naa a22 4500 51080019X CHVBK 20180411083351.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s12028-012-9801-2 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9801-2 Post-subarachnoid Hemorrhage Vasospasm in Patients with Primary Headache Disorders [Elektronische Daten] [Jason Ellis, Hannah Goldstein, Philip Meyers, Sean Lavine, E. Connolly Jr., Stephan Mayer, Neeraj Badjatia, Dorothea Altschul] Background: Altered cerebral vasomotor reactivity leading to vasospasm can be seen both in patients with primary headache disorders (PHD) and in patients with subarachnoid hemorrhage (SAH). The pathogenesis of vasospasm in post-SAH patients and in headache disorder sufferers may be related. To address this hypothesis, we analyzed a large cohort of SAH patients to determine whether a diagnosis of PHD predisposes to vasospasm, delayed cerebral ischemia, or worsened clinical outcome. Methods: Prospectively collected data from patients enrolled in the SAH Outcomes Project between 1996 and 2006 were analyzed. Patients were segregated based on whether they had a diagnosis of PHD or not and were subsequently compared for differences in clinical and radiographic outcome. Results: A total of 921 SAH patients were analyzed, 265 of which had a diagnosis of PHD. In total, symptomatic vasospasm was seen in 17%, while angiographic vasospasm was seen in 28%. Vasospasm rates were similar among patients with a PHD and in those without a PHD (p>0.05). However, on multivariate analysis new ischemic infarcts were more common in patients with a PHD as compared to patients without a PHD (p=0.015). Functional outcomes at 3months were similar among PHD and non-PHD patients (p>0.05). Conclusion: A history of PHD is associated with an increased rate of ischemic infarcts during admission for SAH. Increased rates of vasospasm within small cerebral blood vessels may be implicated. Further studies are warranted to more closely link the mechanisms of vasospasm in PHD and SAH patients. Springer Science+Business Media New York, 2012 Subarachnoid hemorrhage nationallicence Vasospasm nationallicence Migraine nationallicence Headache nationallicence Stroke nationallicence Ischemia nationallicence Angiogram nationallicence Ellis Jason Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut Goldstein Hannah Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut Meyers Philip Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut Lavine Sean Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut Connolly Jr. E. Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut Mayer Stephan Department of Neurology, Columbia University Medical Center, New York, NY, USA aut Badjatia Neeraj Department of Neurology, Columbia University Medical Center, New York, NY, USA aut Altschul Dorothea Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut Neurocritical Care Humana Press Inc 18/3(2013-06-01), 362-367 1541-6933 18:3<362 2013 18 12028 https://doi.org/10.1007/s12028-012-9801-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9801-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ellis Jason Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Goldstein Hannah Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Meyers Philip Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Lavine Sean Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Connolly Jr E. Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Mayer Stephan Department of Neurology, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Badjatia Neeraj Department of Neurology, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 700 1- Altschul Dorothea Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/3(2013-06-01), 362-367 1541-6933 18:3<362 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer