Vasospasm risk factors

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1. Large blood clots (Fisher grade 3)

2. Blood clots in contact with proximal ACA or MCA or with vessels at base of brain

3. Higher Hunt and Hess grade:

  • Grade 1 = 22%
  • Grade 2 = 33%
  • Grade 3 = 52%
  • Grade 4 = 53%
  • Grade 5 = 74%

4. Hypovolemia

5. Increasing age

6. Smoking

7. Pre-existing hypertension

8. Antifibrinolytic therapy

Less often seen with intraparenchymal or intraventricular hemorrhage (Fisher grade 4) or in SAH along the convexity

Greenberg, MS et al.: Handbook of Neurosurgery, 6th edition. New York: Thieme. 2006.

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