Relationship between ultra early stage cerebral vasospasm and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage surgery

Abstract

Objective To investigate the relationship between ultra early stage cerebral vasospasm and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage (SAH) surgery. Methods Sixty-five patients with aneurysmal SAH, admitted to our hospital from January 2016 to December 2016, were selected as research objects. The patients underwent aneurysm clip surgery and accepted middle cerebral artery M2 segment transcranial Doppler (TCD) in ultra early stage (within 48 h of onset) to determine the occurrence of vasospasm examination. Perioperative acute physiology and chronic health evaluation scale II (APACHE II) and Glasgow coma scale (GCS) scores and delayed cerebral infarction rate within 2 weeks in patients with different ultra early vasospasm occurrences were compared, and four-diagnostic tests were applied in analyzing the value of ultra early cerebral vasospasm in predicting postoperative delayed cerebral infarction. Results Ultra early vasospasm rate of the patients was 49.23% (32/65). As compared with the patients without ultra early stage vasospasm, perioperative APACHE II scores and rate of delayed cerebral infarction of the patients with ultra early vasospasm were significantly increased, while GCS scores of the patients with ultra early vasospasm were significantly decreased (P<0.05). And the results of four diagnostic tests showed that the sensitivity, specificity and accuracy of ultra early stage cerebral vasospasm of the patients with aneurysmal SAH predicting the delayed cerebral infarction were 77.27%, 65.12% and 69.23%. Conclusion Ultra early stage cerebral vasospasm of the patients with aneurysmal SAH is high, which can evaluate the risk of postoperative delayed cerebral infarction. Key words: Intracranial aneurysm; Subarachnoid hemorrhage; Delayed cerebral infarction; Cerebral vasospasm