Quantitative Analysis of Hemorrhage Volume for Predicting Delayed Cerebral Ischemia After Subarachnoid Hemorrhage

• Published in: Stroke (1970) 2011-03, Vol.42 (3), p.669-674
• Main Authors: KO, Sang-Bae, CHOI, H. Alex, CARPENTER, Amanda Mary, HELBOK, Raimund, SCHMIDT, J. Michael, BADJATIA, Neeraj, CLAASSEN, Jan, SANDER CONNOLLY, E, MAYER, Stephan A, LEE, Kiwon
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Brain Ischemia - etiology; Brain Ischemia - pathology; Cohort Studies; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Neurology; Neuropharmacology; Neuroprotective agent; Pharmacology. Drug treatments; Predictive Value of Tests; Prospective Studies; Subarachnoid Hemorrhage - complications; Subarachnoid Hemorrhage - pathology; Time Factors; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0039-2499; 1524-4628; 1524-4628
• DOI: 10.1161/strokeaha.110.600775

Delayed cerebral ischemia (DCI) is an important complication after subarachnoid hemorrhage and appears to be associated with clot burden on CT. Quantification of hemorrhage on digitized images may be a more accurate method for predicting DCI than qualitative scales. Quantitative analysis of clot burden on CT was performed in 160 subarachnoid hemorrhage patients who were scanned within 24 hours from the symptom onset between June 25, 2005 and July 19, 2009. Cisternal plus intraventricular hemorrhage volumes (CIHV) were classified into quartiles to evaluate their association with DCI. DCI was defined as neurological deterioration or cerebral infarction, or both attributable to vasospasm. DCI occurred in 25% of the patients included (age, 55.4±14.5; male, 36.3%). Compared to the lowest quartile of CIHV (