gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Demographic and clinical predictors of severity of cerebral vasospasm after subarachnoid hemorrhage

Meeting Abstract

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  • R. Jabbarli - Abteilung Allgemeine Neurochirurgie, Universitätsklinikum Freiburg
  • S. Gläsker - Abteilung Allgemeine Neurochirurgie, Universitätsklinikum Freiburg
  • M. Olschewski - Institut für Medizinische Biometrie und Medizinische Informatik, Albert-Ludwigs-Universität Freiburg
  • J. Weber - Institut für Radiologie, Kantonsspital St. Gallen, Schweiz
  • V.V. Velthoven - Abteilung Allgemeine Neurochirurgie, Universitätsklinikum Freiburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 061

doi: 10.3205/12dgnc448, urn:nbn:de:0183-12dgnc4485

Published: June 4, 2012

© 2012 Jabbarli et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Cerebral vasospasm is one of the leading causes of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). The potential risk factors for the development of vasospasm have been evaluated in many clinical studies. But it remains unclear, whether the severity of vasospasm can be predicted also. This lack of knowledge prevents duly and adequate therapy in many patients.

Methods: We retrospectively analysed a consecutive monocentric series of patients with SAH who underwent an endovascular vasospasm treatment. We studied demographic and clinical characteristics of these patients. The severity of vasospasm was defined by cerebral angiography, transcranial Doppler (TCD) and therapy response on endovascular treatment. Statistical analyses were performed to determine the significant predictors.

Results: A total of 70 patients were included. Early onset of critical vasospasm (>200 cm/s) on TCD was significantly correlated with resistance against pharmacological treatment (P=0.0277). Younger age (<50) was significantly associated with severity of vasospasm regarding extension on angiography (P=0.0286), duration of critical vasospasms on TCD after endovascular treatment (P=0.0004) and response to pharmacological treatment (P=0.03). The patients with higher Hunt & Hess and Fisher grade, as well as female patients showed a trend to more severe vasospasm without statistically significant correlation. Modality of aneurysm treatment and blood group were not correlated with vasospasm severity.

Conclusions: The younger age and early onset of critical vasospasm on TCD seem to be important predictors not only for the occurrence of vasospasm, but also for its severity. We recommend early and aggressive therapy in this subgroup.