Early Cerebral Autoregulation Impairment Linked to Poor Outcomes After Subarachnoid Hemorrhage: A Pilot Study with Ultrasound Insights

Subarachnoid hemorrhage (SAH), a severe type of stroke caused by aneurysm rupture, is often associated with complications such as cerebral vasospasm (CV), delayed cerebral ischemia (DCI), and other inflammatory responses. These complications can lead to unfavorable outcomes, with mortality rates reaching 35% and many survivors left with disabilities. In this observational pilot study, researchers aimed to assess the early status of cerebral autoregulation (CA) within 2–3 days of SAH onset and its association with patient outcomes. Using a noninvasive approach, transcranial Doppler (TCD) was employed to measure cerebral blood flow velocity (CBFV) in response to controlled blood pressure changes induced by inflatable leg recovery boots. This innovative method provided a safe and effective way to generate arterial blood pressure (ABP) variations necessary for reliable CA assessment.

The study involved 29 SAH patients and 15 healthy volunteers for comparison. Results showed that patients with unfavorable outcomes had significantly shorter delay times (∆TCBFV) between ABP and CBFV signals compared to those with favorable outcomes (1.37 ± 1.23 s vs. 2.86 ± 0.99 s). Additionally, baroreflex sensitivity (BRS) measured during ABP changes was found to predict the risk of DCI. A ∆TCBFV of less than 1.6 seconds emerged as a potential early warning sign for poor prognosis. The findings suggest that noninvasive CA monitoring could be a valuable tool for early risk assessment and personalized management of SAH patients.

This study highlights the importance of early CA evaluation in identifying high-risk patients and improving outcomes after SAH. The innovative use of pressotherapy devices offers a practical, noninvasive approach to clinical monitoring, paving the way for improved diagnostics in neurosurgical intensive care.

Early Cerebral Autoregulation Impairment Linked to Poor Outcomes After Subarachn…

by Echo Writer time to read: 1 min
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