PDF icon PDF herunterladen
Open Access
CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(06): s00451809885
DOI: 10.1055/s-0045-1809885
Review Article

Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a narrative review

Ingrid Pereira Marques 
1   Universidade Federal de São Paulo, São Paulo SP, Brazil.
2   Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro RJ, Brazil.
,
Carolina Rouanet Cavalcanti de Albuquerque 
3   Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.
,
Natalia Vasconcellos de Oliveira Souza 
1   Universidade Federal de São Paulo, São Paulo SP, Brazil.
4   Hospital Israelita Albert Einstein, São Paulo SP, Brazil.
,
João Brainer Clares de Andrade 
1   Universidade Federal de São Paulo, São Paulo SP, Brazil.
4   Hospital Israelita Albert Einstein, São Paulo SP, Brazil.
5   Centro Universitário São Camilo, São Paulo SP, Brazil.
6   Instituto Tecnológico de Aeronáutica (ITA), São José dos Campos SP, Brazil.
,
Gisele Sampaio Silva 
1   Universidade Federal de São Paulo, São Paulo SP, Brazil.
4   Hospital Israelita Albert Einstein, São Paulo SP, Brazil.
,
Pedro Kurtz 
2   Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro RJ, Brazil.
7   Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro RJ, Brazil.
› Institutsangaben
› Weitere Informationen
Auch verfügbar aufeRef
  Lizenzen und Reprints
Preview

Abstract

Aneurismal subarachnoid hemorrhage (aSAH) is a condition with elevated mortality and morbidity, which usually affects a working-age population, leading to a high socioeconomic burden. Among those who survive the initial bleeding, approximately 30% will experience delayed cerebral ischemia (DCI), which is a significant factor in poor outcomes. However, it is potentially reversible if appropriate treatment is promptly initiated. The amount of blood present on the initial computed tomography (CT) scan, assessed through the modified Fisher scale (mFisher), and the patient's neurological status upon admission, are the strongest predictors of DCI. Early prevention is essential and typically involves administration of enteral nimodipine and the maintenance of euvolemia, while other treatment options have limited supporting evidence. Diagnosing remains a challenge, primarily due to its reliance on clinical examinations. This is more pronounced in high-grade aSAH patients who are unconscious or sedated. In such cases, additional methods may be necessary, such as transcranial Doppler (TCD), continuous electroencephalography (cEEG), or CT with perfusion (CTP). Treatment aims to prevent cerebral infarction and poor clinical outcomes, and it is based on hemodynamic optimization, hypertension induction, cardiac output augmentation, and endovascular therapy. Nevertheless, randomized data on DCI management remains scarce, highlighting the urgent need for more studies and a better understanding of this SAH complication. Addressing this gap may lead to more effective preventive strategies and treatments, which is crucial for improving the prognosis of these patients.

Keywords

Subarachnoid Hemorrhage - Brain Ischemia - Critical Care - Cerebral Hemorrhage - Intracranial Aneurysm

Authors' Contributions

Conceptualization: IPM, CRCA, NVOS, PK; Methodology: IPM, CRCA, PK; Project administration: IPM, PK; Supervision: GSS, PK; Visualization: NVOS; Writing – original draft: IPM, CRCA; Writing – review & editing: NVOS, JBCA, GSS, PK.


Data Availability Statement

The contents underlying the research text are included in the manuscript.


Editor-in-Chief: Ayrton Roberto Massaro 0000-0002-0487-5299.


Associate Editor: Marcos Christiano Lange 0000-0002-0405-7157.




Publikationsverlauf

Eingereicht: 18. Dezember 2024

Angenommen: 13. April 2025

Artikel online veröffentlicht:
25. Juni 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil

Bibliographical Record
Ingrid Pereira Marques, Carolina Rouanet Cavalcanti de Albuquerque, Natalia Vasconcellos de Oliveira Souza, João Brainer Clares de Andrade, Gisele Sampaio Silva, Pedro Kurtz. Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a narrative review. Arq Neuropsiquiatr 2025; 83: s00451809885.
DOI: 10.1055/s-0045-1809885
 

