Early vs. delayed cerebral infarction after aneurysm repair after subarachnoid hemorrhage.

摘要: BACKGROUND Cerebral infarction is a major contributor to poor outcome after subarachnoid hemorrhage (SAH). Although usually considered complication of delayed cerebral ischemia, infarcts may also occur early, in relation initial brain injury or aneurysm-securing procedures. OBJECTIVE We analyzed the relative frequency and volume early vs SAH their relationship hospital outcome. METHODS Retrospective review consecutive patients admitted with aneurysmal over 4 years who had follow-up imaging 7 days later admission. Imaging 24 48-hours procedures was reviewed classify seen on final as delayed. Infarct volumes were measured by perimeter tracing infarct burden calculated for each patient. RESULTS Of 250 eligible patients, 205 imaging; present 61 patients. these, 29 infarcts, 16 5 both infarcts. Eleven did not undergo postprocedure computed tomography; these presumptively classified having late Early contributed equally burden. associated aneurysm clipping (odds ratio: 4.2, 95% confidence interval: 1.8-9.5 compared coiling), whereas almost always association angiographic vasospasm 3.3, 1.5-7.3). Patients well especially those more than 30 cm worse discharge disposition. CONCLUSION occurs frequently contributes much ischemia Efforts better understand modify contributors appear warranted.