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Introduction Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality, and ischemic lesion burden is a known predictor of worse outcome. Currently, there is no single clinical method or ancillary test that can reliably predict which subset of patients will develop delayed cerebral ischemia (DCI). Previous animal and human studies suggest that SAH leads to a state of systemic inflammation, with DCI as the most striking manifestation. The aim of this study was to find hematological derangements and clinical factors present during the first seven days after bleeding that could help identify patients at risk for development of DCI. Methods Databank analysis of patients with SAH admitted between 2010–2012 in a large quaternary academic center. Data from demographics, imaging, laboratory and clinical factors were collected. Statistical testing was conducted to test for association to the outcome (DCI) and multivariate logistic regression was used to design a predictive model. Results Of 55 patients, 14 developed DCI (25%). Anemia and leukocytosis on the third day after bleeding were significantly correlated with the outcome (p< 0.032, CI 1.12–15.16, OR 4.12 for anemia and p< 0.046, CI 1.03–26.13, OR 5.18 for leukocytosis). Anemia and leukocytosis were still statistically significant after adjustment for age, sex, modified Fisher scale and Hunt-Hess scale. Conclusion The presence of leukocytosis and anemia during the third day after SAH was statistically correlated with the occurrence of DCI. Further investigation is needed to assess the broader applicability of these findings.

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Background: It is not well understood whether age impacts transcranial Doppler (TCD) mean flow velocities (MFVs) in patients with aneurysmal subarachnoid hemorrhage (SAH) with or without delayed cerebral ischemia (DCI). The aim of our study was to analyze the behavior of TCD MFV during the first 7 days after SAH in patients of different ages and correlate them with the occurrence of DCI. Methods: This study is a databank analysis of patients with SAH admitted between 2010 and 2012 in a single center. We analyzed mean MFV of bilateral middle cerebral arteries (MCAs) in all patients enrolled in the study on days 1, 3 and 7. The correlation between age and TCD MFV was analyzed using a univariate linear regression model. Results: Fifty-five patients were studied. Starting on the third day after the bleeding, increasing age was associated with slower MFVs. This trend was not affected by the interrogation of the right or left MCA. After correction to include only patients who developed DCI, the same findings persisted on days 3 and 7. Conclusion: Older age was correlated with a significant decrease on TCD velocities in patients with SAH, even after correction for patients who developed DCI.