title: Prognostic factors in delayed ischaemic deficit with vasospasm in patients undergoing early aneurysm surgery.
abstract: We have examined prognostic factors in delayed ischaemic deficit attributed to vasospasm following subarachnoid haemorrhage (SAH) and early aneurysm surgery. Among 605 patients with SAH, 201 patients developed a delayed ischaemic deficit and 137 of these underwent early surgery. These 137 patients were classified into groups A and B by outcome at 3 months after SAH (group A: the delayed ischaemic deficit was associated with an adverse outcome; group B: no adverse outcome). Factors indicating an unfavourable outcome were as follows: (i) older age; (ii) poor WFNS grade on admission; (iii) Fisher's scale of 4; (iv) intracerebral haemorrhage; (v) delayed ischaemic deficit following rerupture; (vi) complications of surgical intervention; (vii) delayed ischaemic deficit with disturbance of consciousness; (viii) lack of immediate improvement with hypervolaemic therapy; and (ix) intracranial complications after hypervolaemic therapy. We suggest that the reversibility of a delayed ischaemic deficit is determined by preceding brain damage and/or surgical complications.
authors.affiliation: Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Shimoda
authors.forename: S
authors.initials: S
authors.lastname: Oda
authors.forename: R
authors.initials: R
authors.lastname: Tsugane
authors.forename: O
authors.initials: O
authors.lastname: Sato
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications; D002545:Brain Ischemia / Q000209:etiology* / Q000628:therapy; D005440:Fluid Therapy; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D011183:Postoperative Complications / Q000628:therapy; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000601:surgery