SUBARACHNOID HEMORRHAGE IN THE AFRICAN-AMERICAN POPULATION - A COOPERATIVE STUDY

The clinical outcome of patients Following subarachnoid hemorrhage is complicated by delayed cerebral ischemia and contributing factors such as hypertension. To observe the impact of hypertension and delayed ce rebral ischemia on the outcome of a predominantly African-American coh ort following subarachnoid hemorrhage, both retrospective (n=42) and p rospective (n=21) studies were conducted. In the total pool (n=63), th e mean age was 49.7 years (range: 17 to 80) with a preponderance of fe male patients (70%). Aneurysm formation was significant in the region of the posterior communicating artery. Of the patients reviewed, 73.8% had preexisting hypertension and 45.9% developed delayed cerebral isc hemia. Approximately 89% of the patients who suffered from delayed cer ebral ischemia had hypertension. Results failed to display any signifi cant beneficial association between the use of the calcium channel blo cker nimodipine and delayed cerebral ischemia. Use of the antifibrinol ytic drug aminocaproic acid demonstrated a worse patient outcome. It i s not recommended that aminocaproic acid be used in this population. S ubsequently, due to the proportional occurrence of delayed cerebral is chemia in hypertensive patients following subarachnoid hemorrhage, it is suggested that prophylactic surgical management of unruptured intra cranial aneurysms be considered in hypertensive patients. Further stud y is needed to discern the association between hypertension, delayed c erebral ischemia, and stroke in patients following subarachnoid hemorr hage.