Systemic Complications after Subarachnoid Hemorrhage

  • A. Caricato
  • R. Maviglia
  • M. Antonelli
Conference paper

Abstract

Aneurysmal subarachnoid hemorrhage (SAH) is a neurologic emergency that affects an estimated 10 individuals in a population of 100, 000 annually, and is associated with high mortality rates and significant morbidity among survivors [1, 2]. The most important independent determinants of outcome include neurological status on admission [3, 4, 5, 6, 7, 8], age [3, 5, 7, 8, 9], large aneurysm size (< 10 mm) [6], and aneurysm rebleeding [10, 11, 12].

Keywords

Permeability Ischemia Pneumonia Cortisol Anemia 

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References

  1. 1.
    Ingall T, Asplund K, Mahonen M, Bonita R (2000) A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study. Stroke 31: 1054–1061PubMedGoogle Scholar
  2. 2.
    Hop JW, Rinkel GJ, Algra A, van Gijn J (2001) Changes in functional outcome and quality of life in patients and caregivers after aneurysmal subarachnoid hemorrhage. J Neurosurg 95: 957–963CrossRefPubMedGoogle Scholar
  3. 3.
    Hutter BO, Kreitschmann-Andermahr I, Gilsbach JA (2001) Health-related quality of life after aneurysmal subarachnoid hemorrhage: Impacts of bleeding severity, computerized tomography findings, surgery, vasospasm, and neurological grade. J Neurosurg 94: 241–251CrossRefPubMedGoogle Scholar
  4. 4.
    Germanson TP, Lanzino G, Kongable GL, et al (1998) Risk classification after aneurysmal subarachnoid hemorrhage. Surg Neurol 49: 155–163CrossRefPubMedGoogle Scholar
  5. 5.
    Rabinstein AA, Friedman JA, Nichols DA, et al (2004) Predictors of outcome after endovascular treatment of cerebral vasospasm. Am J Neuroradiol 25: 1778–1782PubMedGoogle Scholar
  6. 6.
    Claassen J, Carhuapoma JR, Kreiter KT, et al (2002) Global cerebral edema after subarachnoid hemorrhage: Frequency, predictors and impact on outcome. Stroke 33: 1225–1232CrossRefPubMedGoogle Scholar
  7. 7.
    Lagares A, Goméz PA, Lobate RD, et al (2001) Prognostic factors on hospital admission after spontaneous subarachnoid haemorrhage. Acta Neurochir 143: 665–672CrossRefGoogle Scholar
  8. 8.
    Sarrafzadeh A, Haux D, Kuchler I, et al (2004) Poor grade aneurysmal subarachnoid hemorrhage: relationship of cerebral metabolism to outcome. J Neurosurg 100: 400–406CrossRefPubMedGoogle Scholar
  9. 9.
    Lanzino G, Kassell NF, Germanson TP, et al (1996) Age and outcome after aneurysmal subarachnoid hemorrhage: Why do older patients fare worse? J Neurosurg 85: 410–418CrossRefPubMedGoogle Scholar
  10. 10.
    Roos YBWEM, Beenen LFM, Groen RJM, et al (1997) Timing of surgery in patients with aneurysmal subarachnoid hemorrhage: Rebleeding is still the major cause of poor outcome in neurosurgical units that aim at early surgery. J Neurol Neurosurg Psych 63: 490–493CrossRefGoogle Scholar
  11. 11.
    Shimoda M, Jada S, Tsugane R, et al (1997) Prognostic factors in delayed ischaemic deficit with vasospasm in patients undergoing early aneurysm surgery. Br J Neurosurg 11: 210–215CrossRefPubMedGoogle Scholar
  12. 12.
    Naidech AM, [anjua N, Kreiter KT, et al (2005) Predictors and impact of aneurysm rebleeding after subarachnoid hemorrhage. Arch Neurol 62: 410–416CrossRefPubMedGoogle Scholar
  13. 13.
    Solenski NJ, Haley Jr EC, Kassell NF, et al (1995) Medical complications of aneurysmal subarachnoid hemorrhage: a report of the multicenter, cooperative aneurysm study. Participants of the multicenter cooperative aneurysm study. Crit Care Med 23: 1007–1017CrossRefPubMedGoogle Scholar
  14. 14.
    Gruber A, Reinprecht A, Illievich UM, et al (1999) Extracerebral organ dysfunction and neurologic outcome after aneurysmal subarachnoid hemorrhage. Crit Care Med 27: 505–514CrossRefPubMedGoogle Scholar
  15. 15.
