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Effect of Human Albumin on TCD Vasospasm, DCI, and Cerebral Infarction in Subarachnoid Hemorrhage: The ALISAH Study

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Neurovascular Events After Subarachnoid Hemorrhage

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 120))

Abstract

Background and Purpose: The neuroprotective effects of human albumin have been studied in animal models of stroke and in humans with various intracranial disorders. We investigated the effect of 25 % human albumin (ALB) on mean cerebral blood flow velocities (MCBFV), delayed cerebral ischemia (DCI), and cerebral infarction.

Methods: We studied patients from the Albumin in Subarachnoid Hemorrhage (ALISAH) pilot clinical trial. We collected data on MCBFV as measured by transcranial Doppler ultrasound (TCD), incidence of DCI, and cerebral infarctions on head computed tomography (CT) scan at 90 days.

Results: TCD showed vasospasm in 75 % (n = 15), 55 % (n = 11), and 29 % (n = 2) of subjects in dosage tiers 1, 2, and 3, respectively. DCI was present in 20 % (n = 4), 15 % (n = 3), and 14 % (n = 1) of subjects in dosage tiers 1, 2, and 3, respectively. Cerebral infarctions were seen in 45 % (5 of 9), 27 % (3 of 18), and 25 % (1 of 4) of subjects who had follow-up head CT scans in dosage tiers 1, 2, and 3, respectively.

Conclusions: Higher dosages of ALB were associated with a lower incidence of TCD vasospasm, DCI, and cerebral infarction at 90 days in a dose-dependent manner.

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Acknowledgments and Sources of Funding

ALISAH was funded by the NIH/NINDS (R01NS049135; PI: Suarez JI).

ALB was provided by GRIFOLS International (Barcelona, Spain) at no cost to the study.

Clinical Trial Registration – URL: http://www.clinicaltrials.gov. Unique identifier: NCT00283400.

Disclosures 

None.

Conflict of Interest Statement 

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Division of Vascular Neurology and Neurocritical Care, Baylor College of Medicine, Baylor St Luke’s Medical Center, 6501 Fannin ST, NB:302, Houston, TX, 77030, USA

    Jose I. Suarez MD, E. Calvillo RN, E. M. Bershad MD & C. P. Venkatasubba Rao MD

  2. Division of Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC, USA

    R. H. Martin PhD

Authors
  1. Jose I. Suarez MD
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  2. R. H. Martin PhD
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  3. E. Calvillo RN
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  4. E. M. Bershad MD
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  5. C. P. Venkatasubba Rao MD
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Corresponding author

Correspondence to Jose I. Suarez MD .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Javier Fandino

  2. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Serge Marbacher

  3. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Ali-Reza Fathi

  4. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Carl Muroi

  5. Department of Neurosurgery Neurointensive Care Unit, University Hospital Zurich, Zurich, Switzerland

    Emanuela Keller

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Suarez, J.I., Martin, R.H., Calvillo, E., Bershad, E.M., Venkatasubba Rao, C.P. (2015). Effect of Human Albumin on TCD Vasospasm, DCI, and Cerebral Infarction in Subarachnoid Hemorrhage: The ALISAH Study. In: Fandino, J., Marbacher, S., Fathi, AR., Muroi, C., Keller, E. (eds) Neurovascular Events After Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 120. Springer, Cham. https://doi.org/10.1007/978-3-319-04981-6_48

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  • DOI: https://doi.org/10.1007/978-3-319-04981-6_48

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-04980-9

  • Online ISBN: 978-3-319-04981-6

  • eBook Packages: MedicineMedicine (R0)

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