Adzigbli, Leticia Akua, Agyemang‐Duah, Williams , Ahinkorah, Bright Opoku, Ahmad, Aqeel , Ahmad, Danish , Ahmadzade, Amir Mahmoud , Akkaif, Mohammed Ahmed , Ali, Mohammed Usman, Alif, Sheikh Mohammad , Alimohamadi, Yousef, Alsabri, Mohammed , Altaf, Awais , Alvis‐Guzmán, Nelson , Alwafi, Hassan , Al‐Wardat, Mohammad , Alyahya, Mohammad S. , Amin, Tarek Tawfik , Amindarolzarbi, Alireza , Amusa, Ganiyu , Angappan, Dhanalakshmi , Anuoluwa, Boluwatife Stephen, Anwar, Saleha, Anyasodor, Anayochukwu Edward , Apostol, Geminn Louis Carace, Areda, Demelash, Artamonov, Anton A, Artanti, Kurnia Dwi , Ashemo, Mubarek Yesse , Athar, Mohammad , Aujayeb, Avinash , Awotidebe, Adedapo Wasiu , Azadnajafabad, Sina , Aziz, Shahkaar , Bagheri, Nasser , Taqanaki, Pegah Bahrami , Bahramian, Saeed , Bai, Ruhai , Baig, Atif Amin , Baltatu, Ovidiu Constantin , Bam, Kiran, Barker‐Collo, Suzanne , Bärnighausen, Till , Bastan, Mohammad‐Mahdi , Basu, Sanjay , Bell, Shelly L, Benseñor, Isabela M , Berhie, Alemshet Yirga , Bhagavathula, Akshaya Srikanth , Bhaskar, Sonu , Bhat, Ajay Nagesh, Bhat, Vivek , Birhan, Mekuriaw Mesfin , Borhany, Hamed, Breitner, Susanne , Bulamu, Norma B. , Butt, Zahid A , Cabral, Lucas Scotta , Santos, Florentino Luciano Caetano dos , Cámera, Luis Alberto , Capodici, Angelo , Chadwick, Joshua , Chakraborty, Promit Ananyo , Chanie, Gashaw Sisay , Chattu, Vijay Kumar , Chi, Gerald, Chichagi, Fatemeh , Columbus, Alyssa , Criqui, Michael H, Ohadi, Mohammad Amin Dabbagh , Dadras, Omid , Dalli, Lachlan L. , Debopadhaya, Shayom , Dervišević, Emina , Devanbu, Vinoth Gnana Chellaiyan, Dewan, Syed Masudur Rahman , Dhane, Amol S. , Chi, Thanh, Phuong, Thao Huynh, Dohare, Sushil , Докова, Клара , Dowou, Robert Kokou , Dsouza, Haneil Larson , Dutta, Siddhartha , Dziedzic, Arkadiusz , E’mar, Abdel Rahman, Edvardsson, David , Efendi, Ferry, Nahas, Nevine El , Elgendy, Islam Y. , Eltaha, Chadi, Emeto, Theophilus I. , Fakhradiyev, Ildar , Faris, Pawan , Fauk, Nelsensius Klau , Fazylov, Timur, Fekadu, Ginenus , Fetensa, Getahun, Fischer, Florian, Foschi, Matteo , Fridayani, Ni Kadek Yuni, Gaipov, Abduzhappar , Gajjar, Avi A. , Ganesan, Balasankar , Gebregergis, Miglas Welay, Gebremeskel, Teferi Gebru , Getie, Molla , Ghadirian, Fataneh , Ghasemzadeh, Afsaneh , Gholamalizadeh, Maryam , Gil, Artyom , Goleij, Pouya , Goulart, Alessandra C. , Goulart, Bárbara Niegia Garcia de , Guan, Shi‐Yang , Gupta, Sapna , Habibzadeh, Farrokh , Hadi, Najah R, Hankey, Graeme J. , Harlianto, Netanja I. , Hasani, Hamidreza, Hasnain, Md Saquib , Haubold, Johannes , Havmoeller, Rasmus, Hay, Simon I , Hbid, Youssef , Heidari, Golnaz , Hiraike, Yuta, Hoan, Nguyen Quoc , Hosseinzadeh, Mehdi , Hwang, Bing‐Fang , Ibitoye, Segun Emmanuel , Ikiroma, Adalia , Isola, Gaetano , Iwagami, Masao , Jacob, Louis, Jain, Akhil, Jakovljević, Mihajlo , Jatau, Abubakar Ibrahim , Jawaid, Talha, Jayapal, Sathish Kumar , Jonas, Jost B, Joseph, Nitin , Jürisson, Mikk , Kadashetti, Vidya, Kalani, Rizwan, Kamireddy, Arun , Kandel, Himal , Behnagh, Arman Karimi , Kashoo, Faizan , Kayode, Gbenga A , Kazemi, Foad , Khader, Yousef , Khaing, Inn Kynn , Khan, Fayaz Ahmad , Khan, Mohammad Jobair , Kashani, Hamid Reza Khayat , Khosla, Atulya Aman , Kim, Kwanghyun , Kim, Yun Jin , Korzh, Oleksii , Krishan, Kewal , Krishna, Varun, Krishnamoorthy, Vijay , Kuddus, Mohammed , Kulimbet, Mukhtar , Lahariya, Chandrakant, Lai, Daphne Teck Ching , Lai, Hanpeng , Laksono, Tri, Lallukka, Tea , Latifinaibin, Kaveh, Le, Nhi Huu Hanh, Le, Thao T. , Lee, Munjae , Lee, Yo Han , Lenzi, Jacopo , Leonardi, Matilde, Li, Ming‐Chieh , Li, Xiaopan , Lim, Stephen S , Lin, Jialing , Saute, Ricardo Lutzky , Malik, Ahmad Azam , Marateb, Hamid Reza , Maroufi, Seyed Farzad , Maugeri, Andrea , McPhail, Steven , Mehndiratta, Man Mohan, Mestrovic, Tomislav, Mettananda, Chamila Dinushi Kukulege , Miazgowski, Tomasz , Minervini, Giuseppe , Mithra, Prasanna , Mohamed, Abdalla Z. , Mohammad, Ameen Mosa , Mohammed, Shafiu , Moni, Mohammad Ali , Moradi, Yousef, Moraga, Paula , Morawska, Lídia , Munjal, Kavita , Murray, Christopher J L , Nagarajan, Ahamarshan Jayaraman , Naik, Ganesh R. , Najdaghi, Soroush , Davani, Delaram Narimani , DELETE-ME, Nawsherwan, Nazri-Panjaki, Athare , Negoi, Ruxandra Irina , Nematollahi, Soroush , Nguyen, Hau Thi Hien, Nguyen, Hau Thi Hien, Nguyen, Phat Tuan , Nguyễn, Văn Thành , Niazi, Robina Khan, Nikoobar, Ali , Sá, Antonio Tolentino Nogueira de , Nomura, Shuhei , Nzoputam, Chimezie Igwegbe , Oancea, Bogdan , Ojo-Akosile, Tolulope R, Oliveira, Gláucia Maria Moraes de , Olorukooba, Abdulhakeem Abayomi , Osuagwu, Uchechukwu Levi , Ouyahia, Amel, A, Mahesh Padukudru P, Panagiotakos, Demosthenes B. , Parikh, Romil R., Park, Seoyeon , Pedersini, Paolo , Peprah, Emmanuel , Perico, Norberto, Petermann-Rocha, Fanny Emily, Plotnikov, Evgenii , Полибин, Р. В. , Postma, Maarten J. , Prasad, Manya , Qian, Gangzhen , Rahmanian, Mohammad , Rajaa, Sathish , Rajput, Prashant , Ramadan, Mahmoud M. , Rane, Amey, Rashidi, Mohammad‐Mahdi , Razo, Christian , Reddy, Murali Mohan Rama Krishna, Remuzzi, Giuseppe, Rezaei, Negar , Rezaeian, Mohsen , Rocha, Hermano Alexandre Lima , Rodriguez, Jefferson Antonio Buendia, Roever, Leonardo , Romoli, Michele, Romozzi, Marina, Roy, Nitai , Saddik, Basema Ahmad, Sahoo, Pragyan Monalisa , Salaroli, Luciane Bresciani , Samuel, Vijaya Paul, Samy, Abdallah M , Santric-Milicevic, Milena M., Saravanan, Aswini, Schlaich, Markus P. , Sethi, Yashendra , Seylani, Allen, Shaaban, Ahmed Nabil , Shafie, Mahan , Shaikh, Summaiya Zareen , Shamsutdinova, Alfiya, Sharifan, Amin , Rad, Javad Sharifi, Sharma, Vishal, Shashamo, Bereket Beyene , Shetty, Premalatha