A subarachnoid hemorrhage occurs in about 10 out of 100,000 people each year. This bleeding leads to irritation and constriction of blood vessels in the brain (vasospasm) in two out of three people affected within four to 21 days and thus to reduced blood flow. This can lead to a stroke and serious damage. In order to be able to diagnose and treat a constriction of the blood vessels at an early stage, there are various examination methods which, however, have various disadvantages such as radiation exposure of the patient, low sensitivity or high effort. Therefore, the prediction and timely therapy of vascular constrictions is currently only successful in a few cases before the reduced blood flow has already led to irreversible damage. The aim of this study is to investigate whether the so-called retinal vascular analysis can be used in addition to previous standard examinations for the early detection of diseases of the cerebral blood circulation. This method has few side effects and has been successfully used for 50 years to examine the blood circulation in the eye.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
150
Retinal fundoscopy over a 3 week period in stationary patients after aneurysmatic subarachnoid hemorrhage
Uniklinik RWTH Aachen, Klinik für Neurochirurgie
Aachen, Germany
RECRUITINGClinical Progression of Delayed cortical ischemia
Delayed cortical ischemia as ischemia in cranial computer tomography or cranial magnetic resonance tomography that occurred later than 24 hours after admission to hospital
Time frame: 21 days
Occurrence of delayed ischemic neurological deficit (DIND)
Time frame: 21 days
Angiographic vasospasm
Occurence of an angiographic vasospasm measured by: * Digital subtraction angiography at day 7 +/- 2 days or * transcranial doppler sonography: flow increase \>150 cm/s absolute or increase \>50 cm/s within 24 h
Time frame: 7 days
Metabolic deficiency supply
Measured as change in lactate-pyruvate ratio in microdialysis
Time frame: 21 days
Metabolic deficiency supply
Measured as change in reduction in parenchymal oxygen partial pressure measurement
Time frame: 21 days
Relative underperfusion
Measured by Perfusion-Computer-Tomography
Time frame: 21 days
Objective degree of recovery
Measured by Glasgow-Outcome-Scale; Scale by which patients who have experienced brain damage can be divided into 5 groups that allow to describe the degree of recovery in a standardized and objective manner (1: death; 2: vegetative condition, the patient is unresponsive. The higher cognitive functions are extinguished; 3: severe disability, the patient is conscious, but cannot cope with normal everyday activities without help; 4: moderate disability, the patient can live largely independently, but is not able to pursue a normal working life; 5: light to no handicap, the neurological, physical, and psychological deficits are so low that the patient can participate normally in social and economic activities)
Time frame: 3 Month
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