PROGNOSTIC FACTORS IN DELAYED ISCHEMIC DEFICIT WITH VASOSPASM IN PATIENTS UNDERGOING EARLY ANEURYSM SURGERY

We have examined prognostic factors in delayed ischaemic deficit attri buted to vasospasm following subarachnoid haemorrhage (SAH) and early aneurysm surgery. Among 605 patients with SAH, 201 patients developed a delayed ischaemic deficit and 137 of these underwent early surgery. These 137 patients wore classified into groups A and B by outcome at 3 months after SAH (group A: the delayed ischaemic deficit was associat ed with an adverse outcome; group B: no adverse outcome). Factors indi cating an unfavourable outcome were as follows: (i) older age; (ii) po or WFNS grade on admission; (iii) Fisher's scale of 4; (iv) intracereb ral haemorrhage; (v) delayed ischaemic deficit following rerupture; (v i) complications of surgical intervention; (vii) delayed ischaemic def icit with disturbance of consciousness; (viii) lack of immediate impro vement with hypervolaemic therapy; and (ix) intracranial complications after hypervolaemic therapy. We suggest that the reversibility of a d elayed ischaemic deficit is determined by preceding brain damage and/o r surgical complications.