Convexity subarachnoid hemorrhage after mechanical thrombectomy

Area of Science:

• Neurology
• Neurosurgery
• Vascular Neurology

Background:

• Acute convexity subarachnoid hemorrhage (cSAH) is a rare complication in patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke (AIS).
• Intracranial atherosclerotic stenosis (ICAS)-related large vessel occlusion (LVO) is a specific etiology where the occurrence and impact of cSAH after MT remain underreported.

Purpose of the Study:

• To investigate the incidence and clinical impact of acute cSAH following MT in AIS patients with ICAS-related LVO.
• To evaluate the effect of cSAH on postoperative management and patient prognosis.

Main Methods:

• Retrospective review of AIS patients with ICAS-related LVO who underwent MT.
• Data collected included demographics, clinical details, imaging, treatment, and 90-day modified Rankin scale (mRS) scores.
• Prognosis was defined as an mRS score of 0-2.

Main Results:

• Nine out of 979 patients (0.92%) developed cSAH after MT.
• All patients achieved a good prognosis (mRS 0-2) at 90 days.
• Postoperative management included single or dual antiplatelet therapy, with no cases of intracerebral hemorrhage transformation.

Conclusions:

• cSAH is an infrequent complication after MT in AIS patients with ICAS-related LVO.
• The occurrence of cSAH did not adversely affect patient prognosis or influence antiplatelet therapy decisions.