Effects of Clot Removal by Meticulous Irrigation and Continuous Low-Dose Intravenous Nicardipine on Symptomatic Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage Treated by Clipping

摘要: Background Symptomatic cerebral vasospasm (SCV) is the second most common of morbidity and mortality in aneurysmal subarachnoid hemorrhage (aSAH) after rebleeding. Blood breakdown products are one leading causes vasospasm. We hypothesized that meticulous clot removal addition to continuous low-dose intravenous nicardipine (CLIN) could reduce incidence SCV. Methods SCV was defined as new focal neurologic signs, consciousness deterioration, or both when cause believed be ischemia attributable other possible worsening were excluded. Initial brain damage continued disturbance clipping without acute hydrocephalus, ischemic lesions, sign before clipping. Poor outcome a Glasgow Outcome Scale score 3–5 at 30 days. compared variables for 460 aSAH patients with SCV, poor by multivariate analysis. Results All underwent irrigation removal, observed 56 (12%). 2 (2.9%) among 70 treated CLIN. There higher proportion who older than 65 years ( P  = 0.032) female 0.038), lower CLIN 0.026) The outcomes for 109 (27%) poor; age greater 0.008) related outcomes. Conclusions present study showed might aSAH.