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    Factors affecting the incidence and severity of vasospasm after subarachnoid haemorrhage
    (Springer-Verlag Wien, 2008) Hamamcioglu, M. K.; Kilincer, C.; Altunrende, E.; Hicdonmez, T.; Simsek, O.; Akyel, S.; Cobanoglu, S.
    Cerebral vasospasm remains the leading cause of death and permanent neurological deficit after subarachnoid haemorrhage. We report our clinical experience with a series of 325 patients, in order to identify the factors affecting the incidence aid severity of vasospasm, and to determine its effect on the outcome. Data obtained in all patients with subarachnoid hemorrhage between 1996 and 2005 at the Neurosurgery Department of Trakya University Medical Faculty were reviewed. Patient characteristics, computed tomography and angiography findings, existence of clinical vasospasm, the degree of clinical deterioration, and outcome were analyzed. Sixty-one patients (18.8%) experienced clinical vasospasm. The average beginning day of the clinical vasospasm was 4.8 (+/- 3.2) days (range, 1-15 clays). The clinical decline attributable to vasospasm lasted 12.5 (+/- 6.9) days on average (range, 4-36 days). The mean GCS at the the initial day of vasospasm was 11.3 (+/- 3) points (range, 5-15 points). The worst GCS during the course of vasospasm was 7.2 (+/- 4) points on average (range, 3-14 points). Thirty-seven of 61 patients had permanent motor deficit after vasospasm. Forty patients had infarcted areas on their CT scan. The anterior cerebral artery territory was involved in 31 of them. Twenty-three patients died and 38 patients recovered from vasospasm. The presence of vasospasm was correlated with poor Outcome. We found that the initial loss of consciousness, motor deficit at admission, arterial hypertension, intraventricular blood, and higher Fisher's grade on CT scan correlated with the increased risk of vasospasm.