320-Row Multidetector Computed Tomographic Angiogram in the Evaluation of Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage: A Pilot Study

摘要

Aneurysmal subarachnoid hemorrhage (ASAH) is a devastating condition that affects annually 3 to 25 per 100,000 persons worldwide. Thirty-day mortality reaches 50%, and only half of the survivors are able to live independently. Aneurysmal subarachnoid hemorrhage typically presents with a sudden onset of severe headache, nausea, vomiting, neck pain, photophobia, and loss of consciousness. Patients who survive early complications, such as hydrocephalus and rebleeding, will then be faced with the much-dreaded risk of cerebral vasospasm, with a typical onset of 3 to 5 days posthemorrhage and maximal narrowing at days 5 to 14. Arterial narrowing can be seen in approximately 40% of patients with ASAH, and 20% to 30% of paitients with ASAH develop the neurologic deficits of vasospasm. Typical symptoms of vasospasm include a new focal neurologic deficit unexplained by rebleeding or hydrocephalus and altered level of consciousness. Cerebral vasospasm is thought to lead to neurologic deficits through delayed cerebral ischemia,5,10 although the role of reduced vessel diameter in this process remains unclear.