Vasospasm versus delayed cerebral ischemia as an outcome event in clinical trials and observational studies

Mervyn D I Vergouwen, Participants in the International Multi-Disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage, Michael N Diringer, Thomas P Bleck, Nicolas Bruder, E Sander Connolly Jr, Giuseppe Citerio, Daryl Gress, Daniel Hanggi, J Claude Hemphill 3rd, Brian Hoh, Giuseppe Lanzino, Peter Le Roux, David Menon, Alejandro Rabinstein, Erich Schmutzhard, Lori Shutter, Nino Stocchetti, Jose Suarez, Miriam Treggiari, M Y Tseng, Mervyn D I Vergouwen, Paul Vespa, Stephan Wolf, Gregory J Zipfel, Mervyn D I Vergouwen, Participants in the International Multi-Disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage, Michael N Diringer, Thomas P Bleck, Nicolas Bruder, E Sander Connolly Jr, Giuseppe Citerio, Daryl Gress, Daniel Hanggi, J Claude Hemphill 3rd, Brian Hoh, Giuseppe Lanzino, Peter Le Roux, David Menon, Alejandro Rabinstein, Erich Schmutzhard, Lori Shutter, Nino Stocchetti, Jose Suarez, Miriam Treggiari, M Y Tseng, Mervyn D I Vergouwen, Paul Vespa, Stephan Wolf, Gregory J Zipfel

Abstract

Delayed cerebral ischemia occurs in about 30% of patients during the first 2 weeks after subarachnoid hemorrhage, and can result in substantial disability and death. Research studies investigating the incidence of delayed cerebral ischemia and strategies for prevention and treatment are hampered by inconsistent use of terminology and definitions for this complication, and by reliance on indirect surrogate markers of ischemia. A literature review was conducted to search for studies that addressed the issue of inconsistent definitions of delayed cerebral ischemia through December 2010. A total of four studies were identified. Original research studies and consensus panel recommendations for definitions support limiting the use of combined measures that include both clinical and radiographic assessments, as well as indirect measures, and the current usage of the term vasospasm. Cerebral infarction was supported as the most appropriate definition for delayed cerebral ischemia in the context of clinical trials.

References

    1. Stroke. 2011 Apr;42(4):924-9
    1. J Cereb Blood Flow Metab. 2008 Nov;28(11):1761-70
    1. Stroke. 2009 Jun;40(6):1963-8
    1. Stroke. 2002 Aug;33(8):2043-6
    1. J Cereb Blood Flow Metab. 2011 Jun;31(6):1443-51
    1. J Clin Ultrasound. 2006 Oct;34(8):380-4
    1. Neurosurgery. 1977 Nov-Dec;1(3):245-8
    1. J Neurol Neurosurg Psychiatry. 2000 Mar;68(3):337-41
    1. J Cereb Blood Flow Metab. 2011 Jul;31(7):1545-53
    1. Neuroradiology. 2009 Dec;51(12):813-9
    1. Stroke. 2009 Mar;40(3):994-1025
    1. Neurology. 1986 Mar;36(3):329-33
    1. Stroke. 2010 Oct;41(10):2391-5
    1. Neurosurgery. 2003 Jun;52(6):1307-15; disacussion 1315-7
    1. J Neurosurg. 1977 Apr;46(4):446-53
    1. J Neurosurg. 1978 Apr;48(4):515-25
    1. Stroke. 2009 Nov;40(11):3493-8
    1. Stroke. 1994 Aug;25(8):1623-7
    1. Neurosurgery. 2007 Apr;60(4):658-67; discussion 667
    1. Stroke. 2009 Mar;40(3):e80-1; author reply e82
    1. Stroke. 2009 Jul;40(7):2362-7
    1. Stroke. 2004 Aug;35(8):1862-6
    1. Stroke. 2008 Sep;39(9):2622-6
    1. Brain. 2009 Jul;132(Pt 7):1866-81
    1. J Neurosurg. 2008 Dec;109(6):1052-9

Source: PubMed

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