Relative prognostic significance of vasospasm following subarachnoid hemorrhage.

A retrospective analysis of 274 patients with intracranial aneurysms, diagnosed either angiographically or at autopsy between 1968 and 1973 at the University of Alberta, was carried out. One hundred and forty-six patients had intracranial clipping of the aneurysm. Clinical and radiologic data were abstracted from the chart and the angiographic studies. Probability of survival curves were constructed. Associations between various clinical factors and survival at two months were demonstrated. The most important prognostic factors were the clinical grade at angiography or surgery, followed by the presence of preoperative spasm, hematoma or focal edema, elevated blood pressure on admission, time of interval from hemorrhage to surgery and age. The data lends some support to the policy of operating on patients in good neurological condition, even if their pre-operative angiogram shows spasm.