Subarachnoid hemorrhage outcome

• Blood-Brain Barrier Disruption Predicts Poor Outcome in Subarachnoid Hemorrhage: A Dynamic Contrast-Enhanced MRI Study
• Comprehensive predictive modeling in subarachnoid hemorrhage: integrating radiomics and clinical variables
• Active Cerebrospinal Fluid Exchange vs External Ventricular Drainage in the Neurocritical Care Unit: An International, Retrospective Cohort Study
• APOE epsilon4 and Risk of Intracranial Hemorrhage in Patients With Atrial Fibrillation Taking Apixaban
• Management and outcomes for thoracic anterior spinal artery aneurysms: illustrative case
• Post-traumatic hydrocephalus after decompressive craniectomy: a multidimensional analysis of clinical, radiological, and surgical risk factors
• Risk factors for the development of hydrocephalus in traumatic brain injury: a systematic review and meta-analysis
• Early experience with Target Tetra coils for treatment of small and very small ruptured intracranial aneurysms

see also Aneurysmal subarachnoid hemorrhage prognosis.

QT interval prolongation is associated with worse subarachnoid hemorrhage outcome, which is independent of perioperative cardiac events ¹⁾

Approximately 70% of patients with subarachnoid hemorrhage develop vasospasm; up to 40% experience secondary infarction, part of these without vasospasm. Vasospasm treatment in the large cerebral arteries did not improve mortality or functional outcomes ^{2) 3)}.

The presence of widespread hemorrhage, hydrocephalus, hematoma and ischaemia on the initial CT scan is associated with poor neurological outcome ⁴⁾.

A study evaluated microRNA (MicroRNA) changes in cerebrospinal fluid (CSF) and their association with the occurrence of delayed cerebral ischemia (DCI) and poor functional subarachnoid hemorrhage outcome.

Forty-three selected MicroRNAs were measured in daily CSF samples from a discovery cohort of SAH patients admitted to Rigshospitalet, Copenhagen, Denmark, and compared with neurologically healthy patients. Findings were validated in CSF from a replication cohort of SAH patients admitted to Massachusetts General Hospital, Boston, Massachusetts. The CSF levels of MicroRNA over time were compared with the occurrence of DCI, and functional outcome after 3 months. MicroRNAs were quantified in 427 CSF samples from 63 SAH patients in the discovery cohort, in 104 CSF samples from 63 SAH patients in the replication cohort, and in 11 CSF samples from 11 neurologically healthy patients. The MicroRNA profile changed remarkably immediately after SAH. Elevated miR 9-3p was associated with a poor functional outcome in the discovery cohort (p < 0.0001) after correction for multiple testing (q < 0.01) and in the replication cohort (p < 0.01). Furthermore, elevated miR-9-5p was associated with a poor functional outcome in the discovery cohort (p < 0.01) after correction for multiple testing (q < 0.05). No MicroRNA was associated with DCI in both cohorts. miR-9-3p and miR-9-5p are elevated in the CSF following SAH and this elevation is associated with a poor functional outcome. These elevations have potential roles in the progression of cerebral injury and could add to early prognostication ⁵⁾.

Mental fatigue after SAH is a serious burden to the patient and is associated with impaired long-term functional outcome. Distinguishing different aspects of fatigue is relevant as mental post-SAH fatigue might be a target for treatment aimed to improve long-term outcome ⁶⁾.