  • References

  • 1 Lawton MT, Vates GE. Subarachnoid Hemorrhage. N Engl J Med 2017; 377 (03) 257-266
    CrossrefPubMedSuche in Google Scholar
  • 2 Hoh BL, Ko NU, Amin-Hanjani S, Chou SHY, Cruz-Flores S, Dangayach NS. et al. 2023 Guideline for the management of patients with aneurysmal subarachnoid hemorrhage: A guideline from the American Heart Association/American Stroke Association. Stroke 2023; 54 (07) e314-e370
    CrossrefPubMedSuche in Google Scholar
  • 3 Gonçalves B, Rynkowski C, Turon R, Charris N, Miranda F, Caro Vd. et al. Clinical characteristics and outcomes of patients with aneurysmal subarachnoid hemorrhage: A prospective multicenter study in a middle-income country. Neurocrit Care 2023; 38 (02) 378-387
    CrossrefPubMedSuche in Google Scholar
  • 4 Chou SH-Y. Subarachnoid Hemorrhage. Continuum (Minneap Minn) 2021; 27 (05) 1201-1245
    CrossrefPubMedSuche in Google Scholar
  • 5 Treggiari MM, Rabinstein AA, Busl KM, Caylor MM, Citerio G, Deem S. et al. Guidelines for the neurocritical care management of aneurysmal subarachnoid hemorrhage. Neurocrit Care 2023; 39 (01) 1-28
    CrossrefPubMedSuche in Google Scholar
  • 6 Vergouwen MD, Ilodigwe D, Macdonald RL. Cerebral infarction after subarachnoid hemorrhage contributes to poor outcome by vasospasm-dependent and -independent effects. Stroke 2011; 42 (04) 924-929
    CrossrefPubMedSuche in Google Scholar
  • 7 Mualem W, Durrani S, Ghaith AK, Bhandarkar AR, Wahood W, Tjoumakaris S. et al. Factors associated with increased inpatient charges following aneurysmal subarachnoid hemorrhage with vasospasm: A nationwide analysis. Clin Neurol Neurosurg 2022; 218: 107259
    CrossrefPubMedSuche in Google Scholar
  • 8 Duan W, Pan Y, Wang C, Wang Y, Zhao X, Wang Y, Liu L. CNSR Investigators. Risk factors and clinical impact of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: Analysis from the China National Stroke Registry. Neuroepidemiology 2018; 50 (3-4): 128-136
    CrossrefPubMedSuche in Google Scholar
  • 9 Vergouwen MDI, Vermeulen M, Van Gijn J, Rinkel GJE, Wijdicks EF, Muizelaar JP. et al. Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies: proposal of a multidisciplinary research group. Stroke 2010; 41 (10) 2391-2395
    CrossrefPubMedSuche in Google Scholar
  • 10 Suarez JI, Sheikh MK, Macdonald RL, Amin-Hanjani S, Brown Jr RD, Manoel ALdO. et al; Unruptured Intracranial Aneurysms and SAH CDE Project Investigators. Common data elements for unruptured intracranial aneurysms and subarachnoid hemorrhage clinical research: A National Institute for Neurological Disorders and Stroke and National Library of Medicine project. Neurocrit Care 2019; 30 (Suppl. 01) 4-19
    CrossrefPubMedSuche in Google Scholar
  • 11 Geraghty JR, Testai FD. Delayed cerebral ischemia after subarachnoid hemorrhage: Beyond vasospasm and towards a multifactorial pathophysiology. Curr Atheroscler Rep 2017; 19 (12) 50
    CrossrefPubMedSuche in Google Scholar
  • 12 Manoel ALdO, Mansur A, Murphy A, Turkel-Parrella D, Macdonald M, Macdonald RL. et al. Aneurysmal subarachnoid haemorrhage from a neuroimaging perspective. Crit Care 2014; 18 (06) 557
    CrossrefPubMedSuche in Google Scholar
  • 13 Dodd WS, Laurent D, Dumont AS, Hasan DM, Jabbour PM, Starke RM. et al. Pathophysiology of delayed cerebral ischemia after subarachnoid hemorrhage: A review. J Am Heart Assoc 2021; 10 (15) e021845
    CrossrefPubMedSuche in Google Scholar
  • 14 Motwani K, Dodd WS, Laurent D, Lucke-Wold B, Chalouhi N. Delayed cerebral ischemia: A look at the role of endothelial dysfunction, emerging endovascular management, and glymphatic clearance. Clin Neurol Neurosurg 2022; 218: 107273
