The goal of this observational study is to understand if angiographic cerebral vasospasm (CV) can be predicted by levels of nitric oxide (NO) consumption in patients with aneurysmal subarachnoid hemorrhage (SAH). To reach this goal, the investigators will compare NO consumption levels in SAH and non-SAH patients. NO consumption levels will be analyzed from samples of participants' cerebral spinal fluid (CSF).
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
Accepted
Inclusion Criteria:
* Adult
* patient with SAH and with an external ventricular drainage (EVD) placed within 24 hours after the onset of the hemorrhage
Exclusion Criteria:
* pregnancy
* pre-existing neurological comorbidities
* coagulation disorders
* anemia
* absence of a good cranial window to perform Transcranial Doppler (TDC)
* presence of \>50% stenosis of carotid arteries confirmed by doppler ultrasound
* Technical problems on EVD that prevent CSF withdrawals
For the control group, we will invite to participate patients without neurological comorbidities undergoing spinal anesthesia in the operating room or with a spinal drain for major vascular surgery.
Primary outcome measure(s)
Nitric oxide consumption — Daily for 15 days following aneurysmal subarachnoid hemorrhage; for controls, once at initiation of spinal anesthesia Measurement taken from cerebrospinal fluid using nitric oxide consumption analyzer
Occurrence of cerebral vasospasm in patients with subarachnoid hemorrhage — Daily for 15 days following aneurysmal subarachnoid hemorrhage Transcranial Doppler monitoring will provide peak systolic velocities (PSVs) at the middle (MCA), anterior (ACA), and posterior (PCA) cerebral arteries. Suspected vasospasm will be defined as a mean flow velocity \>120 cm/s and a Lindegaard ratio (LR) ≥3. The LR will be obtained by dividing the mean flow velocities of the MCA by those of ipsilateral extracranial internal carotid artery. In case of suspected vasospasm, and in all comatose patients after 4 days from the bleeding, a CT angiography will be performed to define the angiographic CV.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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