Factores de riesgo asociados a infarto cerebral en pacientes con hemorragia subaracnoidea aneurismática tratados con terapia endovascular

Objective: To determine if risk factors such as advanced age, history of hypertension or diabetes, initial neurologic status, radiological grade of the subarachnoid hemorrhage, therapeutic hypertension, presence of fever, vasospasm and symptomatic vasospasm are associated with the presence of cerebral infarction in aneurismatic subarachnoid hemorrhage (ASAH) treated with endovascular therapy. Material and methods: we conduct a case-control study in the Christus Muguerza Alta Especialidad Hospital in Monterrey, Nuevo Leon, from medical records of the patients, in a period from January 2007 to May 2012. Results: during the period from January 2007 to May 2012 were reviewed 200 cases, and were identified 12 cases with infarction and 22 controls without infarction, both with ASAH and treated with endovascular therapy (relationship cases - controls 1: 1.8), in the population of Christus Muguerza AltaEspecialidad Hospital in Monterrey, Nuevo Leon. We found that for the cases 66.6% were male and 33.3% were female, for the controls 77.2% female and 22.7% were male. With an average age of 54 years for cases and 50 years for controls. Risk factors associated with cerebral infarction in ASAH are the presence of hypertension (OR: 6.3 1.035-43.02 95% p=0.016), male sex (OR: 6.8 95% CI 1.14-45.52 p=0.02), presence of intraventricular hemorrhage (OR: 8.7 95% CI 1.25-77.1 p=0.011). The most important risk factor was the presence of vasospasm, which increases 17 times the probability of infarction (OR: 17, 95% CI: 2.23-168.25, P = 0.001), and symptomatic vasospasm increases 29 times the risk of stroke (OR: 29.4, 95% CI 2.45-809.79, p = 0.001). Also, a binary logistic regression analysis for risk factors was conducted, in which only one variable was significant: symptomatic vasospasm (OR: 16.75 95% CI 0.74 - 375.72, p = 0.0001). Conclusion: symptomatic vasospasm is the most important risk factor for the presence of cerebral infarction in ASAH.