    CrossrefPubMedSuche in Google Scholar
  • 15 Van der Steen WE, Leemans EL, Van den Berg R, Roos YBWEM, Marquering HA, Verbaan D, Majoie CBLM. Radiological scales predicting delayed cerebral ischemia in subarachnoid hemorrhage: systematic review and meta-analysis. Neuroradiology 2019; 61 (03) 247-256
    CrossrefPubMedSuche in Google Scholar
  • 16 Manoel ALdO, Jaja BN, Germans MR, Yan H, Qian W, Kouzmina E. et al; SAHIT collaborators. The VASOGRADE: A simple grading scale for prediction of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Stroke 2015; 46 (07) 1826-1831
    CrossrefPubMedSuche in Google Scholar
  • 17 Souza NVO, Rouanet C, Solla DJF, Lima CVBd, Souza CAd, Rezende F. et al. The role of VASOGRADE as a simple grading scale to predict delayed cerebral ischemia and functional outcome after aneurysmal subarachnoid hemorrhage. Neurocrit Care 2023; 38 (01) 96-104
    CrossrefPubMedSuche in Google Scholar
  • 18 De Rooij NK, Rinkel GJ, Dankbaar JW, Frijns CJ. Delayed cerebral ischemia after subarachnoid hemorrhage: a systematic review of clinical, laboratory, and radiological predictors. Stroke 2013; 44 (01) 43-54
    CrossrefPubMedSuche in Google Scholar
  • 19 Ma X, Lan F, Zhang Y. Associations between C-reactive protein and white blood cell count, occurrence of delayed cerebral ischemia and poor outcome following aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Acta Neurol Belg 2021; 121 (05) 1311-1324
    CrossrefPubMedSuche in Google Scholar
  • 20 Xiao ZK, Wang B, Liu JH, Yang YB, Jie N, Mao XY. et al. Risk factors for the development of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. World Neurosurg 2025; 193: 427-446
    CrossrefPubMedSuche in Google Scholar
  • 21 Messina R, De Gennaro L, De Robertis M, Pop R, Chibbaro S, Severac F. et al. Cerebrospinal fluid lactate and glucose levels as predictors of symptomatic delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage. World Neurosurg 2023; 170: e596-e602
    CrossrefPubMedSuche in Google Scholar
  • 22 Yi HJ, Shin DS, Kim BT. Dynamic changes of systemic inflammation response index and systemic immune-inflammation index are associated with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis 2024; 33 (05) 107626
    CrossrefPubMedSuche in Google Scholar
  • 23 Lu GD, Wang C, Wang B, Zhao LB, Liu S. Higher levels of admission N-terminal pro-brain natriuretic peptide are associated with delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage. Neurocrit Care 2023; 38 (01) 52-59
    CrossrefPubMedSuche in Google Scholar
  • 24 Zheng WL, Kim JA, Elmer J, Zafar SF, Ghanta M, Moura Jr V. et al. Automated EEG-based prediction of delayed cerebral ischemia after subarachnoid hemorrhage. Clin Neurophysiol 2022; 143: 97-106
    CrossrefPubMedSuche in Google Scholar
  • 25 Chen HY, Elmer J, Zafar SF, Ghanta M, Moura Jr V, Rosenthal ES. et al. Combining transcranial Doppler and EEG data to predict delayed cerebral ischemia after subarachnoid hemorrhage. Neurology 2022; 98 (05) e459-e469
    CrossrefPubMedSuche in Google Scholar
  • 26 Shah AH, Snow R, Wendell LC, Thompson BB, Reznik ME, Furie KL, Mahta A. Association of hemoglobin trend and outcomes in aneurysmal subarachnoid hemorrhage: A single center cohort study. J Clin Neurosci 2023; 107: 77-83
    CrossrefPubMedSuche in Google Scholar
  • 27 Zeineddine HA, Divito A, McBride DW, Pandit P, Capone S, Dawes BH. et al. Subarachnoid blood clearance and aneurysmal subarachnoid hemorrhage outcomes: A retrospective review. Neurocrit Care 2023; 39 (01) 172-179
    CrossrefPubMedSuche in Google Scholar
