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  • O15/151  Impact of post-thrombectomy isolated subarachnoid hemorrhage and other types of intracranial hemorrhage on neurological outcomes in patients with anterior circulation ischemic stroke – reperfusion grade determines

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2.3 ISCHEMIC – Treatment
O15/151  Impact of post-thrombectomy isolated subarachnoid hemorrhage and other types of intracranial hemorrhage on neurological outcomes in patients with anterior circulation ischemic stroke – reperfusion grade determines
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  1. Natalie van Landeghem1,
  2. Christoph Ziegenfuß1,
  3. Aydin Demircioglu1,
  4. Philipp Dammann2,
  5. Ramazan Jabbarli2,
  6. Johannes Haubold1,
  7. Michael Forsting1,
  8. Isabel Wanke1,3,
  9. Martin Köhrmann4,
  10. Benedikt Frank4,
  11. Cornelius Deuschl1,
  12. Yan Li1
  1. 1Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
  2. 2Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
  3. 3SNRI (Swiss Neuroradiology Institute), Zürich, Switzerland
  4. 4Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Essen, Germany

Abstract

Introduction Subarachnoid hemorrhage is a common finding, ranging from 5.2% to 15.2% in ischemic stroke patients after mechanical thrombectomy.

Aim of Study We aimed to evaluate neurological outcomes in patient groups without intracranial hemorrhage (non-ICH), with isolated subarachnoid hemorrhage (i-SAH) and with other types of intracranial hemorrhage (o-ICH) than i-SAH after thrombectomy.

Methods Stroke data from 2018 to 2021 in a tertiary care centre were retrospectively analysed. Patients with anterior large vessel occlusion were included. Neurological impairment was assessed using NIHSS. Outcomes were compared using Mann-Whitney-U-test.

Results In a total of 268 patients, i-SAH and o-ICH were found in 10.4% and 10.8%, respectively. NIHSS scores at admission were not significantly different among i-SAH, o-ICH and non-ICH groups. NIHSS scores of i-SAH patients at discharge were comparable to o-ICH patients (median 18 versus 21, p=0.578) and were significantly higher than non-ICH patients (18 versus 7, p=0.008). In patients experiencing complete reperfusion (TICI=3), i-SAH patients tended to have more severe neurological impairment than non-ICH patients (median NIHSS 10 versus 5, p=0.3), although NIHSS at discharge compared to admission decreased similarly between both groups (median reduction 5 versus 6, p=0.866). In patients with successful but incomplete reperfusion (TICI=2b), i-SAH patients showed significantly worse neurological outcomes at discharge than non-ICH patients (NIHSS 23.5 versus 8, p=0.03) and even deterioration of their neurological deficit after thrombectomy (NIHSS increase of 5 versus reduction of 4, p=0.017).

Conclusion Post-thrombectomy i-SAH is an important complication as it might aggravate patient’s neurological impairment, particularly in case of incomplete reperfusion.

Disclosure of Interest Nothing to disclose.

http://dx.doi.org/10.1136/jnis-2023-ESMINT.15

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