Extensive bilateral anterior and posterior circulation ischemic stroke caused by severe vasospasm (Delayed cerebral ischemia) due to aneurysmal subarachnoid haemorrhage (aSAH) - A case report

Abstract

Aneurysmal subarachnoid haemorrhage (aSAH) is a disease with high morbidity and mortality even in this modern era. Since treating vasospasm is a challenging task, we emphasize in developing newer aganets for the treatment of vasospasm. In the hyper acute phase, patients with SAH can have catecholamine surge-related arrhythmia, neurogenic pulmonary edema, and irreversible damage to the hypothalamus and brainstem. Delayed cerebral ischemia (DCI) is a serious complication of aneurysmal subarachnoid haemorrhage (aSAH). Though there are many clinical trials to look upon the therapies for DCI and vasospasm in aSAH, none have led to an improvement in outcome of the patient.The prognosis of patients with SAH is grave even with the recent advancements in medical treatments. One of the main cause for this situation, that there are no usable neuroprotective drugs that can be used as soon as SAH is diagnosed. We report a case of ruptured Post Communicating Artery (PCOM) aneurysm with diffuse SAH causing severe vasospasm leading to extensive bilateral anterior and posterior ischemic stroke causing severe morbidity. Since there is no therapeutic breakthrough in treatment of aneurysmal SAH, we emphasize in developing a same.