  • 28 Topcu A, Ozkul A, Yilmaz A, Yi HJ, Shin DS, Kim B. The impact of collateral status on cerebral vasospasm and delayed cerebral ischemia in subarachnoid hemorrhage. J Cerebrovasc Endovasc Neurosurg 2023; 25 (03) 288-296
    CrossrefPubMedSuche in Google Scholar
  • 29 Kassell NF, Torner JC, Haley Jr EC, Jane JA, Adams HP, Kongable GL. The international cooperative study on the timing of aneurysm surgery. Part 1: Overall management results. J Neurosurg 1990; 73 (01) 18-36
    CrossrefPubMedSuche in Google Scholar
  • 30 Tjerkstra MA, Labib H, Coert BA, Spijker R, Coutinho JM, Vandertop WP, Verbaan D. et al. Laboratory biomarkers of delayed cerebral ischemia following subarachnoid hemorrhage: A systematic review. J Circ Biomark 2023; 12: 17-25
    CrossrefPubMedSuche in Google Scholar
  • 31 Batista S, Bocanegra-Becerra JE, Claassen B, Rubião F, Rabelo NN, Figueiredo EG, Oberman DZ. Biomarkers in aneurysmal subarachnoid hemorrhage: A short review. World Neurosurg X 2023; 19: 100205
    CrossrefPubMedSuche in Google Scholar
  • 32 Santana LS, Diniz JBC, Rabelo NN, Teixeira MJ, Figueiredo EG, Telles JPM. Machine Learning Algorithms to Predict Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis. Neurocrit Care 2024; 40 (03) 1171-1181
    CrossrefPubMedSuche in Google Scholar
  • 33 Ge S, Chen J, Wang W, Zhang LB, Teng Y, Yang C. et al. Predicting who has delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage using machine learning approach: a multicenter, retrospective cohort study. BMC Neurol 2024; 24 (01) 177
    CrossrefPubMedSuche in Google Scholar
  • 34 Caylor MM, Macdonald RL. Pharmacological Prevention of Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care 2024; 40 (01) 159-169
    CrossrefPubMedSuche in Google Scholar
  • 35 Barker II FG, Ogilvy CS. Efficacy of prophylactic nimodipine for delayed ischemic deficit after subarachnoid hemorrhage: a metaanalysis. J Neurosurg 1996; 84 (03) 405-414
    CrossrefPubMedSuche in Google Scholar
  • 36 Francoeur CL, Mayer SA. Management of delayed cerebral ischemia after subarachnoid hemorrhage. Crit Care 2016; 20 (01) 277
    CrossrefPubMedSuche in Google Scholar
  • 37 Hänggi D, Etminan N, Aldrich F, Steiger HJ, Mayer SA, Diringer MN. et al; NEWTON Investigators. Randomized, open-label, phase 1/2a study to determine the maximum tolerated dose of intraventricular sustained release nimodipine for subarachnoid hemorrhage (NEWTON [Nimodipine Microparticles to Enhance Recovery While Reducing Toxicity After Subarachnoid Hemorrhage]). Stroke 2017; 48 (01) 145-151
    CrossrefPubMedSuche in Google Scholar
  • 38 Kuroi Y, Ohbuchi H, Arai N, Takahashi Y, Hagiwara S, Sasahara A. et al. Twelve-year single critical care center experience of nicardipine prolonged-release implants in patients with subarachnoid hemorrhage: a propensity score matching analysis. J Neurointerv Surg 2020; 12 (08) 774-776
    CrossrefPubMedSuche in Google Scholar
  • 39 Wessels L, Wolf S, Adage T, Breitenbach J, Thomé C, Kerschbaumer J. et al. Localized nicardipine release implants for prevention of vasospasm after aneurysmal subarachnoid hemorrhage: A randomized clinical trial. JAMA Neurol 2024; 81 (10) 1060-1065
    CrossrefPubMedSuche in Google Scholar
  • 40 Engel A, Song L, Rauschenbach L, Gümüs M, Santos AN, Dinger TF. et al. Impact of carotid siphon calcification on the course and outcome of patients with aneurysmal subarachnoid hemorrhage. Stroke 2024; 55 (09) 2305-2314
    CrossrefPubMedSuche in Google Scholar
  • 41 Vergouwen MD, Etminan N, Ilodigwe D, Macdonald RL. Lower incidence of cerebral infarction correlates with improved functional outcome after aneurysmal subarachnoid hemorrhage. J Cereb Blood Flow Metab 2011; 31 (07) 1545-1553
    CrossrefPubMedSuche in Google Scholar
