R. Loch Macdonald
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View article: Phase 1, randomized, crossover study comparing intravenous GTX-104 to oral nimodipine in healthy human subjects
Phase 1, randomized, crossover study comparing intravenous GTX-104 to oral nimodipine in healthy human subjects Open
Enterally-administered nimodipine is the only approved drug formulation available in the United States for treatment of patients with aneurysmal subarachnoid hemorrhage. Intravenous nimodipine is available in other countries but it contain…
View article: Microvascular Decompression of the Medulla: A Case Report and Review of the Surgical Management
Microvascular Decompression of the Medulla: A Case Report and Review of the Surgical Management Open
This case study and review of surgical management highlights the efficacy of microvascular decompression (MVD) with transposition of the vertebral artery in alleviating symptoms of vertebral artery compression syndrome (VACS). VACS is a ra…
View article: Phase 1, randomized, crossover study comparing intravenous GTX-104 to oral nimodipine in healthy human subjects
Phase 1, randomized, crossover study comparing intravenous GTX-104 to oral nimodipine in healthy human subjects Open
Enterally-administered nimodipine is the only approved drug formulation available in the United States for treatment of patients with aneurysmal subarachnoid hemorrhage. Intravenous nimodipine is available in other countries but it contain…
View article: Multivariate Models using quantitative CT assessment for prediction of outcome after Subarachnoid Hemorrhage
Multivariate Models using quantitative CT assessment for prediction of outcome after Subarachnoid Hemorrhage Open
Objective To diagnose if a patient has subarachnoid hemorrhage (SAH) and to predict if he/she will develop angiographic vasospasm/delayed cerebral ischemia (DCI) or will die using only admission cranial computed tomography (CT) and World F…
View article: STRIVE-ON: Safety and ToleRability of GTX-104 (Nimodipine Injection for IV Infusion) ComparEd with Oral Nimodipine in Patients Hospitalized for Aneurysmal Subarachnoid Hemorrhage (aSAH): a Prospective, Randomized Trial (STRIVE-ON)
STRIVE-ON: Safety and ToleRability of GTX-104 (Nimodipine Injection for IV Infusion) ComparEd with Oral Nimodipine in Patients Hospitalized for Aneurysmal Subarachnoid Hemorrhage (aSAH): a Prospective, Randomized Trial (STRIVE-ON) Open
Oral nimodipine is the only drug approved in North America for treatment of patients with aneurysmal subarachnoid hemorrhage (aSAH). However, bioavailability is variable and frequently poor, leading to fluctuations in peak plasma concentra…
View article: Prognostication Following Aneurysmal Subarachnoid Hemorrhage: The Modified Hunt and Hess Grading Scale
Prognostication Following Aneurysmal Subarachnoid Hemorrhage: The Modified Hunt and Hess Grading Scale Open
Background This study proposes a modification to the traditional Hunt and Hess (tHH) grading scale for prognostication in aneurysmal subarachnoid hemorrhage (aSAH), which differentiates the most severe‐grade patients based on the presence …
View article: IMMU-32. CAN PEMBROLIZUMAB TREAT RECURRENT GLIOBLASTOMA AND REVERSE HIV LATENCY?
IMMU-32. CAN PEMBROLIZUMAB TREAT RECURRENT GLIOBLASTOMA AND REVERSE HIV LATENCY? Open
Immunotherapy revolutionized treatment for many solid tumors. Early studies show that immunotherapy may be effective for recurrent glioblastoma. The ongoing Phase 2 LEEP-005 clinical trial (pembrolizumab+lenvima) is currently enrolling gli…
View article: Haptoglobin Treatment for Aneurysmal Subarachnoid Hemorrhage: Review and Expert Consensus on Clinical Translation
Haptoglobin Treatment for Aneurysmal Subarachnoid Hemorrhage: Review and Expert Consensus on Clinical Translation Open
Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating form of stroke frequently affecting young to middle-aged adults, with an unmet need to improve outcome. This special report focusses on the development of intrathecal haptoglobin s…
View article: Risk Factors for Delayed Cerebral Ischemia in Good‐Grade Patients With Aneurysmal Subarachnoid Hemorrhage
Risk Factors for Delayed Cerebral Ischemia in Good‐Grade Patients With Aneurysmal Subarachnoid Hemorrhage Open
Background A subset of good‐grade patients with aneurysmal subarachnoid hemorrhage (aSAH) develop delayed cerebral ischemia (DCI) that may cause permanent disabilities after aSAH. However, little is known about the risk factors of DCI amon…
View article: Erratum. Effects of decompressive craniectomy on functional outcomes and death in poor-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis
Erratum. Effects of decompressive craniectomy on functional outcomes and death in poor-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis Open
"Erratum. Effects of decompressive craniectomy on functional outcomes and death in poor-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis" published on 07 Oct 2022 by American Association of Neurological Surge…
View article: Rethinking the initial changes in subarachnoid haemorrhage: Focusing on real-time metabolism during early brain injury
Rethinking the initial changes in subarachnoid haemorrhage: Focusing on real-time metabolism during early brain injury Open
Over the last two decades, neurological researchers have uncovered many pathophysiological mechanisms associated with subarachnoid haemorrhage (SAH), with early brain injury and delayed cerebral ischaemia both contributing to morbidity and…
View article: In Reply: Body Mass Index and the Risk of Poor Outcome in Surgically Treated Patients With Good-Grade Aneurysmal Subarachnoid Hemorrhage
