ArticleStroke and vascular neurology2026
Monitoring treatment of delayed cerebral ischaemia in unconscious patients after aneurysmal subarachnoid haemorrhage: a prospective multimodal neuromonitoring study.
Article in Stroke and vascular neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Invasive Monitoring of Cerebral Autoregulation in Aneurysmal Subarachnoid and Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Induced Hypertension for Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage-A German Nationwide Survey.Neurocritical care · 2026Article
- Multimodal Monitoring Results Around Delayed Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage.Translational stroke research · 2026Article
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Authors and funding
13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAneurysmal subarachnoid haemorrhage (SAH) is a life-threatening condition with high morbidity. Delayed cerebral ischaemia (DCI) significantly contributes to secondary injury and poor outcomes. While perfusion CT (CTP) aids DCI detection, multimodal neuromonitoring-including brain tissue oxygenation (PtiO
methodsThis prospective cohort study included SAH patients monitored with multimodal neuromonitoring at RWTH Aachen University Hospital (2014-2020). DCI was diagnosed with neuromonitoring abnormalities and confirmed by CTP. First-line treatment involved induced hypertension, with endovascular rescue treatment for refractory cases. Physiological data were time-aligned to treatment onset and aggregated into hourly summaries. Binomial logistic regression identified predictors of favourable 1-year outcome (modified Rankin Scale 0-3).
resultsOf 56 patients with confirmed DCI, correctly placed probes and available outcome data, 22 (39.3%) achieved favourable outcome. These patients showed greater post-treatment reductions in pressure reactivity index (PRx) and lactate-to-pyruvate ratio (LPR). In multivariable analysis, greater PRx reduction was significantly associated with favourable outcome (OR 0.023, 95% CI 0.001 to 0.394, p=0.009), translating to a 46.5% increase in odds per 0.1-unit decrease. Greater LPR reductions were also predictive (OR 0.950, 95% CI 0.904 to 0.998, p=0.042), with a 5-unit drop linked to a 29.3% increase in odds. Although PtiO2
conclusionPRx and LPR reflect meaningful physiological responses to DCI treatment and are associated with 1-year outcomes. Multimodal neuromonitoring may support not only diagnosis but also treatment monitoring and decision-making in unconscious SAH patients. TRIAL REGISTRATION NUMBER: German Clinical Trial Registry (DRKS00030505).
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