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A Low Mortality Rat Model to Assess Delayed Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage
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Delayed cerebral ischaemia in patients with aneurysmal subarachnoid haemorrhage: Functional outcome and long-term

Markus Harboe Olsen1, Matias Orre1, Anna Cold Winge Leisner1

  • 1Department of Neuroanaesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Acta Anaesthesiologica Scandinavica
|June 8, 2019
PubMed

Insights

Delayed cerebral ischaemia (DCI) after aneurysmal subarachnoid haemorrhage (aSAH) is linked to worse functional outcomes and increased long-term mortality. Early identification and management of DCI are crucial for improving patient survival and recovery after aSAH.

Area of Science:

  • Neurology
  • Critical Care Medicine
  • Neurosurgery

Background:

  • Delayed cerebral ischaemia (DCI) is a significant complication following aneurysmal subarachnoid haemorrhage (aSAH).
  • DCI contributes to poor functional outcomes and increased mortality rates in affected patients.

Purpose of the Study:

  • To investigate the association between DCI, functional neurological outcome, and long-term mortality in patients with aSAH.
  • To analyze the impact of DCI on modified Rankin Scale (mRS) scores and 4-year survival rates.

Main Methods:

  • Retrospective cohort study of 492 patients with aSAH admitted to a Neurointensive Care Unit.
  • Patients were categorized into groups with DCI, without DCI, or unassessable for DCI.
  • Functional outcome assessed using mRS at 6 months; survival analyzed using Kaplan-Meier curves and incidence risk rates.

Main Results:

  • DCI occurred in 23% of all aSAH patients (33% of assessable patients).
  • Patients without DCI demonstrated significantly better functional outcomes (mRS 0-2) compared to those with DCI or unassessable patients.
  • DCI was associated with significantly higher 4-year mortality rates, even when excluding the initial 14 days post-admission.

Conclusions:

  • Delayed cerebral ischaemia (DCI) is strongly associated with both short-term and long-term morbidity and mortality in aneurysmal subarachnoid haemorrhage (aSAH) survivors.
  • These findings underscore the importance of monitoring and managing DCI to improve patient prognosis.
Abstract

Keywords:
aneurysmal subarachnoid haemorrhagedelayed cerebral ischaemia neurointensive carehaemorrhagicstroke

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