  • 42 Mutoh T, Kazumata K, Terasaka S, Taki Y, Suzuki A, Ishikawa T. Early intensive versus minimally invasive approach to postoperative hemodynamic management after subarachnoid hemorrhage. Stroke 2014; 45 (05) 1280-1284
    CrossrefPubMedSuche in Google Scholar
  • 43 Anetsberger A, Gempt J, Blobner M, Ringel F, Bogdanski R, Heim M. et al. Impact of goal-directed therapy on delayed ischemia after aneurysmal subarachnoid hemorrhage: Randomized controlled trial. Stroke 2020; 51 (08) 2287-2296
    CrossrefPubMedSuche in Google Scholar
  • 44 Blackburn SL, Grande AW, Swisher CB, Hauck EF, Jagadeesan B, Provencio JJ. Prospective trial of cerebrospinal fuid filtration after aneurysmal subarachnoid hemorrhage via lumbar catheter (PILLAR). Stroke 2019; 50 (09) 2558-2561
    CrossrefPubMedSuche in Google Scholar
  • 45 Rao SS, Chung DY, Wolcott Z, Sheriff F, Khawaja AM, Lee H. et al. Intermittent CSF drainage and rapid EVD weaning approach after subarachnoid hemorrhage: association with fewer VP shunts and shorter length of stay. J Neurosurg 2019; 132 (05) 1583-1588
    CrossrefPubMedSuche in Google Scholar
  • 46 Wolf S, Mielke D, Barner C, Malinova V, Kerz T, Wostrack M. et al; EARLYDRAIN Study Group. Effectiveness of Lumbar Cerebrospinal Fluid Drain Among Patients With Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial. JAMA Neurol 2023; 80 (08) 833-842
    CrossrefPubMedSuche in Google Scholar
  • 47 Abdulazim A, Heilig M, Rinkel G, Etminan N. Diagnosis of Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage and Triggers for Intervention. Neurocrit Care 2023; 39 (02) 311-319
    CrossrefPubMedSuche in Google Scholar
  • 48 Shah VA, Gonzalez LF, Suarez JI. Therapies for Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care 2023; 39 (01) 36-50
    CrossrefPubMedSuche in Google Scholar
  • 49 Khawaja AM, McNulty J, Thakur UV, Chawla S, Devi S, Liew A. et al. Transcranial Doppler and computed tomography angiography for detecting cerebral vasospasm post-aneurysmal subarachnoid hemorrhage. Neurosurg Rev 2022; 46 (01) 3
    CrossrefPubMedSuche in Google Scholar
  • 50 Rouanet C, Chaddad F, Freitas F, Miranda M, Vasconcellos N, Valiente R. et al. Kinetics of cerebral blood flow velocities during treatment for delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage. Neurocrit Care 2022; 36 (01) 226-239
    CrossrefPubMedSuche in Google Scholar
  • 51 De Oliveira Manoel AL, Goffi A, Marotta TR, Schweizer TA, Abrahamson S, Macdonald RL. The critical care management of poor-grade subarachnoid haemorrhage. Crit Care 2016; Jan 23; 20: 21
    CrossrefPubMedSuche in Google Scholar
  • 52 Brisson RT, Santos RDSA, Stefano LHSS, Barreira CMA, Arruda JFdL, Dias FA. et al. Association between Tomographic Characteristics of the Temporal Bone and Transtemporal Window Quality on Transcranial Color Doppler Ultrasound in Patients with Stroke or Transient Ischemic Attack. Ultrasound Med Biol 2021; 47 (03) 511-516
    CrossrefPubMedSuche in Google Scholar
  • 53 Mursch K, Wachter A, Radke K, Buhre W, Al-Sufi S, Munzel U. et al. Blood flow velocities in the basal vein after subarachnoid haemorrhage. A prospective study using transcranial duplex sonography. Acta Neurochir (Wien) 2001; 143 (08) 793-799 , discussion 799–800
    CrossrefPubMedSuche in Google Scholar
  • 54 Connolly F, Schreiber SJ, Leithner C, Bohner G, Vajkoczy P, Valdueza JM. Assessment of intracranial venous blood flow after subarachnoid hemorrhage: a new approach to diagnose vasospasm with transcranial color-coded duplex sonography. J Neurosurg 2018; 129 (05) 1136-1142
    CrossrefPubMedSuche in Google Scholar