    Claassen J, Vu A, Kreiter KT, et al (2004) Effect of acute physiologic derangements on outcome after subarachnoid hemorrhage. Crit Care Med 32: 832–838CrossRefPubMedGoogle Scholar
  16. 16.
    Gruber A, Reinprecht A, Gorzer H, et al (1998) Pulmonary function and radiographic abnor malities related to neurological outcome after aneurysmal subarachnoid hemorrhage. J Neurosurg 88: 28–37CrossRefPubMedGoogle Scholar
  17. 17.
    Wartenberg K, Schmidt JM, Claassen J, et al (2006) Impact of medical complications on outcome after subarachnoid hemorrhage Crit Care Med 34: 617–623Google Scholar
  18. 18.
    Macrea LM, Tramer MR, Walder B (2005) Spontaneous subarachnoid hemorrhage and serious cardiopulmonary dysfunction. A systematic review. Resuscitation 65: 139–148CrossRefPubMedGoogle Scholar
  19. 19.
    Naidech AM, Kreiter KT, Janjua N, et al (2005) Cardiac troponin elevation, cardiovascular morbidity, and outcome after Subarachnoid Hemorrhage. Circulation 112: 2851–2856CrossRefPubMedGoogle Scholar
  20. 20.
    Bulsara KR, MCGirt MJ, Liao L, et al (2003) Use of the peak troponin value to differentiate myocardial infarction from reversible neurogenic left ventricular dysfunction associated with aneurismal subarachnoid hemorrhage. J Neurosurg 98: 524–528 2003CrossRefPubMedGoogle Scholar
  21. 21.
    Van der Bilt lAC, Hasan D, Vandertop WP, et al (2009) Impact of cardiac complications on outcome after aneurysmal subarachnoid hemorrhage. A meta-analysis. Neurology 72: 635–642CrossRefPubMedGoogle Scholar
  22. 22.
    Hays A, Diringer MN (2006) Elevated troponin levels are associated with higher mortality following intracerebral hemorrhage. Neurology 66: 1330–1334CrossRefPubMedGoogle Scholar
  23. 23.
    Banki N, Kopelnik A, Tung P, et al (2006) Prospective analysis of prevalence, distribution, and rate of recovery of left ventricular systolic dysfunction in patients with subarachnoid hemorrhage. J Neurosurg 105: 15–20CrossRefPubMedGoogle Scholar
  24. 24.
    Kopelnik A, Fisher L, Miss JC (2005) Prevalence and implications of diastolic dysfunction after subarachnoid hemorrhage. Neurocrit Care 3: 132–138CrossRefPubMedGoogle Scholar
  25. 25.
    Lee VH, Oh JK, Mulvagh SL, Wijdicks EF (2006) Mechanisms in neurogenic stress cardiomyopathy after aneurysmal subarachnoid hemorrhage. Neurocrit Care 5: 243–249CrossRefPubMedGoogle Scholar
  26. 26.
    Lee VH, Connolly HM, Fulgham JR, Manno EM, Brown RD Jr, Wijdicks EF (2006) Takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage: an underappreciated ventricular dysfunction J Neurosurg 105: 264–270Google Scholar
  27. 27.
    Wittstein IS, Thiemann DR, Lima JAC, et al (2005) Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 352: 539–48.CrossRefPubMedGoogle Scholar
  28. 28.
    Friedman AJ, Pichelmann MA, Piepgras DG, et al (2003) Pulmonary complications of aneurismal subarachnoid hemorrhage. Neurosurgery 52: 1025–1032CrossRefPubMedGoogle Scholar
  29. 29.
    Sirvent JM, Torres A, EI-Ebiary M, Castro P, de Batlle J, Bonet A (1997) Protective effect of intravenously administered cefuroxime against nosocomial pneumonia in patients with structural coma. Am J Respir Crit Care Med 155: 1729–1734PubMedGoogle Scholar
  30. 30.
    Acquarolo A, Urli T, Perone G, Giannotti G, Candiani A, Latronico N (2005) Antibiotic prophylaxis of early onset pneumonia in critically ill comatose patients. A randomized study. Intensive Care Med 31: 510–516CrossRefPubMedGoogle Scholar
  31. 31.
    Verhamme KMC, De Coster W De Roo L, et al (2007) Pathogens in early-onset and late-onset intensive care unit-acquired pneumonia. Infect Control Hosp Epidemiol 28: 389–397CrossRefPubMedGoogle Scholar
  32. 32.
    Theodore J, Robin ED. Speculations on neurogenic pulmonary edema. Am Rev Respir Dis 113: 405–409Google Scholar
  33. 33.
