• George Kwok Chu Wong and Wai Sang Poon.
• Division of Neurosurgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. georgewong@surgery.cuhk.edu.hk
• Acta Neurochir. Suppl. 2013 Jan 1;115:9-11.

ObjectiveWe aimed to investigate the profiles and prognostic values of delayed cerebral ischemia (DCI) and delayed cerebral infarction.MethodsIMASH (Intravenous Magnesium Sulphate for Aneurysmal Subarachnoid Hemorrhage) was registered at http://www.strokecenter.org/trials , and http://www.ClinicalTrials.gov (NCT00124150). Data of 327 patients were retrieved for logistic regression analyses.ResultsSeventy-one (22%) patients developed DCI, and 35 (11%) patients developed delayed cerebral infarction. Only 18 (25%) patients with DCI and 7/35 (20%) patients with delayed cerebral infarction had mean middle cerebral artery velocities (transcranial Doppler ultrasound) over 120 cm/s. Regarding the prognostic significance of the components of DCI, delayed cerebral infarction predicted unfavorable outcome in terms of Extended Glasgow Outcome Scale (OR 3.1, 95% [CI] 1.3-7.8), poor outcome in terms of modified Rankin Scale (odds ratio [OR] 3.0, 95% confidence interval CI 1.2-7.7), and dependent activity of daily living in terms of Barthel Index (OR 3.6, 95% CI 1.4-9.2) at 6 months, after adjustments for other prognostic factors. On the other hand, clinical deterioration predicted inpatient mortality (OR 8.8, 95% CI 1.6-48.8) after adjustments for other prognostic factors.ConclusionsDelayed cerebral ischemia and delayed cerebral infarction carried different prognostic values in aneurysmal subarachnoid hemorrhage.

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