Predicting cerebral ischemia after aneurysmal subarachnoid hemorrhage: influences of clinical condition, CT results, and antifibrinolytic therapy. A report of the Cooperative Aneurysm Study

Harold P Adams Jr; Neal F Kassell; James C Torner; E Clarke Haley Jr

doi:10.1212/WNL.37.10.1586

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Predicting cerebral ischemia after aneurysmal subarachnoid hemorrhage: influences of clinical condition, CT results, and antifibrinolytic therapy. A report of the Cooperative Aneurysm Study

Journal article

Peer reviewed

Predicting cerebral ischemia after aneurysmal subarachnoid hemorrhage: influences of clinical condition, CT results, and antifibrinolytic therapy. A report of the Cooperative Aneurysm Study

Harold P Adams Jr, Neal F Kassell, James C Torner and E Clarke Haley Jr

Neurology, Vol.37(10), pp.1586-1591

10/1987

DOI: 10.1212/WNL.37.10.1586

PMID: 3658161

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Abstract

Cerebral ischemia from vasospasm is a major cause of death and disability following aneurysmal subarachnoid hemorrhage (SAH). This study examines and compares the relative utility of the initial neurologic examination and early CT in predicting cerebral ischemia after SAH. The influence of antifibrinolytic drugs (AFD) in the development of cerebral ischemia was also studied. AFD increased the risk of cerebral ischemia regardless of the admitting neurologic condition or the findings of CT. Among patients given AFD, impaired orientation or alertness was associated with a higher risk of ischemia. Other neurologic signs were not predictive of ischemia. Clinical features were not predictive of ischemia among patients not given AFD. Focal, thick collections of blood on CT were highly predictive of ischemia, whether or not patients received AFD. Admitting CT is the best prognostic indicator for the development of cerebral ischemia after SAH. It should be used to supplement the clinical examination in selecting patients best suited for therapy to prevent vasospasm.

Antifibrinolytic Agents - therapeutic use

Intracranial Aneurysm - diagnostic imaging

Consciousness

Humans

Risk Factors

Tomography, X-Ray Computed

Brain Ischemia - physiopathology

Intracranial Aneurysm - complications

Subarachnoid Hemorrhage - complications

Brain Ischemia - etiology

Subarachnoid Hemorrhage - diagnostic imaging

Forecasting

Brain Ischemia - psychology

Subarachnoid Hemorrhage - drug therapy

Details

Title: Subtitle: Predicting cerebral ischemia after aneurysmal subarachnoid hemorrhage: influences of clinical condition, CT results, and antifibrinolytic therapy. A report of the Cooperative Aneurysm Study
Creators: Harold P Adams Jr - Department of Neurology, University of Iowa, Iowa City
Neal F Kassell
James C Torner
E Clarke Haley Jr
Resource Type: Journal article
Publication Details: Neurology, Vol.37(10), pp.1586-1591
DOI: 10.1212/WNL.37.10.1586
PMID: 3658161
NLM abbreviation: Neurology
ISSN: 0028-3878
eISSN: 1526-632X
Publisher: United States
Grant note: 5-R01-NS15940-02 / NINDS NIH HHS
Language: English
Date published: 10/1987
Academic Unit: Neurology; Epidemiology; Iowa Neuroscience Institute; Surgery; Injury Prevention Research Center; Neurosurgery
Record Identifier: 9983996084002771

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