Normandie Univ, UNICAEN, CHU de Caen, Service d'Anesthésie-Réanimation chirurgicale, 14000 Caen, France; Normandie Univ, UNICAEN, INSERM U1237, Physiopathology and imaging of neurological disorders (PhIND), GIP Cyceron, 14000, France.
Normandie Univ, UNICAEN, CHU de Caen, Service d'Anesthésie-Réanimation chirurgicale, 14000 Caen, France.
Anaesth Crit Care Pain Med. 2020 Dec;39(6):832-836. doi: 10.1016/j.accpm.2020.03.020. Epub 2020 Aug 7.
Cervical arterial abnormalities are associated with intracranial aneurysm but their frequency and association with outcome in case of aneurysmal subarachnoid haemorrhage (aSAH) remains unknown.
Data were retrospectively extracted from a prospective database. Consecutive angiographies of aSAH patients on a 13-month period were reviewed as well as consecutive angiographies of SAH patients without evidence of aneurysm on a 20-month period. Occurrence of secondary neurological complications was collected with 3-month functional outcome (modified Rankin Scale ≥ 3 was considered as poor outcome). Cervical arterial abnormalities on angiographies were classified into two subcategories: trajectory and lumen vessel abnormalities.
Forty-five patients displayed aneurysmal rupture (aSAH) while 39 patients had no evidence of aneurysm (non-aneurysmal SAH). Prevalence of cervical arterial abnormalities in aSAH and non-aneurysmal SAH patients were 82% (n = 37) and 64% (n = 25), respectively (p = 0.082). Lumen vessel abnormalities were significantly more frequent in case of aSAH (n = 31; 69%) than non-aneurysmal SAH: (n = 9; 23%; p < 0.001). Twenty-eight (62%) aSAH patients experienced poor outcome at 3 months. Lumen vessel abnormalities were significantly associated with 3-month poor outcome (74% (n = 23) versus 36% (n = 5); p = 0.021) without any significant increased occurrence of secondary complications such arterial vasospasm or delayed cerebral ischemia.
Cervical arterial abnormalities are frequent in a cohort of aSAH patients. Lumen vessel abnormalities are associated with 3-month poor outcome.
颈内动脉异常与颅内动脉瘤有关，但在蛛网膜下腔出血（aSAH）患者中，其发生频率及其与结局的关系尚不清楚。
数据从一个前瞻性数据库中回顾性提取。对 13 个月内的 aSAH 患者连续进行血管造影检查，对 20 个月内无动脉瘤证据的 aSAH 患者连续进行血管造影检查。收集 3 个月时的继发性神经并发症发生情况，并采用改良 Rankin 量表（mRS）评估功能结局（mRS 评分≥3 为预后不良）。血管造影上的颈内动脉异常分为两个亚类：轨迹和管腔血管异常。
45 例患者显示动脉瘤破裂（aSAH），39 例患者无动脉瘤证据（非动脉瘤性 aSAH）。aSAH 和非动脉瘤性 aSAH 患者的颈内动脉异常发生率分别为 82%（n=37）和 64%（n=25）（p=0.082）。管腔血管异常在 aSAH 患者中更为常见（n=31；69%），而非动脉瘤性 aSAH 患者中则相对较少（n=9；23%；p<0.001）。28 例（62%）aSAH 患者在 3 个月时预后不良。管腔血管异常与 3 个月时预后不良显著相关（74%（n=23）vs.36%（n=5）；p=0.021），但无明显增加动脉痉挛或迟发性脑缺血等继发性并发症的发生率。
颈内动脉异常在 aSAH 患者中较为常见。管腔血管异常与 3 个月时的不良预后相关。
