Relationship between aneurysmal location in subarachnoid hemorrhagic patients and both blood clot thickness and radiological vasospasm

Abstract

Objective The aim was to detect the relationship between site of cerebral aneurysms and the amount of blood in computerized tomography and liability for early vasospasm using transcranial Doppler (TCD). Background The mortality with subarachnoid hemorrhage (SAH) is associated with cerebral vasospasm, rebreeding hydrocephalus, and seizures. Patients and methods This randomized controlled clinical trial recruited 30 patients from both sexes with acute aneurysmal SAH. Patients were recruited from Matarya Teaching Hospital during the period from October 2018 to June 2019. Outcome was assessed by Glasgow coma scale, Hunt and Hess scale (HHS), and modified Fisher scale (MFS). Patients were followed up by TCD on first, third, fifth, seventh, and 10th day of appearance of symptoms. Results There was no significant difference between cases with positive vasospasm vs negative vasospasm regarding age and sex. There was a significant association between early vasospasm and hypertension (P = 0.001), as well as smoking (P = 0.007). There was a significant difference between cases with positive vasospasm vs negative vasospasm regarding systolic blood pressure and diastolic blood pressure and glycosylated hemoglobin. There is a significant association between early vasospasm and symptomatic to vasospasm (P = 0.018). There was a significant difference between cases with positive vasospasm vs negative vasospasm regarding Glasgow coma scale, HHS, and MFS (P = 0.001 for all). Conclusion Continuous TCD measurements are valuable methods for early detection of vasospasm following SAH. Glasgow coma scale, HHS, MFS, aneurysmal size, aneurysmal site, systolic blood pressure and diastolic blood pressure, and glycosylated hemoglobin seem to be important predictors for vasospasm severity.