Cerebral Vasospasm After Subarachnoid Hemorrhage Differential Diagnoses

Updated: Jul 10, 2016
  • Author: William W Ashley, Jr, MD, PhD, MBA; Chief Editor: Brian H Kopell, MD  more...
  • Print
DDx

Diagnostic Considerations

Early diagnosis of vasospasm and delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be challenging clinically. [10] There are many complications following aSAH that may cause a decreased level of consciousness or a new focal neurologic deficit.

Any cause of increased intracranial pressure (ICP), such as recurrent hemorrhage, hydrocephalus, or cerebral edema, can present similarly to vasospasm. Both obstructive and communicating hydrocephalus are common after aSAH, as are convulsive and nonconvulsive seizures, which have been seen in as many as 90% of aSAH patients and must be included in the differential diagnosis with a worsening or focal neurologic examination. Many of these diagnoses must be ruled out concomitantly before a definitive diagnosis of cerebral vasospasm is made.

Differential Diagnoses