Clinical and radiological predictors for early detection of cerebral vasospasm after subarachnoid haemorrhage

Document Type : Original Article

Authors

1 110 reyad street with gamal abd elnasser street

2 Lecturer of Neurology Faculty of Medicine, Benha University

3 Assist. Professor of Neurology Faculty of Medicine, Benha University

4 Consultant of Neurology and head of neuropsychiatric department at El Mataria teaching hospital.

5 Professor of Neurology Faculty of Medicine, Benha University.

Abstract

Abstract: Cerebral vasospasm after subarachnoid haemorrhage is a potentially preventable and reversible condition where an early identification can prevent or limit cerebral infarction. Vasospasm may be assessed on a clinical, radiographic, or angiographic basis.

Aim: Early detection of cerebral vasospasm in a sample of Egyptian patients presented with spontaneous subarachnoid haemorrhage.

Methods and subjects:In this study we enrolled 40 aSAH patients diagnosed by non-contrast brain CT and CT angiography and managed by interventional aneurysmal embolization . Early detection of vasospasm and DCI was assessed on clinical and radiological basis using transcranial duplex studies (TCD) on the 1st, 3rd, 5th, 7th and 10th days of the onset of the symptoms .

Results: Fourty patients with aSAH , of them 67.5% developed vasospasm but only 33.3% progressed to DCI. The most significant day of vasospasm development as detected by TCD was on the 7th day.The most common arteries undergoing vasospasm were the MCA followed by the ACA and lastly the PCA. Clinical scalas on admission as (GCS,HHS,WFNS and Ogilvy and Carter scale) are highly significant predictors of cerebral vasospasm

Conclusion: Clinical risk factors and the use of TCD are tools for early detection of vasospasm following SAH. This allows for early therapeutic intervention before irreversible ischemic neurological deficits take place.

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