Angiographic Findings in Refractory Delayed Cerebral Ischemia
Arq. bras. neurocir
;
38(3): 157-165, 15/09/2019.
Article
in English
| LILACS
| ID: biblio-1362589
ABSTRACT
Background Delayed cerebral ischemia (DCI) follows a refractory course in a subgroup of patients with aneurysmal subarachnoid hemorrhage (SAH), leading to diffuse ischemic injury. The role of angiographic vasospasm (AV) is unknown. Our goal is to study the angiographic alterations and the clinical profile of refractory DCI patients. Methods Retrospective study of patients with SAH who presented with DCI treated with medical and endovascular therapy, with a refractory evolution, defined asmultiple ischemic infarction and brain death. Results Out of a cohort of 336 patients, 7 (2%) developed refractory DCI. The median age of the patients was 48 (3860) years old. Five patients had ruptured anterior communicating artery (ACoA) aneurysms. Four patients were treated with coil embolization, and three with microsurgical clipping. Angiographic vasospasm was classified as severe in 5 cases. Compromise of bilateral circulation was detected in six patients. Distal circulation vasospasm occurred in five cases. Slow circulatory transit times were observed in three patients. Conclusion Angiographic findings such as bilateral circulatory compromise and distal vasospasm were frequent alterations. Further studies are required to establish the association of these findings with the clinical outcomes.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Subarachnoid Hemorrhage
/
Intracranial Aneurysm
/
Brain Ischemia
Type of study:
Diagnostic study
/
Etiology study
/
Incidence study
/
Observational study
/
Risk factors
Language:
English
Journal:
Arq. bras. neurocir
Journal subject:
Cirurgia
/
Neurosurgery
Year:
2019
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Hospital Regional Rancagua/CL
/
Institute of Neurosurgery Asenjo/CL
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