Transcranial Doppler Sonography Defined Vasospasm, Ischemic Brain Lesions, and Delayed Ischemic Neurological Deficit in Younger and Elderly Patients after Aneurysmal Subarachnoid Hemorrhage

Autor: Marco Stein, Malgorzata Kolodziej, Michael Bender, Eberhard Uhl, Marcus H.T. Reinges, Frank P. Schwarm, Eva Richter
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Subarachnoid hemorrhage
Critical Care
Databases
Factual
Ultrasonography
Doppler
Transcranial
Brain Ischemia
03 medical and health sciences
0302 clinical medicine
Ischemic brain
Predictive Value of Tests
Internal medicine
medicine
Humans
Vasospasm
Intracranial
In patient
cardiovascular diseases
Prospective Studies
Neurological deficit
Aged
Aged
80 and over
Receiver operating characteristic
business.industry
Transcranial doppler sonography
Age Factors
Vasospasm
Middle Aged
Subarachnoid Hemorrhage
musculoskeletal system
medicine.disease
nervous system diseases
030220 oncology & carcinogenesis
Cerebrovascular Circulation
cardiovascular system
Cardiology
Surgery
Female
Neurology (clinical)
Mean flow velocity
Nervous System Diseases
business
030217 neurology & neurosurgery
circulatory and respiratory physiology
Zdroj: World neurosurgery. 138
ISSN: 1878-8769
Popis: Vasospasm, delayed ischemic neurologic deficit (DIND), and ischemic brain lesions after acute subarachnoid hemorrhage (SAH) are associated with increased morbidity and mortality. The purpose of this study was to analyze age cutoffs for vasospasm, DIND, and ischemic brain lesions after SAH.This study included 292 aneurysmal SAH patients from January 2005 to December 2015. Patients' data were extracted from a prospective database with measurements of transcranial Doppler sonography. Any vasospasm was defined as a maximum mean flow velocity (MMFV)120 cm/sec. Severe vasospasms were defined as at least 2 measurements of MMFVs200 cm/sec or an increase of MMFV50 cm/sec/24 hours over 2 consecutive days or a new neurologic deficit. All MMFVs120 cm/sec in absence of severe vasospasm criteria were defined as mild vasospasm. Age-related cutoff values were calculated using receiver operating curve analysis.Any vasospasms occurred in 142 patients and thereof mild vasospasm in 86/142 (60.6%) patients and severe vasospasm in 56/142 patients (39.4%). Significantly higher incidences of any vasospasm (P = 0.005), severe vasospasm (P = 0.003), DIND (P = 0.031), and ischemic brain lesions (P = 0.04) were observed in patients aged50 years. According to receiver operating curve analysis, the optimal age cutoff was 50 years for the presence of overall vasospasms, severe vasospasms, DIND, and ischemic brain lesions and 65 years for mild vasospasms.Higher incidences of any vasospasms, severe vasospasms, DIND, and ischemic brain lesions were observed in younger SAH patients.
Databáze: OpenAIRE
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