Factors Related to Clinical Vasospasm after Aneurysmal Subarachnoid Hemorrhage

ABSTRACT

Authors analysed a series of 175 patients with aneurysmal subarachnoid hemorrhage(SAH) who have undergone the treatment for subarachnoid hemorrhage from July, 1990 to May, 1994 to assess the clinical factors related to clinical vasospasm. This investigation revealed following conclusions. 1) The severity of subarachnoid hemorrhage as seen on computed tomography seemed to be correlated with the appearance of clinical vasospasm. Patients with severe SAH on initial CT scan were at higher risk or clinical vasospasm. 2) Patients with history of hypertension had more significant clinical vasospasm than did normotensive patients after aneurysmal SAH. 3) Aneurysms of the anterior communicating artery were showen to have the highest incidence of clinical vasospasm. 4) Patients with moderate to severe diffuse vasospasm on cerebral angiography had more significant clinical vasospasm than patients with no or local vasospasm. These conclusions suggest that clinical vasospasm after aneurysmal SAH are related to the followi ng predictable factors;amount of blood on the initial CT scan;angiographic vasspasm;history of hypertension and location of aneurysm. Proper management of these factors may diminish the incidence and severity of clinical vasospasm and reduce the morbidity and mortality rate.