title: Predictors of aneurysmal rebleed before definitive surgical or endovascular management.
abstract: Aneurysmal rebleed is the most dreaded complication following subarachnoid hemorrhage. Being a cause of devastating outcome, the stratification of risk factors can be used to prioritize patients, especially at high volume centers.
  
  
  
  A total of 99 patients with aneurysmal rebleed were analyzed in this study both prospectively and retrospectively from August 2010 to July 2014. In the control group, 100 patients were selected randomly from the patient registry. A total of 25 variables from the demographic, historical, clinical and radiological data were compared and analyzed by univariate and multivariate logistic regression analysis.
  
  
  
  Significant independent predictors of aneurysm rebleed were the presence of known hypertension (p = 0.023), diastolic blood pressure of >90 mmHg on admission (p = 0.008); presence of loss of consciousness (p = 0.013) or seizures (p = 0.002) at first ictus; history of warning headaches (p = 0.005); higher Fisher grade (p < 0.001); presence of multiple aneurysms (p = 0.021); irregular aneurysm surface (0.002).
  
  
  
  Identification of high risk factors can help in stratifying patients in the high risk group. The risk stratification strategy with early intervention can prevent rebleeds. This in turn may translate into better outcomes of patients with intracranial aneurysms.
authors.affiliation: Department of Neurosurgery, NIMHANS (National Institute of Mental Health and Neuroscinences), Bengaluru, Karnataka, 560029, India.
authors.forename: Chirag
authors.initials: C
authors.lastname: Solanki
authors.affiliation: Consultant Neurosurgeon, Manipal Hospital, Bengaluru, Karnataka, India.
authors.forename: Paritosh
authors.initials: P
authors.lastname: Pandey
authors.affiliation: Department of Neurosurgery, NIMHANS, Bengaluru, Karnataka, 560029, India. neuronarsi@gmail.com.|Department of Neurosurgery, Faculty Block, Neurosurgery office, NIMHANS campus, Bengaluru, Karnataka, 560029, India. neuronarsi@gmail.com.
authors.forename: K V L N
authors.initials: KV
authors.lastname: Rao
mesh_terms: D000328:Adult; D000368:Aged; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000601:surgery*
keywords: Aneurysm; Fisher grade; Hypertension; Rebleeding; Seizures; Subarachnoid hemorrhage; Warning headache