The Relationship Between Subarachnoid Hemorrhage Volume and Development of Cerebral Vasospasm

Objective: The objective of this study is to verify the relationship between subarachnoid hemorrhage (SAH) volume (not Fisher grade) and develop-ment of cerebral vasospasm prospectively. Methods: Patients who visited our hospital with a diffuse or localized thick subarachnoid blood clot seen on computed tomography (CT), taken within 48 hours after SAH and the aneurysm was confirmed by CT Angiogram (CTA) from March 2010 to July 2011 were enrolled in this study. CTA was checked at least twice after admission. Angiographic vas-ospasm (AVS) on CTA was defined as irregularity or narrowing of intra-cranial vessels on follow up CTA compared with initial CTA. Total intra-cranial hemorrhage (ICH) volume (subdural, SAH, intracerebral and intra-ventricular) was calculated and SAH volume (all supratentorial and in-fratentorial cisterns) was also calculated using the MIPAV software package. Results: A total of 55 patients were included in our study. Thirty six pa-tients did not show AVS on CTA or clinical deterioration (non vasospasm group: NVS). AVS without ischemic neurologic symptoms was observed in four patients and development of symptomatic vasospasm (SVS), defined as AVS with ischemic symptoms, was observed in 15 patients. SAH vol-ume in SVS patients was statistically larger than that in NVS patients (p < 0.05). Total ICH volume in SVS patients was larger than that in NVS patients. However, the difference was not statistically significant. Conclusion: Results of this study indicate an association of development of vasospasm with the SAH volume, not intracranial hemorrhage. J Cerebrovasc Endovasc Neurosurg