CDE Detailed Report

Clinical deterioration consistent with brain shifting, manifesting as progressive reduction in level of consciousness associated with motor posturing and either pupillary abnormalities, gaze abnormalities, or autonomic instability (HR, BP, RR)

Day after SAH on which the neurological complication 'Brain stem herniation' first occurred (day of ictus = day 0)

Sudden clinical deterioration with signs of increased hemorrhage on CT scan compared with previous CT imaging or found at autopsy, or a sudden clinical deterioration suspect for rebleeding with fresh blood in the ventricular drain in which no CT scan or autopsy was obtained

Day after SAH on which the neurological complication 'Hydrocephalus' first occurred (day of ictus = day 0)

The occurrence of focal neurological impairment (such as hemiparesis, aphasia, apraxia, hemianopia, or neglect), or a decrease of at least 2 points on the Glasgow Coma Scale (either on the total score or on one of its individual components [eye, motor on either side, verbal]). This should last for at least 1 hour, is not apparent immediately after aneurysm occlusion, and cannot be attributed to other causes by means of clinical assessment, CT or MRI scanning of the brain, and appropriate laboratory studies.

The presence of cerebral infarction on CT or MR scan of the brain within 6 weeks after SAH, or on the latest CT or MR scan made before death within 6 weeks, or proven at autopsy, not present on the CT or MR scan within 48 hours after early aneurysm occlusion, and not attributable to other causes such as surgical clipping or endovascular treatment. Hypodensities on CT imaging resulting from ventricular catheter or intraparenchymal hematoma should not be regarded as cerebral infarctions from DCI.