{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:15:12Z","timestamp":1792844112426,"version":"4.5.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"10","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Aneurysmal subarachnoid hemorrhage is a condition resulting from the rupture of a cerebral aneurysm, sometimes leading to delayed cerebral ischemia, primarily due to angiographic vasospasm; its prediction is crucial to improve patient management and outcomes.<\/jats:p>\n                  <jats:p>To assess the predictive value of clinical, analytical and imaging parameters for vasospasm in aneurysmal subarachnoid hemorrhage and to develop a clinical practical score.<\/jats:p>\n                  <jats:p>The current single-center retrospective study included 115 patients with aneurysmal subarachnoid hemorrhage who underwent a computed tomography scan within 24\u2009hours of ictus. Clinical and analytical data were collected, and Hounsfield unit (HU) measurements were independently assessed. Statistical analyses were conducted to identify predictors of vasospasm.<\/jats:p>\n                  <jats:p>Vasospasm occurred in 40% of patients (46\/115). The multivariate analysis identified intracerebral hemorrhage (odds ratio [OR]\u2009=\u20092.482; 95%CI\u2009=\u20091.019\u20136.046; p\u2009=\u20090.045), interpeduncular HU value (per 5 HU increase: OR\u2009=\u20091.253; 95%CI\u2009=\u20091.044\u20131.504; p\u2009=\u20090.016), and serum chloride \u2265 106\u2009mEq\/L (OR\u2009=\u20093.545; 95%CI\u2009=\u20091.457\u20138.621; p\u2009=\u20090.005) as independent predictors (p\u2009&lt;\u20090.05) of vasospasm. The model, combined as a simplified score including these 3 variables, demonstrated excellent discriminative capacity (area under the curve [AUC]\u2009=\u20090.886; bootstrapped AUC\u2009=\u20090.885).<\/jats:p>\n                  <jats:p>We identified significant predictors of vasospasm in patients with aneurysmal subarachnoid hemorrhage, namely interpeduncular HU value, intracerebral hemorrhage, and serum chloride levels. A practical 5-point score based on these factors offers a potentially-robust, easy-to-use tool for early risk stratification, which may guide personalized follow-up and timely interventions. Further prospective multicenter studies are recommended to validate these findings.<\/jats:p>","DOI":"10.1055\/s-0046-1829045","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:49:45Z","timestamp":1790981385000},"page":"001-010","source":"Crossref","is-referenced-by-count":1,"title":["Aneurysmal subarachnoid hemorrhage: predictive score for angiographic vasospasm"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4240-3792","authenticated-orcid":false,"given":"Mariana Duarte","family":"Gomes","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de Braga, Departamento de Neurorradiologia, Braga, Portugal."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6266-9055","authenticated-orcid":false,"given":"Henrique Manuel Campos","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Universidade do Minho, Escola de Medicina, Instituto de Investiga\u00e7\u00e3o em Ci\u00eancias da Vida e Sa\u00fade (ICVS), Braga, Portugal."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4219-7759","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Saraiva","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de Braga, Departamento de Neurorradiologia, Braga, Portugal."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8183-5717","authenticated-orcid":false,"given":"Miguel","family":"Quintas-Neves","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de Braga, Departamento de Neurorradiologia, Braga, Portugal."},{"name":"Universidade do Porto, Faculdade de Medicina, Porto, Portugal."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1016\/j.emc.2016.06.011","article-title":"Subarachnoid Hemorrhage","volume":"34","author":"M K Abraham","year":"2016","journal-title":"Emerg Med Clin North Am"},{"issue":"04","key":"ref2","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1016\/j.emc.2017.07.001","article-title":"Subarachnoid hemorrhage: updates in diagnosis and management","volume":"35","author":"B Long","year":"2017","journal-title":"Emerg Med Clin North Am"},{"key":"ref3","doi-asserted-by":"publisher","author":"N Etminan","year":"2021","DOI":"10.1016\/B978-0-444-64034-5.00009-2"},{"issue":"12","key":"ref4","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1136\/jnnp.2007.117655","article-title":"Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends","volume":"78","author":"N K De Rooij","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"05","key":"ref5","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1001\/jamaneurol.2019.0006","article-title":"Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis","volume":"76","author":"N Etminan","year":"2019","journal-title":"JAMA Neurol"},{"issue":"08","key":"ref6","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1161\/01.STR.22.8.971","article-title":"A review of hemoglobin and the pathogenesis of cerebral vasospasm","volume":"22","author":"R L Macdonald","year":"1991","journal-title":"Stroke"},{"issue":"01","key":"ref7","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1038\/nrneurol.2013.246","article-title":"Delayed neurological deterioration after subarachnoid haemorrhage","volume":"10","author":"R L Macdonald","year":"2014","journal-title":"Nat Rev Neurol"},{"issue":"12","key":"ref8","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1038\/jcbfm.2013.173","article-title":"The role of the microcirculation in delayed cerebral ischemia and chronic degenerative changes after