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dc.contributor.authorBøthun, Marianne Lunderviken_US
dc.contributor.authorHaaland, Øystein Ariansenen_US
dc.contributor.authorMoen, Gunnaren_US
dc.contributor.authorLogallo, Nicolaen_US
dc.contributor.authorSvendsen, Frodeen_US
dc.contributor.authorThomassen, Larsen_US
dc.contributor.authorHelland, Christian Andreen_US
dc.date.accessioned2020-03-25T15:02:26Z
dc.date.available2020-03-25T15:02:26Z
dc.date.issued2019
dc.PublishedBøthun 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.issn0022-510X
dc.identifier.issn1878-5883
dc.identifier.urihttps://hdl.handle.net/1956/21594
dc.description.abstractIntroduction: 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. 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. 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. 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.en_US
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 hemorrhageen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2020-01-17T07:41:30Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2019 The Authors
dc.identifier.doihttps://doi.org/10.1016/j.jns.2019.116539
dc.identifier.cristin1748461
dc.source.journalJournal of the Neurological Sciences


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