Preventing delayed brain infarction after aneurysmal subarachnoid hemorrhage with spasmolysis and induced hypertension
Delayed Cerebral Infarction Beyond Endoluminal Spasmolysis and Induced Hypertension
This observational project follows adults in intensive care after aneurysmal subarachnoid hemorrhage to see if multimodal neuromonitoring can identify and guide treatment of delayed brain infarction in patients treated with induced hypertension and endoluminal spasmolysis.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 200 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Region Stockholm Government |
| Locations | 1 site (Stockholm) |
| Trial ID | NCT07305922 on ClinicalTrials.gov |
What this trial studies
This is an observational cohort of adults (≥18) admitted to critical care at Karolinska University Hospital after aneurysmal subarachnoid hemorrhage with suspected severe cerebral vasospasm. Patients whose aneurysms are secured and who receive induced hypertension with norepinephrine and/or endoluminal spasmolysis will undergo multimodal neuromonitoring including transcranial Doppler and bedside physiologic monitoring. The protocol collects neuromonitoring data, clinical examinations, imaging findings, and treatment details to relate monitoring patterns to delayed cerebral infarction and clinical outcomes. Care decisions are made by the treating clinicians and data are recorded prospectively without randomization.
Who should consider this trial
Good fit: Adults (≥18) in critical care after an aneurysmal subarachnoid hemorrhage whose aneurysm has been secured and who have suspected, emerging, or established severe cerebral vasospasm are the intended participants.
Not a fit: Patients with an anticipated survival under five days, those with an inadequate transcranial Doppler signal, or pregnant people are unlikely to benefit from participation.
Why it matters
Potential benefit: If successful, this work could enable earlier detection and more targeted treatment of vasospasm-related ischemia, reducing delayed infarcts and improving recovery.
How similar studies have performed: Induced hypertension, endoluminal spasmolysis, and multimodal neuromonitoring are used clinically and prior observational work suggests they can help detect and reduce delayed infarction, but randomized outcome evidence is limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adults 18 years or older * Critical care after subarachnoid haemorrhage * Aneurysm secured by surgical clipping or endovascular procedure * Suspected, emerging or established severe cerebral vasospasm Exclusion Criteria: * Anticipated survival less than five days, as determined by treating clinician * Transcranial Doppler signal too weak * Pregnancy
Where this trial is running
Stockholm
- Karolinska University Hospital — Stockholm, Sweden (Recruiting)
Study contacts
- Study coordinator: Peter C Rudberg, M.D. Ph.D.
- Email: peter.rudberg@ki.se
- Phone: +46-8-12370000
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.