Bruno Gonçalves1, Ricardo Turon2, Antenor Mendes3, Nivea Melo3, Paula Lacerda4, Pedro Brasil5, Fernando Augusto Bozza6, Pedro Kurtz3, Cassia Righy7. 1. Paulo Niemeyer State Brain Institute, Intensive Care Unit, Rio de Janeiro, Brazil; Oswaldo Cruz Foundation, National Institute of Infectology, Rio de Janeiro, Brazil; Copa Star Hospital, Intensive Care Unit, Rio de Janeiro, Brazil. Electronic address: brunogs@gmail.com. 2. Paulo Niemeyer State Brain Institute, Intensive Care Unit, Rio de Janeiro, Brazil; Niterói Hospital Complex, Neurocritical Care Unit, Niterói, Brazil. 3. Paulo Niemeyer State Brain Institute, Intensive Care Unit, Rio de Janeiro, Brazil; Copa Star Hospital, Intensive Care Unit, Rio de Janeiro, Brazil. 4. Paulo Niemeyer State Brain Institute, Intensive Care Unit, Rio de Janeiro, Brazil. 5. Oswaldo Cruz Foundation, National Institute of Infectology, Rio de Janeiro, Brazil. 6. Oswaldo Cruz Foundation, National Institute of Infectology, Rio de Janeiro, Brazil; D'Or Institute for Research and Eduaction, Rio de Janeiro, Brazil. 7. Paulo Niemeyer State Brain Institute, Intensive Care Unit, Rio de Janeiro, Brazil; Oswaldo Cruz Foundation, National Institute of Infectology, Rio de Janeiro, Brazil.
Abstract
OBJECTIVE: Aneurysmal subarachnoid hemorrhage (aSAH) is an acute cerebrovascular event that leads to devastating consequences. Early brain infarction (EBI) develops very early, within the first 72 hours after bleeding, and may have a significant impact on long-term outcomes. The incidence and impact of EBI in the prognosis of aSAH remain uncertain. We performed a systematic review and meta-analysis to evaluate the incidence of EBI in patients with aSAH and determine its effect on mortality and functional outcomes. METHODS: We performed a systematic review and meta-analysis. Inclusion criteria were 1) studies that evaluated aSAH within 72 hours after bleeding; 2) performed a brain imaging study up to 72 hours of hemorrhage; 3) used computed tomography or magnetic resonance imaging; and 4) included a description of the findings of the brain imaging study (whether or not an infarct was present). RESULTS: Ten studies that met the criteria were included. The incidence of EBI was 17%. The risk ratio for 3-month mortality was 2.18 (95% confidence interval 1.48-3.30). The overall risk ratio for poor outcome was 2.26 (95% confidence interval 1.75-2.93). CONCLUSIONS: EBI plays an important role in the outcome of patients with aSAH. Its significant impact could represent a new therapeutic frontier for improving outcomes of these patients.
OBJECTIVE:Aneurysmal subarachnoid hemorrhage (aSAH) is an acute cerebrovascular event that leads to devastating consequences. Early brain infarction (EBI) develops very early, within the first 72 hours after bleeding, and may have a significant impact on long-term outcomes. The incidence and impact of EBI in the prognosis of aSAH remain uncertain. We performed a systematic review and meta-analysis to evaluate the incidence of EBI in patients with aSAH and determine its effect on mortality and functional outcomes. METHODS: We performed a systematic review and meta-analysis. Inclusion criteria were 1) studies that evaluated aSAH within 72 hours after bleeding; 2) performed a brain imaging study up to 72 hours of hemorrhage; 3) used computed tomography or magnetic resonance imaging; and 4) included a description of the findings of the brain imaging study (whether or not an infarct was present). RESULTS: Ten studies that met the criteria were included. The incidence of EBI was 17%. The risk ratio for 3-month mortality was 2.18 (95% confidence interval 1.48-3.30). The overall risk ratio for poor outcome was 2.26 (95% confidence interval 1.75-2.93). CONCLUSIONS:EBI plays an important role in the outcome of patients with aSAH. Its significant impact could represent a new therapeutic frontier for improving outcomes of these patients.
Authors: Fawaz Al-Mufti; Stephan A Mayer; Gurmeen Kaur; Daniel Bassily; Boyi Li; Matthew L Holstein; Jood Ani; Nicole E Matluck; Haris Kamal; Rolla Nuoman; Christian A Bowers; Faizan S Ali; Hussein Al-Shammari; Mohammad El-Ghanem; Chirag Gandhi; Krishna Amuluru Journal: Neuroradiol J Date: 2021-09-03
Authors: Bruno Gonçalves; Pedro Kurtz; Ricardo Turon; Thayana Santos; Marco Prazeres; Cassia Righy; Fernando Augusto Bozza Journal: Ann Intensive Care Date: 2019-08-20 Impact factor: 6.925