  • 55 Lolli VE, Guenego A, Sadeghi N, Jodaitis L, Lubicz B, Taccone FS, Bogossian EG. CT perfusion imaging in aneurysmal subarachnoid hemorrhage. State of the art. Front Radiol 2024; 4: 1445676
    CrossrefPubMedSuche in Google Scholar
  • 56 Han H, Chen Y, Li R, Lin F, Lu J, Chen X, Wang S. The value of early CT perfusion parameters for predicting delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Neurosurg Rev 2022; 45 (04) 2517-2531
    CrossrefPubMedSuche in Google Scholar
  • 57 Claassen J, Hirsch LJ, Kreiter KT, Du EY, Connolly ES, Emerson RG, Mayer SA. Quantitative continuous EEG for detecting delayed cerebral ischemia in patients with poor-grade subarachnoid hemorrhage. Clin Neurophysiol 2004; 115 (12) 2699-2710
    CrossrefPubMedSuche in Google Scholar
  • 58 Scherschinski L, Catapano JS, Karahalios K, Koester SW, Benner D, Winkler EA. et al. Electroencephalography for detection of vasospasm and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a retrospective analysis and systematic review. Neurosurg Focus 2022; 52 (03) E3
    CrossrefPubMedSuche in Google Scholar
  • 59 Kondziella D, Friberg CK, Wellwood I, Reiffurth C, Fabricius M, Dreier JP. Continuous EEG monitoring in aneurysmal subarachnoid hemorrhage: a systematic review. Neurocrit Care 2015; 22 (03) 450-461
    CrossrefPubMedSuche in Google Scholar
  • 60 Park JJ, Kim Y, Chai CL, Jeon JP. Application of near-infrared spectroscopy for the detection of delayed cerebral ischemia in poor-grade subarachnoid hemorrhage. Neurocrit Care 2021; 35 (03) 767-774
    CrossrefPubMedSuche in Google Scholar
  • 61 Winberg J, Holm I, Cederberg D, Rundgren M, Kronvall E, Marklund N. Cerebral Microdialysis-Based Interventions Targeting Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care 2022; 37 (01) 255-266
    CrossrefPubMedSuche in Google Scholar
  • 62 Deem S, Diringer M, Livesay S, Treggiari MM. Hemodynamic Management in the Prevention and Treatment of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care 2023; 39 (01) 81-90
    CrossrefPubMedSuche in Google Scholar
  • 63 Muench E, Horn P, Bauhuf C, Roth H, Philipps M, Hermann P. et al. Effects of hypervolemia and hypertension on regional cerebral blood flow, intracranial pressure, and brain tissue oxygenation after subarachnoid hemorrhage. Crit Care Med 2007; 35 (08) 1844-1851 , quiz 1852
    CrossrefPubMedSuche in Google Scholar
  • 64 Kurtz P, Helbok R, Claassen J, Schmidt JM, Fernandez L, Stuart RM. et al. The effect of packed red blood cell transfusion on cerebral oxygenation and metabolism after subarachnoid hemorrhage. Neurocrit Care 2016; 24 (01) 118-121 PubMed
    CrossrefPubMedSuche in Google Scholar
  • 65 Said M, Gümüs M, Rodemerk J, Rauschenbach L, Chihi M, Dinger TF. et al. Systematic review and meta-analysis of outcome-relevant anemia in patients with subarachnoid hemorrhage. Sci Rep 2022; 12 (01) 20738
    CrossrefPubMedSuche in Google Scholar
  • 66 Taccone FS, Rynkowski CB, Møller K, Lormans P, Quintana-Díaz M, Caricato A. et al; TRAIN Study Group. Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury: The TRAIN Randomized Clinical Trial. JAMA 2024; 332 (19) 1623-1633
    CrossrefPubMedSuche in Google Scholar
  • 67 English SW, Delaney A, Fergusson DA, Chassé M, Turgeon AF, Lauzier F. et al; SAHARA Trial Investigators on behalf of the Canadian Critical Care Trials Group.. Liberal or Restrictive Transfusion Strategy in Aneurysmal Subarachnoid Hemorrhage. N Engl J Med 2025; 392 (11) 1079-1088
    CrossrefPubMedSuche in Google Scholar
  • 68 Roy B, McCullough LD, Dhar R, Grady J, Wang YB, Brown RJ. Comparison of initial vasopressors used for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Cerebrovasc Dis 2017; 43 (5-6): 266-271
    CrossrefPubMedSuche in Google Scholar
