The Effect of Methamphetamine Use on Radiographic Vasospasm Following Angiogram-Negative Subarachnoid Hemorrhage: A...

Area of Science:

• Neurology
• Neurosurgery
• Toxicology

Background:

• The impact of methamphetamine use on outcomes following angiogram-negative subarachnoid hemorrhage (ANSAH) remains largely unexamined.
• Understanding factors that influence vasospasm after ANSAH is crucial for improving patient management and prognosis.

Purpose of the Study:

• To investigate the association between methamphetamine use and the occurrence of radiographic vasospasm in patients with ANSAH.
• To evaluate the relationship between methamphetamine positivity and clinical outcomes, including clinical vasospasm and discharge disposition.

Main Methods:

• Retrospective cohort analysis of 101 consecutive ANSAH patients treated between 2011 and 2022.
• Methamphetamine positivity (MP) determined by urine toxicology and/or patient report.
• Multivariate logistic regression analysis used to assess outcomes such as radiographic vasospasm, clinical vasospasm, and discharge home.

Main Results:

• Methamphetamine-positive patients were significantly younger than methamphetamine-negative patients (47.5 vs. 60.8 years, p=0.004).
• Univariate analysis revealed MP patients were nearly 12 times more likely to experience radiographic vasospasm (OR 11.6, p=0.008).
• Multivariate analysis confirmed MP was significantly associated with increased radiographic vasospasm (OR 18.8, p=0.017), but not clinical vasospasm or discharge home.

Conclusions:

• Methamphetamine use is independently associated with a significantly higher risk of radiographic vasospasm in patients with ANSAH.
• While not reaching statistical significance, there was a trend towards increased clinical vasospasm in methamphetamine-positive patients.
• This study underscores the importance of considering methamphetamine use as a potential risk factor for vasospasm in ANSAH patients.