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Updated: Jan 30, 2026
A Low Mortality Rat Model to Assess Delayed Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage
Published on: January 17, 2013
Vasospasm following aneurysmal subarachnoid hemorrhage: prediction, detection, and intervention
Hassan Gamal Eldeen Nassar1, Azza Abbas Ghali1, Wafik Said Bahnasy1
1Department of Neuropsychiatry, Faculty of Medicine, Tanta University, 31527 Tanta, Egypt.
Insights
Early detection of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) using continuous electroencephalogram (EEG) monitoring and transcranial Doppler (TCD) studies is crucial. These methods enable timely intervention to prevent delayed cerebral ischemia (DCI).
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Cerebral vasospasm is a frequent complication following aneurysmal subarachnoid hemorrhage (aSAH).
- Vasospasm can lead to delayed cerebral ischemia (DCI), significantly worsening patient outcomes.
- Early identification and management of vasospasm are critical in aSAH patients.
Purpose of the Study:
- To evaluate the efficacy of continuous electroencephalogram (EEG) monitoring and transcranial Doppler (TCD) studies for early vasospasm detection in aSAH patients.
- To assess the timing of vasospasm development relative to clinical signs of DCI.
Main Methods:
- 41 aSAH patients underwent diagnosis via CT, CT angiography, and digital subtraction angiography, followed by embolization.
- Patients were monitored for 20 days using clinical assessment, EEG, and TCD for vasospasm and DCI detection.
- Analysis included identifying ruptured aneurysm sites and affected cerebral arteries.
Main Results:
- The incidence of vasospasm was 36.8%, with 57% progressing to DCI.
- Middle cerebral artery (MCA) was the most commonly affected vessel.
- Vasospasm was detected by EEG/TCD at a mean of 8.4 days, significantly earlier than clinical signs (12.5 hours prior to DCI).
Conclusions:
- Continuous EEG monitoring and TCD are effective tools for the early detection of cerebral vasospasm.
- Early detection allows for timely therapeutic interventions, potentially preventing irreversible neurological deficits.
- These monitoring techniques are valuable in managing aSAH complications.
Background:
Vasospasm of the cerebral blood vessels is a common complication of aneurysmal subarachnoid hemorrhage (aSAH) which results in delayed cerebral ischemia (DCI) and worsening of the outcome.
Methods:
This study was performed on 41 aSAH patients diagnosed by non-contrast brain CT, CT angiography, and digital subtraction angiography followed by interventional aneurysmal embolization. Patients were followed up for 20 days by clinical assessment, EEG monitoring, and transcranial duplex studies (TCD) for early detection of vasospasm and DCI.
Results:
The most common ruptured aneurysmal sites were middle cerebral, anterior communicating, posterior communicating, terminal internal carotid, and anterior cerebral arteries respectively. The incidence of vasospasm was 36.8% of the included cases; 57% progressed to DCI while 43% passed a spontaneous regressive course. The most common arteries undergoing vasospasm were the MCA followed by the ACA, ICA, and lastly the basilar arteries. The mean time of vasospasm development as detected by EEG monitoring and/or TCD was 8.4 ± 2.8 days which was earlier than clinical signs by 12.5 ± 5.3 h in those progressed to DCI.
Conclusion:
Continuous EEG monitoring and TCD are valuable methods for early detection of vasospasm and they allow for early therapeutic intervention before irreversible ischemic neurological deficits take place.
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