Secondary infarction in single or in multiple vascular territories: two different entities following subarachnoid hemorrhage?
J Neurol
; 258(12): 2133-9, 2011 Dec.
Article
en En
| MEDLINE
| ID: mdl-21553082
ABSTRACT
The pathogenesis of secondary infarctions (SI) after aneurysmal subarachnoid hemorrhage (SAH) is poorly understood. To assess whether SI in single (SSI) or multiple (MSI) vascular territories represent different disease entities, we compared clinical profiles of patients with these patterns of SI. CT/MRI-examinations of 448 patients were reviewed for new infarctions within 28 days after SAH, and categorized into SSI or MSI. Only patients with adequate follow-up imaging excluding any new infarctions were included for analysis (269 patients). Procedure-related infarctions were excluded. Odds ratios (ORs) with corresponding 95% confidence intervals (CI) were calculated for patients with SSI or MSI versus patients without SI to analyze differences in demographic characteristics, vascular risk factors, disease-related characteristics and treatment modalities. Thirty-six patients had SSI, 53 MSI and 180 no SI. ORs in MSI-patients were >1.5 times higher compared with ORs in SSI-patients for multiple vascular risk factors [MSI5.4 (2.3-13) versus SSI1.2 (0.5-2.8)], poor clinical condition on admission [MSI4.6 (2.4-8.9) versus SSI2.4 (1.1-5.2)], initial loss of consciousness [MSI2.6 (1.3-5.3) versus SSI1.1 (0.5-2.3)] and large amounts of intraventricular blood [MSI2.9 (1.4-5.8) versus SSI1.5 (0.7-3.2)]. In multivariate analysis ORs remained higher in MSI for presence of multiple vascular risk factors [MSI1.9 (1.2-2.9) versus SSI1.1 (0.8-1.7)] and initial loss of consciousness [MSI3.0 (1.0-8.9) versus SSI1.6 (0.6-4.0)]. Our findings suggest that SSI and MSI after SAH are not distinct disease entities. MSI was related to the same characteristics as SSI but to a larger extent, specifically to the presence of multiple vascular risk factors, initial loss of consciousness, larger amounts of intraventricular blood, and poor clinical status on admission.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Hemorragia Subaracnoidea
/
Infarto Encefálico
Tipo de estudio:
Etiology_studies
Límite:
Adolescent
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Adult
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Aged
/
Aged80
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Neurol
Año:
2011
Tipo del documento:
Article
País de afiliación:
Países Bajos