Relation of cerebral vasospasm to operative findings of subarachnoid blood around ruptured aneurysms.

An investigation was carried out in 28 patients in order to evaluate the relationship between angiographically documented vasospasm, amount of subarachnoid blood found at surgery around ruptured intracranial aneurysms, and delayed ischaemic deficits. Angiography was performed at time intervals ranging between 5 and 17 days, and surgery not later than 21 days following subarachnoid haemorrhage. The absence of subarachnoid clots was associated in ten patients, with no or minor vasospasm and no or mild neurological deficits. Thin clots were found in eight patients; one of them had no vasospasm, six had minor vasospasm, and one showed severe vessel narrowing. Major clinical signs were absent in these cases. All ten patients with thick clots developed severe vasospasm, and eight of them severe neurological signs. The important aetiological role of local subarachnoid clots developed severe vasospasm, and eight of them severe neurological signs. The important aetiological role of local subarachnoid clots in determining vasospasm in emphasized in view of surgical timing.