Abstract
Cerebral vasospasm is the major cause of a poor outcome after aneurysmal subarachnoid hemorrhage (aSAH), and effective treatments for vasospasm are limited. The purpose of this study was to research the impact of electroacupuncture (EA) on cerebral vasospasm and the outcomes of patients with aSAH. A total of 60 age- and sex-matched aSAH patients were collected from Ningbo First Hospital between December 2015 and June 2017. All patients were given a basic treatment of nimodipine and randomized into two groups. The study group was treated with EA therapy on the Baihui (GV20) acupoint, and the control group was given mock transcutaneous electrical nerve stimulation. Cerebral vasospasm was measured by computed tomographic perfusion (CTP) and transcranial doppler (TCD). The mean flow velocity (MFV) in the middle cerebral artery (MCA), cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) of the patients were analyzed. The CBV and MTT exhibited significant differences between the study and control groups on the 1st (p = 0.026 and p = 0.001), 7th (p = 0.020 and p < 0.001), and 14th (p = 0.001 and p < 0.001) day after surgery, whereas CBF exhibited statistical significance only on the 14th day after surgery (p = 0.002). The MFV in MCA were significantly reduced after EA treatment in all patients (all p < 0.001). Additionally, the MFV in the MCA in patients treated with EA were considerably reduced compared with those of the control group (3rd day p = 0.046; 5th day, p = 0.010; 7th day, p < 0.001). Moreover, better outcomes were noted in the EA-treated group for the 1st month (p < 0.001) and 3rd month (p = 0.001) after surgery than in the control group. In conclusion, EA represents a potential method to treat cerebral vasospasm after aSAH and can improve the outcomes of patients with aSAH.
Highlights
Aneurysmal subarachnoid hemorrhage is a devastating event accounted for 5% of all stroke cases (Sehba et al, 2012; Garg and Bar, 2017)
Inclusion criteria were as follows: (1) the individuals were aged older than 18 years and had the ability to begin acupuncture treatment within 24 h after aneurysmal subarachnoid hemorrhage (aSAH); (2) aSAH were independently diagnosed by at least two neurosurgeons using computed tomography and cerebral angiography; (3) the patients with aneurysm who had been treated by the operative treatment such as endovascular coiling or surgical clipping; (4) written informed consent was obtained before the study
Cerebral vasospasm after aSAH may related with multifactorial etiology, and this hypothesis was confirmed by the massive available treatment modalities
Summary
Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating event accounted for 5% of all stroke cases (Sehba et al, 2012; Garg and Bar, 2017). The incidence of aSAH is approximately 9 per 100,000, and the mortality is approximately 60% within 6 months (Steiner et al, 2013). There are a lot of complications frequently occur after successful surgery (Connolly et al, 2012; Steiner et al, 2013), such as cerebral vasospasm, rebleeding, or hydrocephalus. Cerebral vasospasm typically appears on the third day after aSAH, is maximal at 6–8 days, and subsequently lasts 2–3 weeks (Wilkins, 1990). There are approximately 23% of deaths or disabilities in patients with aSAH due to cerebral vasospasm (Keyrouz and Diringer, 2007). Delayed cerebral vasospasm is considered as the major cause of poor outcomes in aSAH patients in subsequent decades (Dusick and Gonzalez, 2013)
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