Poor Grade Subarachnoid Hemorrhage, Subarachnoid Hemorrhage, Aneurysmal
Conditions
Brief summary
Multicentric registry study in order to define outcome, predictors, treatment effects and their modifiers in poor grade aneurysmal subarachnoid haemorrhage patients. The search for outcome predictors is going to be subdivided into three main research areas: 1. outcome predictors in the emergency department (so called early brain injury phase). 2. outcome predictors in the neurocritical care unit (so called delayed brain injury phase). 3. Treatment strategies. Two other areas of research are identified: delayed cerebral ischemia (incidence, treatment, predictors, impact on outcome) and long term follow-up (recent evidences suggest that there may be a non-negligible proportion of poor grade subarachnoid hemorrhage patients who may benefit from substantial improvement at long-term (after 6-12 months of follow-up).
Interventions
OTHERStandard management according to international/national guidelines
Standard management according to international/national guidelines. Observational study
Sponsors
Azienda Ospedaliera Universitaria Integrata Verona
Azienda Ospedaliero-Universitaria di Parma
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
A.O. Ospedale Papa Giovanni XXIII
ASL Taranto
Ospedale V. Fazzi
IRCCS Istituto delle Scienze Neurologiche di Bologna
Azienda Ospedaliero Universitaria Maggiore della Carita
IRCCS San Raffaele
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Patients admitted to the emergency department because of aneurysmal subarachnoid hemorrhage of poor grade (IV-V) according to the WFNS classification.
Exclusion criteria
* Patients younger than 18 years old. * Pregnant or breast-feeding patients. * Aneurysmal subarachnoid hemorrhage due to trauma or vascular malformations other than cerebral aneurysms.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Outcome | 6 months. | modified Rankin Scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Delayed Cerebral Ischemia | onset-30 days | Delayed Cerebral Ischemia |
| Rebleeding | onset-48hours | Rebleeding |
| Treatment Complications | onset-1 week | Treatment Complications |
| Decompressive Craniotomy | onset-3 weeks | Incidence, strategy (primary or secondary), predictors and clinical impact |
| Long-Term clinical outcome | 12-60 months | modified Rankin Scale (mRS). Scale ranging from 0 (no symptoms) to 6 (dead) |
| CSF drainage | onset-3 weeks | Use of external ventricular drainage or lumbar drainage according to institutional protocol. Clinical impact. |
| Volumetric analysis of intracranial bleeding | onset-24hours | Volumetric analysis and distribution assessment of intracranial bleeding. Clinical impact |
| Volumetric analysis of delayed cerebral ischemia | onset-3 weeks | Volumetric analysis and location assessment of delayed cerebral ischemia. Clinical impact |
| Ventriculo-peritoneal shunt | onset-4 weeks | Incidence, strategy (primary or secondary), predictors and clinical impact |
Countries
Italy
Contacts
Primary ContactPietro Panni, P.I., M.D.
Backup ContactAndrea Falini, Professor of Neuroradiology
Outcome results
None listed