Different criteria for vasospasm:
(1) symptomatic
(2) delayed cerebral ischemia (DCI)
(3) angiographic
(4) transcranial Doppler (TCD)
Symptomatic vasospasm - all of the following:
(1) one or both of the following:
(1a) development of new focal neurological signs
(1b) deterioration in the level of consciousness
(2) attributed to vasospasm-associated ischemia
(3) exclusion of other causes
Delayed Cerebral Ischemia - at least one of the following:
(1) symptomatic vasospasm (above)
(2) appearance of a new cerebral infarct on CT or MRI attributable to vasospasm
Angiographic vasospasm - both of the following:
(1) moderate-to-severe arterial narrowing on digital subtraction angiography
(2) exclusion of atherosclerosis, catheter-induced spasm, or vessel hypoplasia
Transcranial Doppler vasospasm: mean flow velocity in any vessel > 120 cm/sec.
The authors found that:
(1) delayed cerebral ischemia (DCI) was the only definition associated with death or severe disability at 3 months after SAH.
(2) DCI and symptomatic vasospasm were associated with disability, cognitive impairment and poor quality of life.
(3) Neither angiographic nor TCD was associated with clinical outcome.
