Predictors and outcome of acute symptomatic cerebral infarctions following aneurysmal subarachnoid hemorrhage.
The leading cause of unfavorable outcomes following aneurysmal subarachnoid hemorrhage (SAH) is cerebral infarction. In this 3-year retrospective study, we have retrospectively evaluated 172 hospitalized patients with aneurysmal SAH, and compared those who developed a complicated cerebral infarction with those who did not. In this study, acute symptomatic cerebral infarctions accounted for 22.6% (39/172) of all episodes. Significant statistical analysis between the two patient groups included age at onset, hypertension as the underlying disease, presence of symptomatic vasospasm, mean hospitalization days and Glasgow Outcome Score at the time of discharge. After a minimum 1.5-year follow-up period, the median (interquantile range) Barthel index score was 75 (6-85) for those patients who had cerebral infarctions, and 80 (0-90) for those who had no cerebral infarctions. Multiple logistic regression analysis demonstrated that the presence of symptomatic vasospasm was independently associated with the presence of acute symptomatic cerebral infarctions. The presence of symptomatic vasospasm implies the danger of acute symptomatic cerebral events after aneurysmal SAH. Although our study demonstrates a worse short-term outcome and longer duration of hospitalization in this special group of patients, the functional outcome for patients with cerebral infarction was not inferior to those patients without cerebral infarction after a follow-up of at least 1.5-years.
Su
Feng-Wen
FW
Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Lin
Yu-Jun
YJ
Chang
Wen-Neng
WN
Ho
Jih-Tsun
JT
Wang
Hung-Chen
HC
Yang
Tzu-Ming
TM
Su
Thung-Ming
TM
Lin
Wei-Che
WC
Tsai
Nai-Wen
NW
Ding
Yu-Ling
YL
Lu
Cheng-Hsien
CH
D000208:Acute Disease; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000150:complications