Article Text

Download PDFPDF
E-171 Low glasgow coma score in traumatic intracranial hemorrhage predicts development of cerebral vasospasm
  1. F Al-Mufti1,
  2. K Amuluru2,
  3. N Majmundar3,
  4. M Lander3,
  5. M Matthew3,
  6. M El-Ghanem3,
  7. R Nuoman4,
  8. S Park4,
  9. V Patel4,
  10. C Gandhi5
  1. 1Neurology – Division of Neuroendovascular Surgery and Neurocritical Care, Rutgers-RWJMS, New Brunswick, NJ
  2. 2Department of Interventional Neuroradiology, University of Pittsburgh Medical Center – Hamot, Erie, PA
  3. 3Neurological Surgery, Rutgers-NJMS, Newark, NJ
  4. 4Neurology, Rutgers-NJMS, Newark, NJ
  5. 5Neurosurgery, Westchester Medical Center at NY Medical College, Valhalla, NY


Background The exact mechanism, incidence and risk factors for cerebral vasospasm following traumatic intracranial hemorrhage (ICH) continues to be poorly characterized. The incidence of post-traumatic vasospasm (PTV) varies depending on the detection modality.

Objective We aimed to shed light on the predictors, associations and true incidence of cerebral vasospasm following traumatic ICH using digital subtraction angiography (DSA) as the gold standard.

Methods We examined a prospectively maintained database of traumatic brain injury (TBI) patients to identify patients with ICH secondary to TBI enrolled between 2002 and 2015 at our trauma center. Patients with TBI-associated ICH and evidence of vasospasm confirmed with digital subtraction angiography (DSA) were included. The diagnostic cerebral angiograms were evaluated by 2 blinded neurointerventionalists for cerebral vasospasm. Statistical analyses were conducted to determine predictors of PTV.

Results 20 patients with ICH secondary to TBI and evidence of vasospasm underwent DSAs. Seven patients (7/20; 35%) with traumatic ICH developed cerebral vasospasm and of those, one developed delayed cerebral ischemia (DCI) (1/7; 14%). Of these 7 patients, 6 presented with subarachnoid hemorrhage (SAH) (6/7; 85%). Vasospasm was substantially more common in patients with a Glasgow Coma Scale (GCS)<9 (p=0.017) than in all other groups.

Conclusions PTV as demonstrated by DCA may be more common than previously reported. Patients who exhibit PTV were more likely to have a GCS<9. This subgroup of patients may benefit from more systematic screening for the development of PTV, and earlier monitoring for signs of DCI.

Disclosures F. Al-Mufti: None. K. Amuluru: None. N. Majmundar: None. M. Lander: None. M. Matthew: None. M. El-Ghanem: None. R. Nuoman: None. S. Park: None. V. Patel: None. C. Gandhi: None.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.