In Reply: Body Mass Index and the Risk of Poor Outcome in Surgically Treated Patients With Good-Grade Aneurysmal Subarachnoid Hemorrhage Open
To the Editor: We want to thank Drs Wang and Yang for their great interest and feedback regarding our recent article in Neurosurgery.1 In their Letter,2 Drs Wang and Yang have pointed out 4 factors, namely (1) age, (2) cohort heterogeneity…
View article: Body Mass Index and the Risk of Poor Outcome in Surgically Treated Patients With Good-Grade Aneurysmal Subarachnoid Hemorrhage
Body Mass Index and the Risk of Poor Outcome in Surgically Treated Patients With Good-Grade Aneurysmal Subarachnoid Hemorrhage Open
BACKGROUND: Heterogeneity among study populations and treatment procedures has led to conflicting results on outcome predictors for patients with aneurysmal subarachnoid hemorrhage (aSAH). One such conflicting predictor is body mass index …
View article: Statistical Analysis of Aneurysmal Subarachnoid Hemorrhage Trials
Statistical Analysis of Aneurysmal Subarachnoid Hemorrhage Trials Open
Background : Many randomized controlled trials (RCT) have assessed new treatments in subarachnoid hemorrhage (SAH), yet most show no treatment efficacy. One explanation is the statistical analysis of the primary endpoint was not as efficie…
View article: International Practice Variability in Treatment of Aneurysmal Subarachnoid Hemorrhage
International Practice Variability in Treatment of Aneurysmal Subarachnoid Hemorrhage Open
Prior research suggests substantial between-center differences in functional outcome following aneurysmal subarachnoid hemorrhage (aSAH). One hypothesis is that these differences are due to practice variability. To characterize practice va…
View article: Role of perivascular and meningeal macrophages in outcome following experimental subarachnoid hemorrhage
Role of perivascular and meningeal macrophages in outcome following experimental subarachnoid hemorrhage Open
The distribution and clearance of erythrocytes after subarachnoid hemorrhage (SAH) is poorly understood. We aimed to characterize the distribution of erythrocytes after SAH and the cells involved in their clearance. To visualize erythrocyt…
View article: Lessons from the CONSCIOUS-1 Study
Lessons from the CONSCIOUS-1 Study Open
After years of research on treatment of aneurysmal subarachnoid hemorrhage (aSAH), including randomized clinical trials, few treatments have been shown to be efficacious. Nevertheless, reductions in morbidity and mortality have occurred ov…
View article: Intrathecal Nicardipine for Cerebral Vasospasm Post Subarachnoid Hemorrhage – a Retrospective Analysis and Propensity-Based Comparison
Intrathecal Nicardipine for Cerebral Vasospasm Post Subarachnoid Hemorrhage – a Retrospective Analysis and Propensity-Based Comparison Open
Background and Purpose Cerebral vasospasm and delayed cerebral ischemia (DCI) contribute to poor outcome following subarachnoid hemorrhage (SAH). With the paucity of effective treatments, we describe our experience with intrathecal (IT) ni…
View article: Thick and diffuse cisternal clot independently predicts vasospasm-related morbidity and poor outcome after aneurysmal subarachnoid hemorrhage
Thick and diffuse cisternal clot independently predicts vasospasm-related morbidity and poor outcome after aneurysmal subarachnoid hemorrhage Open
OBJECTIVE Aneurysmal subarachnoid hemorrhage (aSAH) is associated with significant morbidity and mortality. The presence of thick, diffuse subarachnoid blood may portend a worse clinical course and outcome, independently of other known pro…
View article: Endovascular Intervention Versus Surgery in Ruptured Intracranial Aneurysms in Equipoise
Endovascular Intervention Versus Surgery in Ruptured Intracranial Aneurysms in Equipoise Open
Background and Purpose— The benefits of endovascular intervention over surgery in the treatment of ruptured aneurysms of anterior circulation remains uncertain. Recently, published studies did not find superiority of endovascular intervent…
View article: Collagen Turnover in Relation to Risk Factors and Hemodynamics in Human Intracranial Aneurysms
Collagen Turnover in Relation to Risk Factors and Hemodynamics in Human Intracranial Aneurysms Open
Background and Purpose— Determinants for molecular and structural instability, that is, impending growth or rupture, of intracranial aneurysms (IAs) remain uncertain. To elucidate this, we endeavored to estimate the actual turnover rates o…
View article: Nimodipine Reappraised: An Old Drug With a Future
Nimodipine Reappraised: An Old Drug With a Future Open
Nimodipine is a dihydropyridine calcium channel antagonist that blocks the flux of extracellular calcium through L-type, voltage-gated calcium channels. While nimodipine is FDAapproved for the prevention and treatment of neurological defic…
View article: Letter to the Editor. Limited data?
Letter to the Editor. Limited data? Open
tumor control following stereotactic radiosurgery for jugular paraganglioma using 3D volumetric segmentation.
View article: Prospective Multicenter Study of Changes in MTT after Aneurysmal SAH and Relationship to Delayed Cerebral Ischemia in Patients with Good- and Poor-Grade Admission Status
Prospective Multicenter Study of Changes in MTT after Aneurysmal SAH and Relationship to Delayed Cerebral Ischemia in Patients with Good- and Poor-Grade Admission Status Open
BACKGROUND AND PURPOSE: Patients with aneurysmal SAH and good clinical status at admission are considered at a lower risk for delayed cerebral ischemia. Prolonged MTT may be associated with an increased risk. It is unclear whether this is …