Abstract
We have examined prognostic factors in delayed ischaemic deficit attributed to vasospasm following subarachnoid haemorrhage (SAH) and early aneurysm surgery. Among 605 patients with SAH, 201 patients developed a delayed ischaemic deficit and 137 of these underwent early surgery. These 137 patients were classified into groups A and B by outcome at 3 months after SAH (group A: the delayed ischaemic deficit was associated with an adverse outcome; group B: no adverse outcome). Factors indicating an unfavourable outcome were as follows: (i) older age; (ii) poor WFNS grade on admission; (iii) Fisher's scale of 4; (iv) intracerebral haemorrhage; (v) delayed ischaemic deficit following rerupture; (vi) complications of surgical intervention; (vii) delayed ischaemic deficit with disturbance of consciousness; (viii) lack of immediate improvement with hypervolaemic therapy; and (ix) intracranial complications after hypervolaemic therapy. We suggest that the reversibility of a delayed ischaemic deficit is determined by preceding brain damage and/or surgical complications.