{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T20:12:36Z","timestamp":1785787956195,"version":"3.56.0"},"reference-count":72,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Studies examining the risk factors and clinical outcomes of arterial vasospasm secondary to cerebral arteriovenous malformation (cAVM) rupture are scarce in the literature. The authors used a population-based national registry to investigate this largely unexamined clinical entity.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Admissions for adult patients with cAVM ruptures were identified in the National Inpatient Sample during the period from 2015 to 2019. Complex samples multivariable logistic regression and chi-square automatic interaction detection (CHAID) decision tree analyses were performed to identify significant associations between clinical covariates and the development of vasospasm, and a cAVM\u2013vasospasm predictive model (cAVM-VPM) was generated based on the effect sizes of these parameters.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Among 7215 cAVM patients identified, 935 developed vasospasm, corresponding to an incidence rate of 13.0%; 110 of these patients (11.8%) subsequently progressed to delayed cerebral ischemia (DCI). Multivariable adjusted modeling identified the following baseline clinical covariates: decreasing age by decade (adjusted odds ratio [aOR] 0.87, 95% CI 0.83\u20130.92; p < 0.001), female sex (aOR 1.68, 95% CI 1.45\u20131.95; p < 0.001), admission Glasgow Coma Scale score < 9 (aOR 1.34, 95% CI 1.01\n \u2013<\/jats:italic>\n 1.79; p = 0.045), intraventricular hemorrhage (aOR 1.87, 95% CI 1.17\u20132.98; p = 0.009), hypertension (aOR 1.77, 95% CI 1.50\u20132.08; p < 0.001), obesity (aOR 0.68, 95% CI 0.55\u20130.84; p < 0.001), congestive heart failure (aOR 1.34, 95% CI 1.01\u20131.78; p = 0.043), tobacco smoking (aOR 1.48, 95% CI 1.23\u20131.78; p < 0.019), and hospitalization events (leukocytosis [aOR 1.64, 95% CI 1.32\u20132.04; p < 0.001], hyponatremia [aOR 1.66, 95% CI 1.39\u20131.98; p < 0.001], and acute hypotension [aOR 1.67, 95% CI 1.31\u20132.11; p < 0.001]) independently associated with the development of vasospasm. Intraparenchymal and subarachnoid hemorrhage were not associated with the development of vasospasm following multivariable adjustment. Among significant associations, a CHAID decision tree algorithm identified age 50\u201359 years (parent node), hyponatremia, and leukocytosis as important determinants of vasospasm development. The cAVM-VPM achieved an area under the curve of 0.65 (sensitivity 0.70, specificity 0.53). Progression to DCI, but not vasospasm alone, was independently associated with in-hospital mortality (aOR 2.35, 95% CI 1.29\u20134.31; p = 0.016) and lower likelihood of routine discharge (aOR 0.62, 95% CI 0.41\u20130.96; p = 0.031).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n This large-scale assessment of vasospasm in cAVM identifies common clinical risk factors and establishes progression to DCI as a predictor of poor neurological outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2022.4.focus2277","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T07:36:45Z","timestamp":1656661005000},"page":"E15","source":"Crossref","is-referenced-by-count":8,"title":["Cerebral vasospasm following arteriovenous malformation rupture: a population-based cross-sectional study"],"prefix":"10.3171","volume":"53","author":[{"given":"Alis J.","family":"Dicpinigaitis","sequence":"first","affiliation":[{"name":"School of Medicine, New York Medical College, Valhalla;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Feldstein","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haris","family":"Kamal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Bauerschmidt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna","family":"Amuluru","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Ascension St. Vincent Medical Center, Carmel, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Pisapia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha S.","family":"Dangayach","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mount Sinai Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mount Sinai Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian A.","family":"Bowers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan A.","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag D.","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz","family":"Al-Mufti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Westchester Medical Center, Valhalla, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Semin Neurol","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1055\/s-0033-1364212","article-title":"Cerebral arteriovenous malformation diagnosis and management","volume":"33","author":"Asif K","year":"2013","unstructured":"Asif K, Leschke J, Lazzaro MA. 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