We are analyzing https://link.springer.com/article/10.1007/s12028-012-9801-2.

Title:
Post-subarachnoid Hemorrhage Vasospasm in Patients with Primary Headache Disorders | Neurocritical Care
Description:
Altered cerebral vasomotor reactivity leading to vasospasm can be seen both in patients with primary headache disorders (PHD) and in patients with subarachnoid hemorrhage (SAH). The pathogenesis of vasospasm in post-SAH patients and in headache disorder sufferers may be related. To address this hypothesis, we analyzed a large cohort of SAH patients to determine whether a diagnosis of PHD predisposes to vasospasm, delayed cerebral ischemia, or worsened clinical outcome. Prospectively collected data from patients enrolled in the SAH Outcomes Project between 1996 and 2006 were analyzed. Patients were segregated based on whether they had a diagnosis of PHD or not and were subsequently compared for differences in clinical and radiographic outcome. A total of 921 SAH patients were analyzed, 265 of which had a diagnosis of PHD. In total, symptomatic vasospasm was seen in 17 %, while angiographic vasospasm was seen in 28 %. Vasospasm rates were similar among patients with a PHD and in those without a PHD (p > 0.05). However, on multivariate analysis new ischemic infarcts were more common in patients with a PHD as compared to patients without a PHD (p = 0.015). Functional outcomes at 3 months were similar among PHD and non-PHD patients (p > 0.05). A history of PHD is associated with an increased rate of ischemic infarcts during admission for SAH. Increased rates of vasospasm within small cerebral blood vessels may be implicated. Further studies are warranted to more closely link the mechanisms of vasospasm in PHD and SAH patients.
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Keywords {🔍}

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Topics {✒️}

neeraj badjatia & dorothea altschul month download article/chapter post-subarachnoid hemorrhage vasospasm poor-grade subarachnoid hemorrhage delayed cerebral ischemia aneurysmal subarachnoid hemorrhage primary headache disorders full article pdf delayed intracerebral hemorrhage privacy choices/manage cookies subarachnoid hemorrhage aneurysmal subarachnoid haemorrhage related subjects author correspondence transient ischaemic attack check access instant access cerebrovascular reactivity disease classification system post-sah patients headache disorder sufferers european economic area sander connolly jr sphingosine 1-phosphate levels dacey rg jr crit care med transient ischemic attacks neurological surgery conditions privacy policy infrared spectroscopy study article log cerebral arterial spasm case-control study accepting optional cookies cellular mechanisms involved vascular headach unruptured intracranial aneurysms subarachnoid haemorrhage worsened clinical outcome sah outcomes project bmc med article cite journal finder publish cerebral vasospasm neurol neurosurg psychiatry article ellis cerebrovascular disease rogers jd cerebrovascular risk stroke risk

Questions {❓}

Arterial stenosis in migraine: spasm or arteriopathy?
Migraine aura or transient ischemic attacks?
Migraine aura without headache: transient ischaemic attack or not?
Sentinel headaches in aneurysmal subarachnoid haemorrhage: what is the true incidence?

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         description:Altered cerebral vasomotor reactivity leading to vasospasm can be seen both in patients with primary headache disorders (PHD) and in patients with subarachnoid hemorrhage (SAH). The pathogenesis of vasospasm in post-SAH patients and in headache disorder sufferers may be related. To address this hypothesis, we analyzed a large cohort of SAH patients to determine whether a diagnosis of PHD predisposes to vasospasm, delayed cerebral ischemia, or worsened clinical outcome. Prospectively collected data from patients enrolled in the SAH Outcomes Project between 1996 and 2006 were analyzed. Patients were segregated based on whether they had a diagnosis of PHD or not and were subsequently compared for differences in clinical and radiographic outcome. A total of 921 SAH patients were analyzed, 265 of which had a diagnosis of PHD. In total, symptomatic vasospasm was seen in 17 %, while angiographic vasospasm was seen in 28 %. Vasospasm rates were similar among patients with a PHD and in those without a PHD (p > 0.05). However, on multivariate analysis new ischemic infarcts were more common in patients with a PHD as compared to patients without a PHD (p = 0.015). Functional outcomes at 3 months were similar among PHD and non-PHD patients (p > 0.05). A history of PHD is associated with an increased rate of ischemic infarcts during admission for SAH. Increased rates of vasospasm within small cerebral blood vessels may be implicated. Further studies are warranted to more closely link the mechanisms of vasospasm in PHD and SAH patients.
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