title: Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage.
abstract: Predictors for cerebral infarction, an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH), were examined. This study used data from the Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) cohort, which included 579 patients whose ruptured aneurysms were treated with either clipping or coiling within 12 days of onset. Patient, clinical, radiographic, and treatment variables associated with cerebral infarction were determined. Ruptured aneurysms were clipped in 282 patients and coiled in 297 patients. Cerebral infarction occurred in 162 patients (28.0 %): 101 patients by cerebral vasospasm, 34 patients by clipping, and 33 patients by coiling. Univariate analyses showed that significant factors associated with cerebral infarction development were Fisher computed tomography (CT) group 3 on admission, premature aneurysm rupture during clipping procedure, cerebrospinal fluid drainage, symptomatic vasospasm, endovascular treatment for vasospasm, and shunt-dependent hydrocephalus. Multivariable logistic regression analyses showed that cerebral infarction was significantly associated with Fisher CT group 3 on admission, larger aneurysm dome size, ruptured posterior circulation aneurysms, premature aneurysm rupture during clipping procedure, symptomatic vasospasm, and infection, while endovascular treatment for vasospasm significantly decreased the development of cerebral infarction. The most important potentially treatable factor associated with cerebral infarction was symptomatic vasospasm.
authors.affiliation: Department of Neurosurgery, Suzuka Kaisei Hospital, Suzuka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kanamaru
authors.affiliation: Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan. suzuki02@clin.medic.mie-u.ac.jp.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
authors.forename: Waro
authors.initials: W
authors.lastname: Taki
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D002544:Cerebral Infarction / Q000453:epidemiology*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology*; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019635:Neurosurgical Procedures; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D020301:Vasospasm, Intracranial / Q000453:epidemiology*
keywords: Cerebral aneurysm; Cerebral infarct; Cerebral vasospasm; Endovascular treatment; Microsurgery; Subarachnoid hemorrhage