• World Neurosurg · Jun 2020

    Transcranial Doppler Sonography defined Vasospasm, ischemic brain lesions, and delayed ischemic neurological deficit in younger and elderly patients after aneurysmal subarachnoid hemorrhage.

    • Michael Bender, Eva Richter, Frank P Schwarm, Malgorzata A Kolodziej, Eberhard Uhl, Reinges Marcus H T MHT Department of Neurosurgery, Justus-Liebig-University Gießen, Gießen, Germany; Department of Neurosurgery, Bremen-Mitte Hospital, Bremen, Bremen, Ge, and Marco Stein.
    • Department of Neurosurgery, Justus-Liebig-University Gießen, Gießen, Germany. Electronic address: michael.bender@neuro.med.uni-giessen.de.
    • World Neurosurg. 2020 Jun 1; 138: e718-e724.

    BackgroundVasospasm, delayed ischemic neurologic deficit (DIND), and ischemic brain lesions after acute subarachnoid hemorrhage (SAH) are associated with increased morbidity and mortality. The purpose of this study was to analyze age cutoffs for vasospasm, DIND, and ischemic brain lesions after SAH.MethodsThis study included 292 aneurysmal SAH patients from January 2005 to December 2015. Patients' data were extracted from a prospective database with measurements of transcranial Doppler sonography. Any vasospasm was defined as a maximum mean flow velocity (MMFV) >120 cm/sec. Severe vasospasms were defined as at least 2 measurements of MMFVs >200 cm/sec or an increase of MMFV >50 cm/sec/24 hours over 2 consecutive days or a new neurologic deficit. All MMFVs >120 cm/sec in absence of severe vasospasm criteria were defined as mild vasospasm. Age-related cutoff values were calculated using receiver operating curve analysis.ResultsAny vasospasms occurred in 142 patients and thereof mild vasospasm in 86/142 (60.6%) patients and severe vasospasm in 56/142 patients (39.4%). Significantly higher incidences of any vasospasm (P = 0.005), severe vasospasm (P = 0.003), DIND (P = 0.031), and ischemic brain lesions (P = 0.04) were observed in patients aged <50 years. According to receiver operating curve analysis, the optimal age cutoff was 50 years for the presence of overall vasospasms, severe vasospasms, DIND, and ischemic brain lesions and 65 years for mild vasospasms.ConclusionsHigher incidences of any vasospasms, severe vasospasms, DIND, and ischemic brain lesions were observed in younger SAH patients.Copyright © 2020 Elsevier Inc. All rights reserved.

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