Cerebral vasospasm after subarachnoid haemorrhage is a potentially preventable and
reversible condition where an early identification can prevent or limit cerebral
infarction. Vasospasm may be assessed on a clinical, radiographic, or angiographic
basis.
Aim: Early detection of cerebral vasospasm in a sample of Egyptian patients
presented with spontaneous subarachnoid haemorrhage.
Methods and subjects: In this study we enrolled 40 aSAH patients diagnosed by noncontrast brain CT and CT angiography and managed by interventional aneurysmal
embolization . Early detection of vasospasm and DCI was assessed on clinical and
radiological basis using transcranial duplex studies (TCD) on the 1st, 3rd, 5th, 7th and
10th days of the onset of the symptoms . Results: Fourty patients with aSAH , of
them 67.5% developed vasospasm but only 33.3% progressed to DCI. The most
significant day of vasospasm development as detected by TCD was on the 7th day.The
most common arteries undergoing vasospasm were the MCA followed by the ACA
and lastly the PCA. Clinical scalas on admission as (GCS,HHS,WFNS and Ogilvy
and Carter scale) are highly significant predictors of cerebral vasospasm
Conclusion: Clinical risk factors and the use of TCD are tools for early detection of
vasospasm following SAH. This allows for early therapeutic intervention before
irreversible ischemic neurological deficits take place. |
