The Relationship Between Subarachnoid Hemorrhage Volume and Development of Cerebral Vasospasm

Jung, Sang-Won; Lee, Chang-Young; Yim, Man-Bin

doi:10.7461/jcen.2012.14.3.186

Cited by 23 publications

(11 citation statements)

References 21 publications

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“…As expected, patients diagnosed with NPM-SAH had higher Fisher scale scores ( 13 ) and a higher risk of vasospasm, ( 14 , 15 ) which is in line with notion that patients with an aggressive clinical presentation and a greater amount of blood detected in the subarachnoid space have a poorer prognosis. ( 16 )…”

Section: Discussionsupporting

confidence: 84%

Non-aneurysmal spontaneous subarachnoid hemorrhage: perimesencephalic versus non-perimesencephalic

Coelho¹,

Costa²,

Azevedo³

2016

Revista Brasileira De Terapia Intensiva

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Objective To compare the clinical evolution of perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage.Methods The study was conducted retrospectively in a tertiary hospital center in the north region of Portugal. Included patients had no identifiable cause for subarachnoid hemorrhage. Several epidemiologic, clinical and imaging aspects were statistically analyzed, taking into account the differences in perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage.Results Sixty-two patients met the inclusion criteria (46.8% - perimesencephalic subarachnoid hemorrhage; 53.2% - non-perimesencephalic subarachnoid hemorrhage). Demographic and clinical background characteristics were similar in both groups. Complications were more frequent in patients with non-perimesencephalic subarachnoid hemorrhage - 84.8% of the patients had at least one complication versus 48.3% in perimesencephalic subarachnoid hemorrhage. Vasospasm, infection and hydrocephaly were the most common complications (each was detected more frequently in the non-perimesencephalic subarachnoid hemorrhage group than in perimesencephalic subarachnoid hemorrhage group). Two patients died, both had a non-perimesencephalic subarachnoid hemorrhage. The median inpatient time was longer in the non-perimesencephalic subarachnoid hemorrhage group (21 versus 14 days). No incidents of rebleeding were reported during the follow-up period (mean time of 15 ± 10.3 months).Conclusion Perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage are two different entities that have different clinical outcomes, namely in terms of complication rate and median inpatient time. The management of these patients should respect this difference to improve treatment and optimize health care resources.

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Section: Discussionsupporting

confidence: 84%

Non-aneurysmal spontaneous subarachnoid hemorrhage: perimesencephalic versus non-perimesencephalic

Coelho¹,

Costa²,

Azevedo³

2016

Revista Brasileira De Terapia Intensiva

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“…Concern for the collection of blood products in the subarachnoid space cannot be understated as the degree of SAH is frequently considered the most important factor influencing vasospasm after aSAH. One recent prospective study demonstrated an average SAH volume of 17.67±5.18ml in patients who developed symptomatic vasospasm compared with 9.50±2.57ml in those not experiencing symptomatic or angiographic vasospasm [24]. In our case a small amount of IVH was observed, however, no identifiable subarachnoid hemorrhage was present.…”

Section: Discussioncontrasting

confidence: 53%

Cerebral Vasospasms Following Endoscopic Endonasal Surgery for Pituitary Adenoma Resection in the Absence of Post-Operative Subarachnoid Hemorrhage

Koutourousiou¹

2016

JNSK

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The endoscopic endonasal approach (EEA) is a widely accepted and commonly utilized approach for the resection of various pituitary tumors. While complications commonly include diabetes insipidus, cerebrospinal fluid leaks, and anterior lobe insufficiency cerebral vasospasm may also rarely occur. Herein, we report the unique case of a 44-year-old female who underwent uncomplicated endoscopic endonasal surgery for resection of a giant pituitary adenoma. Subsequent cerebral vasospasms were identified on postoperative day 3 and 19 resulting in ischemic strokes with neurological consequence. In the postoperative period, imaging at no point revealed any evidence of subarachnoid hemorrhage or hematoma formation in the subarachnoid space. Risk factors for cerebral vasospasm are discussed and the potential for subsequent vasospasm events is addressed.

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“…It is defined as clinical neurological symptoms of ischemia (confusion, decreased level of consciousness, focal neurological deficits), with narrowing of cerebral vessels, visualized by computed tomography angiography (CTA). Cerebral vasospasm occur in approximately one third of aSAH patients (Frontera et al, 2009), and the risk of vasospasm is related to the thickness and amount of blood in the subarachnoid space and/or the presence of intraventricular blood assessed on computed tomography (CT), the Fisher grade (Fisher et al, 1980; Jung et al, 2012). The risk of developing cerebral vasospasm is highest during dag 6–8 following ictus (Weir et al, 1978).…”

Section: Introductionmentioning

confidence: 99%

Can S100B Predict Cerebral Vasospasms in Patients Suffering from Subarachnoid Hemorrhage?

2013

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Background: Protein S100B has proven to be a useful biomarker for cerebral damages. Increased levels of serum and cerebrospinal fluid (CSF) S100B have been shown in patients suffering subarachnoid hemorrhage (SAH), severe head injury and stroke. In patients with SAH, the course of S100B levels has been correlated with neurological deficits and outcome. Cerebral vasospasm is a major contributor to morbidity and mortality. The primary aim of this study was to investigate the potential of S100B protein as a predictor of cerebral vasospasm in patients with severe SAH.Materials and Methods: Patients with SAH, Fisher grade 3 and 4, were included in the study. Five samples of CSF and serum S100B were collected from each patient. The first sample (baseline sample) was drawn within the first 3 days following ictus and the following four samples, once a day on days 5–8, with day of ictus defined as day 1. Clinical suspicion of cerebral vasospasm confirmed by computed tomography angiography was used to diagnose cerebral vasospasm.Results: A total of 18 patients were included. Five patients (28%) developed cerebral vasospasm, two (11%) developed ventriculitis. There were no significant differences between S100B for those with and without vasospasm. Serum S100B levels in patients with vasospasm were slightly lower within the first 5 days following ictus, compared to patients without vasospasm. Two out of five patients had elevated and increasing serum S100B prior to vasospasm. Only one showed a peak level of S100B 1 day before vasospasm could be diagnosed. Due to the low number of patients in the study, statistical significance could not be reached.Conclusion: Neither serum nor CSF S100B can be used as predictor of cerebral vasospasm in patients suffering from SAH.

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The Relationship Between Subarachnoid Hemorrhage Volume and Development of Cerebral Vasospasm

Cited by 23 publications

References 21 publications

Non-aneurysmal spontaneous subarachnoid hemorrhage: perimesencephalic versus non-perimesencephalic

Non-aneurysmal spontaneous subarachnoid hemorrhage: perimesencephalic versus non-perimesencephalic

Cerebral Vasospasms Following Endoscopic Endonasal Surgery for Pituitary Adenoma Resection in the Absence of Post-Operative Subarachnoid Hemorrhage

Can S100B Predict Cerebral Vasospasms in Patients Suffering from Subarachnoid Hemorrhage?

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