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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointervention

Treatment of Poor-Grade Subarachnoid Hemorrhage Trial

D. Mitra, B. Gregson, V. Jayakrishnan, A. Gholkar, A. Vincent, P. White and P. Mitchell
American Journal of Neuroradiology January 2015, 36 (1) 116-120; DOI: https://doi.org/10.3174/ajnr.A4061
D. Mitra
aFrom the Departments of Neuroradiology (D.M., V.J., A.G.)
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B. Gregson
eNeurosciences (B.G.), Newcastle University, Newcastle upon Tyne, United Kingdom.
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V. Jayakrishnan
aFrom the Departments of Neuroradiology (D.M., V.J., A.G.)
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A. Gholkar
aFrom the Departments of Neuroradiology (D.M., V.J., A.G.)
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A. Vincent
cAnesthesiology and Intensive Care (A.V.), Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
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P. White
dInstitutes of Aging and Health (P.W.)
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P. Mitchell
bNeurosurgery (P.M.)
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Article Figures & Data

Tables

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    Table 1:

    Reason for ineligibility for randomization among the patients screened for the trial

    Reason for IneligibilityNo.%
    Improvement of neurologic status before randomization823
    Expiry of time window for randomization513
    Emergency clot evacuation513
    Hemodynamic instability513
    Beyond age range411
    Pure intraventricular hemorrhage38
    Signs of coning38
    Lack of equipoise38
    No aneurysm on CT angiogram (AVM found)13
    • View popup
    Table 2:

    Treatment-unrelated adverse events

    Treatment-Unrelated Adverse EventNo.
    Aneurysm rebleeding1
    Hydrocephalus (early)5
    Hydrocephalus (late)1
    Intracerebral hematoma2
    Intraventricular hemorrhage2
    Diffuse cerebral edema1
    • View popup
    Table 3:

    Summary of outcomes between early treatment and treatment after recovery arms

    Early Treatment ArmTreatment after Recovery Arm
    No. of patients53
    WFNS score on admissionWFNS IV-IIWFNS IV-I
    WFNS V-IIIWFNS V-II
    Good outcome1 (MRS 1)1 (MRS 0)
    Poor outcome4 (all MRS 6)2 (all MRS 6)
    • View popup
    Table 4:

    Summary of studies of patients with poor-grade subarachnoid hemorrhage treated with early endovascular coiling

    Study (yr)No. of PatientsMethodologyGood Outcome (%)Mortality Rate (%)
    Bracard et al5 (2002)80Included HH grades 4 and 5, good outcome GOS 1 or 2, up to 1 year follow-up52.5 (GOS 1–2) 8.75 GOS 337.5
    van Loon et al6 (2002)11WFNS grade V, outcome measure GOS, mean follow-up 12 months3618
    Weir et al7 (2003)27HH grades 4 and 5, outcome assessed by mRS, mean follow-up 23 months3059
    Jain et al8 (2004)13Older than 70 yr, poor HH grades 4 and 5, outcome measure GOS1547
    Bergui and Bradac9 (2004)454844
    Suzuki et al10 (2006)111HH grades 4/5, outcome by mRS, follow-up ≤24 mo35.132.4
    Pereiera et al11 (2007)51Outcome by GOS at 12 mo, GOS 1–3 considered good; 4–5, poor5735
    Taylor et al12 (2011)47WFNS grades IV/V, 6-month GOS for outcome5327
    • Note:—GOS indicates Glasgow Outcome Scale; HH, Hunt and Hess.

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American Journal of Neuroradiology: 36 (1)
American Journal of Neuroradiology
Vol. 36, Issue 1
1 Jan 2015
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Cite this article
D. Mitra, B. Gregson, V. Jayakrishnan, A. Gholkar, A. Vincent, P. White, P. Mitchell
Treatment of Poor-Grade Subarachnoid Hemorrhage Trial
American Journal of Neuroradiology Jan 2015, 36 (1) 116-120; DOI: 10.3174/ajnr.A4061

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Treatment of Poor-Grade Subarachnoid Hemorrhage Trial
D. Mitra, B. Gregson, V. Jayakrishnan, A. Gholkar, A. Vincent, P. White, P. Mitchell
American Journal of Neuroradiology Jan 2015, 36 (1) 116-120; DOI: 10.3174/ajnr.A4061
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  • Endovascular Coiling versus Surgical Clipping for Poor-Grade Ruptured Intracranial Aneurysms: Postoperative Complications and Clinical Outcome in a Multicenter Poor-Grade Aneurysm Study
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