Risks factors for cerebral infarction in good-grade patients after aneurysmal subarachnoid hemorrhage and surgery: a prospective study

J Neurosurg. 1991 Jan;74(1):14-20. doi: 10.3171/jns.1991.74.1.0014.


A prospective series of 265 patients with aneurysmal subarachnoid hemorrhage (SAH) of Grades I to III (Hunt and Hess classification) upon admission were evaluated as to neurological outcome and computerized tomography (CT) findings 1 to 3 years (mean 1.4 years) after the SAH and surgery. A total of 73 patients underwent acute surgery (within 72 hours after the bleed: Days 0 to 3), 86 were operated on subacutely (between Days 4 and 7), and 91 had late surgery (on Day 8 or later). Fifteen patients died before surgery was undertaken and another 20 patients died during the follow-up period. A total of 104 patients received nimodipine and the rest of the patients received either placebo (109 patients) or no medication (52 patients). A logistical regression analysis revealed the following prognostic factors for cerebral infarction, in order of importance: the amount of blood on the primary CT scan; postoperative angiographic vasospasm; the timing of the operation; and a history of hypertension. The use of nimodipine was associated with a significant reduction of cerebral infarcts visualized by CT scanning in patients who received intermediate or late surgery. In patients who underwent acute surgery no significant difference between the incidence of cerebral infarcts was observed.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / etiology
  • Cerebral Angiography
  • Cerebral Infarction / diagnostic imaging
  • Cerebral Infarction / etiology*
  • Cerebral Infarction / pathology
  • Female
  • Humans
  • Hypertension / complications
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / surgery*
  • Ischemic Attack, Transient / complications
  • Ischemic Attack, Transient / diagnostic imaging
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Subarachnoid Hemorrhage / complications
  • Subarachnoid Hemorrhage / surgery*
  • Time Factors
  • Tomography, X-Ray Computed