The section, EDAIC part-1: MCQs with explanations, covers a different topic each day with the intent that candidates can prepare one small topic each day, making steady progress in their exam preparation.
Question: A 54-year-old male patient is diagnosed with SAH. Identify the true statements regarding the possibility of vasospasm
- Does not occur after successful clipping of the aneurysm
- Rise with hypertension, hypervolemia or hemodilution
- Maximum incidence is within 48 hours of the insult
- Incidence is significantly reduced by nimodipine
- The incidence of angiographic vasospasm is much higher than symptomatic vasospasm
Answers:
- false
- false
- false
- true
- true
Explanation:
Cerebral vasospasm is usually seen 3–12 days after SAH, and lasts for an average of 2 weeks, and affects 60–70% of patients with SAH.
Significantly more patients develop angiographic vasospasm (up to 70%) than symptomatic vasospasm (20–30%).
It frequently results in cerebral ischaemia and is the major cause of morbidity and mortality after SAH. Cerebral ischaemia may cause subtle (e.g. decrease in the level of arousal) and obvious neurological deficits (e.g. new hemiparesis) and death.
Severe cerebral vasospasm may account for infarction and death in up to one-third of patients with SAH.
Calcium channel blockers (nimodipine) significantly lower the chances of vasospasm.
Triple-H therapy (hypertension, hypervolaemia, and haemodilution) is the standard therapy for patients of SAH.
Successful clipping of an aneurysm does not eliminate the chances of SAH. in contrast to this, Â It is assumed that temporal clipping and the application of two or more clips increase the risk for the development of vasospasm post clipping.
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The ‘EDAIC part-1: Questions and explanations’ section covers a different topic each day with the intent that candidates can prepare one small topic each day, making steady progress in their exam preparation.
