{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:33:11Z","timestamp":1792175591889,"version":"4.4.0"},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Cerebral vasospasm following subarachnoid hemorrhage (SAH) causes significant morbidity in a delayed fashion. The authors recently published a new scale that grades the maximum thickness of SAH on axial CT and is predictive of vasospasm incidence. In this study, the authors further investigate whether different aneurysm locations result in different SAH clot burdens and whether any concurrent differences in ruptured aneurysm location and maximum SAH clot burden affect vasospasm incidence.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Two hundred fifty patients who were part of a prospective randomized controlled trial were reviewed. Most outcome and demographic variables were included as part of the prospective randomized controlled trial. Additional variables were also collected at a later time, including vasospasm data and maximum clot thickness.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Aneurysms were categorized into 1 of 6 groups: intradural internal carotid artery aneurysms, vertebral artery (VA) aneurysms (including the posterior inferior cerebellar artery), basilar trunk or basilar apex aneurysms, middle cerebral artery aneurysms, pericallosal aneurysms, and anterior communicating artery aneurysms. Twenty-nine patients with nonaneurysmal SAH were excluded. Patients with pericallosal aneurysms had the least average maximum clot burden (5.3 mm), compared with 6.4 mm for the group overall, but had the highest rate of symptomatic vasospasm (56% vs 22% overall, OR 4.9, RR 2.7, p = 0.026). Symptomatic vasospasm occurrence was tallied in patients with clinical deterioration attributable to delayed cerebral ischemia. There were no significant differences in maximum clot thickness between aneurysm sites. Middle cerebral artery aneurysms resulted in the thickest mean maximum clot (7.1 mm) but rates of symptomatic and radiographic vasospasm in this group were statistically no different compared with the overall group. Vertebral artery aneurysms had the worst 1-year modified Rankin scale (mRS) scores (3.0 vs 1.9 overall, respectively; p = 0.0249). A 1-year mRS score of 0\u20132 (good outcome) was found in 72% of patients overall, but in only 50% of those with pericallosal and VA aneurysms, and in 56% of those with basilar artery aneurysms (p = 0.0044). Patients with stroke from vasospasm had higher mean clot thickness (9.71 vs 6.15 mm, p = 0.004).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The location of a ruptured aneurysm minimally affects the maximum thickness of the SAH clot but is predictive of symptomatic vasospasm or clinical deterioration from delayed cerebral ischemia in pericallosal aneurysms. The worst 1-year mRS outcomes in this cohort of patients were noted in those with posterior circulation aneurysms or pericallosal artery aneurysms. Patients experiencing stroke had higher mean clot burden.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.10.jns13419","type":"journal-article","created":{"date-parts":[[2013,12,6]],"date-time":"2013-12-06T15:16:13Z","timestamp":1386342973000},"page":"391-397","source":"Crossref","is-referenced-by-count":59,"title":["The relationship between ruptured aneurysm location, subarachnoid hemorrhage clot thickness, and incidence of radiographic or symptomatic vasospasm in patients enrolled in a prospective randomized controlled trial"],"prefix":"10.3171","volume":"120","author":[{"given":"Adib A.","family":"Abla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W.","family":"Williamson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nakaji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron G.","family":"McDougall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Zabramski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe C.","family":"Albuquerque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Spetzler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns13419","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1161\/STROKEAHA.110.597005","article-title":"Angiographic vasospasm is strongly correlated with cerebral infarction after subarachnoid hemorrhage","volume":"42","author":"Crowley","year":"2011"},{"key":"b2-jns13419","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1227\/00006123-198001000-00001","article-title":"Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning","volume":"6","author":"Fisher","year":"1980"},{"key":"b3-jns13419","series-title":"Neurosurgery","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":"Harrod","year":"2005"},{"key":"b4-jns13419","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.1161\/01.STR.21.8.1156","article-title":"Grading the amount of blood on computed tomograms after subarachnoid hemorrhage","volume":"21","author":"Hijdra","year":"1990"},{"key":"b5-jns13419","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1212\/WNL.33.4.424","article-title":"The relation of cerebral vasospasm to the extent and location of subarachnoid blood visualized by CT scan: a prospective study","volume":"33","author":"Kistler","year":"1983"},{"key":"b6-jns13419","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"135","DOI":"10.3171\/2011.8.JNS101767","article-title":"The Barrow Ruptured Aneurysm Trial. Clinical article","volume":"116","author":"McDougall","year":"2012"},{"key":"b7-jns13419","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1862","DOI":"10.1161\/01.STR.0000133132.76983.8e","article-title":"Predictors of cerebral infarction in aneurysmal subarachnoid hemorrhage","volume":"35","author":"Rabinstein","year":"2004"},{"key":"b8-jns13419","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"146","DOI":"10.3171\/2013.3.JNS12683","article-title":"The Barrow Ruptured Aneurysm Trial: 3-year results. Clinical article","volume":"119","author":"Spetzler","year":"2013"},{"key":"b9-jns13419","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1227\/NEU.0b013e318267360f","article-title":"A simple and quantitative method to predict symptomatic vasospasm after subarachnoid hemorrhage based on computed tomography: beyond the Fisher scale","volume":"71","author":"Wilson","year":"2012"},{"key":"b10-jns13419","series-title":"Acta Neurochir Suppl","first-page":"175","article-title":"Predictors analysis of symptomatic cerebral vasospasm after subarachnoid hemorrhage","volume":"110","author":"Yin","year":"2011"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/120\/2\/article-p391.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/120\/2\/article-p391.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/120\/2\/article-p391.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T13:57:46Z","timestamp":1658671066000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/120\/2\/article-p391.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2014,2]]},"references-count":10,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2013.10.jns13419","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2]]}}}