Abstract Details

Title CT Pattern of Cerebral Infarct in Subarachnoid Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) (-)

Poster/Presentation
Number 005

Objective

Background The CT pattern of CI after SAH and its impact on outcome and mortality is not well establish.

Design/Methods We retrospectively reviewed consecutive nontraumatic SAH patients hospitalized at our institution between August 2006 and March 2011. Data was collected on medical history, clinical grade, symptomatic vasospasm (defined as cerebral vasospasm requiring intra-arterial treatment), CT findings, length of stay (LOS), and good discharge disposition (categorized as home or acute rehabilitation facility). CI (defined as new hypodensity identified on CT brain) was categorized by pattern as Single cortical (SC), Single deep (SD), Multiple cortical (MC), Multiple deep (MD), and Multiple cortical and deep (MCD).

Results Among 400 SAH patients, the mean age was 56.9 years (range, 21 to 96) and 80 patients (20%) died. Cerebral infarct was identified in 101 patients (25.2%). Compared to patients without CI, patients with CI more likely to have symptomatic vasospasm (41.5% vs 12.4%, p < 0.0001). In multivariate analysis adjusting for factors associated with mortality, CI was not associated with in hospital mortality (p 0.76). In multivariate analysis, patients with CI had increased LOS (p < 0.0001) and were less likely to have a good discharge disposition (p 0.01). Among the patients with CI, the patterns included SC (44), SD (30), MC (15), and MCD (12). In multivariate analysis, the pattern of CI was associated with increased LOS (p 0.05) and discharge disposition (p 0.002), and this significance was driven by longer LOS in the MCD group and decreased rate of good discharge disposition in the multiple pattern group (MC or MCD).

Conclusions CI after SAH is associated with significantly increased LOS and worse discharge disposition, but does not impact in-hospital mortality in SAH.

Authors/Disclosures
Vivien H. Lee, MD, FAAN (OSU Comprehensive Neurovascular Center) PRESENTER	Dr. Lee has nothing to disclose.
	No disclosure on file
Sayona John, MD, FAAN (Rush University Medical Center)	Dr. John has nothing to disclose.
Rajeev Garg, MD, FAAN (Rush University Medical Center)	No disclosure on file
James Conners, MD (Rush University Medical Center)	The institution of Dr. Conners has received research support from nih.
Richard E. Temes, MD (Northwell Health)	No disclosure on file
Thomas P. Bleck, MD, FAAN (Northwestern University Department of Neurology)	Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Marinus Pharmaceuticals. Dr. Bleck has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for iECURE. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acasti. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Society of Critical Care Medicine. Dr. Bleck has received research support from NIH.
Shyam Prabhakaran, MD (University of Chicago)	Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. The institution of Dr. Prabhakaran has received research support from NIH . The institution of Dr. Prabhakaran has received research support from AHRQ. Dr. Prabhakaran has received publishing royalties from a publication relating to health care.
Peter A. Calabresi, MD, FAAN (Johns Hopkins University)	Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Idorsia. An immediate family member of Dr. Calabresi has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MyMD. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Myelin Repair Foundation. The institution of Dr. Calabresi has received research support from Genentech. Dr. Calabresi has received publishing royalties from a publication relating to health care. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Grant reveiwer with Myelin Repair Foundation. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker for CME with NYAS. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Academic CME.

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