Risk Prediction of Cerebral Infarction after Anterior Circulation Aneurysm Rupture in an Under-Equipped Centre

Area of Science:

• Neurosurgery
• Neurology
• Critical Care Medicine

Background:

• Aneurysm rupture leads to high morbidity and mortality, often due to vasospasm and cerebral infarction (CI).
• Existing prediction tools for CI post-aneurysmal subarachnoid hemorrhage (SAH) are complex and not universally available.
• There is a need for a simple model to identify high-risk patients for early CI prevention.

Purpose of the Study:

• To develop a simple and reliable prediction score for cerebral infarction (CI) in patients following aneurysmal subarachnoid hemorrhage (SAH).
• To facilitate early identification of high-risk individuals for timely preventive interventions.

Main Methods:

• A cohort of 200 patients with anterior circulation aneurysm rupture undergoing surgical clipping was analyzed.
• Demographic data and factors associated with CI were collected and statistically analyzed.
• A prediction score, the VINODH score (VS), was developed using significant predictors identified through multivariate analysis.

Main Results:

• Multivariate analysis identified four significant predictors (P < 0.01) for CI development.
• The developed VINODH score (VS) demonstrated high predictive accuracy with 79.0% sensitivity and 83.0% specificity.
• Internal validation confirmed the score's reliability, with a receiver operating characteristic (ROC) curve of 0.902.

Conclusions:

• The VINODH score (VS) is a reliable tool for the early identification of patients at risk of cerebral infarction (CI) after aneurysmal subarachnoid hemorrhage (SAH).
• This simple score can aid clinicians in initiating timely preventive treatments for CI.