subarachnoid hemorrhage","volume":"33","author":"L \u00d8stergaard","year":"2013","journal-title":"J Cereb Blood Flow Metab"},{"issue":"10","key":"ref9","doi-asserted-by":"publisher","first-page":"6627","DOI":"10.21037\/qims-23-355","article-title":"Hounsfield unit as a predictor of symptomatic vasospasm and hydrocephalus in good-grade subarachnoid hemorrhage treated with endovascular coiling","volume":"13","author":"J S Park","year":"2023","journal-title":"Quant Imaging Med Surg"},{"issue":"01","key":"ref10","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1161\/STROKEAHA.119.026962","article-title":"Hounsfield unit value of interpeduncular cistern hematomas can predict symptomatic vasospasm","volume":"51","author":"H Ishihara","year":"2020","journal-title":"Stroke"},{"issue":"04","key":"ref11","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1227\/01.NEU.0000156644.45384.92","article-title":"Prediction of cerebral vasospasm in patients presenting with aneurysmal subarachnoid hemorrhage: a review","volume":"56","author":"C G Harrod","year":"2005","journal-title":"Neurosurgery"},{"issue":"02","key":"ref12","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1159\/000346087","article-title":"European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage","volume":"35","author":"T Steiner","year":"2013","journal-title":"Cerebrovasc Dis"},{"issue":"10","key":"ref13","doi-asserted-by":"publisher","first-page":"2391","DOI":"10.1161\/STROKEAHA.110.589275","article-title":"Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies: proposal of a multidisciplinary research group","volume":"41","author":"M DI Vergouwen","year":"2010","journal-title":"Stroke"},{"issue":"07","key":"ref14","doi-asserted-by":"publisher","first-page":"2011","DOI":"10.3390\/jcm11072011","article-title":"Standardized classification of cerebral vasospasm after subarachnoid hemorrhage by digital subtraction angiography","volume":"11","author":"H Merkel","year":"2022","journal-title":"J Clin Med"},{"issue":"11","key":"ref15","doi-asserted-by":"publisher","first-page":"1956","DOI":"10.3174\/ajnr.A7279","article-title":"Impact of implementing an elaborated CT perfusion protocol for aneurysmal SAH on functional outcome: CTP protocol for SAH","volume":"42","author":"V Malinova","year":"2021","journal-title":"AJNR Am J Neuroradiol"},{"issue":"03","key":"ref16","doi-asserted-by":"publisher","first-page":"187","DOI":"10.2176\/nmc.51.187","article-title":"Quantification of subarachnoid hemorrhage by three-dimensional computed tomography: correlation between hematoma volume and symptomatic vasospasm","volume":"51","author":"T Sato","year":"2011","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"107087","DOI":"10.1016\/j.clineuro.2021.107087","article-title":"Predictive effects of admission white blood cell counts and hounsfield unit values on delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage","volume":"212","author":"P Hu","year":"2022","journal-title":"Clin Neurol Neurosurg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"751008","DOI":"10.3389\/fphys.2021.751008","article-title":"Calcium-activated chloride channels in myometrial and vascular smooth muscle","volume":"12","author":"S Wray","year":"2021","journal-title":"Front Physiol"},{"issue":"04","key":"ref19","doi-asserted-by":"publisher","first-page":"107579","DOI":"10.1016\/j.jstrokecerebrovasdis.2024.107579","article-title":"A retrospective study on the relationship between serum electrolyte disorder and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage","volume":"33","author":"Y Zhou","year":"2024","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.jocn.2017.08.037","article-title":"Decreased serum sodium levels predict symptomatic vasospasm in patients with subarachnoid hemorrhage","volume":"46","author":"Y Uozumi","year":"2017","journal-title":"J Clin Neurosci"},{"issue":"01","key":"ref21","doi-asserted-by":"publisher","first-page":"106186","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.106186","article-title":"Sodium variability and probability of vasospasm in patients with aneurysmal subarachnoid hemorrhage","volume":"31","author":"M MJ Chua","year":"2022","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"05","key":"ref22","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1007\/s13760-020-01496-y","article-title":"Associations between C-reactive protein and white blood cell count, occurrence of delayed cerebral ischemia and poor outcome following aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis","volume":"121","author":"X Ma","year":"2021","journal-title":"Acta Neurol Belg"},{"issue":"01","key":"ref23","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1227\/01.neu.0000243277.86222.6c","article-title":"Prediction of symptomatic vasospasm after subarachnoid hemorrhage: the modified fisher scale","volume":"59","author":"J A Frontera","year":"2006","journal-title":"Neurosurgery"}],"container-title":["Arquivos de Neuro-Psiquiatria"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0046-1829045.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:49:46Z","timestamp":1790981386000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0046-1829045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":23,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,8,13]]},"published-print":{"date-parts":[[2026,10]]}},"alternative-id":["s00461829045"],"URL":"https:\/\/doi.org\/10.1055\/s-0046-1829045","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0004-282X","1678-4227"],"issn-type":[{"value":"0004-282X","type":"print"},{"value":"1678-4227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]}}}