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

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

Research output: Contribution to journalArticle

7 Citations (Scopus)

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 2008
Externally publishedYes

Fingerprint

Cerebrovascular Circulation
Intracranial Vasospasm
Subarachnoid Hemorrhage
Infarction
Xenon
Logistic Models
Regression Analysis
Demography
Prospective Studies
Morbidity

Keywords

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

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Cite this

Reduced ipsilateral hemispheric cerebral blood flow at admission is predictive of vasospasm with infarction after aneurysmal subarachnoid hemorrhage. / Gupta, Rishi; Crago, Elizabeth A.; Gallek, Matthew J; Horowitz, Michael; Hoffman, Leslie; Jovin, Tudor; Yonas, Howard.

In: Neurocritical Care, Vol. 9, No. 1, 08.2008, p. 27-30.

Research output: Contribution to journalArticle

Gupta, Rishi ; Crago, Elizabeth A. ; Gallek, Matthew J ; Horowitz, Michael ; Hoffman, Leslie ; Jovin, Tudor ; Yonas, Howard. / Reduced ipsilateral hemispheric cerebral blood flow at admission is predictive of vasospasm with infarction after aneurysmal subarachnoid hemorrhage. In: Neurocritical Care. 2008 ; Vol. 9, No. 1. pp. 27-30.
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N2 - 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.

AB - 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.

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