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Cerebral Vasospasm: Neurovascular Events After Subarachnoid Hemorrhage pp 9–11Cite as

Clinical, Transcranial Doppler Ultrasound, Radiological Features and, Prognostic Significance of Delayed Cerebral Ischemia

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Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 115))

Abstract

Objective: We aimed to investigate the profiles and prognostic values of delayed cerebral ischemia (DCI) and delayed cerebral infarction.

Methods: IMASH (Intravenous Magnesium Sulphate for Aneurysmal Subarachnoid Hemorrhage) was registered at http://www.strokecenter.org/trials, and http://www.ClinicalTrials.gov (NCT00124150). Data of 327 patients were retrieved for logistic regression analyses.

Results: Seventy-one (22%) patients developed DCI, and 35 (11%) patients developed delayed cerebral infarction. Only 18 (25%) patients with DCI and 7/35 (20%) patients with delayed cerebral infarction had mean middle cerebral artery velocities (transcranial Doppler ultrasound) over 120 cm/s. Regarding the prognostic significance of the components of DCI, delayed cerebral infarction predicted unfavorable outcome in terms of Extended Glasgow Outcome Scale (OR 3.1, 95% [CI] 1.3–7.8), poor outcome in terms of modified Rankin Scale (odds ratio [OR] 3.0, 95% confidence interval CI 1.2–7.7), and dependent activity of daily living in terms of Barthel Index (OR 3.6, 95% CI 1.4–9.2) at 6 months, after adjustments for other prognostic factors. On the other hand, clinical deterioration predicted inpatient mortality (OR 8.8, 95% CI 1.6–48.8) after adjustments for other prognostic factors.

Conclusions: Delayed cerebral ischemia and delayed cerebral infarction carried different prognostic values in aneurysmal subarachnoid hemorrhage.

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Acknowledgements

None.

Sources of Funding

IMASH was supported by the Hong Kong Research Grant Council. The funding source had no role in the study design, collection, analysis or interpretation of data, manuscript preparation or decision for submission.

Disclosure

None.

Conflicts of Interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Neurosurgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China

    George Kwok Chu Wong M.D. & Wai Sang Poon FRCS

  2. Department of Surgery, Prince of Wales Hospital, 4/F Clinical Science Building, 1 Ngan Shing Street, Shatin, Hong Kong SAR, China

    George Kwok Chu Wong M.D.

Authors
  1. George Kwok Chu Wong M.D.
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  2. Wai Sang Poon FRCS
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Corresponding author

Correspondence to George Kwok Chu Wong M.D. .

Editor information

Editors and Affiliations

  1. , Department of Neurosurgery, University of Cincinnati, Stetson, Suite 2200 260, Cincinnati, 45267-0515, Ohio, USA

    Mario Zuccarello

  2. College of Medicine, Department of Neurology, University of Cincinnati, Albert Sabin Way 231MSB room 1, Cincinnati, 46267-0536, Ohio, USA

    Joseph F. Clark

  3. College of Medicine, Dept. of Neurology and Neurosurgery, University of Cincinnati, Albert Sabin Way 231ML0517, Cincinnati, 45267-0517, Ohio, USA

    Gail Pyne-Geithman

  4. College of Medicine, Dept. of Neurosurgery, University of Cincinnati, Stetson St. Suite 260ML0515, Cincinnati, 45219, Ohio, USA

    Norberto Andaluz

  5. College of Medicine, Dept. of Neurosurgery, University of Cincinnati, Stetson, Suite 2200 260, Cincinnati, 45219, Ohio, USA

    Jed A. Hartings

  6. , Dept. of Emergency Medicine, University of Cincinnati, Albert Sabin Way 231ML0769, Cincinnati, 45267-0769, Ohio, USA

    Opeolu M. Adeoye

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Wong, G.K.C., Poon, W.S. (2013). Clinical, Transcranial Doppler Ultrasound, Radiological Features and, Prognostic Significance of Delayed Cerebral Ischemia. In: Zuccarello, M., Clark, J., Pyne-Geithman, G., Andaluz, N., Hartings, J., Adeoye, O. (eds) Cerebral Vasospasm: Neurovascular Events After Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 115. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1192-5_3

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  • DOI: https://doi.org/10.1007/978-3-7091-1192-5_3

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  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-1191-8

  • Online ISBN: 978-3-7091-1192-5

  • eBook Packages: MedicineMedicine (R0)

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