Predictors of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a cardiac focus.

Neurocritical Care
Khalil YousefMarilyn Hravnak

Abstract

Myocardial injury after aneurysmal subarachnoid hemorrhage (aSAH) is associated with poor outcomes. Delayed cerebral ischemia (DCI) is also a complication of aSAH. We sought to determine whether (1) DCI could be predicted by demographics, aSAH severity/aneurysm location, or aSAH-associated myocardial injury (SAHMI), and (2) DCI is associated with increased mortality after aSAH. Prospective longitudinal study of 149 aSAH subjects with definitive DCI evaluation, age 18-75 years, Hunt and Hess (HH) ≥ 3, and/or Fisher ≥ 2, and admitted to the Neurovascular ICU. DCI was defined by the presence of neurological deterioration accompanied by evidence of abnormal cerebral blood flow. Subjects were 48% DCI(+) and 52% DCI(-). DCI(+) subjects had more severe aSAH [HH (P = 0.002), Fisher (P = 0.004), admission Glasgow Coma Scale (P = 0.018)]. More DCI(+) subjects had pulmonary congestion than DCI(-) subjects (63 vs. 39%, P = 0.003). On echocardiogram, cardiac output (CO, liters per minute [LPM]) was significantly higher in DCI(+) than in DCI(-) subjects (6 ± 2 vs. 5 ± 1 LPM; P = 0.015). Multivariate analysis identified CO and Fisher grade as independent predictors of DCI (P = 0.02, 0.019). For each 1 LPM increase in CO, the odds of DCI incre...Continue Reading

References

Oct 1, 1992·Stroke; a Journal of Cerebral Circulation·D O WiebersI Meissner
Oct 1, 1988·Stroke; a Journal of Cerebral Circulation·A HijdraH van Crevel
Jul 1, 1985·Stroke; a Journal of Cerebral Circulation·R Bonita, S Thomson
Mar 1, 1997·Stroke; a Journal of Cerebral Circulation·J W HopJ van Gijn
Nov 5, 1999·Stroke; a Journal of Cerebral Circulation·J W HopJ van Gijn
May 8, 2000·Stroke; a Journal of Cerebral Circulation·T IngallR Bonita
Apr 18, 2003·Neurosurgery·Jonathan A FriedmanEelco F M Wijdicks
Sep 10, 2004·Acta Neurologica Scandinavica·E A CragoA Kassam
Jun 23, 2006·Acta neurochirurgica·W J SchuilingG J E Rinkel
Dec 19, 2007·Neurocritical Care·Preeti RamappaJames D Marsh
Jun 6, 2008·Cerebrovascular Diseases·Jennifer A FronteraStephan A Mayer
Feb 3, 2009·Neurocritical Care·J Michael FrangiskakisBarry London
Apr 11, 2009·Stroke; a Journal of Cerebral Circulation·Jennifer A FronteraStephan A Mayer
Apr 25, 2009·Cerebrovascular Diseases·Emmanuel CarreraStephan A Mayer

❮ Previous
Next ❯

Citations

Nov 10, 2013·AJNR. American Journal of Neuroradiology·R P KilleenP C Sanelli
Feb 21, 2013·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Ramazan JabbarliVera Van Velthoven
Sep 12, 2014·Neurocritical Care·Fabio Silvio TacconeUNKNOWN Participants in the International Multi-disciplinary Consensus Conference on Multimodality Monitoring
Nov 21, 2015·Journal of Intensive Care Medicine·Alfredo E UrdanetaMonica S Vavilala
Apr 29, 2018·Acta neurochirurgica·Marvin Darkwah OppongRamazan Jabbarli
Dec 27, 2011·Stroke; a Journal of Cerebral Circulation·Emanuela CrobedduAlejandro A Rabinstein
Dec 20, 2012·Stroke; a Journal of Cerebral Circulation·Nicolien K de RooijCatharina J M Frijns
Jul 18, 2017·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Khalil M YousefMarilyn Hravnak

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.