Defining Vasospasm After Subarachnoid Hemorrhage. What Is the Most Clinically Relevant Definition?

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Defining Vasospasm After Subarachnoid Hemorrhage. What Is the Most Clinically Relevant Definition?

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Background and Purpose—Vasospasm is an important complication of subarachnoid hemorrhage, but is variably defined in the literature. Methods—We studied 580 patients with subarachnoid hemorrhage and identified those with: (1) symptomatic vasospasm, defined as clinical deterioration deemed secondary to vasospasm after other causes were eliminated; (2) delayed cerebral ischemia (DCI), defined as symptomatic vasospasm, or infarction on CT attributable to vasospasm; (3) angiographic spasm, as seen on digital subtraction angiography; and (4) transcranial Doppler (TCD) spasm, defined as any mean flow velocity >120 cm/sec. Logistic regression analysis was performed to test the association of each definition of vasospasm with various hospital complications, and 3-month quality of life (sickness impact profile), cognitive status (telephone interview of cognitive status), instrumental activities of daily living (Lawton score), and death or severe disability at 3 months (modified Rankin scale scor

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