  • 69 Murphy A, Manoel ALdO, Macdonald RL, Baker A, Lee TY, Marotta T. et al. Changes in Cerebral Perfusion with Induced Hypertension in Aneurysmal Subarachnoid Hemorrhage: A Pilot and Feasibility Study. Neurocrit Care 2017; 27 (01) 3-10
    CrossrefPubMedSuche in Google Scholar
  • 70 Reynolds MR, Buckley RT, Indrakanti SS, Turkmani AH, Oh G, Crobeddu E. et al. The safety of vasopressor-induced hypertension in subarachnoid hemorrhage patients with coexisting unruptured, unprotected intracranial aneurysms. J Neurosurg 2015; 123 (04) 862-871
    CrossrefPubMedSuche in Google Scholar
  • 71 Haegens NM, Gathier CS, Horn J, Coert BA, Verbaan D, Van den Bergh WM. Induced hypertension in preventing cerebral infarction in delayed cerebral ischemia after subarachnoid hemorrhage. Stroke 2018; 49 (11) 2630-2636
    CrossrefPubMedSuche in Google Scholar
  • 72 Gathier CS, Van den Bergh WM, Van der Jagt M, Verweij BH, Dankbaar JW, Müller MC. et al; HIMALAIA Study Group. Induced Hypertension for Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial. Stroke 2018; 49 (01) 76-83
    CrossrefPubMedSuche in Google Scholar
  • 73 Lannes M, Teitelbaum J, Del Pilar Cortés M, Cardoso M, Angle M. Milrinone and homeostasis to treat cerebral vasospasm associated with subarachnoid hemorrhage: the Montreal Neurological Hospital protocol. Neurocrit Care 2012; 16 (03) 354-362
    CrossrefPubMedSuche in Google Scholar
  • 74 Bernier TD, Schontz MJ, Izzy S, Chung DY, Nelson SE, Mazwi TML. et al. Treatment of Subarachnoid Hemorrhage-associated Delayed Cerebral Ischemia With Milrinone: A Review and Proposal. J Neurosurg Anesthesiol 2021; 33 (03) 195-202
    CrossrefPubMedSuche in Google Scholar
  • 75 Abulhasan YB, Ortiz Jimenez J, Teitelbaum J, Simoneau G, Angle MR. Milrinone for refractory cerebral vasospasm with delayed cerebral ischemia. J Neurosurg 2020; 134 (03) 971-982
    CrossrefPubMedSuche in Google Scholar
  • 76 Lakhal K, Hivert A, Alexandre PL, Fresco M, Edan VR, Talbere PAR. et al. Intravenous Milrinone for Cerebral Vasospasm in Subarachnoid Hemorrhage: The MILRISPASM Controlled Before-After Study. Neurocrit Care 2021; 35 (03) 669-679
    CrossrefPubMedSuche in Google Scholar
  • 77 Steiger HJ, Ensner R, Andereggen L, Remonda L, Berberat J, Marbacher S. Hemodynamic response and clinical outcome following intravenous milrinone plus norepinephrine-based hyperdynamic hypertensive therapy in patients suffering secondary cerebral ischemia after aneurysmal subarachnoid hemorrhage. Acta Neurochir (Wien) 2022; 164 (03) 811-821
    CrossrefPubMedSuche in Google Scholar
  • 78 Shah VA, Kazmi SO, Damani R, Harris AH, Hohmann SF, Calvillo E, Suarez JI. Regional variability in the care and outcomes of 8subarachnoid hemorrhage patients in the United States. Front Neurol 2022; 13: 908609
    CrossrefPubMedSuche in Google Scholar
  • 79 Guenego A, Fahed R, Rouchaud A, Walker GW, Faizy TD, Sporns PB. et al; Research Committee of the European Society of Minimally Invasive Neurological Therapy (ESMINT). Diagnosis and endovascular management of vasospasm after aneurysmal subarachnoid hemorrhage - survey of real-life practices. J Neurointerv Surg 2024; 16 (07) 677-683
    CrossrefPubMedSuche in Google Scholar
  • 80 Zwienenberg-Lee M, Hartman J, Rudisill N, Madden LK, Smith K, Eskridge J. et al; Balloon Prophylaxis for Aneurysmal Vasospasm (BPAV) Study Group. Effect of prophylactic transluminal balloon angioplasty on cerebral vasospasm and outcome in patients with Fisher grade III subarachnoid hemorrhage: results of a phase II multicenter, randomized, clinical trial. Stroke 2008; 39 (06) 1759-1765
    CrossrefPubMedSuche in Google Scholar