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Classification of cerebral infarction after subarachnoid hemorrhage impacts outcome

Andrew M Naidech1, Bernard R Bendok, Sarice L Bassin

  • 1Department of Neurology, Northwestern University, Chicago, Illinois 60611, USA. naidech@northwestern.edu

Neurosurgery
|June 3, 2009
PubMed

Insights

A new classification for cerebral infarction (CI) after subarachnoid hemorrhage (SAH) helps predict patient outcomes. This classification, detailing CI location and type, is crucial for understanding prognosis after SAH.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Cerebral infarction (CI) is a significant complication following subarachnoid hemorrhage (SAH).
  • Currently, a validated classification system for CI post-SAH is lacking.
  • Understanding CI patterns is vital for predicting patient outcomes.

Purpose of the Study:

  • To prospectively evaluate a classification system for cerebral infarction (CI) in patients with subarachnoid hemorrhage (SAH).
  • To determine the association between CI classification and patient outcomes.
  • To identify factors influencing outcomes after SAH.

Main Methods:

  • 119 consecutive SAH patients were enrolled, recording neurological grades and CT scores.
  • Vasospasm, CI (via imaging), and timing of detection were documented.
  • Outcomes were assessed using NIH Stroke Scale and modified Rankin Scale (mRS) at various time points.

Main Results:

  • Vasospasm increased CI risk (OR 2.6).
  • CI classification correlated with NIH Stroke Scale and ICU length of stay.
  • CI location (cortical, deep, combined) predicted 14-day, 28-day, and 3-month outcomes (mRS).
  • Combined cortical and deep CI was linked to poorer outcomes.

Conclusions:

  • A CI classification system effectively predicts outcomes in SAH patients.
  • This classification, considering CI location and extent, is valuable for prognostication.
  • Standardized reporting of CI characteristics post-SAH is recommended.
Abstract

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