Impact of Hyperglycemia on Cerebral Vasospasm and Delayed Cerebral Ischemia in Spontaneous Subarachnoid Hemorrhage

摘要

 Background: Subarachnoid hemorrhage (SAH) is a significant cause of morbidity and mortality. Hyperglycemia seems to play a role in predictive outcome. Aggressive hyperglycemic control is associated with better prognosis. Objective: Evaluate hyperglycemia following spontaneous subarachnoid hemorrhage and its impact on outcome. Methods: Twenty patients with spontaneous SAH were recruited at day one of hemorrhage and followed for 14 days. Transcranial Doppler examination using Lindegaard ratio (Lr) was used to assess vasospasm. CT scan was used to assess delayed cerebral ischemia (DCI). Average mean glucose burden (GB) was calculated all through the first 14 days. Results: At the day of admission the Mean GB was 150±76.4 mg/dl. Vasospasm occurred in 16 patients. DCI occurred in 9 patients. Mean GB was higher in patients with severe vasospasm (Lr6) and those with DCI (P=0.02 and 0.03 respectively). Conclusion: Hyperglycaemia affects the course of the SAH critical illness through increasing the incidence of vasospasm and delayed cerebral ischemia. [Egypt J Neurol Psychiat Neurosurg.  2014; 51(1): 7-11]