ArticleAJNR. American journal of neuroradiology2025
Risk Factors for Unfavorable Functional Outcome after Endovascular Treatment of Cerebral Vasospasm following Aneurysmal Subarachnoid Hemorrhage.
Article in AJNR. American journal of neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Early Onset of Cerebral Vasospasm and the Mediating Impact of Secondary Infarction on In-Hospital Mortality Following Aneurysmal Subarachnoid Hemorrhage.Diagnostics (Basel, Switzerland) · 2026Article
- Microglia-Derived Exosomal miR-223-3p Targets the RhoB-NF-κB-CCL11 Axis in Astrocytes and Relieves Neuronal Damage in Subarachnoid Hemorrhage.Neurochemical research · 2025Article
- Machine learning-driven risk prediction of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage using peripheral inflammatory markers.Frontiers in neurology · 2025Article
- A novel clinical perspective on subarachnoid hemorrhage complicated by myocardial injury: independent predictors and short-term prognostic assessment.Frontiers in neurologyArticle
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12 authors.
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Abstract
background and purposeCerebral vasospasm remains a strong predictor of poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH). Endovascular treatment of vasospasm can be considered when conservative treatment options are exhausted, but its superiority over standard treatment remains a subject of critical debate. This study focuses on patients with clinically relevant vasospasm after aSAH who underwent endovascular vasospasm treatment and aims to analyze patients' individual risk factors, intensity, and extent of cerebral vasospasm associated with poor functional outcomes after aSAH. MATERIALS AND
methodsWe conducted a retrospective cohort study of consecutive patients with aSAH admitted at a tertiary stroke center between January 2016 and December 2022. Patients with medically refractory cerebral vasospasm necessitating at least 1 endovascular intervention were analyzed. Primary end point was defined as functional outcome defined as modified Rankin Scale (mRS) scores after 6 months. Secondary end point was the occurrence of cerebral infarctions following cerebral vasospasm.
resultsOverall, 138 patients received endovascular treatment due to cerebral vasospasm, including 322 treatments, with 78 patients receiving more than 1 endovascular treatment. In 65.2% (90) of patients, cerebral vasospasm developed in both hemispheres; in 16.7% (23), cerebral vasospasm occurred involving the posterior circulation; and in 10.1% (14), percutaneous transluminal angioplasty was performed. Multivariable logistic regression analysis showed an association of higher age (adjusted odds ratio [aOR], 1.05, 95% CI: 1.0-1.1), higher Hunt and Hess grades (aOR, 2.12, 95% CI: 1.38-3.24), the occurrence of rebleeding (aOR, 4.97, 95% CI: 1.0-24.65), and bihemispheric vasospasm (aOR, 4.05, 95% CI: 1.4-11.72) with unfavorable outcome (mRS 3-6). Further analysis showed that higher age (aOR, 1.07, 95% CI: 1.03-1.13) was associated with an increased risk of developing vasospasm-associated infarctions.
conclusionsOur results indicate an association between bihemispheric cerebral vasospasm and poor functional outcomes after aSAH. This finding supports a more aggressive treatment strategy in patients developing bihemispheric vasospasm to prevent unfavorable disease courses.
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