Background: Cerebral vasospasm is one of the most significant causes of insufficient blood flow to the brain and is a significant cause of death and disability following aneurysmal subarachnoid hemorrhage- (aSAH). This study evaluated whether patients who were treated with surgical clipping or endovascular coiling of a ruptured aneurysm had different occurrences of vasospasm.
Methods: A retrospective review of patients with aSAH admitted to a single tertiary care center between 2012 and 2019 was performed. Aneurysm characteristics including size, shape, location, and treatment details, were reported for each patient and analyzed. Clinical outcomes were also recorded, including the number of days that vasospasm was reported following aneurysm rupture.
Results: Of the 344 patients reviewed with aSAH, 115 patients satisfied the selection criteria for analysis (66 from 2012-2015 and 49 from 2016-2019). From 2012-2019 the proportion of clipping versus coiling remained constant during the study period, with 76% of patients being clipped and 24% of patients coiled (p> 0.05). There was no significant difference in patient age, time in hospital, or aneurysm characteristics. The average number of symptomatic vasospasm days in the 2012-2015 group was 1.3, compared to 0.5 in the 2016-2019 cohort (p=0.03). The only significant predictor of cerebral vasospasm was aneurysm shape (p<0.05). 82% of patients in the 2012-2015 group and 96% of patients in the 2016-2019 group presented with saccular aneurysms.
Conclusions: Treatment method showed no association with incidence of detected vasospasm in patients with aSAH. However, aneurysm shape was identified as a significant predictor of clinical vasospasm.