van der Harst et al reported CTA Vasospasm Score for evaluating vasospasm in a patient who has had aneurysmal subarachnoid hemorrhage. The authors are from University Medical Center Groningen in The Netherlands.
Patient selection: aneurysmal subarachnoid hemorrhage
Exam: computed tomography angiography (CTA)
Arterial segments:
(1) left internal carotid
(2) first segment of the left MCA M1
(3) second segment of the left MCA M2
(4) first segment of the left ACA, A1
(5) second segment of the left ACA, A2
(6) left vertebral artery
(7) first segment of the left PCA P1
(8) second segment of left PCA P2
(9) right internal carotid
(10) first segment of the right MCA M1
(11) second segment of the right MCA M2
(12) first segment of the right ACA, A1
(13) second segment of the right ACA, A2
(14) right vertebral artery
(15) first segment of the right PCA P1
(16) second segment of right PCA P2
(17) basilar artery
Vasospasm
|
Points
|
none
|
0
|
mild (< 50% luminal decrease)
|
1
|
severe (> 50% luminal decrease
|
2
|
total score =
= SUM(points for all of the arterial segments)
Interpretation:
• minimum score: 0
• maximum score: 34
• The higher the score the more severe the vasospasm
• The more severe the vasospasm the greater the risk for cerebral ischemia and unfavorable functional outcome.
Performance:
• The area under the ROC curve is 0.89 on Day 5 after the hemorrhage.