• Essi Raatikainen, Annukka Vahtera, Anne Kuitunen, Eija Junttila, Heini Huhtala, Antti Ronkainen, Liisa Pyysalo, and Heikki Kiiski.
• Tampere University Hospital, Department of Anesthesiology and Intensive Care, Tampere, Finland; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland. Electronic address: essi.raatikainen@fimnet.fi.
• J. Neurol. Sci. 2021 Jan 15; 420: 117261.

Background And PurposeDelayed cerebral ischemia (DCI) complicates the recovery of approximately 30% of patients with aneurysmal subarachnoid hemorrhage (aSAH). The definition of DCI widely varies, even though a consensus definition has been recommended since 2010. This study aimed to evaluate the prognostic value of the 2010 consensus definition of DCI in a cohort of patients with aSAH.MethodsWe conducted a single-center, retrospective, observational study that included consecutive adult patients with aSAH who were admitted to the intensive care unit from January 2010 to December 2014. DCI was evaluated 48 h to 14 days after onset of aSAH symptoms using the 2010 consensus criteria and outcome was assessed by the Glasgow Outcome Scale (GOS) at discharge from hospital.ResultsA total of 340 patients were analyzed and the incidence of DCI was 37.1%. The median time from primary hemorrhage to the occurrence of DCI was 97 h. Neurological deterioration was observed in most (89.7%) of the patients who fulfilled the DCI criteria. The occurrence of DCI was strongly associated with an unfavorable outcome (GOS 1-3) at hospital discharge (OR 2.65, 95% CI 1.69-4.22, p < 0.001).ConclusionsThe incidence of DCI after aSAH is high and its occurrence is strongly associated with an unfavorable neurological outcome. This finding adds to the previous literature, which has shown that DCI appears to be a major contributor affecting the functional ability of survivors of aSAH. To further advance reliable knowledge of DCI, future studies should adhere to the consensus definition of DCI.Copyright © 2020 Elsevier B.V. All rights reserved.

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