K, Shigematsu, Mika, Shorofi, Seyed Afshin, Singh, Paramdeep , Singh, Puneetpal , Singh, Surjit , Sobia, Farrukh , Solanki, Shipra, Soraneh, Soroush , Spartalis, Michael, Srinivasamurthy, Suresh Kumar , Stanikzai, Muhammad Haroon , Sun, Zhong , Swain, Chandan Kumar , Damavandi, Payam Tabaee , Tabatabaeizadeh, Seyed-Amir, Tabche, Celine , Taiba, Jabeen , Tamuzi, Jacques Lukenze , Tan, Ker‐Kan , Teramoto, Masayuki , Thakur, Ramna, Thankappan, Kavumpurathu Raman , Thayakaran, Rasiah , Thirunavukkarasu, Sathish, Ticoalu, Jansje Henny Vera, Tiwari, Krishna Raj , Tonelli, Marcello , Topór-Mądry, Roman , Tovani-Palone, Marcos Roberto Roberto, Tran, Jasmine, Tran, Thang Huu , Duc, Nguyen Tran Minh , Truelsen, Thomas Clement, Unim, Brigid, Vahdati, Sanaz, Vaithinathan, Asokan Govindaraj , Eynde, Jef Van den , Vladimirov, Sergey Konstantinovitch , Waheed, Yasir, Wahood, Waseem , Walde, Mandaras Tariku, Wang, Yanzhong , Wickramasinghe, Nuwan Darshana , Wolfe, Charles D. A., Wubie, Yihun Miskir, Xiao, Hong , Xu, Xiaoyue , Yano, Yuichiro , Yarahmadi, Amir , Ye, Pengpeng, Yon, Dong Keon , Zanghì, Aurora , Zare, Iman, Zastrozhin, Michael, Zhang, Zhi-Jiang , Zhang, Zhiqiang , Zhang, Zhiqiang, Zhao, Hanqing , Zhou, Shang Cheng, Zhumagaliuly, Abzal , Zia, Hafsa, Roth, Gregory A., Topór‐Mądry, Roman , Oliveira, Arão Belitardo , Rahim, Fakher , Saddik, Basema , Waheed, Yasir , Liu, Xuefeng , Zhang, Yunquan , Ozair, Ahmad , Buendía, Jefferson Antonio , Korja, Miikka , Baig, Atif Amin , Shanawaz, Mohd , Elgendy, Islam Y , Hankey, Graeme J , Alif, Sheikh M , Rezaei, Negar , Bhagavathula, Akshaya Srikanth , Van den Eynde, Jef , Ozair, Ahmad , Collaborators, GBD 2021 Global Subarachnoid Hemorrhage Risk Factors, Rautalin, Ilari Matias , Volovici, Victor , Ranta, Annemarei , Rinkel, Gabriël J.E. , Abate, Yohannes Habtegiorgis, Abbastabar, Hedayat , Abd-Allah, Foad , Abdi, Parsa , Abdollahi, Arash , Abiodun, Olugbenga Olusola , Aboagye, Richard Gyan , Abouzid, Mohamed , Abtahi, Dariush , Abu‐Rumeileh, Samir , Abualhasan, Ahmed , Abu‐Zaid, Ahmed , Addo, Isaac Yeboah , Adedoyin, Rufus Adesoji , Adra, Saryia , Ahinkorah, Bright Opoku , Ahmed, Ali , Ahmed, Haroon , Ahmed, Syed Anees , Aji, Budi , Al‐Ajlouni, Yazan A. , Al‐Aly, Ziyad , ALBashtawy, Mohammed , Aljunid, Syed Mohamed , Alomari, Mahmoud A. , Alrawashdeh, Ahmad , Alsabri, Mohammed A., Salman, Rustam Al‐Shahi , Al‐Tammemi, Ala’a B. , Al‐Worafi, Yaser Mohammed , Aly, Hany Z. , Alzoubi, Karem Hasan , Amani, Reza, Anderlini, Deanna , Anil, Abhishek , Arabloo, Jalal , Ärnlöv, Johan , Arumugam, Ashokan , Aryan, Zahra , Jafarabadi, Mohammad Asghari , Ashraf, Tahira , Athari, Seyyed Shamsadin , Azzam, Ahmed Y , Babu, Giridhara R. , Bako, Abdulaziz Tijjani , Banach, Maciej , Bandyopadhyay, Soham , Banik, Biswajit , Bardhan, Mainak , Barqawi, Hiba Jawdat , Barua, Lingkan , Beyene, Kebede Abera , Bhat, Vivek, Bhatti, Gurjit Kaur , Bhatti, Jasvinder Singh , Bijani, Ali , Bikbov, Boris , Birhanu, Mulugeta Molla , Bitra, Veera Raghavulu , Boloor, Archith , Brenner, Hermann , Bugiardini, Raffaele , Călina, Daniela Cornelia , Campos, Luciana Aparecida , Campos‐Nonato, Ismael , Carvalho, Félix , Castañeda-Orjuela, Carlos A , Catapano, Alberico Luigi , Cegolon, Luca , Chakraborty, Chiranjib , Chakraborty, Sandip , Chandika, Rama Mohan , Chaudhary, Anis Ahmad , Chi, Gerald , Ching, Patrick R , Chopra, Hitesh , Choudhari, Sonali Gajanan , Chowdhury, E. , Chu, Dinh‐Toi , Chung, Sheng‐Chia , Silva, Alanna Gomes da , Dai, Xiaochen , Dalal, Koustuv , D’Amico, Emanuele , Dashti, Mohsen , Davletov, Kairat , Cruz-Góngora, Vanessa Vianey De la , Delgado‐Enciso, Iván , Devanbu, Vinoth Gnana Chellaiyan, Dibas, Mahmoud , Doheim, Mohamed Fahmy , Dongarwar, Deepa , D’Oria, Mario , Doshi, Ojas Prakashbhai , Doshi, Rajkumar , Efendi, Defi , Efendi, Ferry , Elhadi, Muhammed , Eltahir, Mohd. Elmagzoub , Fabin, Natalia , Fagbamigbe, Adeniyi Francis , Fahim, Ayesha , Fares, Jawad , Ferreira, Nuno Bravo , Gandhi, Aravind P. , Garg, Ravindra Kumar , Gebrehiwot, Mesfin , Ghadimi, Delaram J. , Ghahramani, Sulmaz , Ghazy, Ramy Mohamed , Ghozy, Sherief , Gilani, Jaleed Ahmed , Gnedovskaya, Elena V. , Hadei, Mostafa , Hamidi, Samer , Hanifi, Nasrin , Haro, Josep María , Hasan, Faizul , Tabatabaei, Mahgol Sadat Hassan Zadeh , Heidari, Mohammad , Hemmati, Mehdi , Holla, Ramesh , Hostiuc, Sorin , Huang, Junjie , Huynh, Hong-Han , Ikeda, Nayu , Ilaghi, Mehran , Ilesanmi, Olayinka Stephen , Ilić, Irena , Ilić, Milena , Islam, Md. Rabiul , Ismail, Nahlah Elkudssiah , Iso, Hiroyasu , Jafarzadeh, Abdollah , Jairoun, Ammar Abdulrahman , Kalani, Rizwan, Kamal, Vineet Kumar , Kanchan, Tanuj , Karami, Jafar , Karaye, Ibraheem M. , Karimi, Yeganeh , Kesse‐Guyot, Emmanuelle , Khan, Fayaz, Khatatbeh, Haitham , Khatatbeh, Moawiah Mohammad , Kheirallah, Khalid Ahmed , Khidri, Feriha Fatima , Khormali, Moein , Kısa, Adnan , Kısa, Sezer , Kivimäki, Mika , Kolahi, Ali‐Asghar , Kompani, Farzad , Kostev, Karel , Kothari, Nikhil , Kunutsor, Setor K. , Kurniasari, Maria Dyah , Kusuma, Dian Palupi , Kytö, Ville , Vecchia, Carlo La , Lahariya, Chandrakant , Latief, Kamaluddin , Lee, Seung Won , Lee, Wei‐Chen , Leonardi, Matilde, Liu, Xuefeng , Lohner, Valerie , Lorenzovici, László , Lotufo, Paulo A. , Lucchetti, Giancarlo , Lusk, Jay B. , Amin, Hawraz Ibrahim M. , Malhotra, Armaan Kush , Malhotra, Kashish , Malta, Déborah Carvalho , Mansournia, Mohammad Alì , Mantovani, LG , Manu, Emmanuel, Marino, Mirko , Martínez, Ramón , Martini, Santi , Martorell, Miquel , Marzo, Roy Rillera , Mathangasinghe, Yasith , Mathews, Elezebeth , Mehmood, Asim , Mehrabani-Zeinabad, Kamran , Menezes, Ritesh G. , Meo, Sultan A , Meretoja, Atte , Meštrović, Tomislav , Sá, Ana Carolina Micheletti Gomide Nogueira de , Minh, Le Huu Nhat , Mirică, Andreea , Мirrakhimov, Erkin М , Mirza‐Aghazadeh‐Attari, Mohammad , Mishra, Ajay Kumar , Mohamed, Ahmed Ismail , Mohammadi, Soheil , Mohammadian-Hafshejani, Abdollah , Mokdad, Ali H. , Molinaro, Sabrina , Momani, Shaher , Ghalibaf, AmirAli Moodi , Moradi, Maryam , Msherghi, Ahmed A.A. , Ansari, Noureddin Nakhostin , Nargus, Shumaila , Natto, Zuhair S. , Nauman, Javaid , DELETE-ME, Nawsherwan, Nayak, Vinod C , Newton, Charles R. , Nigatu, Yeshambel T. , Noubiap, Jean Jacques , Nugen, Fred , Oduro, Michael Safo , Okati‐Aliabad, Hassan , Okeke, Sylvester Reuben , Okekunle, Akinkunmi Paul , Olagunju, Andrew T , Olaiya, Muideen Tunbosun , Olufadewa, Isaac Iyinoluwa , Ornello, Raffaele , Ortiz‐Prado, Esteban , Ouyahia, Amel , Owolabi, Mayowa , Padrón‐Monedero, Alicia , Padubidri, Jagadish Rao , Panos, Leonidas D , Pantazopoulos, Ioannis N. , Parikh, Romil R., Patel, Jay , Patel, Urvish , Patoulias, Dimitrios , Pereira, Gavin F , Perianayagam, Arokiasamy , Perna, Simone , Petermann‐Rocha, Fanny , Philip, Anil K. , Пирадов, М. А. , Pradhan, Jalandhar , Puvvula, Jagadeesh , Qasim, Nameer Hashim , Raggi, Alberto , Rahimi‐Movaghar, Vafa , Rahman, Muhammad Aziz , Rahmani, Amir Masoud , Sanati, Ali Rajabpour , Ramasamy, Shakthi Kumaran , Ramazanu, Sheena , Rathish, Devarajan , Rawaf, Salman , Redwan, Elrashdy M , Remuzzi, Giuseppe , Romoli, Michele, Romozzi, Marina , Ross, Allen Guy , Rout, Himanshu Sekhar , Roy, Priyanka , Saad, Aly M A , Saadatian, Zahra , Sabour, Siamak , Sacco, Simona , Sadeghi, Erfan , Saeed, Usman, Sharif‐Askari, Fatemeh Saheb , Sahebkar, Amirhossein , Sajib, Md Refat Uz Zaman , Saleh, Mohamed A. , Samodra, Yoseph Leonardo , MİLİCEVİC, Milena Santric, Saravanan, Aswini , Sarkar, Tanmay, Sarode, Sachin Chakradhar , Sartorius, Benn , Satpathy, Maheswar , Schneider, Ione Jayce Ceola , Schuermans, Art , Selvaraj, Siddharthan , Senthilkumaran, Subramanian , Sepanlou, Sadaf Ghajarieh , Shahwan, Moyad Jamal , Shamim, Muhammad Aaqib , Shamsi, Anas , Shannawaz, Mohammed , Rad, Javad Sharifi, Sharma, Vishal , Shittu, Aminu , Shiue, Ivy , Shlobin, Nathan A. , Siddig, Emmanuel Edwar , Spartalis, Michael , Stanaway, Jeffrey D , Starodubova, Antonina Vladimirovna , Szarpak, Łukasz , Tabatabaeizadeh, Seyed‐Amir , Tabatabaeizadeh, Seyed-Amir, Talaat, Iman Mamdouh , Temsah, Mohamad‐Hani , Thakur, Ramna , Thirunavukkarasu, Sathish, Tiwari, Krishna, Truyen, Thien Tan Tri Tai , Tsai, Daniel Hsiang‐Te , Ullah, Atta , Unnikrishnan, Bhaskaran , Unsworth, Carolyn Anne, Usman, Jibrin Sammani , Valizadeh, Rohollah , Varghese, Joe , Vasankari, Tommi Juhani , Venketasubramanian, Narayanaswamy , Vervoort, Dominique , Villafañe, Jorge Hugo , Vinayak, Manish , Wafa, Hatem A , Walde, Mandaras Tariku, Willeit, Peter , Wolfe, Charles D.A. , Wolfe, Charles D. A., Yamagishi, Kazumasa , Yaribeygi, Habib , Yaya, Sanni , Ye, Pengpeng, Yonemoto, Naohiro , Yu, Chuanhua , Zastrozhin, Michael, Zhang, Chen , Zhang, Zhiqiang, Zielińska, Magdalena , Zyoud, Samer H. , Roth, Gregory A. , Feigin, Valery L. , Kulimbet, Mukhtar , Rahim, Fakher
