Retrospective analysis of predictors of cerebral vasospasm after ruptured cerebral aneurysm surgery: influence of the location of subarachnoid blood

Nomura, Yasumitsu; Kawaguchi, Masahiko; Yoshitani, Kenji; Kurita, Naoko; Hayashi, Hironobu; Tamura, Kentarou; Motoyama, Yasushi; Nakase, Hiroyuki; Furuya, Hitoshi

doi:10.1007/s00540-009-0836-2

Cited by 15 publications

(18 citation statements)

References 23 publications

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“…First, between total ICH volume and SAH volume, they did not show which one was really associated with development of cerebral vasospasm 5)14). Second, some studies only included patients with Fisher grade 3 4)11). Third, no study of a single modality treated group was conducted.…”

Section: Discussionmentioning

confidence: 99%

“…Some quantitative trials have been reported in the literature 1)4)5)11)14). However, those trials had some limitations in the following respects.…”

Section: Discussionmentioning

confidence: 99%

“…Among those, a strong association of patients with higher Fisher grade on the initial computed tomography (CT) scan with development of a cerebral vasospasm has been demonstrated 1)4)7)19). However, the measurements used in the scale are increments displayed on printed CT scans, which have no relationship to the real clot thickness 11). Therefore, volumetric analyses of blood in SAH patients are necessary and have been previously reported by some authors 4)11)15)18)19).…”

Section: Introductionmentioning

confidence: 99%

“…However, the measurements used in the scale are increments displayed on printed CT scans, which have no relationship to the real clot thickness 11). Therefore, volumetric analyses of blood in SAH patients are necessary and have been previously reported by some authors 4)11)15)18)19). However, previous studies did not show which component of intracranial hemorrhage (ICH), between total ICH volume and total SAH volume, was really associated with development of cerebral vasospasm.…”

Section: Introductionmentioning

confidence: 99%

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The Relationship Between Subarachnoid Hemorrhage Volume and Development of Cerebral Vasospasm

Jung

Lee

Yim

2012

J Cerebrovasc Endovasc Neurosurg

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ObjectiveThe objective of this study is to verify the relationship between subarachnoid hemorrhage (SAH) volume (not Fisher grade) and development of cerebral vasospasm prospectively.MethodsPatients who visited our hospital with a diffuse or localized thick subarachnoid blood clot seen on computed tomography (CT), taken within 48 hours after SAH and the aneurysm was confirmed by CT Angiogram (CTA) from March 2010 to July 2011 were enrolled in this study. CTA was checked at least twice after admission. Angiographic vasospasm (AVS) on CTA was defined as irregularity or narrowing of intracranial vessels on follow up CTA compared with initial CTA. Total intracranial hemorrhage (ICH) volume (subdural, SAH, intracerebral and intraventricular) was calculated and SAH volume (all supratentorial and infratentorial cisterns) was also calculated using the MIPAV software package.ResultsA total of 55 patients were included in our study. Thirty six patients did not show AVS on CTA or clinical deterioration (non vasospasm group: NVS). AVS without ischemic neurologic symptoms was observed in four patients and development of symptomatic vasospasm (SVS), defined as AVS with ischemic symptoms, was observed in 15 patients. SAH volume in SVS patients was statistically larger than that in NVS patients (p < 0.05). Total ICH volume in SVS patients was larger than that in NVS patients. However, the difference was not statistically significant.ConclusionResults of this study indicate an association of development of vasospasm with the SAH volume, not intracranial hemorrhage.

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Section: Discussionmentioning

confidence: 99%

“…Some quantitative trials have been reported in the literature 1)4)5)11)14). However, those trials had some limitations in the following respects.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Relationship Between Subarachnoid Hemorrhage Volume and Development of Cerebral Vasospasm

Jung

Lee

Yim

2012

J Cerebrovasc Endovasc Neurosurg

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“…The American Heart Association/American Stroke Association guidelines also recommend induced hypertension targeted euvolemia for managing delayed cerebral ischemia (DCI) 4 . The World Federation of Neurological Surgeons (WFNS) grade of the patient at presentation and the location of epicenter of the subarachnoid bleed has shown to be positively correlated with the onset of vasospasm 5, 6 . Since indocyanine green (ICG) flow studies are safe, easily applicable, readily reproducible and now routinely utilized technique during the microvascular clipping of aneurysms, addition of FLOW 800, an automated vascular map study generated by the microscope with the provision for quantitative study of flow velocities and time lag for appearance of the dye between relevant vessels, can help us segregate and outline groups at high-risk of developing post-operative vasospasm and form an evidence-based management algorithm for better therapeutic benefits and clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

A pilot study on assessing the role of intra-operative Flow 800 vascular map model in predicting onset of vasospasm following micro vascular clipping of ruptured intracranial aneurysms

Munakomi

Poudel

2018

F1000Res

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Objective To ascertain the predictive value of intra-operative FLOW 800 vascular map model in predicting onset of post-operative clinical vasospasm and delayed cerebral ischemia among patients undergoing micro-vascular clipping of ruptured intracranial aneurysms. Material and methods A total of 40 patients were enrolled in the study and their variables such as age, World Federation of Neurological Surgeons (WFNS) grade at presentation, Computerized Tomography (CT) Fisher grading, location of the aneurysms, and Indocyanine Green (ICG) flow status were compared and statistically analyzed along with differences in Absorption Intensities (AI) and difference in time lag values obtained from the FLOW 800 vascular map studies for predicting onset of vasospasm. Results The Receiver Operating curve (ROC) of the model for predicting post-operative vasospasm was highest (.892) for difference in the AI followed by CT Fisher grading (.778), difference in time lag (.700) and WFNS grading (.699).Analysis of variance for different variables studied in our model for predicting vasospasm was significant for all except for age (.991) and the ICG flow through the parent vessel (.079).Multivariate analysis done for predicting the vasospasm was significant for all variables except for age (.869) and ICG main flow (.196) Conclusion Our study confirmed the role of FLOW 800 study model in predicting clinical vasospasm. Inclusion of this entity would therefore help in taking timely and correct therapeutics measures to ensure better patient outcomes.

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Critical Care Management of Subarachnoid Hemorrhage (SAH)

Mascia

Mazzeo

Caccia

2017

Practical Trends in Anesthesia and Intensive Care 2017

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Retrospective analysis of predictors of cerebral vasospasm after ruptured cerebral aneurysm surgery: influence of the location of subarachnoid blood

Abstract: The results indicated that the amount of blood in the right sylvian fissure was significantly associated with the development of angiographic vasospasm after SAH.

Cited by 15 publications

References 23 publications

The Relationship Between Subarachnoid Hemorrhage Volume and Development of Cerebral Vasospasm

The Relationship Between Subarachnoid Hemorrhage Volume and Development of Cerebral Vasospasm

A pilot study on assessing the role of intra-operative Flow 800 vascular map model in predicting onset of vasospasm following micro vascular clipping of ruptured intracranial aneurysms

Critical Care Management of Subarachnoid Hemorrhage (SAH)

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