Cerebral vasospasm following traumatic subarachnoid hemorrhage

Background: cerebral vasospasm is a preventable cause of death and disability in patients who experience aneurysmalsubarachnoid hemorrhage (sah). the aim of this study is to investigate the incidence of cerebral vasospasm following traumatic sah and its relationship with different brain injuries and severity of trauma.methods: this cross-sectional study was conducted from october 2006 to march 2007 in department of neurosurgeryin al-zahra hospital. consecutive head-injured patients who had sah on the basis of an admission ct scan were prospectivelyevaluated. the severity of the trauma was evaluated by determining glasgow coma scale (gcs) score onadmission. transcranial doppler ultrasonography evaluations were performed at least 48 hours after admission and oneweek thereafter. vasospasm in the mca and aca was defined by mean flow velocity (fv) of more than 120 cm/secwith a lindegaard index (mva/ica fv ratio) higher than 3. basilar artery vasospasm was defined by fv higher than85 cm/sec.results: seventy seven patients with tsah were enrolled from whom 13 were excluded. the remaining were 52(81.2%) men and 12 (18.7%) women, with a mean age of 37.89 years. trauma was severe in 11 (17.2%), moderate in13 (20.3%), and mild in 40 (62.5%) patients. from all, 27 patients (42.1%) experienced at least one vasospasm duringthe study period and mca vasospasm was the most common in the first and second weeks (55.5%).conclusions: traumatic sah is associated with a high incidence of cerebral vasospasm with a higher probability inpatients with severe tbi.