Association of a younger age with an increased risk of angiographic and symptomatic vasospasms following subarachnoid hemorrhage.

Abstract:

OBJECT:Vasospasm is a leading cause of morbidity and death following aneurysmal subarachnoid hemorrhage (SAH). It is important to predict which patients are at risk for vasospasm so that interventions can be made. There are several potential risk factors for vasospasm, one of which is age. However, the effect of age on vasospasm, particularly symptomatic vasospasm, remains controversial. METHODS:Three hundred ninety-one patients were retrospectively identified from a prospective observational database of patients with SAH who had been admitted to a single center. Demographic and clinical data were recorded, and cerebral angiograms obtained at admission and between 5 and 10 days later were compared. The relationship between age and angiographic and symptomatic vasospasms was examined using logistic regression techniques. RESULTS:Mild (86 patients), moderate (69 patients), severe (56 patients), and no angiographic vasospasms (180 patients) were documented by comparing admission and follow-up angiograms in each patient. Symptomatic vasospasm was identified in 69 patients (17.6%). Angiographic vasospasm was more frequent as age decreased. Except in patients < 30 years old, the frequency of symptomatic vasospasm also increased with decreasing age (p = 0.0001). After adjusting for variables known to be associated with vasospasm, an advanced age was associated with a reduced incidence of any angiographic vasospasm (OR 0.96, 95% CI 0.94-0.97), severe angiographic vasospasm (OR 0.96, 95% CI 0.95-0.98), and symptomatic vasospasm (OR 0.98, 95% CI 0.96-0.99). CONCLUSIONS:Results in this study show that a younger age is associated with an increased incidence of angiographic and symptomatic vasospasm.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Magge SN,Chen HI,Ramakrishna R,Cen L,Chen Z,Elliott JP,Winn HR,Le Roux PD

doi

10.3171/2009.9.JNS081670

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

1208-15

issue

6

eissn

0022-3085

issn

1933-0693

journal_volume

112

pub_type

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