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Decrease in platelet count as an independent risk factor for symptomatic vasospasm following aneurysmal subarachnoid
Yutaka Hirashima1, Hideo Hamada, Masanori Kurimoto
1Department of Neurosurgery, Toyama Medical and Pharmaceutical University, Toyama, Japan. yhira@ms.toyama-mpu.ac.jp
Journal of Neurosurgery
|June 2, 2005
Summary
Platelet consumption increases in patients with subarachnoid hemorrhage (SAH), especially those with symptomatic vasospasm (SV). Lower platelet counts and hypertension predict fewer SV cases, while Fisher Grade 3 predicts more.
Area of Science:
- Neurology
- Hematology
- Critical Care Medicine
Background:
- Cerebral vasospasm is a known complication following subarachnoid hemorrhage (SAH).
- Platelet consumption is hypothesized to play a role in the development of vasospasm.
- Understanding predictors of vasospasm is crucial for patient management.
Purpose of the Study:
- To investigate sequential changes in platelet counts after SAH.
- To compare platelet consumption between patients with and without symptomatic vasospasm (SV).
- To identify independent predictors of SV in SAH patients.
Main Methods:
- Retrospective analysis of 100 consecutive SAH patients.
- Examination of clinical, radiological, and blood cell count variables.
- Univariate and multivariate analyses to determine SV predictors.
Main Results:
- Platelet counts decreased post-SAH, then increased, a pattern specific to SAH.
- Platelet consumption was more severe in patients with SV.
- Independent predictors of SV included platelet count ratio (lower predicts less SV), hypertension history (predicts less SV), and Fisher Grade 3 (predicts more SV).
Conclusions:
- A decrease in platelet count is associated with the occurrence of SV.
- Platelets play a significant role in the pathophysiology of vasospasm after SAH.