Delayed Ischemic Neurological Deficits (DINDs)
A high percentage of SAH patients who survived the first few days following the ictus shows a secondary deterioration of the neurological status such as the drop of the level of consciousness and the appearance of hemiparesis. The neurological deficits which appear delayed to the onset of SAH are called “delayed neurological deficits” and they may be due to any kind of intracranial and systemic disorders occurring after SAH. Thus, delayed neurological deficits may be ascribed to the occurrence of acute hydrocephalus, electrolyte imbalances, rebleeding from the aneurysm, progressive elevation of ICP due to the presence of intracerebral hematoma, brain edema, or cardiorespiratory disorders. In addition to the above complications, there is a group of disorders which is ascribable to a primary impediment of cerebral circulation. A number of autopsy studies have shown the frequent occurrence of focal or wide-spread brain infarction in such cases. In distinction from disorders due to other causes, it is called “delayed ischemic neurological deficits” (DINDs).
KeywordsCerebral Artery Intracranial Aneurysm Cerebral Vasospasm Myosin Light Chain Kinase Aneurysmal Rupture
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