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Diagnosis and Treatment of Late Neurological Ischemic Deficit in Patients Suffering From Subarachnoid Hemorrhage.
Sponsor: Fondazione IRCCS San Gerardo dei Tintori
Summary
Recent studies state that patients affected by aneurysmal subarachnoid hemorrhage (aSAH) today survive longer because they are treated early. Unfortunately, patients often develop chronic disabling neurological deficits at a rate that is still unacceptable given the progress in the specific treatment of this pathology and the volume of systems of neurological monitoring available to date in Italy. The main cause of unfavorable neurological outcome is delayed cerebral ischemia (DCI), often resulting from symptomatic vasospasm defined as delayed neurological ischemic deficit (DIND). The incidence of DIND is not defined and is difficult to diagnose early as there is no gold standard for identifying it, nor guidelines regarding the most effective treatment. Given these gaps, the primary objective of this study is to describe the incidence of DIND in patients affected by aSAH, collecting information regarding the diagnostic imaging (neurological symptom on clinical examination or alteration on instrumental monitoring). Secondary objectives will be to evaluate the different therapeutic strategies adopted in the different participating centers and compare these strategies to mortality and short- and long-term functional neurological outcome. Furthermore, as there are no data in the literature, the Investigators want to describe the indications, usefulness and intensity of treatment in the aSAH patient in case of monitoring of parenchymal intracranial pressure.
Official title: Late Neurological Ischemic Deficit in Patients Suffering From Subarachnoid Hemorrhage: Diagnosis and Treatment
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
OBSERVATIONAL
Enrollment
1400
Start Date
2024-09-28
Completion Date
2026-10
Last Updated
2025-02-03
Healthy Volunteers
No
Locations (33)
ASST Papa Giovanni XXIII
Bergamo, BG, Italy
IRCCS Istituto delle Scienze Neurologiche
Bologna, BO, Italy
ASST Spedali Civili
Brescia, BS, Italy
Fondazione Poliambulanza
Brescia, BS, Italy
ASST Lariana Ospedale Sant'Anna
San Fermo della Battaglia, CO, Italy
ASST Cremona
Cremona, CR, Italy
Azienda Ospedaliero-Universitaria Careggi
Florence, FI, Italy
IRCCS Ospedale Policlinico San Martino
Genova, GE, Italy
ASST Lecco - Ospedale A. Manzoni
Lecco, LC, Italy
Fondazione IRCCS San Gerardo dei Tintori
Monza, MB, Italy
ASST Ovest Milanese - Ospedale di Legnano
Legnano, MI, Italy
ASST Fatebenefratelli Sacco
Milan, MI, Italy
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Milan, MI, Italy
ASST Grande Ospedale Metropolitano Niguarda
Milan, MI, Italy
ASST Santi Paolo e Carlo - Ospedale San Carlo Borromeo
Milan, MI, Italy
Fondazione IRCCS Istituto Neurologico Carlo Besta
Milan, MI, Italy
Human Research Hospital
Rozzano, MI, Italy
IRCCS San Raffaele
Segrate, MI, Italy
ASST Mantova
Mantua, MN, Italy
Azienda Ospedale-Università di Padova
Padova, PD, Italy
Azienda Ospedaliera di Perugia
Perugia, PG, Italy
Azienda Ospedaliero-Universitaria di Parma
Parma, PR, Italy
Fondazione IRCCS Policlinico San Matteo
Pavia, PV, Italy
Azienda Ospedaliera San Camillo Forlanini
Roma, RM, Italy
Fondazione Policlinico Universitario A. Gemelli
Roma, RM, Italy
ASST Valtellina e Alto Lario
Sondrio, SO, Italy
ASL Città di Torino - Ospedale San Giovanni Bosco
Torino, TO, Italy
Azienda Sanitaria Universitaria Giuliano Isontina
Trieste, TS, Italy
Azienda Sanitaria Universitaria Friuli Centrale
Udine, UD, Italy
ASST Sette Laghi - Ospedale di Circolo e Fondazione Macchi
Varese, VA, Italy
Ospedale San Bortolo
Vicenza, VI, Italy
Azienda Ospedaliero Universitaria Integrata
Verona, VR, Italy
AOU Maggiore della Carità
Novara, Italy