Dataset Information

Pre-hospital ct diagnosis of subarachnoid hemorrhage.

ABSTRACT: Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the better.The Norwegian Acute Stroke Pre-hospital Project (NASPP) has developed a Mobile Stroke Unit (MSU) model, which is staffed with anesthesiologists also trained in pre-hospital clinical assessment of acute stroke patients and interpretation of computerized tomography (CT). The MSU was operated on-call from the local dispatch center in a rural area 45-160 km away from a neurosurgical department. Two patients presented with clinical symptoms and signs compatible with SAH. In both cases, the CT examination confirmed the diagnosis of SAH. Both were transported directly from patient location to the regional neurosurgical department, saving at least 2-2.5 h of pre-neurosurgical time.The Norwegian MSU model staffed with anesthesiologists can rapidly establish an exact diagnosis of SAH, which in a rural area significantly reduces time to neurosurgical care.Study data are retrospectively registered in ClinicalTrail.gov. NCT03036020 Unique Protocol ID: NASPP-2 Brief Title: The Norwegian Acute Stroke Prehospital Project Overall Status: Completed Primary Completion Date: January 2016 [Actual] Verification Date: January 2017.

SUBMITTER: Hov MR

PROVIDER: S-EPMC5331704 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Pre-hospital ct diagnosis of subarachnoid hemorrhage.

Hov Maren Ranhoff MR Ryen Annette A Finsnes Katrine K Storflor Janne J Lindner Thomas T Gleditsch Jostein J Lund Christian Georg CG

Scandinavian journal of trauma, resuscitation and emergency medicine 20170228 1

<h4>Background</h4>Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the better.<h4>Case presentation</h4>The Norwegian Acute Stroke Pre-hospital Project (NASPP) has developed a Mobile Stroke Unit (MSU) model, which is staffed with anesthesiolog ...[more]

PMID: 28245880

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Project description:The diagnosis of cerebral vasospasm after Subarachnoid-Hemorrhage is currently very difficult, additional tools such as blood biomarkers are necessary. We tested the ability of gene expression profiles of blood cells to predict vasospasm. 32 patients suffering subarachnoid-hemorrhage were included in this prospective monocentre study. They were grouped according to have a complicated cerebral vasospasm (Vasospasm) or not (Control) and Paired according to age (+/- 10 years), sex, Fisher grade (+/- 1), location, smoking (at least 3 first parameters). Gene expression profiles of blood cells were determined using 25,000~gene microarray. Blood sample: 2.5 mL harvested in PAXgene® Blood RNA tubes (PreAnalytix) RNA extraction: PAXgene® Blood RNA kit (Qiagen). We used a Universel Reference RNA (Stratagene). RNA amplification and labelling: kit Amino Allyl MessageAmp II (Ambion). We hybridized 4 microarrays per patient using pangenomic microarrays from the "Réseau National des Génopôles" (Illkirch, France). 2 slides were hybridized with reference RNA labelled Cy3 and patient RNA labelled Cy5, and 2 slides were hybridized with reference RNA labelled Cy5 and patient RNA labelled Cy3. Hybridation : Agilent protocol with few modifications : 750 ng of each labelled RNA were hubriddized at 60°C during 17 hours in an Aglient hybridization oven. After washings, Slides were scanned with a GenePix 4000B scanner (Molecular Devices). Image intensity data were extracted with GenePix Pro 6.0 analysis software. Quantification of Cy3 and Cy5 and selection of good spots were performed using the MAIA software (Novikov E and Barillot E. Software package for automatic microarray image analysis (MAIA). The ACUITY software was then used to normalize log ratios Cy3/Cy5 with Lowess non linear normalization, to filter out genes not present in at least 3 slides out of 4, to evaluate the reproducibility of the 4 microarrays of each patient (hierarchical clustering, Self Organizing Maps). Statistical analyses to insure reproducibility was performed using Excel (correlation coefficients, ANOVA). Only slides that passed all reprocubility tests were validated.

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Pre-hospital ct diagnosis of subarachnoid hemorrhage.

Publications

Pre-hospital ct diagnosis of subarachnoid hemorrhage.

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