Risk Factors for Ischemic Lesions on Computed Tomography in Aneurysmal Subarachnoid Hemorrhage

Hyun, Seung Jae; Suk, Jong Sik; Kwon, Jeong Taik; Hong, Hyun Jong; Kim, Young Baeg

Abstract

OBJECTIVE
The aim of this study was to investigate predictive risk factors for permanent ischemic lesions visible on follow-up computerized tomography scans obtained after subarachnoid hemorrhage (SAH).
METHODS
A hundred and two patients who were treated with surgery for aneurysmal SAH from November 2002 to February 2005 were retrospectively analyzed. The predictive risk factors for permanent ischemic lesions used in this study were as follows ; age, sex, obesity, preoperative clinical condition, amount of SAH (Fisher grade), location of aneurysm, intracerebral hemorrhage (ICH), intraventricular hemorrhage, symptomatic vasospasm, duration of temporary artery occlusion, transfusion, hypertension, diabetes mellitus, cigarette smoking and time of SAH.
RESULTS
Permanent ischemic lesions developed in 55 (60%) patients. The presence of lesions correlated highly with preoperative clinical condition (p=0.032), amount of subarachnoid blood (p=0.007), middle cerebral artery aneurysms (p=0.041), ICH (p=0.039), symptomatic vasospasm (p=0.027), duration of temporary artery occlusion during surgery (p=0.004), diabetes mellitus (p=0.043), excessive alcohol drinking (p=0.040), cigarette smoking (p=0.037) and nocturnal occurrence of SAH (that is, between 12:01 a.m. and 8:00 a.m., p=0.044). Hypertension, obesity and other factors were not associated with the lesions.
CONCLUSION
The presence of ischemic lesions can be predicted by preoperative clinical condition, amount of SAH, the location of aneurysm, ICH, symptomatic vasospasm, duration of temporary artery occlusion, diabetes mellitus, excessive alcohol drinking, cigarette smoking and time of aneurysm rupture.