Document Detail


Retrospective analysis of predictors of cerebral vasospasm after ruptured cerebral aneurysm surgery: influence of the location of subarachnoid blood.
MedLine Citation:
PMID:  20039076     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The amount of blood on computed tomography (CT) has been shown to be a predictor of cerebral vasospasm after subarachnoid hemorrhage (SAH). However, the influence of the location of the blood on the incidence of vasospasm remains unclear. We retrospectively assessed the association of the blood volumes in the individual components (cisterns and fissures) of CT scans with angiographic vasospasm after SAH. METHODS: One hundred forty-nine SAH patients scheduled for cerebral aneurysm clipping were enrolled. The amount of subarachnoid blood was classified using the Fisher CT grade. The amounts of subarachnoid blood in 5 cisterns or 3 fissures were also evaluated using SAH scores ranging from 0 to 3 (0, no blood; 3, completely filled with blood). Cerebral vasospasm was diagnosed by the results of angiography. RESULTS: Angiographic vasospasm developed in 51 of 149 patients (34%). Of those, 26 patients were symptomatic. The Fisher CT grade and SAH scores in the right and left sylvian fissures and suprasellar cisterns were significantly higher in patients with angiographic vasospasm than in those without it. Univariate logistic regression analysis revealed that a high Fisher CT grade and high SAH scores in the right and left sylvian fissures and suprasellar cisterns were predictors of angiographic vasospasm. Multivariate analysis indicated that the SAH score in the right sylvian fissure was an independent predictor of angiographic vasospasm (odds ratio, 3.6; 95% confidence interval (CI), 1.7-7.7; P = 0.01). CONCLUSION: The results indicated that the amount of blood in the right sylvian fissure was significantly associated with the development of angiographic vasospasm after SAH.
Authors:
Yasumitsu Nomura; Masahiko Kawaguchi; Kenji Yoshitani; Naoko Kurita; Hironobu Hayashi; Kentarou Tamura; Yasushi Motoyama; Hiroyuki Nakase; Hitoshi Furuya
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Publication Detail:
Type:  Journal Article     Date:  2009-12-29
Journal Detail:
Title:  Journal of anesthesia     Volume:  24     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-08     Completed Date:  2010-05-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aneurysm, Ruptured / surgery*
Angiography, Digital Subtraction
Brain / pathology*
Cerebral Angiography
Female
Humans
Incidence
Intracranial Aneurysm / surgery*
Male
Middle Aged
Organ Specificity
Postoperative Hemorrhage / radiography*
Regression Analysis
Retrospective Studies
Rupture, Spontaneous
Severity of Illness Index
Subarachnoid Hemorrhage / radiography*
Tomography, X-Ray Computed
Vasospasm, Intracranial / epidemiology,  etiology*,  prevention & control

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


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