Evidence map›Paper›PMID 42390597›Full record

ArticleNeuroradiology2026

Pre-existing intracranial arterial stenosis independently predicts delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

Ross Moseley, Ahmed Helal, Mohamed Salem, Yan Zhou, Hayley Granberg, Daron Assatoury, Zach Folzenlogen, Christopher Roark, Joshua Seinfeld, David Case

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Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Ross MoseleySchool of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. ross.moseley@cuanschutz.edu.ORCID http://orcid.org/0009-0003-4956-2266
Ahmed HelalDepartment of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Mohamed SalemDepartment of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Yan ZhouSchool of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Hayley GranbergRocky Vista University, Parker, Colorado, USA.
Daron AssatourySchool of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Zach FolzenlogenDepartment of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Christopher RoarkDepartment of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Joshua SeinfeldDepartment of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
David CaseDepartment of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDelayed cerebral ischemia (DCI) remains a significant cause of morbidity and mortality following aneurysmal subarachnoid hemorrhage (aSAH). Despite identification of numerous predictors, risk remains variable even among patients with similar hemorrhage severity suggesting presence of unrecognized modifiers. One factor receiving little attention is intracranial arterial disease (ICAD): stenosis and calcification. We aim to examine their additive impacts to known modifiers.

methodsWe analyzed 526 patients with aSAH treated at a single, tertiary care center between 2015 and 2025. DCI was defined as new neurologic deficits and/or new cerebral infarction ≥ 48 h from hemorrhage not explained by other etiologies. Stenosis (≥ 25% of luminal diameter) and calcification (CTA hyperdensity ≥ 100 HU) were assessed in all arteries including and distal to the petrous ICA on admission CTA. Multivariable logistic regressions were used to determine independent associations with DCI. For easy clinical applicability, ICAD was dichotomized as presence vs. absence.

resultsAmong 526 patients with aSAH, 440 survived ≥ 48 h and were included (median age = 56 IQR [45-64], 63.7% female). 132/440 (30.1%) developed DCI. DCI was associated with significantly worse outcomes (median mRS DCI: 4, No DCI 2, p < 0.001). Stenosis, not calcification, was an independent predictor of DCI (aOR:3.556, 95%CI: 1.90-6.65, p < 0.001). Vasospasm significantly correlated with DCI (OR:5.89, 95%CI: 3.62-9.57, p < 0.001), and more common in patients with stenosis (aOR:2.391 95%CI: 1.240-4.608, p < 0.001).

conclusionPre-existing ICAD confers substantial, independent DCI risk after aSAH, enhancing rather than competing with traditional predictors. This suggests that baseline cerebrovascular integrity meaningfully predicts ischemic vulnerability following hemorrhage.

Indexed as

Delayed cerebral ischemiaIntracranial atherosclerosisSubarachnoid hemorrhage

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.