gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Refractory vasospasms in SAH-can we assess who is at risk?

Meeting Abstract

  • Daniela Müller - Universitätsklinikum Essen, Essen, Deutschland
  • Ramazan Jabbarli - Universitätsklinikum Essen, Essen, Deutschland
  • Bernadette Kleist - Universitätsklinikum Essen, Essen, Deutschland
  • Nicolai El Hindy - Universitätsklinikum Essen, Essen, Deutschland
  • Ulrich Sure - Essen, Deutschland
  • Oliver Müller - Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.02.07

doi: 10.3205/17dgnc013, urn:nbn:de:0183-17dgnc0130

Published: June 9, 2017

© 2017 Müller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Refractory vasospasms remain a hazardous complication in the course of (aneurysmal) subarachnoid hemorrhage (SAH). The aim of this study was to identify risk factors for refractory vasospasms in a single center patient cohort.

Methods: Between 2003 and 2015 a total of 955 consecutive patients with SAH were treated. Vasospasms were detected by transcranial Doppler sonography on the ICU according to predefined criteria and confirmed by digital subtraction angiography (DSA). Vasospamolysis was done interventionally with nimodipine and / or ballon angioplasty wherever necessary. Patients records were analyzed and the data of patients with only one vasospasm and of patients who suffered from two or more vasospasms, defined as refractory vasospasms, were compared by |2-test in regard tosex, Hunt & Hess grade at admission and concomitant meningitis.

Results: A total of 164 patients (17.2%) with vasospasms was identified by DSA, 119 female (72.6%) and 45 male patients (27.4%) were in this series. In 80 patients two or more vasospasmolyses were performed. There was no significant association between the number of vasospasms and Hunt & Hess grade at admission (p=0.157), sex (p=0.867) or accompanying meningitis (p=0.336). Nevertheless, amongst patients requiring multiple vasospasmolyses (defined as 5+; n=12) were 10 female and 2 male patients.

Conclusion: Despite a very large series of patients suffering from SAH, statistical analysis failed to identifiy factors that might be associated with refractory vasospasms. The common prejudice that women are more prone to experience vasospasms after SAH in general cannot hold stand according to our data. More research has to be done to identify who is at risk for severe refractory vasospasms.