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Updated: May 28, 2026

A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage
08:12

A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage

Published on: July 28, 2018

Attributing hypodensities on CT to angiographic vasospasm is not sensitive and unreliable

George M Ibrahim1, Stephan Weidauer, Hartmut Vatter

  • 1Division of Neurosurgery, St Michael's Hospital, Toronto, ON M5B 1W8, Canada.

Stroke
|October 15, 2011
PubMed

Insights

Interobserver variability in interpreting CT hypodensities for vasospasm is considerable. These findings suggest CT hypodensities may not be a reliable marker for angiographic vasospasm severity.

Area of Science:

  • Neuroradiology
  • Neurology
  • Stroke Imaging

Background:

  • Computed tomography (CT) hypodensities are utilized in clinical decisions for angiographic vasospasm treatment.
  • These hypodensities serve as a surrogate marker for the severity of angiographic vasospasm in research settings.

Purpose of the Study:

  • To assess the interobserver variability in attributing CT hypodensities to vasospasm-related delayed ischemic neurological deficit.
  • To evaluate the reliability of CT hypodensities as a marker for angiographic vasospasm severity.

Main Methods:

  • Independent review of CT scans from 413 patients in the CONSCIOUS-1 trial by 3 experienced reviewers.
  • Calculation of interobserver variability using the κ statistic and association analysis with the χ(2) test.

Main Results:

  • Considerable interobserver variability was observed (κ=0.51-0.78).
  • CT hypodensities were associated with severe angiographic vasospasm (P=0.001), but 19% had mild/no spasm.
  • Sensitivity and specificity for severe spasm were 41% and 93%, respectively.

Conclusions:

  • Significant interobserver variability exists in attributing CT hypodensities to angiographic vasospasm.
  • CT hypodensities may not be a robust marker for angiographic vasospasm severity, even with expert consensus.
Abstract

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