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dc.contributor.authorBøthun, Marianne Lundervik
dc.contributor.authorHaaland, Øystein Ariansen
dc.contributor.authorMoen, Gunnar
dc.contributor.authorLogallo, Nicola
dc.contributor.authorSvendsen, Frode
dc.contributor.authorThomassen, Lars
dc.contributor.authorHelland, Christian Andre
dc.date.accessioned2020-03-25T15:02:26Z
dc.date.available2020-03-25T15:02:26Z
dc.date.issued2019
dc.identifier.citationBøthun M, Haaland ØA, Moen G, Logallo N, Svendsen F, Thomassen L, Helland CA. Impaired cerebrovascular reactivity may predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Journal of the Neurological Sciences. 2019;407:116539eng
dc.identifier.urihttp://hdl.handle.net/1956/21594
dc.description.abstract<p>Introduction: Delayed cerebral ischemia (DCI) is a major cause of disability and death after aneurysmal subarachnoid hemorrhage. The literature suggests that impaired cerebrovascular reactivity (CVR) may be a predictor for DCI; still no CVR based prediction model has been developed. Increased knowledge about possible predictors of DCI can improve patient management in high-risk patients and allow for shorter hospital stay in low-risk patients.</p> <p>Method: CVR was examined in 42 patients with aneurysmal subarachnoid hemorrhage and 37 patients treated for unruptured intracranial aneurysm, using acetazolamide test with transcranial Doppler monitoring of blood flow velocities. Patients were followed for development of DCI, separated into clinical deterioration and radiographic infarction.</p> <p>Results: For all patients, regardless of aneurysm rupture status, CVR was on average 5.5 percentage points lower on the ipsilateral side of aneurysm treatment. Patients with clinical deterioration due to DCI had lower CVR than patients without DCI, and the difference was larger on the contralateral side (33.9% vs. 49.2%). Two prediction models were constructed for clinical deterioration due to DCI. The area under the receiver operating characteristic curve was 0.82 in the model using established predictors, and 0.86 in the model that also included CVR.</p> <p>Conclusion: Our findings support the hypothesis that impaired CVR may be an independent predictor of clinical deterioration due to DCI, and may assist in identifying patients at risk after aneurysmal subarachnoid hemorrhage. Ipsilateral CVR reduction occurs in all patients after aneurysm treatment, regardless of DCI development, thus highlighting the need to evaluate ipsi- and contralateral CVR separately.</p>eng
dc.language.isoengeng
dc.publisherElseviereng
dc.rightsAttribution-Non Commercial-No Derivatives CC BY-NC-NDeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/eng
dc.titleImpaired cerebrovascular reactivity may predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhageeng
dc.typeJournal articleeng
dc.date.updated2020-01-17T07:41:30Z
dc.rights.holderCopyright 2019 The Authorseng
dc.type.versionpublishedVersioneng
bora.peerreviewedPeer reviewedeng
dc.type.documentJournal article
dc.identifier.cristinID1748461
dc.identifier.doi10.1016/j.jns.2019.116539eng
dc.source.issn0022-510Xeng
dc.source.issn1878-5883eng
dc.relation.journalJournal of the Neurological Sciences


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