title: Risk Factors for Postoperative Cerebral Vasospasm After Surgical Resection of Acoustic Neuroma.
abstract: BACKGROUND
  Cerebral vasospasm is an important cause of morbidity after subarachnoid hemorrhage, but can also occur after resection of acoustic neuroma. This study aimed to identify factors associated with postoperative cerebral vasospasm in patients with acoustic neuroma.
  
  
  METHODS
  This was a retrospective analysis of patients with acoustic neuroma (diagnosed by preoperative magnetic resonance imaging and postoperative pathology) treated between April 2013 and February 2014 in a hospital in China. Patients with other intracranial abnormalities, postoperative vasoactive drug use, or postoperative abnormalities in consciousness, vital signs, blood electrolytes, or arterial blood gases were excluded. The neurilemmoma was removed using the suboccipital retrosigmoid sinus approach, with care taken to minimize bleeding and protect the facial, trigeminal, and lower cranial nerves and brainstem. Flow velocities in the bilateral internal carotid, middle cerebral, and anterior cerebral arteries, assessed with transcranial Doppler ultrasonography before surgery and on postoperative days 1, 3, 5, 7, and 9, were used to detect cerebral vasospasm (mild, 120-140 cm/s; moderate, 141-200 cm/s; severe, >200 cm/s). Factors associated with vasospasm were identified by univariate and multivariate analyses.
  
  
  RESULTS
  Forty-three (53.8%) of the 80 patients (36 men) included were diagnosed with cerebral vasospasm: 5 (11.6%) were categorized as mild, 36 (83.7%) as moderate, and 2 (4.7%) as severe. Multivariate analysis showed that younger patient age, larger tumor size, and firm tumor consistency were independently associated with postoperative cerebral vasospasm (P <0.05).
  
  
  CONCLUSIONS
  Younger patient age, larger tumor size, and firmer tumor consistency were independently associated with postoperative cerebral vasospasm in patients with acoustic neuroma.
authors.affiliation: Beijing Tiantan Hospital Affiliated Capital Medical University, Beijing, People's Republic of China.
authors.forename: Ji
authors.initials: J
authors.lastname: Qi
authors.affiliation: Beijing Tiantan Hospital Affiliated Capital Medical University, Beijing, People's Republic of China.
authors.forename: Wang
authors.initials: W
authors.lastname: Jia
authors.affiliation: Beijing Tiantan Hospital Affiliated Capital Medical University, Beijing, People's Republic of China. Electronic address: zhanglwsci@sina.com.
authors.forename: Liwei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Beijing Tiantan Hospital Affiliated Capital Medical University, Beijing, People's Republic of China.
authors.forename: Junting
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Beijing Tiantan Hospital Affiliated Capital Medical University, Beijing, People's Republic of China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017585:Ultrasonography, Doppler, Transcranial; D020301:Vasospasm, Intracranial / Q000453:epidemiology* / Q000209:etiology*
keywords: Acoustic neuroma; Cerebral vasospasm; Risk factors; Transcranial Doppler ultrasound