Document Detail

Infarction after aneurysm rupture does not depend on distribution or clearance rate of blood.
MedLine Citation:
PMID:  1542899     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: We sought to determine the contribution of the amount, distribution, and clearance rate of extravasated blood in relation to occurrence of infarction and outcome in patients with aneurysmal subarachnoid hemorrhage. METHODS: We prospectively studied 59 consecutive patients with aneurysmal subarachnoid hemorrhage admitted within 72 hours by means of serial computed tomographic scanning, close clinical observation, and assessment of outcome after 3 months. RESULTS: Infarction occurred in 17 of the 59 patients. The arterial territories involved hardly reflected the distribution of subarachnoid blood in the basal cisterns on computed tomography, and even the side of the infarcts corresponded only weakly with the side on which most extravasated blood was seen. Infarction occurred twice as often in patients with large amounts of subarachnoid blood; this difference was not significant on its own but is in agreement with previous studies. A low clearance rate of cisternal blood was not related to the occurrence of infarction; a relation between clearance rate and poor outcome was largely explained by the amount of subarachnoid blood on the initial computed tomogram and by a low Glasgow Coma Scale score on admission. CONCLUSIONS: The fact that infarction is related to the total amount but not to the distribution or clearance rate of extravasated blood argues against a direct role of extravasated blood and in favor of systemic factors, dependent on the severity of the initial hemorrhage.
P J Brouwers; E F Wijdicks; J Van Gijn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  23     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-04-08     Completed Date:  1992-04-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  374-9     Citation Subset:  IM    
University Department of Neurology, University Hospital Utrecht, The Netherlands.
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MeSH Terms
Cerebral Infarction / etiology*,  physiopathology,  radiography
Cerebrovascular Circulation*
Intracranial Aneurysm / complications*,  physiopathology,  radiography
Prospective Studies
Regression Analysis
Rupture, Spontaneous
Subarachnoid Hemorrhage / etiology,  physiopathology,  radiography
Tomography, X-Ray Computed

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