Reduced ipsilateral hemispheric cerebral blood flow at admission is predictive of vasospasm with infarction after aneurysmal subarachnoid hemorrhage

Rishi Gupta, Elizabeth A. Crago, Matthew Gallek, Michael Horowitz, Leslie Hoffman, Tudor Jovin, Howard Yonas

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background and Purpose: Cerebral vasospasm (CV) with infarction causes a significant degree of morbidity and mortality after aneurysmal subarachnoid hemorrhage (aSAH). We sought to determine if reduced cerebral blood flow (CBF) on Xenon CT within 48 h of the ictus was predictive of developing CV with infarction. Methods: This is a prospective study from 1999 to 2006 of 97 patients with aSAH who underwent Xenon CT within 48 h of their bleed. Demographic, clinical, radiographic, and angiographic parameters were investigated as potential risk factors for the development of CV with infarction. A binary logistic regression analysis was performed to determine the independent predictors of this endpoint. Results: A total of 97 patients with a mean age of 54 ± 12 years were studied. A total of 78 (80.4%) patients presented with a Fisher grade of 3 and 51 (52.6%) patients with a Hunt Hess score ≥3. CV with infarction was found in 33 (34%) patients. In univariate modeling, younger patients with a Fisher scale of 3 or a reduced ipsilateral mean hemispheric CBF had an association with developing CV with infarction. In binary logistic regression modeling, patients with lower initial hemispheric CBF's were at a significant risk of CV with infarction in the ipsilateral hemisphere. Conclusions: Lower initial CBF at presentation is a risk factor for developing CV with infarction. These findings may help in early prediction of this entity and may have therapeutic implications in the future.

Original languageEnglish (US)
Pages (from-to)27-30
Number of pages4
JournalNeurocritical Care
Volume9
Issue number1
DOIs
StatePublished - Aug 1 2008

Keywords

  • Cerebral blood flow
  • Subarachnoid hemorrhage
  • Vasospasm
  • Xenon CT

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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