    Muroi C, Keller M, Pangalu A, Fortunati M, Yonekawa Y, Keller E (2008) Neurogenic pulmonary edema in patients with subarachnoid hemorrhage. J Neurosurg Anesthesiol 20: 188–192CrossRefPubMedGoogle Scholar
  34. 34.
    Kahn JM, Caldwell EC, Deem S (2006) Acute lung injury in patients with subarachnoid hemorrhage: Incidence, risk factors, and outcome. Crit Care Med 34: 196–202CrossRefPubMedGoogle Scholar
  35. 35.
    Albrecht RF, Wass CT, Lanier WL (1998) Occurrence of potentially detrimental temperature alterations in hospitalized patients at risk for brain injury. Mayo Clin Proc 73: 629–635.CrossRefPubMedGoogle Scholar
  36. 36.
    Fernandez A, Schmidt JM, Claassen J, et al (2007) Fever after subarachnoid hemorrhage: Risk factors and impact on outcome. Neurology 68: 1013–1019CrossRefPubMedGoogle Scholar
  37. 37.
    Badjatia N (2009) Fever control in the neuro-ICU: why, who, and when? Curr Opin Crit Care 15: 79–82CrossRefPubMedGoogle Scholar
  38. 38.
    Naidech A, Jovanovic B, Wartenberg KE (2007) Higher hemoglobin is associated with improved outcome after subarachnoid hemorrhage. Crit Care Med 35: 2383–2389CrossRefPubMedGoogle Scholar
  39. 39.
    Kramer AH, Gurka MJ, Nathan B, Dumont AS, Kassell NF, Bleck TP (2008) Complications associated with anemia and blood transfusion in patients with aneurysmal subarachnoid hemorrhage. Crit Care Med 36: 2070–2075CrossRefPubMedGoogle Scholar
  40. 40.
    Marik PE, Corwin HL (2008) Efficacy of red blood cell transfusion in the critically ill: A systematic review of the literature. Crit Care Med 36: 2667–2674CrossRefPubMedGoogle Scholar
  41. 41.
    The NICE-SUGAR Study Investigators (2009) Intensive versus conventional glucose control in critically ill patients, N Eng J Med 360: 1283–1297CrossRefGoogle Scholar
  42. 42.
    Van den Berghe G, Wouters P, Weekers F, et al (2001) Intensive insulin therapy in the critically ill patients. N Engl J Med 345: 1359–1367CrossRefPubMedGoogle Scholar
  43. 43.
    Van den Berghe G, Wilmer A, Hermans G, et al (2006) Intensive insulin therapy in the medical ICU. N Engl J Med 354: 449–461CrossRefPubMedGoogle Scholar
  44. 44.
    Vespa P, Boonyaputthikul R, McArthur DL, et al (2006) Intensive insulin therapy reduces microdialysis glucose values without altering glucose utilization or improving the lactate! pyruvate ratio after traumatic brain injury. Crit Care Med 34: 850–856CrossRefPubMedGoogle Scholar
  45. 45.
    Oddo M, Schmidt JM, Mayer SA, Chiolero RL (2008) Glucose control after severe brain injury. Curr Opin Clin Nutr Metab Care 11: 134–139CrossRefPubMedGoogle Scholar
  46. 46.
    Stevens RD, Nyquist PA (2007) The systemic implications of aneurysmal subarachnoid hemorrhage. J Neurol Sci 261: 143–156CrossRefPubMedGoogle Scholar
  47. 47.
    Leblanc PE, Cheisson G, Geeraerts T, Tazarourte K, Duranteau J, Vigue B (2007) Does cerebral salt wasting syndrome exist? Ann Fr Anesth Reanimation 26: 948–953Google Scholar
  48. 48.
    Du Cheyron D, Lesage A, Daubin C, Ramakers M, Charbonneau P (2003) Hyperreninemic hypoaldosteronism: a possible etiological factor of septic shock-induced acute renal failure. Intensive Care Med 29: 1703–1709CrossRefPubMedGoogle Scholar
  49. 49.
    Wijdicks EF, Vermeulen M, ten Haaf JA, Hijdra A, Bakker WH, Van Gijn J (1985) Volume depletion and natriuresis in patients with a ruptured intracranial aneurysm. Ann Neurol 18: 211–216CrossRefPubMedGoogle Scholar
  50. 50.
    Wijdicks EF, Vermeulen M, Hijdra A, van Gijn J (1985) Hyponatremia and cerebral infarction in patients with ruptured intracranial aneurysms: is fluid restriction harmful? Ann Neurol 17: 137–140CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media Inc. 2010

Authors and Affiliations

  • A. Caricato
    • 1
  • R. Maviglia
    • 1
  • M. Antonelli
    • 1
  1. 1.Institute of Anesthesiology and Intensive CareCatholic University School of MedicineRomeItaly

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