The effect of combined treatment with cisternal irrigation and head shaking for preventing cerebral vasospasm after subarachnoid hemorrhage

Early removal of the subarachnoid clot is known to prevent cerebral vasospasm after subarachnoid hemorrhage (SAH). In 1994 we introduced combined treatment with cisternal irrigation with urokinase (CIUK) and head shaking (HS). The incidence of cerebral vasospasm and clinical outcome are significantly improved in patients with the combination treatment, but few reports are available on the effectiveness of the combination treatment in preventing vasospasm while taking differences in the clinical characteristics of patients into account. In this study, statistical analysis was performed to evaluate the significance of the combination treatment in preventing vasospasm. The subjects were 159 patients with aneur. ysmal SAH. Information on sex, age, preoperative neurological status, timing of surgery, site of aneurysm in addition to CIUK and HS were collected from medical charts. Multiple logistic regression analysis for cerebral infarction on computed tomography due to vasospasm was conducted by using all the variables. The results revealed that the combination treatment decreased the probability of occurrence of cerebral infarction (odds ratio 0.25, 95% confidence interval=0.08∼0.80). Whereas using CIUK or HS separately as well as the other variables did not affect the occurrence of cerebral infarction.