Document Detail


Post-subarachnoid Hemorrhage Vasospasm in Patients with Primary Headache Disorders.
MedLine Citation:
PMID:  23192335     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Altered cerebral vasomotor reactivity leading to vasospasm can be seen both in patients with primary headache disorders (PHD) and in patients with subarachnoid hemorrhage (SAH). The pathogenesis of vasospasm in post-SAH patients and in headache disorder sufferers may be related. To address this hypothesis, we analyzed a large cohort of SAH patients to determine whether a diagnosis of PHD predisposes to vasospasm, delayed cerebral ischemia, or worsened clinical outcome. METHODS: Prospectively collected data from patients enrolled in the SAH Outcomes Project between 1996 and 2006 were analyzed. Patients were segregated based on whether they had a diagnosis of PHD or not and were subsequently compared for differences in clinical and radiographic outcome. RESULTS: A total of 921 SAH patients were analyzed, 265 of which had a diagnosis of PHD. In total, symptomatic vasospasm was seen in 17 %, while angiographic vasospasm was seen in 28 %. Vasospasm rates were similar among patients with a PHD and in those without a PHD (p > 0.05). However, on multivariate analysis new ischemic infarcts were more common in patients with a PHD as compared to patients without a PHD (p = 0.015). Functional outcomes at 3 months were similar among PHD and non-PHD patients (p > 0.05). CONCLUSION: A history of PHD is associated with an increased rate of ischemic infarcts during admission for SAH. Increased rates of vasospasm within small cerebral blood vessels may be implicated. Further studies are warranted to more closely link the mechanisms of vasospasm in PHD and SAH patients.
Authors:
Jason A Ellis; Hannah Goldstein; Philip M Meyers; Sean D Lavine; E Sander Connolly; Stephan A Mayer; Neeraj Badjatia; Dorothea Altschul
Related Documents :
24380485 - Editorial: workforce needs for endovascular acute ischemic stroke therapy: myth or real...
15507275 - How much warfarin is enough in aps related thrombosis?
2368875 - Surgical procedures for bleeding esophagogastric varices when sclerotherapy fails: a pr...
15558915 - Clinical correlation between effective anticoagulants and risk of stroke: are we using ...
2343685 - Cytologic findings in posttransplant lymphoproliferative disease.
18983285 - Microalbuminuria in nondiabetic and nonhypertensive systolic heart failure patients.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-29
Journal Detail:
Title:  Neurocritical care     Volume:  -     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA, jae2109@columbia.edu.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Nodal status is not a prognostic factor in patients with HPV-positive oral/oropharyngeal tumors.
Next Document:  New modalities of brain stimulation for stroke rehabilitation.