JAMA Neurology | May 23, 2025 | Volume: 82 | Issue: 8 | Pages: 765
Importance Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure. Objective To estimate the worldwide burden of SAH. Design, Setting, and Participants Based on the repeated cross-sectional Global Burden of Disease (GBD) 2021 study, the global burden of SAH in 1990 to 2021 was estimated. Moreover, the SAH burden was compared with other diseases, and its associations with 14 individual risk factors were investigated with available data in the GBD 2021 study. The GBD study included the burden estimates of nontraumatic SAH among all ages in 204 countries and territories between 1990 and 2021. Exposures SAH and 14 modifiable risk factors. Main Outcomes and Measures Absolute numbers and age-standardized rates with 95% uncertainty intervals (UIs) of SAH incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) as well as risk factor–specific population attributable fractions (PAFs). Results In 2021, the global age-standardized SAH incidence was 8.3 (95% UI, 7.3-9.5), prevalence was 92.2 (95% UI, 84.1-100.6), mortality was 4.2 (95% UI, 3.7-4.8), and DALY rate was 125.2 (95% UI, 110.5-142.6) per 100 000 people. The highest burden estimates were found in Latin America, the Caribbean, Oceania, and high-income Asia Pacific. Although the absolute number of SAH cases increased, especially in regions with a low sociodemographic index, all age-standardized burden rates decreased between 1990 and 2021: the incidence by 28.8% (95% UI, 25.7%-31.6%), prevalence by 16.1% (95% UI, 14.8%-17.7%), mortality by 56.1% (95% UI, 40.7%-64.3%), and DALY rate by 54.6% (95% UI, 42.8%-61.9%). Of 300 diseases, SAH ranked as the 36th most common cause of death and 59th most common cause of DALY in the world. Of all worldwide SAH-related DALYs, 71.6% (95% UI, 63.8%-78.6%) were associated with the 14 modeled risk factors of which high systolic blood pressure (population attributable fraction [PAF] = 51.6%; 95% UI, 38.0%-62.6%) and smoking (PAF = 14.4%; 95% UI, 12.4%-16.5%) had the highest attribution. Conclusions and Relevance Although the global age-standardized burden rates of SAH more than halved over the last 3 decades, SAH remained one of the most common cardiovascular and neurological causes of death and disabilities in the world, with increasing absolute case numbers. These findings suggest evidence for the potential health benefits of proactive public health planning and resource allocation toward the prevention of SAH.
