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This retrospective before-after study investigates the effects of a management strategy integrating perfusion computed tomography (CTP), vigilant clinical monitoring and standardized systemic administration of milrinone on the occurrence of delayed cerebral infarction (DCIn). The <jats:inline-formula><jats:alternatives><jats:tex-math>$${\\text{\"before\"}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                  <mml:mtext>\"before\"<\/mml:mtext>\n                <\/mml:math><\/jats:alternatives><\/jats:inline-formula> period included 277 patients, and the <jats:inline-formula><jats:alternatives><jats:tex-math>$${\\text{\"after\"}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                  <mml:mtext>\"after\"<\/mml:mtext>\n                <\/mml:math><\/jats:alternatives><\/jats:inline-formula> one 453. There was a higher prevalence of Modified Fisher score III\/IV and more frequent diagnosis of vasospasm in the <jats:inline-formula><jats:alternatives><jats:tex-math>$${\\text{\"after\"}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                  <mml:mtext>\"after\"<\/mml:mtext>\n                <\/mml:math><\/jats:alternatives><\/jats:inline-formula> period. Conversely, the occurrence of DCIn was reduced with the <jats:inline-formula><jats:alternatives><jats:tex-math>$${\\text{\"after\"}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                  <mml:mtext>\"after\"<\/mml:mtext>\n                <\/mml:math><\/jats:alternatives><\/jats:inline-formula> management strategy (adjusted OR 0.48, 95% CI [0.26; 0.84]). Notably, delayed ischemic neurologic deficits were less prevalent at the time of vasospasm diagnosis (24 vs 11%, <jats:inline-formula><jats:alternatives><jats:tex-math>$$p=0.001$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                  <mml:mrow>\n                    <mml:mi>p<\/mml:mi>\n                    <mml:mo>=<\/mml:mo>\n                    <mml:mn>0.001<\/mml:mn>\n                  <\/mml:mrow>\n                <\/mml:math><\/jats:alternatives><\/jats:inline-formula>), suggesting that CTP facilitated early detection. In patients diagnosed with vasospasm, intravenous milrinone was more frequently administered (80 vs 54%, <jats:inline-formula><jats:alternatives><jats:tex-math>$$p&lt;0.001$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                  <mml:mrow>\n                    <mml:mi>p<\/mml:mi>\n                    <mml:mo>&lt;<\/mml:mo>\n                    <mml:mn>0.001<\/mml:mn>\n                  <\/mml:mrow>\n                <\/mml:math><\/jats:alternatives><\/jats:inline-formula>) and associated with superior hemodynamics. The present study from a large cohort of aSAH patients suggests, for one part, the interest of CTP in early diagnosis of vasospasm and DCI, and for the other the efficacy of CT perfusion-guided systemic administration of milrinone in both preventing and treating DCIn.<\/jats:p>","DOI":"10.1038\/s41598-024-65706-w","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T14:04:52Z","timestamp":1719497092000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["CT perfusion-guided administration of IV milrinone is associated with a reduction in delayed cerebral infarction after subarachnoid hemorrhage"],"prefix":"10.1038","volume":"14","author":[{"given":"Vivien","family":"Szabo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Baccialone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florentin","family":"Kucharczak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril","family":"Dargazanli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oceane","family":"Garnier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederique","family":"Pavillard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Molinari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Costalat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Francois","family":"Perrigault","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Chalard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"65706_CR1","doi-asserted-by":"publisher","unstructured":"Suarez, J. 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