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Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage
Kenji Kanamaru1, Hidenori Suzuki2, Waro Taki3
1Department of Neurosurgery, Suzuka Kaisei Hospital, Suzuka, Japan.
Acta Neurochirurgica. Supplement
|October 15, 2015
Summary
Predictors for cerebral infarction after aneurysmal subarachnoid hemorrhage (SAH) were identified. Symptomatic vasospasm was the most critical treatable factor, while endovascular treatment for vasospasm reduced infarction risk.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Cerebral infarction is a major cause of poor outcomes following aneurysmal subarachnoid hemorrhage (SAH).
- Identifying predictors of cerebral infarction is crucial for improving patient management and outcomes.
Purpose of the Study:
- To examine predictors of cerebral infarction in patients with aneurysmal SAH.
- To identify potentially treatable factors associated with cerebral infarction.
Main Methods:
- Analysis of data from the Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) cohort (n=579).
- Inclusion of patients treated with clipping or coiling within 12 days of SAH onset.
- Assessment of patient, clinical, radiographic, and treatment variables using univariate and multivariable logistic regression analyses.
Main Results:
- Cerebral infarction occurred in 28.0% of patients, primarily due to cerebral vasospasm (101 cases).
- Significant predictors included Fisher CT group 3, larger aneurysm dome size, posterior circulation aneurysms, premature rupture during clipping, symptomatic vasospasm, and infection.
- Endovascular treatment for vasospasm was associated with a decreased risk of cerebral infarction.
Conclusions:
- Symptomatic vasospasm is the most important potentially treatable factor associated with cerebral infarction after aneurysmal SAH.
- Early identification and management of these predictors, particularly vasospasm, are essential for reducing cerebral infarction rates.
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