The impact of collateral status on cerebral vasospasm and delayed cerebral ischemia in subarachnoid hemorrhage.

Autor: Topcu A; Department of Neurosurgery, Adnan Menderes University Faculty of Medicine, Aydın, Tükiye., Ozkul A; Department of Neurology, Adnan Menderes University Faculty of Medicine, Aydın, Tükiye., Yilmaz A; Department of Neurosurgery, Adnan Menderes University Faculty of Medicine, Aydın, Tükiye., Yi HJ; Department of Neurosurgery, Soonchunhyang University College of Medicine, Bucheon, Korea., Shin DS; Department of Neurosurgery, Soonchunhyang University College of Medicine, Bucheon, Korea., Kim B; Department of Neurosurgery, Soonchunhyang University College of Medicine, Bucheon, Korea.
Jazyk: angličtina
Zdroj: Journal of cerebrovascular and endovascular neurosurgery [J Cerebrovasc Endovasc Neurosurg] 2023 Sep; Vol. 25 (3), pp. 288-296. Date of Electronic Publication: 2023 May 26.
DOI: 10.7461/jcen.2023.E2022.11.005
Abstrakt: Objective: Cerebral collateral circulation may affect subarachnoid hemorrhage (SAH) induced cerebral vasospasm and delayed cerebral ischemia. In this study our aim was to investigate the relationship between collateral status, vasospasm and delayed cerebral ischemia (DCI) in both aneurysmal and nonaneurysmal SAH.
Methods: Patients diagnosed as SAH with and without aneurysm were included and their data investigated retrospectively. After the patients diagnosed as SAH according to cerebral computed tomography (CT)/magnetic resonance imaging (MRI), they underwent cerebral angiography to check for cerebral aneurysm. The diagnosis of DCI was made according to the neurological examination and control CT/MRI. All the patients had their control cerebral angiography on days 7 to 10 in order to assess vasospasm and also collateral circulation. The American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) Collateral Flow Grading System was modified to measure collateral circulation.
Results: A total of 59 patients data were analyzed. Patients with aneurysmal SAH had higher Fisher scores and DCI was more common. Although there was no statistically significant difference between the patients with and without DCI in terms of demographics and mortality, patients with DCI had worse collateral circulation and more severe vasospasm. These patients had higher Fisher scores and more cerebral aneurysm overall.
Conclusions: According to our data, patients with higher Fisher scores, more severe vasospasm, and poor cerebral collateral circulation may experience DCI more frequently. Additionally aneurysmal SAH had higher Fisher scores and DCI was seen more common. To improve the clinical results for SAH patients, we believe that physicians should be aware of the DCI risk factors.
Databáze: MEDLINE
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