vasospasm SAH

 Q: Which group of patients is more prone to have vasospasm after subarachnoid hemorrhage (SAH)? (select one)

A) less than 50 years of age

B) more than 50 years of age

Answer: A

The risk and the severity of vasospasm after SAH depends on the following factors 

• severity of bleed 
• proximity to the major intracerebral blood vessels
• higher grade on Fisher and Claassen scales
• age less than 50 years (due to higher capacity of vascular tone & elasticity)
• hyperglycemia 
• higher Glasgow coma scale score

Vasospasm follows SAH around day 3 and usually peaks at days 7 or 8. This lag is due to spasmogenic substances produced by the lysis of subarachnoid blood.

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Reference:

Charpentier C, Audibert G, Guillemin F, et al. Multivariate analysis of predictors of cerebral vasospasm occurrence after aneurysmal subarachnoid hemorrhage. Stroke 1999; 30:1402.