Swallowing Disorders in Patients with Chiari Malformation Type I After Decompression Neurosurgery
Oliveira, Luciana B. de, Queiroz, Moisés A. S. de, Filho, Leonardo de Macêdo , Otamendi-Lopez, Andrea, Barbosa, Priscilla Mayara Estrela , Filho, Euler N. Sauaia, de Macêdo Filho, Leonardo J M , Shlobin, Nathan A. , Porto, Andréa Cintia Laurindo
No container title available | April 6, 2022 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract OBJECTIVE: The present study aimed to investigate postoperative swallowing disorders in patients diagnosed with CM I after decompression neurosurgery.METHODS: We selected 54 patients after decompression neurosurgery procedure for CM I from January 2017 to December 2019. We evaluated the speech-language assessment (CSLSA) 24-hours after post-surgical extubation. CSLSA observed aspects of posture, sensitivity, tone, and extra- and intraoral mobility of the FAO and visualizing the functions of breathing, phonation, articulation, chewing, and swallowing. We correlated the severity of the dysphagia and the presence of associated malformations in the CM I patients.RESULTS: In our study, 39 patients were female (mean age 41.3±47.1 years). Thirty-seven patients had associated malformations (p=0.0243): 21 patients syringomyelia, 11 basilar invagination and 5 syringomyelia and basilar invagination. Dysphagia was present in 37 of the cases (68.5%;p=0.0016). Dysphonia in 13 (24.1%;p=0.4785) and dysarthria in 3 (5.6%;p=0.0042). We observed in the CSLSA: orofacial hypomobility (29-patients–53.7%;p=0.0204), orofacial hyposensitivity (26-patients–48.1%; p=0.3023), reduced GAG reflex (24 patients–44.5%;p=0.1041), ineffective cough (19 patients–35.2%;p=0.0022), ineffective saliva swallowing (18-patients–33.3%;p=0.0396), dyspnea (13-patients–24.1%;p=0.4785), orofacial hypotonia (11-patients–20.4%;p=0.0004), altered cervical auscultation (10-patients–18.5%;p=0.0003), and dysarthria (3-patients–9.3%;p=0.0042). The presence of associated malformations significantly influenced the appearance of swallowing disorders, the severity of oropharyngeal dysphagia, the post-surgical complications (17-patients–31.5%;p<0.001), and the clinical outcomes (p=0.0029) of patients with CM type I. CONCLUSION: Decompressive neurosurgery for CM I had low rates of post-surgical complications overall. However, there was a high incidence of dysphagia. The presence of associated malformations is related with poorer prognosis and greater severity of oropharyngeal dysphagia in patients with CM I.
Research advances in the diagnosis and treatment of Chiari malformations: a bibliometric analysis
Rangel, India , McLelland, Marissa D. , Dodd, Armaan, Meyer, Jenna H., Hudson, Miles , Gottfried, Oren N., Singh, Rohin , Shlobin, Nathan A.
No container title available | February 11, 2022 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Chiari malformation is a relatively rare condition involving herniation of the brain out of the skull and into the spinal canal. The purpose of this review was to identify top contributors to the world of Chiari research, as well as to highlight the publications which have shaped our perception of this condition.We performed a search of the Web of Science between the years 1900 and 2021 using the terms “Chiari I malformation”, “Arnold Chiari malformation”, “Chiari II malformation”, “Chiari malformation type 1”, and “Chiari malformation type 2”. After screening for duplicates and assessing for relevance using two independent reviewers, the top 100 most frequently cited articles were collected and sorted. These articles were published between the years 1938 and 2015 and were cited 145.7 times on average, ranging from 79 to 724 citations per article. Authored by Milhorat et al., the 1999 Neurosurgery article “Chiari I Malformation Redefined: Clinical and Radiographic Findings for 364 Symptomatic Patients” received most citations (724 citations). Journal of Neurosurgery contributed the most articles to the top-100 with 21 publications. The University of California system accounted for the most articles by institution (8 of 100) and the USA was the highest contributing country (62%). In this study, we identified and analyzed the most cited articles on Chiari malformations to gain a better understanding of the publications contributing our knowledge of this disorder. This analysis serves both as a way of gauging the current state of research and of recognizing gaps where further research is necessary.