Predictors and outcome of acute symptomatic cerebral infarctions following aneurysmal subarachnoid hemorrhage

Abstract

The leading cause of unfavorable outcomes following aneurysmal subarachnoid hemorrhage (SAH) is cerebral infarction. In this 3-year retrospective study, we have retrospectively evaluated 172 hospitalized patients with aneurysmal SAH, and compared those who developed a complicated cerebral infarction with those who did not. In this study, acute symptomatic cerebral infarctions accounted for 22.6% (39/172) of all episodes. Significant statistical analysis between the two patient groups included age at onset, hypertension as the underlying disease, presence of symptomatic vasospasm, mean hospitalization days and Glasgow Outcome Score at the time of discharge. After a minimum 1.5-year follow-up period, the median (interquantile range) Barthel index score was 75 (6-85) for those patients who had cerebral infarctions, and 80 (0-90) for those who had no cerebral infarctions. Multiple logistic regression analysis demonstrated that the presence of symptomatic vasospasm was independently associated with the presence of acute symptomatic cerebral infarctions. The presence of symptomatic vasospasm implies the danger of acute symptomatic cerebral events after aneurysmal SAH. Although our study demonstrates a worse short-term outcome and longer duration of hospitalization in this special group of patients, the functional outcome for patients with cerebral infarction was not inferior to those patients without cerebral infarction after a follow-up of at least 1.5-years.

The Relationship Between Subarachnoid Hemorrhage Volume and Development of Cerebral Vasospasm

“…- with development of cerebral vasospasm 6)20). However, in our study, there was no association with development of cerebral vasospasm and those factors.…”

Perioperative safety of Hydrosoft coils

“…All strokes were thought to be due to vasospasm. The risk of stroke for patients with SAH reportedly ranges from 7.2% to 43% in this patient population 16 19 20. Clinically significant vasospasm was found to be present in 26.2% of cases, which is also consistent with the risk of vasospasm after SAH in other series 21–23.…”

Incidence and Predictors of Angiographic Vasospasm, Symptomatic Vasospasm and Cerebral Infarction in Chinese Patients with Aneurysmal Subarachnoid Hemorrhage

“…Additionally, we found 42.4% of patients who developed SV had cerebral infarction. The incidence proportion of cerebral infarction among SV cases ranged from 34.5%-80.0% in previous studies [5,28,29], depending on type and frequency of neuroimaging method used to detect cerebral infarction. We did not perform serial MRI or CT perfusion on scheduled basis, but rather CT scan on as-needed basis.…”