Subarachnoid Hemorrhage, Aneurysmal Clinical Trial
Endothelin-1 (ET-1) seems to be involved in the pathogenesis of cerebral vasospasm after
subarachnoid hemorrhage. However measurements of cerebrospinal fluid concentrations (CSF) of
ET-1 are not sensitive enough to predict the development of vasospasm representing the
average value throughout the entire cerebral circulation. Cerebral microdialysis (MD) is a
technique able to detect molecule concentrations in a small perivascular area. The
investigators performed a prospective observational clinical study to test the hypothesis
that MD ET-1 concentrations should be a sensitive predictor for vasospasm.
Patients with subarachnoid hemorrhage at high risk for vasospasm according to Fisher scale
admitted to the ICU were consecutively studied. All patients received surgery within 48
hours from the bleeding; MD probe was placed in the area at risk for vasospasm after surgery
and samples were hourly collected and analysed to measure lactate, piruvate and glutamate
levels; ET-1 levels in CSF and MD fluids were measured from admission until day 7. At
admission and after 7 days two angiographies were performed to detect the degree and extent
of vasospasm, Transcranial Doppler and neurological evaluation were daily performed.
Patients were then classified according to the presence of vasospasm in 3 groups: absence of
vasospasm (NV), presence of vasospasm (CV), acute neurological deterioration (AND).
n/a
Observational Model: Cohort, Time Perspective: Prospective
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